The EHIC Card is the most well-known document giving entitlement to treatment abroad. It gives the right to receive medical care only to the extent necessary. This means that the scope of treatment authorised by the EHIC is quite narrow. If you are planning a longer stay abroad, it’s better to obtain a document that will guarantee the possibility to benefit from medical care services in a much wider scope than the EHIC card. The S1 document is such a certificate.
1. Who can obtain the S1 document?
The S1 document can be obtained by a person who:
- is entitled to health services in Poland,
- moved from Poland to another EU Member State (changed his/her place of residence),
- won’t lose the right to receive health services in Poland, despite the change of place of residence.
In practice, the S1 Document is most often requested by cross-border workers. This group of employees provides work in one country (e.g. Poland), but returns home to another Member State (e.g. Germany) every day. Employed persons posted by a Polish employer to perfom work in another EU Member State also apply for the S1. Moreover, such a document is requested by persons who move to one of the EU countries, but are entitled to health care services in Poland on a basis other than an activity as an employed person or conducting an economic activity. These are, for example, persons receiving pre-retirement benefits (bridging pension, pre-retirement benefit or pre-retirement allowance, teachers’ compensatory benefit), family members of an insured person who are reported to NFZ (Narodowy Fundusz Zdrowia – the National Health Fund) as eligible for health insurance, pensioners receiving Polish pension.
2. Application and its annexes
The S1 document is issued by NFZ at the request of the person concerned. A model of application is available at: https://www.nfz.gov.pl/dla-pacjenta/nasze-zdrowie-w-ue/leczenie-w-krajach-unii-europejskiej-i-efta/dokumenty-do-pobrania/
The application shall be accompanied by an A1 certificate and a document confirming the change of residence to the foreign address indicated in the request. NFZ may also require the presentation of other documents, e.g. a certificate of continuing education, a certificate of the degree of disability.
If the application for a S1 document is submitted by a proxy, the request shall be accompanied by the appropriate authorisation.
The application for the issuance of S1 document should be submitted to the NFZ branch locally competent for the applicant.
If the request is approved, NFZ will notify in writing that S1 document has been granted. In the event that the mail doesn’t contain such a document, this means that it has been sent to the foreign insurance institution indicated in the application.
3. How to obtain the right to treatment based on the S1 document?
The condition for obtaining the right to treatment in the country of residence is to register the S1 document with a foreign insurance institution. It should be the institution indicated in the application for the issuance of such a document.
The registration procedure may vary from one EU country to another. Member States determine it themselves.
Registration of the S1 Document will be refused if the competent institution of the country of residence finds that the applicant isn’t entitled to use the rights provided by the document. Such a situation occurs when:
- the person applying for the registration of the S1 Document has been employed in the country of residence,
- the person applying for registration of the S1 Document conducts an economic activity in the country of residence,
- it isn’t confirmed that the person applying for the registration of the S1 Document permanently resides in the country where the Document is to be registered,
- the person indicated as a family member doesn’t fulfil the conditions for being registered for health insurance in the country where the S1 Document is to be registered.
The S1 document entitles to treatment only in public health institutions.
4. S1 document for family members
Family members of the person who obtained the S1 Document can receive medical care in the country of residence. For this purpose, when registering such a document, it’s necessary to declare the willing to register an entitlement for a family member. After receiving the notification, the competent institution of the place of residence will check whether the person indicated in the notification fulfils the conditions for being declared as a family member. It should be noted that the definition of a family member varies from country to country. There may be a situation where a person has a status of a family member in the State that issued the S1 document, but doesn’t have it in the country where this document is to be registered. In the next stage, the competent institution of the country of residence will ask the competent one of the State that granted the S1 to issue documents confirming the health insurance of the reported family members.
5. Period for which the S1 document is issued
The S1 document can be issued for an indefinite period, from the date on which the change of residence was officially notified. It may also be issued for a fixed period. This is the case when the date of losing the Document’s rights is known.
6. Loss of the right to benefits from NFZ
The holder of the S1 document will lose the right to the medical benefits to which such a document entitles if:
- he/she notifies the payer who pays contributions for him/her in Poland of the change of place of residence and indicates his/her Polish address as that one of residence,
- he/she takes up work in the country of residence,
- he/she starts conducting an economic activity in the country of residence,
- he/she loses the right to health services in Poland – this occurs, among others, in the event that he/she loses his/her job in Poland;
The right expires 30 days after the end of the insurance title. The deadline is calculated from the date on which the event resulting in the loss of entitlements took place (e.g. the date of termination of the employment contract in Poland).
In the event that the holder of the S1 document has registered the members of his/her family with the institution competent of the country of residence, the right of a family member expires along with the expiry of his/her right.
7. Legal notice
The study is a work within the meaning of the Act of 4 February 1994 on Copyright and Related Rights (OJ 2006, No. 90, item 631, consolidated text, as amended). Publishing or reproducing this study or its part, quoting opinions, as well as disseminating in any other way the information contained therein without the written consent of Crede sp. z o.o. is prohibited.