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Before you come to Poland please make sure you check the given Embassy or Consulate General of the Republic of Poland's requirements concerning the health insurance.
A national visa applicant shall personally submit a document confirming the possession of Travel Medical Insurance. Travel medical insurance with an insurance amount of no less than EUR 30,000 must be valid for the period of the intended stay of the foreigner on the territory of the Republic of Poland, cover all expenses that may occur during the stay in Poland due to the necessity of return travel for medical reasons, the need for urgent medical assistance, emergency hospital treatment or death, in which the insurer undertakes to cover the costs of healthcare services provided to the insured directly to the entity providing such benefits, on the basis of a bill issued by this entity.
It is possible to apply for the National Health Insurance after you arrive in Poland and are enrolled.
Block I:
Item 01 –„4” means the deadline for submission of declarations
Item 02 – the number of declaration, month, year for which a declaration is made up
Block II:
It should be completed in accordance with the declaration on the document ZUS ZZA
Block III:
Item 01 –„1” – one person insured
Block VII:
Item 01 and 04 – the amount of premium
Block IX:
Item 01 – the amount of premium
Block XI:
Item 01 – code for the title insurance„24 10 00”
Item 04 – the basis on which a premium is charged
Block XII:
Item 08 – the date of completion of the document
Item 09 – signature
Block I:
Item 01 – mark the declaration „X” (means registration)
Block II:
Item 01 – (NIP) Tax Identification Number
Item 03 – (PESEL) Personal Identification Number
Item 04 – number 2
Item 05 – the number of passport
Item 07 – surname
Item 08 – first name
Block III:
Repeat the data according to the pattern from Block II
Block IV:
Item 01 – second name
Item 02 – the name at borth
Item 03 – nationality
Item 0 4 – sex (”K” – Female,„M” – Male)
Block V:
Code for the title insurance:„24 10 00”
Block VII:
Date of signing the agreement
Block VIII:
Health insurance code: 01R
Block IX:
Your registered address in PL
Block X:
Your residence address in PL
Block XI:
The address for correspondence in PL
Block XII:
Item 01 – the date of completion of the document
Item 02 – the signature