Regulations of private health care package

§ 1

1. The Central Clinical Hospital of the Ministry of Interior (CSK) patient card holder can be a person under the age of 65 or those who are over 65 years old, provided that they are professionally active and their medical care coverage is paid by the employer. In addition, CSK reserves the right to refuse to extend the coverage for any reason for persons over 65 years old, unless they are professionally active and their medical care coverage is paid by the employer.

2. If a person over 65 years old wants to become a patient card holder, he/she should make ​​an application to the Vice-Director of Medical Affairs of the CSK to issue such acard.

§ 2

Limitations and exclusions:

1. All services provided under a contract with CSK MSW are subject to a 12-months limitation associated with a pre-existing medical condition.

2. The pre-existing medical condition means occurring previously, repeated, prolonged or chronic diseases or disorders for which the card holder has been previously treated, received medical advice or undergone a surgery within 6 months prior to the date of signature of the contract, or which were the cause of symptoms occurrence within 6 months prior to the date of conclusion of this contract, and would force any duly careful person to seek medical advice.

3. The limitation of pre-existing medical condition means that CSK will not incur any medical expenses related to the state previously qualified as a pre-existing medical condition, except the costs of visits to the primary health care physician, emergency interventions and home visits.

4. High-risk pregnancy existing at the date of the contract coming into force results in the same restrictions on the services provided by CSK as those resulting from a pre-existing medical condition.

5. Limitation due to the pre-existing medical condition concerns the persons signing the contract with CSK, as well as those who are already under the care of CSK and extend the range of services provided in the contract.

6. CSK will not cover the cost of medical services, examinations or consultations if they are not approved or performed by the hospital staff, or those which, according to the CSK, are not necessary from the medical point of view.

§ 3

1. CSK reserves the right to refuse to increase the range of services provided by a health care package for any reason.

2. CSK is not liable for damages occurred to the patient due to the delay in provision of medical help by CSK or its inability to provide help, caused by force majeure or other causes beyond the control of CSK.

§ 4

According to Polish law, medical documentation will be prepared in Polish and all the translations will be ordered and paid for by authorized persons.

§ 5

CSK is committed to provide home medical visits (for a gold card), provided that the medical dispatcher receiving emergency medical notification considers that such a visit is necessary from the medical point of view and appropriate for the case.

§ 6

1. After the conclusion of the contract, the card holder is obliged to make a payment for six months in advance.

2. After a period of six months, the card holder is obliged to make a payment before the first day of each subsequent month.

3. If the card holder does not pay for a health care package for a period of six consecutive months, the card holder has the option to settle the outstanding payment and reactivate the card.

4. If the card holder does not pay for the health care for a period longer than six months it results in termination of the contract and lack of possibility to conclude another contract for the next three years, counted from the date of cessation of payments.

§ 7

The Terms and Conditions ofthe private health care package are an integral part of the contract.