Specialist Referrals in Poland (Skierowanie): Which Doctors Need One
Short answer: Most NFZ specialist visits in Poland require a referral from a public-system doctor. No referral is needed for gynecology, dentistry, venereology, oncology, psychiatry, sports medicine, psychology or optometry; hospital treatment still needs one.
In Poland's public health system (NFZ), most specialist visits start with one document: a skierowanie, a referral. Show up without one and the clinic will turn you away - unless the specialist is on the no-referral list. The rules are set by the Act on Publicly Funded Healthcare Benefits (consolidated text: Journal of Laws 2025, item 1461), and the exception list was expanded on September 17, 2025. As of October 14, 2026, this is how referrals work.
The basic rule
Under Article 57(1) of the Act, publicly funded outpatient specialist care is provided on the basis of a referral from a doctor in the public health insurance system (lekarz ubezpieczenia zdrowotnego). In practice:
- Your family doctor (POZ GP) writes most referrals. Any doctor working within the NFZ system can write one, including a specialist sending you to another specialist.
- A referral written at a purely private visit is not valid for NFZ-funded care. The doctor must issue it within the public system.
- Referrals are issued on paper or electronically (Article 59aa). Electronic referrals are visible in your Internet Patient Account (IKP).
- One exception inside the rule: eye doctor (okulista) visits can also be based on a referral from an optometrist who works with the NFZ.
Specialists you can see without a referral
Article 57(2) lists the exceptions - specialists and services where no referral is required. Since the September 17, 2025 amendment, the list is:
- gynecologist and obstetrician (ginekolog i poloznik),
- dentist,
- venereologist,
- oncologist,
- psychiatrist,
- sports medicine doctor (lekarz medycyny sportowej),
- psychologist,
- optometrist.
No referral is needed either for:
- people with tuberculosis or HIV,
- war and military invalids, combatants, repressed persons and related groups,
- addiction treatment, including for co-dependent family members,
- psychological, psychotherapy and community support services for children and young people.
The 2025 amendment added the sports medicine doctor, psychologist and optometrist to the specialist list - before that, a psychologist visit still needed a paper trail.
When a referral is still required
For everything else on the NFZ - cardiologist, dermatologist, orthopaedist, neurologist, endocrinologist, ENT and the rest - you need the skierowanie. The same applies higher up the chain:
- Hospital treatment requires a referral from a doctor, dentist or feldsher, issued when the treatment goal cannot be reached outpatient (Article 58). Emergencies are the exception by nature: if your life or health is suddenly threatened, you go straight to the emergency room or call 999 - see our guide to the night doctor versus the ER.
- Medical rehabilitation also requires a referral (Article 59).
Referrals from abroad
If you arrived with a referral from another EU member state, Polish law treats it as a valid referral, provided it meets the same requirements (Article 59a). Attach a translation into Polish - it does not need to be sworn. This is useful for expats who were mid-diagnosis in another EU country before moving.
Practical tips for expats
1. Start with your GP. Register a POZ declaration first - our guide to choosing a family doctor in Poland explains how. Without a GP, getting routine referrals is much harder. 2. Ask for the referral at the visit. Polish GPs write skierowania on the spot, electronically, when they judge the specialist visit justified. 3. Check IKP before you book. Your referral appears there with its code, and the clinic will ask for it at registration. 4. Use the no-referral list. For the specialties above you can register directly at any clinic with an NFZ contract - no GP visit needed.
Frequently asked questions
### Do I need a referral to see a specialist in Poland?
For most publicly funded specialists, yes: Article 57(1) of the benefits act requires a referral from a doctor in the public insurance system. The exceptions are gynecology and obstetrics, dentistry, venereology, oncology, psychiatry, sports medicine, psychology and optometry, plus several patient groups.
Which doctors can I see without a referral in Poland?
Since September 17, 2025: gynecologist/obstetrician, dentist, venereologist, oncologist, psychiatrist, sports medicine doctor, psychologist and optometrist - plus addiction treatment, TB and HIV care, and psychological support for children and youth.
Can a private doctor write an NFZ referral?
No. A valid referral must be issued within the public insurance system. A note from a purely private consultation will not be accepted for NFZ-funded care.
Do I need a referral for hospital treatment in Poland?
Yes. Hospital admission requires a referral from a doctor, dentist or feldsher under Article 58 of the benefits act, except in emergencies, when you go directly to the emergency room.
