Schengen Health Insurance – What Are the Minimum Requirements?

Schengen Health Insurance — How to Read the Policy and the General Terms and Conditions?

Insurance selected for visa or residence permit applications should not be evaluated based solely on the product name. First, you must determine the requirements specific to your case, and then compare them with the policy, coverage options, and General Terms and Conditions of Insurance. The actual scope of coverage is key, rather than simply using the word „Schengen” in the offer description.

In this guide, we show you how to conduct such a review without having to guess amounts, coverage limits, or exceptions. We also explain what information can be found in Compensa and Uniqa product documents and what data to keep on hand in case of a sudden illness or accident. Make your final decision based on current documents regarding the selected option and its procedure.

How to Distinguish Between Formal Requirements and the Scope of the Policy

There’s no point in starting by comparing prices if you don’t yet know what requirements the document must meet in a specific case. You should check the formal requirements for the applicable procedure and the product specifications in the policy and the General Terms and Conditions. These are two separate steps. The official document specifies the formal requirements, while the insurance documents explain how the selected coverage works.

This guide does not establish formal requirements for a specific procedure. Instead, it shows how to review an insurance policy and the General Terms and Conditions to ensure they meet the specified requirements. The fact that a policy from one insurance company meets certain criteria does not mean that the same criteria apply to every procedure.

Before you buy, write down the answers to these four questions:

Only with this set can you review the offerings. Don't assume compatibility based solely on the product name. If any provision is not clearly specified in the policy or the General Terms and Conditions, it must be confirmed before the contract is concluded.

The product description may be helpful to people seeking protection related to their stay in Poland Health insurance for a foreign national. A website dedicated to this topic may also be useful for employees Protection for Foreigners Working in Poland. These pages are intended to help you make an initial selection of a solution—final decisions should be based on the specific contract documents.

What coverage should you check first?

The starting point should be situations where immediate assistance is needed: a sudden illness or the aftermath of an accident. Security measures are intended to address emergency situations, rather than replace routine medical care.

This example concerns the clause on medical expenses for foreign nationals in Compensa’s insurance policy, from the document marked 2026. It covers medically necessary medical expenses for the treatment of an illness or the consequences of an accident that the insured person must undergo immediately during their stay in Poland. This is a specific product provision: it applies to the clause in question, not to all policies available on the market.

The same clause provides for the organization of medical care and the coverage of its costs until the insured person’s health permits a return or transport to their country of permanent residence. The organization of assistance and the financing of costs are part of the specific scope. These provisions should be read in conjunction with the coverage table and the other provisions of the General Terms and Conditions.

You shouldn't assume that every product works the same way. Before purchasing, check to see if the version you're interested in describes:

How to Interpret the Sum Insured and Sublimits

The sum insured alone does not fully describe the contract. Sublimits, how they are applied, and whether subsequent payouts reduce the available limit are also important factors. The total amount and sublimits define the limits of liability, which is why they must be analyzed for a specific scenario.

This mechanism is well illustrated by Uniqa’s General Insurance Conditions (GIC) designated as 2020. According to this document, the sum insured, the coverage limit, and the sublimits define the upper limit of the insurer’s liability toward a single insured. Benefits or indemnities paid reduce the corresponding sum or sublimit. The document also specifies that these amounts are indicated in the policy and in the table of options included in the GTI.

This is not a recommendation of a specific option, nor is it a confirmation of its current availability. The older General Terms and Conditions should be compared with the documents provided at the time of purchase. Even if the product name has remained the same, this does not automatically mean that the variants, limits, or liability provisions have not changed.

When comparing two offers, you should check the same elements in both documents. Do not compare the total amount with the sub-limit of another benefit, nor should you consider the higher figure to be decisive if the other option has a different scope. A comparison is fair only if the same criteria are used.

Reviewing a Policy Before Purchasing It

The safest approach is to go through the documents in a set order. First, confirm the requirements for your specific situation. Next, select the appropriate product, download the relevant General Terms and Conditions, and review the information that will appear on the policy. Finally, compare the two sets point by point.

Insured Person's Information

The first name, last name, and other identifying information must match the documents used in the proceedings. Correct any typos before submitting the policy. Also, check who the policyholder is and who the insured person is, especially if someone else is purchasing the policy.

Protection Period and Area

Don't rely solely on the purchase date. Check the start and end dates of coverage listed on the policy, as well as the coverage area specified for the plan you selected. The protection dates must correspond to the planned situation, and not just the premium payment due date.

Scope, Limits, and Exclusions

Select the covered events, the aggregate limit, all relevant sublimits, and the terms for organizing assistance. Then, carefully review the exclusions and post-event obligations. The scope of coverage should always be read in the context of the limitations. A single sentence from sales materials does not replace the full terms and conditions of the contract.

Supporting document

Make sure that after your purchase, you receive a policy containing the insured person’s details, the insurance period, the territorial coverage, and an indication of the selected plan. Also, keep the relevant General Insurance Terms and Conditions (GITC) that correspond to the contract you have entered into. The policy, together with the applicable General Terms and Conditions, should constitute a complete set of documents.

For more information on preparing insurance documents, see the guide Health insurance for a Schengen visa.

What to Prepare in Case of an Emergency

A good insurance policy should not only be the right fit, but also easy to use. Write down your policy number and the information you’ll need to file a claim. Keep your documents in a place where you can access them even if you’re unable to look for them in your mail yourself.

Uniqa’s General Terms and Conditions (OWU), designated as 2020, provide an example of the information required when filing a claim for medical expenses. The claim should include the policy number, a detailed description of the circumstances of the incident, and a medical report covering a description of the injuries, the diagnosis, and the recommended treatment. It should be emphasized that The three items listed do not constitute an exhaustive list – The full list of required documents is longer.

After the incident, follow the instructions in your contract. Keep all documentation related to the incident and the assistance provided. Check the current filing requirements in the applicable General Insurance Terms and Conditions (GITC), as procedures may vary depending on the product, the insurance company, and the version of the document.

A practical checklist to get you started:

Don't put off reading the reporting instructions until the time when assistance is needed. Familiarizing yourself with the procedure in advance reduces the risk of overlooking an important document or a contractual obligation.

The most common questions

Before purchasing, compare the requirements specific to your situation with the duration, territory, and scope of coverage, as well as the sum insured and sublimits specified in the documents for the product you have selected. If any term is unclear, ask for clarification before signing the contract. If you need a policy for a foreign national, use the medical expense insurance purchase form.