Deregistering a family member from health insurance

Service

Regardless of the title that affects the subject of insurance, coverage by health insurance may be compulsory or voluntary. The person registered for this insurance must take into account that some persons who, for the purposes of health insurance, are considered family members of the insured person and do not have their own title to be insured, must be registered for health insurance on the ZUS ZCNA form in order to be able to use the ZUS ZCNA form free of charge. publicly funded healthcare services. When is it necessary to deregister a family member from health insurance?

Persons Considered As Family Members

A family member of an insured person who does not have his own title to be covered by health insurance is considered to be:

  • own child, spouse's child, adopted child, grandson or a foreign child for whom a custody or a foreign child has been established as part of a foster family or family orphanage, until they turn 18, and if they continue to study at school, teacher training institution, university or a research unit conducting doctoral studies - until the age of 26, and if it has a certificate of significant disability or other conditions treated equally - no age limit;

  • spouse;

  • ascendants staying in the same household with the insured person (e.g. grandfather, grandmother, mother, father).

Important!

No additional health insurance contributions are payable for the registered family members.

Deregistering a family member from health insurance

Insured persons who are not payers of contributions for their own insurance (applies to persons employed under an employment contract, contractors, persons with the status of an unemployed person, etc.), are obliged to notify their employer / principal / person acting as contribution payer about family members who should be deregistered from health insurance because, as a result of circumstances, they no longer have the status of a family member for insurance purposes.
This information is provided to the payer within 7 days from the occurrence of the circumstances that determine the deregistration of a family member from health insurance.

On the other hand, persons who apply for health insurance (e.g. self-employed persons), themselves deregister a family member from health insurance when a family member covered by health insurance ceases to meet the conditions to be eligible for this insurance.

Attention!

In the case of entrepreneurs suspending their business activity, family members who were reported for health insurance will be deregistered by the Social Insurance Institution (ZUS) on the day the suspension commences on the basis of data received from CEIDG.

Consequences of not registering a family member

A person covered by health insurance who does not report or deregister eligible members of his family for this insurance, is exposed to the consequences that are specified in Art. 193 of the Act on health care services financed from public funds, including those who:

  • does not submit to health insurance or deregister from health insurance on time,

  • being the insured, he does not inform the entity competent to register for health insurance about the circumstances causing the necessity to report or deregister a family member,

is subject to a fine.

To sum up, the insured, the contribution payer or the person acting on behalf of a legal person or an organizational unit without legal personality may be fined for failing to notify or deregister a person entitled to health insurance.