The health contribution (składka zdrowotna) in 2026: why it isn't a flat fee

The health contribution (składka zdrowotna) is not a flat fee because it follows your tax form. On the tax scale and the flat tax it is a percentage of last month’s income; on ryczałt (the lump-sum tax) it is a fixed amount that depends on your revenue since 1 January. It is due every month you run the business, with a minimum even when you earn nothing.

It is part of your monthly payment to ZUS, the Social Insurance Institution, and it pays for public healthcare through NFZ, the National Health Fund.

Why you pay it even when “ZUS is free”

If you run a JDG (jednoosobowa działalność gospodarcza, a sole proprietorship), your monthly ZUS payment has two parts: social contributions (pension, disability, accident and optional sickness) and the health contribution. The reliefs you hear about only touch the first part. For the full picture of both, see what ZUS is and what it costs.

It is compulsory for almost every sole trader insured in Poland. ZUS calls it “monthly and indivisible”, which means:

• you pay it in full for any month in which you ran the business, even for one day
• there is no reduction for part of a month or for days on sick leave
• it is due with zero income (the minimum applies)
• it is due during ulga na start, the 6-month start-up relief, which only removes social contributions
• it is due in the month of a ZUS holiday (wakacje składkowe), which also covers social contributions only
• it is due even if you also have a job, because each source of insurance (the job, the business) pays its own

A few narrow exceptions set it to zero. For example, on ryczałt when a job paid no more than the minimum wage already insures you and the business brings in at most 2,403 PLN a month in 2026. Some pensioners and people with a disability certificate have similar rules; ask ZUS if you think one applies.

In return, you and the family members you register with ZUS are covered by NFZ.

How much you pay depends on your tax form

The rule follows the way your income is taxed, which is why the health contribution matters so much when you choose your tax form.

The minimum of 432.54 PLN is 9% of the 2026 minimum wage (4,806 PLN).

Tax scale and flat tax: a share of your income

Here “income” means revenue minus costs, minus the social contributions you did not already book as costs. The contribution for a month is based on the income of the month before: the March contribution, paid by 20 April, uses your February income.

The contribution year for these two forms runs from February to January, so the 2026 minimum of 432.54 PLN applies from February 2026 to January 2027. The January 2026 contribution still used the old minimum of 314.96 PLN, left over from a one-year cut in 2025.

Example: On the flat tax, an income of 10,000 PLN in a month gives 4.9% × 10,000 = 490 PLN. On the tax scale the same income gives 900 PLN. A month with 3,000 PLN of income gives 147 PLN on the flat tax, so you pay the minimum, 432.54 PLN.

If you use IP Box (the 5% rate on qualifying IP income), the rate follows your main tax form: 4.9% if you are on the flat tax, 9% on the tax scale.

Ryczałt: three fixed bands

On ryczałt the contribution does not follow your monthly income. It depends on your revenue since 1 January, and the bands are set from the average wage in the enterprise sector in the last quarter of 2025 (9,228.64 PLN).

You move up a band in the month your revenue crosses the threshold, and pay the higher amount from then on. For choosing the band, revenue is reduced by the social contributions you paid, if you have not deducted them elsewhere.

There is an alternative. If you ran the business for the whole previous year, you can declare in your January ZUS DRA (the monthly settlement form) that you will use last year’s revenue to pick your band for the whole year. Any difference is settled in the annual reconciliation.

Watch out: the ryczałt amounts are fixed for the calendar year, January to December, and change every January. The 2027 amounts are not known yet (see below).

Paying it every month

It goes into the same monthly ZUS transfer as your social contributions, to your personal 26-digit ZUS account number (NRS). You file the ZUS DRA and pay by the 20th of the following month. When the 20th falls on a Saturday, Sunday or public holiday, the deadline moves to the next working day. In 2026 that means 22 June, 21 September and 21 December 2026.

The annual reconciliation in May

Monthly amounts rarely add up to the right figure for the year, so once a year you reconcile (roczne rozliczenie składki zdrowotnej).

• Where: in block XII of the ZUS DRA for April, not in your income tax return (the PIT is due 30 April, the reconciliation later).
• When: by 20 May of the next year. The one for 2026 is due by 20 May 2027.
• Who: anyone on the tax scale, flat tax or ryczałt who was health-insured through the business for even one day of the year, including people who suspended or closed during it.

How the year is worked out:

• Tax scale and flat tax: 9% or 4.9% of the whole year’s income, but never less than the monthly minimum × the number of months insured.
• Ryczałt: months insured × the band that matches the whole year’s revenue.

If you paid too little, you pay the difference with the April contributions, by 20 May. If you paid too much, ZUS creates a refund request, RZS-R, in eZUS (ZUS’s online portal) the day after you file. You check it, add a bank account, sign it and send it. For the 2025 reconciliation the dates were:

If you do not send the refund request, the overpayment is set off against your ZUS account by the end of the year.

Since 2025, revenue and costs from selling business assets (such as fixed assets) are left out of the base; from the 2025 reconciliation, people on the tax scale or flat tax may choose to include them.

Can you deduct it from your tax?

It depends on your tax form. The rules for 2026:

The flat-tax limit goes up each year by a formula, and the Finance Ministry announces it by the end of the year before. It was 12,900 PLN for 2025; the 2027 limit is due by 31 December 2026.

Your social contributions are a separate matter: they are deductible under every form.

Tip: Some pages written in spring 2025 say the health contribution “stops being deductible from 2026”. That described a reform the President vetoed on 7 May 2025. It never took effect.

What happens when you suspend

When you suspend your business (zawieszenie działalności) in CEIDG, the public register of sole traders, you owe no health contribution from the suspension date until the day before you resume.

Two months are still paid in full: the month you suspend (if the business ran for even one day of it) and the month you resume. Unlike social contributions, the health contribution is not reduced for part of a month.

Your NFZ cover ends 30 days after the insurance obligation ends. If you need cover during a longer suspension, you can buy voluntary health insurance from NFZ.

Revenue earned during a suspension is left out of the health base (on ryczałt, it does not count towards your band), unless you use the cash method (metoda kasowa): then payments received while suspended still count. If you were suspended for a whole year, you file no reconciliation for it, except when you resume in January of the next year on the tax scale or flat tax.

What changes in 2027

No change to the method has been enacted, and on 24 September 2026 no bill changing it was before the Sejm, the lower house of parliament.

The amounts will still move, because they follow the minimum wage and the average wage:

• The 2027 minimum wage is 4,950 PLN. If the rules stay as they are, the minimum on the tax scale and flat tax becomes 445.50 PLN from February 2027 (January 2027 is still 432.54 PLN), and karta podatkowa also 445.50 PLN for 2027.
• The ryczałt bands for 2027 are not known yet; they depend on a wage figure due around late January 2027.

What to do next

1. Find your tax form in the first table.
2. On the tax scale or flat tax, work out 9% or 4.9% of last month’s income each month, and pay at least 432.54 PLN (until January 2027).
3. On ryczałt, keep a running total of revenue since 1 January, so you notice when you cross 60,000 or 300,000 PLN.
4. Put 20 May 2027 in your calendar for the 2026 reconciliation, and check eZUS the next day for a refund request.
5. On the flat tax or ryczałt, make sure the deduction reaches your tax return.