Formalities · 5 min read

The medical device prescription. One sheet of paper your prosthesis depends on

Artur Wąsowicz · August 4, 2026

A prosthesis does not start at the prosthetics workshop. It starts with a document somebody has to issue for you, and not every doctor is allowed to do it.

A prosthesis is a medical device. Which means the road to one runs through a document with an official name: zlecenie na zaopatrzenie w wyroby medyczne, a prescription for the supply of medical devices. It is worth understanding how it works before you need it.

What it actually is

The prescription is the document on the strength of which NFZ, Poland's national health fund, pays towards a medical device. A prosthesis is a medical device. So is a liner, so are residual limb socks, a socket replacement, a wheelchair, crutches.

The prescription has its own official template and its own route through the system. It is not a referral, it is not a drug prescription, it is not a doctor's certificate. Without it a prosthetics workshop can still build you a prosthesis, but you will pay for the whole thing yourself.

Since 2020 the route has been electronic. The person issuing the prescription enters it into the eZWM system, and at that same moment the system checks two things: whether you are entitled to public healthcare, and whether this particular device is available to you. If the check passes, the prescription is ready to use straight away. You do not have to take anything to an NFZ branch.

You go to a branch only when something has gone wrong: the prescription was issued outside the system, or the check came back negative. Then it has to be confirmed, and that can be done remotely, by scan or by email, at any regional branch.

Since July 2023 there is also a fully electronic version. You get a prescription number and a PIN, and you use those at the provider instead of paper.

Who is allowed to issue it

This is where most people lose time.

Not every doctor. Each entry in the official list of devices comes with its own list of eligible specialisations, and for limb prostheses it looks like this:

• general surgery, vascular surgery, oncological surgery, paediatric surgery
• orthopaedics and traumatology of the locomotor system
• medical rehabilitation
• physiotherapy specialist

A GP is not on that list. They cannot issue you a prescription for a prosthesis, however much they might want to. That comes straight from the regulation, not from a decision made by the clinic.

Residual limb socks are a different story. There the list of eligible people is much wider, GPs and nurses included. Worth remembering, because socks wear out faster than anyone expects.

One practical point. Whoever issues the document has to know the naming from the official list, because they enter a device code. Wrong code, wrong amount. If the doctor does not do this every day, bring the code with you to the appointment. A prosthetics workshop will usually tell you which one applies within a minute.

A limit is not a price

The prescription does not give you a free prosthesis. It gives you a funding limit, the amount up to which NFZ pays.

For lower and upper limb prostheses your own share within the limit is zero per cent. Which means that up to the limit you pay nothing.

The limit covers a prosthesis meeting the criteria set out in the official list. Some people fit inside it completely. For others, a solution matched to how they actually move costs more, and the difference is covered privately. How large that difference is only becomes clear once the workshop has quoted you.

That is where the rest of the puzzle comes from: PFRON funding, money from a PCPR, fundraisers. There are separate texts about those on this site.

The second thing worth knowing right away: the size of the limit depends on the mobility level entered on the prescription. Mobility level decides not only the amount, but what goes into the prosthesis at all: which knee, which foot, which suspension. An above-knee prosthesis at level 1 or 2 and the same prosthesis at level 3 or 4 are two different devices with two different limits. The level is set by the person issuing the prescription, based on how you move and what you want to do. That conversation, held before anyone signs anything, is one of the more important conversations in the whole process.

Replacement periods

Reimbursement is not available whenever you want it. It becomes available once the replacement period has run out. It is counted from the date you collected the previous device, not from the date the prescription was issued.

For a definitive lower limb prosthesis that period is three years. A temporary prosthesis is a one-off, available before the definitive one. A liner once a year. Residual limb socks once a year. A socket replacement in a definitive prosthesis every three years, where there are confirmed medical grounds.

The period can be shortened if your physical condition has changed and the adjustment range of the device has been used up. The application for shortening is issued by an eligible person and has to contain detailed medical reasoning. A residual limb changes volume, particularly in the first year, so this is not a dead letter.

There is also a second route. People holding a certificate confirming a severe degree of disability, znaczny stopień niepełnosprawności, are entitled to medical devices without regard to replacement periods, according to medical need. That is a statutory entitlement and it is worth knowing about, because not everyone at the reception desk remembers it.

Where to use it

At any provider holding a contract with NFZ for the supply of medical devices. There is no catchment area. You can travel to a workshop in a different city if you decide they will build you a better prosthesis there.

Prescriptions for devices other than monthly supplies stay valid for twelve months from the date of issue, and have to be used within that time. Prescriptions for monthly supplies are issued for a maximum of twelve consecutive months, or six if the prescription was written outside the system and confirmed by an NFZ officer.

Choosing a workshop is a subject of its own and I take it seriously. The prescription is the same everywhere. The prosthesis is not.

A repair is a separate document

A repair cannot be handled on the prescription that got you the prosthesis. There is a separate repair prescription for medical devices, with its own template.

The repair price limit is listed in the official list next to each entry. For a definitive above-knee prosthesis for an adult at the highest mobility level it runs to several thousand złoty. For a temporary prosthesis and for a socket replacement the repair limit is zero, so in practice repairs there are not reimbursed at all.

Better to know that in advance than on the day something snaps.

Three things worth asking straight away

Who at this clinic can issue a prescription for a prosthesis or for the other devices you need. For prostheses the list of eligible specialisations is narrow and a GP is not on it. For other devices, residual limb socks for instance, it is much wider.

What mobility level will be entered. The amount depends on it, so that is a conversation to have before the signature, not after.

How large the difference between the limit and the price will be. Once you know that, you can start arranging the rest of the funding in parallel, rather than waiting for the quote to land.

The rest is manageable. Those three questions, asked early, can cut months off the whole thing.

Artur Wąsowicz

Founder of the Świat Bioniki Foundation, prosthesis user since 2020