Abstract Background Protecting households against financial hardship when using health care is an integral element of universal health coverage. Previous analysis showed that in Poland, catastrophic spending on health is more common than in many European countries. Over the last decade, several measures were undertaken to reduce the burden of out-of-pocket payments for households in Poland. Methods The study aimed to assess financial protection in Poland using the indicators of catastrophic and impoverishing health spending. It relies on the methodology developed by the WHO Region Office for Europe. Catastrophic expenditure is defined as out-of-pocket payments that are greater than 40% of household capacity to pay. The study uses data from the Polish household budget surveys in 2013-2021. Results The incidence of catastrophic health spending remained relatively constant over the years analyzed, with 9% of households affected. Only in the first year of the COVID-19 pandemic (2020) it reached nearly 10%, although overall household out-of-pocket expenditure declined that year. The share of households impoverished or further impoverished due to out-of-pocket payments decreased from 4% in 2013 to 3% in 2021. Payments on medicines are the main driver of catastrophic spending, particularly among poorer households, although their role has diminished over time. Household’s available resources, gender, age, education, disability status, residence place, number of children, and household’s main source of income are significantly associated with catastrophic health payments. Conclusions Despite the implemented policies, household financial protection against out-of-pocket payments in Poland did not improve significantly between 2013 and 2021. Available evidence should be used to design well-tailored measures to reduce the burden of out-of-pocket payments, targeting the most vulnerable population groups and specific healthcare areas. Key messages • Household financial protection against out-of-pocket payments in Poland did not improve significantly between 2013 and 2021. • Out-of-pocket payments for medicines are the main cause of financial hardship for Polish households.