How does the state health insurance system work?
Statutory healthcare is provided by a number of government-approved insurers, and you have the right to choose between them (the biggest is VZP, which covers around 60% of the population).
If you are employed and you are covered by an insurer chosen by your workplace, your deductions will come directly from your salary. Your employer will typically also pay a percentage of the insurance premium.
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Who is eligible for state healthcare?
Medical insurance is compulsory and the majority of expats are eligible for the state insurance system. The government subsidises health insurance for the unemployed.
If you are not eligible for the state system, you may be eligible for VZP’s subsidiary insurance company, Pojištovna VZP. This is a health insurance scheme specifically for foreigners, is linked to AXA, and is recognized by the Department of Migration and Asylum Policy of the Ministry of the Interior.
If you are going to be in the country for more than 90 days, you must have proof of coverage, so even if you are planning to apply under Pojištovna VZP it is advisable to sort out your insurance before you go, with a private provider if necessary.
Expats who do not have a residency permit may also be eligible for one of two contractual schemes run by the General Health Insurance Company (GHIC).
How do you apply to join the state health insurance system?
If you are employed, then your employer will do this for you, but if you are self-employed you will need to do it yourself. You can apply online via the PVZP website, or by phone. Expats report that staff on the other end of the phone line are helpful and speak good English.
Your insurance will be valid once the premium is paid and undertaking the process online may entitle you to discounts: as much as 20% for full family coverage. Note that PVZP’s ‘exclusive’ package is the only one to offer coverage on pre-existing conditions: double check if this applies to you.
You can also go through an intermediary: Hamilton Hudson has signed an exclusivity agreement with the Czech government and is licensed to arrange coverage for expats.
Once you have signed up you will receive your insurance card, which will include your personal identification number (rodné císlo). You must take this with you to any surgery or hospital appointments as proof that you are insured, otherwise you could be denied treatment or have to pay. A copy of your child’s insurance card will be kept at their school or summer camp, and in the location of some after-school activities.
If applying for a visa, consider taking the following steps when applying for insurance:
- apply for Complex Health Insurance
- make sure that you have coverage to a minimum of 60 000 EUR
- have coverage provided by a Czech Health Insurance company
- get your coverage through an official Health Insurance Agent registered with the Czech National Bank
These steps should ensure the validity of your insurance for a visa application.
What is covered by the state health insurance system?
Most outpatient and inpatient treatment is covered by the state health insurance system, with a few exceptions such as cosmetic surgery. The scheme covers:
- out-patient medical care and care provided in hospitals
- preventative care
- dispensary care
- emergency and rescue service
- rehabilitation and medical spa care
- care related to pregnancy and childbirth
- care for blood, tissue and organ donors
- drugs and medical aids
- assessment activities
- examination, transport and autopsy of the deceased
You can choose your own doctor (praktický lékar) and your visits will be free of charge at the point of delivery. Most doctors will take VZP/PVZP patients. The medical practitioner may offer you additional treatment for an extra cost.
You will have to pay a small charge for prescriptions. If you need after-hours emergency care, you may have to contribute a fee of around 90 CZK, which can be claimed back. If your doctor is outside the state insurance system, you will have to pay but you might still be able to claim it back – enquire with your insurer.
Are retirees covered by state medical insurance?
If you are not employed in the Czech Republic, and do not have long term residency, you will not be covered under the state health insurance scheme and must take out private cover.
If you are a British expat and you receive one of the following benefits, then you may be eligible for national health insurance in the Czech Republic:
- an exportable UK pension
- contribution-based Employment Support Allowance
- another exportable benefit
You will need to fill in an S1 form to prove your eligibility.
Are students covered by state medical insurance?
If you are an international student, the nature of your coverage will depend on the length of your stay, and your nationality: if you are an EU citizen, and staying for under 90 days, you will need a different type of insurance. Check whether you are already likely to be covered by an EHIC card or a certified E128 health form, which you will need to bring into the country with you. British-issued EHICs cannot be used in the Czech Republic.
If you are not from the EU, and you are staying for longer than 90 days, you will need to take out private insurance and this cover must be approved by the Czech National Bank.
Will your family be covered by your insurance?
Family members might not be automatically covered by the state health insurance scheme due to measures put in place in 1995 to reduce incidences of medical tourism. Check with your employer or the VZP to see if your dependents are eligible, or if they need to take out private cover.
Is dental treatment covered by state health insurance?
Basic dental treatment and materials are also covered under the state insurance scheme, but expect to have to pay for extras such as orthodontics. However, remember that costs in the Czech Republic might be lower than in your home nation: the region is still a destination for medical tourism, and that includes dentistry.
What are the contribution rates for state health insurance?
Your overall contribution is around 13.5% of your income. Your employer should be paying 9% of this, with your contributions, deducted from your salary, making up the rest.
If you are self-employed, you will have to contribute 13.5% of your income.
Minimum contributions are currently as follows:
- CZK 1,803 per month for employees
- CZK 2,208 per month for self-employed persons
- CZK 1,803 per month for persons with no taxable income
The state pays the contributions to the Redistribution Fund, who apportion the money to the individual health insurance companies.
Why buy private health insurance?
Private health insurance is available for anyone who is not covered under VZP, or for those who are waiting for their national cover to be put in place.
Check with your employer to see if they have an agreement with a private provider. As with other countries, private health insurance and care tends to speed up waiting times and allows you to be treated in greater comfort, although the quality of the actual care is not necessarily better.
Czech healthcare is highly ranked by the World Health Organization. Private providers may afford you some linguistic advantages: non-state clinics and hospitals are reported to have a larger number of English-speaking staff.
You may need to take some medical tests as part of your application for private cover. Some providers may not take some forms of private insurance: it is important to check this prior to receipt of treatment.
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What is covered by private health insurance?
As well as speed of access and better facilities, private insurance will cover:
- advanced dental treatment
- cosmetic surgery
- additional maternity care
- access to English-speaking medical personnel
The state system is in the process of being modernized; it used to have a reputation for unattractive institutional buildings, long queues, and overstretched medical staff. Taking out private cover should avoid the worst of this, but the state sector has dramatically improved in recent years.
How much does private health insurance cost?
Numerous variables can have an impact on the cost of private health insurance in The Czech Republic.
The most important variables are:
- Age (the higher the more expensive)
- Area of cover (i.e. just The Czech Republic or other areas too? If those other areas include any of the US, the Caribbean, Singapore, China, Hong Kong or Dubai this can significantly increase the overall price)
- Product choice (higher end insurance products are more expensive)
Other variables include:
- Payment frequency
- Country of residence
As so many variables have an effect on the cost of private medical insurance in The Czech Republic it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.
Which companies offer private health insurance?
Private health insurance in the Czech Republic is provided by a range of companies:
- Alliance Partnership
- Bupa Global
- Cigna Global
- Hamilton Hudson (agents for VZP)
- Pacific Prime
Always ask for quotes from as many companies as possible before choosing a health insurance provider.
Glossary of health insurance terms
mám kartu Ehic - I have an EHIC card
rodné císlo - personal identification number
soukromé zdravotní pojištení - Private health insurance
Všeobecna Zdravotní Pojištovna - General Healthcare Insurance (VZP)