This chapter describes the set-up of the healthcare system in the Czech Republic. It explains the basic operation of health insurance and the eligibility of insured parties who are Czech or other EU nationals. Healthcare is free for insured persons in most cases but there are some mandatory fees and payments for special services.

We will explain how the following works:

• entitlement to healthcare and medical aids.

In what situation can I claim?

Healthcare is provided to anyone insured in the Czech Republic who falls ill or requires medical care.

This includes EU nationals and their family members who are insured in Member States outside the Czech Republic. Persons working or residing in the Czech Republic are eligible for full healthcare. Those in the country for a short period of time (tourism or business) are provided necessary care in case of an illness or accident.

Healthcare is free of charge, if:

• the beneficiary is insured with a health insurance fund;
• the healthcare provider has concluded a contract with the given health insurance fund (not applicable when emergency healthcare needs to be provided);
• the examination is covered by the public health insurance system.

Healthcare is provided under a compulsory health insurance scheme (zdravotní pojištění).

What conditions do I need to meet?

Access to healthcare is not at all limited. Entitled persons must register with one of seven health insurance funds.

Employers pay insurance contributions for employees in form of a separate payment (earmarked payment). Self-employed persons (see Jargon busters) pay contributions themselves. Persons without a gainful activity and for whom the State does not pay the contribution (see below) must pay their own insurance contributions as persons with no taxable income (see Jargon busters).

Insurance contributions for employees and self-employed persons are defined at the same rate of 13.5% of the assessment base (see Jargon busters).

The minimum insurance contribution in 2023 is as follows:

• CZK 2,336 per month for employees;
• CZK 2,722 per month for self-employed persons;
• CZK 2,336 per month for persons with no taxable income.

The State pays health insurance contributions for specific groups. These are primarily:

• dependent children up to the age of 26;
• old-age pensioners and invalidity pension beneficiaries;
• women on maternity or family (parental) leave, parental allowance beneficiaries;
• persons providing full-time care for a child up to the age of 7 or for two children up to the age of 15;
• jobseekers registered with the Labour Office;
• persons receiving social welfare benefits due to social needs;
• completely disabled persons and their caregivers;
• persons in custody or in prison.
• Full-time PhD students older than 26 enrolled for the first time in doctoral study programmes.

What am I entitled to and how can I claim?

Insured persons are entitled to a free choice of a primary care physician (GP, GP for children, dentist, gynaecologist). The prerequisite for free healthcare is that this physician has a contract with the person's insurance fund.

It is recommended to visit a general practitioner to get a referral before contacting a specialist. However, this is not required.

The following is covered by health insurance:

• out-patient medical care and hospital (in-patient) care;
• preventative care;
• dispensary care (see Jargon busters);
• emergency service;
• rehabilitation and medical spa care;
• care related to pregnancy and childbirth;
• care for blood, tissue and organ donors;
• drugs and medical devices;
• dental prosthetics;
• assessment service;
• examination, transport and autopsy of the deceased.

Some medical procedures are not covered by health insurance.

Examples include:

• cosmetic procedures and plastic surgery conducted for purely cosmetic reasons;
• acupuncture procedures;
• premium or cosmetic dental procedures.

Patients are also eligible for free care even when they visit a healthcare provider that is not a contractual partner of their insurance in specific cases. Such situations involve a serious threat to the life or health of such patients:

• an accident;
• an acute illness;
• an acute deterioration of health;
• emergency childbirth.

Jargon busters

• Self-employed person (osoba samostatně výdělečně činná) is the term used for a person with income from business or other self-employment (private farmer, trade licence holder or artist).
• A person with no taxable income (osoba bez zdanitelných příjmů) is any person who has no income and does not fall into any category for which the State pays health insurance contributions. Such a person may be a student over the age of 26, housewives or unemployed persons who are not registered with the Labour Office as jobseekers.
• The assessment base (vyměřovací základ) is a sum of income used to calculate health insurance contributions. The calculation is different for employees and self-employed persons.
• Regulatory fees (regulační poplatky) are compulsory fees for visiting physicians and using other services.
• Medical procedures (zdravotní výkony) are decree-defined physician activities reimbursed by health insurance companies using the price list.
• Dispensary care (dispenzární péče) is regular medical supervision provided to patients usually suffering from a chronic disease (e.g. diabetes or TB). It may also involve the monitoring of a group with a specific health risk.

Forms you may need

No forms are needed.

Know your rights

These links do not lead to European Commission websites and do not represent the views of the European Commission:

• Patients' rights in the Czech Republic (Práva pacientů v České republice) (in Czech);
• Act on Healthcare Services and related decrees (Zákon o zdravotních službách a příslušné vyhlášky) (in Czech);
• Act on Health Insurance and related decrees (Zákon o zdravotním pojištění a příslušné vyhlášky) (in Czech).

Please make use of EU assistance services if you experience any problems in applying your rights:

• Social security: your rights in the EU

Useful contacts

Ministry of Health of the Czech Republic (Ministerstvo zdravotnictví ČR)
Palackého nám. 4
128 01 Prague 2
CZECH REPUBLIC
Tel. +420 224971111
Email: mzcr@mzcr.cz
http://www.mzcr.cz/

Portal for Patients and Patient Organisations (Portál pro pacienty a pacientské organizace)

https://pacientskeorganizace.mzcr.cz/

Health Insurance Bureau (Kancelář zdravotního pojištění)
Czech national contact point for healthcare
nám. W. Churchilla 1800/2
130 00 Prague 3
CZECH REPUBLIC           tel: +420236033411
info@kancelarzp.cz     
www.kancelarzp.cz

Contact list of Czech public health insurance funds
https://kancelarzp.cz/en/contacts/ceske-zdravotni-pojistovny-2/