In what situation can I claim?
Healthcare is provided to anyone insured in the Czech Republic who falls ill or requires medical care. The system is paid for from health insurance (zdravotní pojištění).
This includes EU nationals and their family members who are ensured 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 for business) are afforded emergency care in the case of an illness or accident.
Healthcare is free of charge, if:
- the beneficiary is insured with a health insurance company;
- the healthcare facility has concluded a contract with the given health insurance company;
- the examination or procedure is defined in the list of medical procedures (see Jargon busters) reimbursed by the insurance.
What conditions do I need to meet?
Access to healthcare is not at all limited. Czech nationals can select from seven health insurance companies. Health insurance is compulsory.
Employers pay insurance contributions for employees in the form of a separate payment and an amount deducted from employee wages. Self-employed persons (see Jargon busters) pay this insurance themselves. Persons who are not working and who are not insured by the State (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 from wages (see Jargon busters).
The minimum insurance contribution rate in 2018 is as follows:
- CZK 1,647 per month for employees;
- CZK 2,024 per month for self-employed persons;
- CZK 1,647 per month for persons with no taxable income;
The State pays health insurance contributions for specific groups of residents. These are primarily:
- dependent children up to the age of 26;
- old-age pensioners and beneficiaries of invalidity pension;
- women on maternity or family leave, parental allowance beneficiaries;
- persons providing full-time care for a child up to the age of 7 or 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.
Medical care is also accessible to persons who are not insured (e.g. third-country citizens). They must pay for their healthcare in full or have private party insurance.
What am I entitled to and how can I claim?
Insured persons are entitled to a free choice of physician. The prerequisite for free healthcare is that this physician has a contract with the person's insurance company.
It is recommended to visit a general practitioner to get a referral before contacting a specialist. However, this is not required.
The following are paid by health insurance:
- out-patient medical care and care provided in hospitals;
- preventative care;
- dispensary care (see Jargon busters);
- 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;
- dental products;
- assessment activities;
- examination, transport and autopsy of the deceased.
Health insurance companies pay for care in the exact same amounts under the law. Differences only exist in the form of the bonuses they offer. Some insurance companies contribute to their clients in a preventative manner (stays by the sea or nurseries in nature for children). Others offer contributions towards dental braces or contact lenses for children.
Some medical procedures are not covered by health insurance.
- cosmetic procedures and plastic surgery conducted for purely cosmetic reasons;
- acupuncture procedures;
- premium or cosmetic dental procedures.
Basic dental care is covered by insurance. The list of procedures that are not covered is defined in a specific decree. The patient must pay for premium procedures and materials (such as higher quality fillings, etc.).
Some hospital facilities offer the option to pay for a premium room.
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.
How to receive healthcare
Visit a physician in person or make an appointment over the phone in order to receive healthcare. Some examinations, procedures or other activities have waiting periods if the patient is not an emergency. The 155 emergency telephone number should be used in crisis or emergency situations. The 112 emergency telephone number should be used in order to communicate in English.
Patients are obliged to produce their health insurance card when visiting a physician. Treatment can be refused if no card is produced. This card is also a European Health Insurance Card and is therefore valid everywhere in the EU.
The physician is responsible for resolving payment with the insurance company. The patient has a right to request that their insurance company provides a list of procedures that have been billed.
- 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 specific decreased portion 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;
- Decree on the List of Procedures Paid by Health Insurance (Vyhláška o seznamu výkonů hrazených ze zdravotního pojištění), in Czech.
Please make use of EU assistance services if you experience any problems in applying your rights: