- Last Updated: 05 December 2016
In connection with increasing number of questions we would like to point out again that the Czech-US social security agreement covers also the area of health insurance as of 1st May 2016. One of the consequences of this change is that American citizens – self-employed in the Czech Republic (“živnostenský list”) are to be insured in the public health insurance system starting from 1st May 2016 even if they do not have permanent residence in the Czech Republic.
JUDr. Ladislav Švec, director
- Last Updated: 01 April 2016
Information about contracting medical providers in the place of stay and other information concerning health care during the temporary stay in the Czech Republic are available here.
In case of any problems concerning healthcare during your stay in the Czech Republic you can also contact us:
Kancelář zdravotního pojištění (Health Insurance Bureau)
nám. Winstona Churchilla 2, 113 59 Prague 3
phone: +420 236 033 411
fax: +420 222 734 951
info @ kancelarzp.cz
In emergency cases dial 112 (international, communication in foreign languages) or 155 (local, usually communication in Czech language only).
General information and administrative procedures
To obtain treatment under the provisions of the European regulations it is important to contact a healthcare provider (doctor, dentist, hospital), which is in a contractual relationship with any of the Czech healthcare insurance funds. Most of the providers are contractual.
Your European health insurance card (EHIC) or Provisional certificate has to be submitted to attending physician. If none of the above mentioned documents is presented, the physician can ask for an upfront payment.
The healthcare provider needs to see your EHIC or a Provisional certificate in order to get the reimbursement of costs from contracting Czech health insurance fund. Your personal data has to be filled in a specific form called „Potvrzení o nároku“ (Certificate of entitlement). The healthcare provider may also check your passport or ID card.
He should also ask you to confirm an expected length of stay in the Czech Republic and to choose one of the Czech contracting health insurance funds. You will confirm your choice and expected length of your stay by signing the above mentioned „Potvrzení o nároku“ (Certificate of entitlement).
If any medicines, laboratory examinations, or any other examinations were prescribed, the healthcare provider should give you an appropriate number of copies of „Potvrzení o nároku“ (Certificate of entitlement). The copy should be then submitted to pharmacy, laboratory or surgery.
If the EHIC or Provisional certificate is presented, the costs of treatment are covered by the chosen Czech health insurance fund.
In case you have to pay for the treatment by yourself in cash (e.g. if you didn´t present appropriate documents), the costs cannot be reimbursed by the Czech health insurance fund during your stay in the Czech Republic. You should ask your competent institution for reimbursement once you return home.
If you travel to the Czech Republic in order to obtain a specific health care, ask your competent institution for authorisation (S2 or E112 form). This form should be submitted before a provision of healthcare to the chosen Czech health insurance fund. If you do not have this form or you did not submit it to the Czech health insurance fund the cost of healthcare cannot be borne by Czech health insurance fund and you will have to pay upfront.
In case of need of a medical treatment during the temporary stay in the Czech Republic, you can go to the doctor/dentist/hospital directly presenting your EHIC or Provisional certificate to them.
Possibility of previous registration
When staying in the Czech Republic for a longer time (e.g. the posted workers or students) it is possible to choose and contact one of the Health insurance funds, where you can be registered. You will receive a registration document called „Potvrzení o registraci“ (Certificate of Registration) which shall be submitted to the attending doctor/dentist/at the hospital before getting the treatment.
The standard dental care is generally covered by the public health insurance system, only for some special dental treatments and materials participation is to be paid in particular amounts.
When requiring the treatment by a specialist, recommendation of an attending physician has to be acquired.
In urgent cases visitors can go to the hospital with the EHIC directly. In other cases the practitioner issues a recommendation for access to the hospital.
Transport to the hospital is covered by the public health insurance system and is provided free of charge. In a case of urgent medical transport or in a case of treatment by doctor of emergency service it is also necessary to present your EHIC or Provisional certificate.
If the doctor decides to prescribe you medicines, he issues a prescription. He should also give you one copy of „Potvrzení o nároku“ (Certificate of entitlement). Medicines are available at the pharmacies. For some drugs and medicines compulsory participation is to be paid – there are groups, which are fully reimbursed, partially and not covered groups of drugs and medicines as well.
Every insured person (or his/her legal representative) is obliged to pay the regulatory fee of CZK 90 for emergency care that was provided by the first aid medical service including first aid medical service provided by the dentists.
The legal act also specifies the exceptions from this rule, when the insured person does not have the obligation to pay the regulatory fees – resulting hospitalisation.
The overall limit of 2.500 and 5.000 CZK
If the total amount of compulsory co-payment for partially covered drugs and medicines paid by the insured person (or his/her legal representative) exceeds 5.000 CZK per calendar year, the health insurance fund is obliged to refund the insured person (or his/her legal representative) the exceeding amount no later than within 60 days after the end of the calendar quarter in which the limit was exceeded.
For children under the age of 18 and for pensioners above the age of 65 the overall limit is 2.500 CZK per calendar year.
The healthcare provider has to issue a receipt confirming the payment of the regulation charge only upon request.