Health Insurance for Foreigners

Once you´ve deciphered exactly how to get healthcare, paying for it is the next step. Compared to many other countries, basic health insurance in the Czech Republic is extremely inexpensive – there´s simply no excuse for not having it. Some people choose not to arrange coverage and ‘hope for the best´; this may be feasible if you are extraordinarily healthy, but if you need emergency treatment such an approach is unwise, as you´ll be expected to pay for care on the spot. Also keep in mind that those living in the Czech Republic are required to have some form of health insurance before entering the country.

As you shop for coverage you should take your employment status, residence status, and citizenship (the Czech Republic now complies with EU laws on healthcare) into account. Wherever you come from you should at least arrange coverage through the public healthcare system, depending on your status. Under Czech law you must be covered by it if you have permanent residence or are working for an employer that has a registered business address in the Czech Republic. People working here on a self-employed basis, whether EU citizens or not, have obligations, too. You should therefore make sure you know whether you are obliged to be part of a Czech public health insurance scheme. Private insurance is of course an option too, and many expats are members of private schemes.

Once you are registered in the system, either as an employee or on a self-employed basis, you will be issued a card by your insurance company. You should keep it with you at all times and produce it every time you go to hospital or see your doctor. Remember that public GPs have a contract with one of the health insurance companies, and when you sign up for a local doctor you may find that he or she does not have a contract with the same company. You should therefore check which insurance firm the doctor has an agreement with. If you have to visit a doctor who has a contract with a different healthcare company, then your provider will reimburse the doctor for any costs involved. However, this is the case only where ‘essential´ and ‘urgent´ treatment is required. You should also be aware that having public healthcare provision does not cover you if you visit private clinics or hospitals – which many expats opt to do.

If you are working on a freelance basis and have permanent residence then you will pay your contributions on an annual basis. If you are self-employed and have a long-term residence permit you should arrange contractual insurance individually with a public health insurance company. Premiums are paid upfront and the contract will apply for a certain period. You will need to undergo a medical examination and fill out a simple questionnaire. The policy can be extended if you are renewing your residence permit.

The situation for EU citizens changed when the Czech Republic became a member of the European Union. These days, even if you only have temporary residence (přechodný pobyt), which lasts five years; you enjoy similar rights as Czech citizens, based on the principle of common healthcare provision across the EU. This means that if you are working for an employer then the arrangements described above still apply. If you are working on a freelance basis, e.g. as a translator, then you still have to make monthly payments. Before, you had to take out contractual insurance (if you had long-term residence) but now you have to make an arrangement with a health insurance company yourself. It´s also possible to set up insurance with a non-domestic healthcare company if you are an EU citizen, but this arrangement must comply with EU law on public healthcare, so you should obviously confirm that it does before purchasing coverage.

You may also choose to be part of a private healthcare scheme. If you are working independently, you can arrange for cover with a company from home. If you work for a large multi-national firm the situation is often very straightforward: it may have set up private care for you. Many expats have arrangements with firms such as BUPA, through their employer, and they go to private clinics that accept these and other private policies. Depending on your situation, you may be obliged to make contributions to the Czech public healthcare system also (see above). This can be advantageous if you must go to a public hospital for emergency treatment. If you tell the hospital you have private care, it may mean paperwork, which can be rather unpleasant if you are in severe pain. But showing proof of coverage by the Czech public healthcare system should enable treatment straight away. If you arrange to pay for treatment with your private coverage you might be asked to pay upfront and be reimbursed by your provider later.