Hidden fees, denied care: What foreigners should know about Czech healthcare rights

Finding suitable healthcare in a foreign country is often tricky, made even more difficult by hidden, unexpected charges and denied care. However, what are doctor's offices legally allowed to charge, and when are such fees unlawful?

In Czechia, certain fees charged by doctors' offices are prohibited. For example, doctors cannot require a registration fee simply for enrolling a new patient, as confirmed by František Tlapák, spokesperson for the Occupational Health Insurance Company, speaking to Czech media outlet iDnes.

Registration fees are prohibited because they conflict with the terms of the healthcare provider’s contract with health insurance companies, Tlapák explains. 

Under Czech law, the registration process is simply an agreement between the patient and the healthcare provider to ensure the patient receives comprehensive care under their health insurance. 

Lawyer Kristýna Pintová of the Pak & Švehelka law firm told Expats.cz that doctor’s offices in Prague should not be charging any sort of sign-up fees. “Doctors justify the collection of additional fees by citing services that are not covered by a health insurance company, which they can—such behavior is difficult to punish. However, doctors should not charge for the admission of care,” she added.

You have the right to health services covered by your insurance, as listed by law. The doctor must tell you if the care is fully, partly, or not covered before providing it. Routine examinations should not be charged, as health insurance covers these.

In 2024, Expats.cz reached out to laywer and specialist in healthcare law Barbora Steinlauf on the issue. “Healthcare providers can’t demand payment for services already covered by health insurance. This would be a so-called double payment, which is against the law and breaks the contract between the provider and the health insurance company,” she said.

Health insurance doesn't cover exams, check-ups, medicines, special food, medical devices, or other services requested for personal or business reasons that are not aimed at improving or maintaining the insured person's health. This includes confirmation of medical fitness for various purposes like studies, driving, or medical certificates.

"Patient care can only be terminated if a patient intentionally and consistently fails to comply with the proposed individual treatment procedure, or if they have ceased to provide necessary cooperation,” says spokesperson for the Ministry of Health Ondřej Jakob.

This means that, for example, missing a preventive examination is not grounds for a doctor’s office removing you as a patient. 

If your care is stopped and you’re deregistered from a practice, the provider must give you a written explanation of why it happened and inform your health insurance company about it. 

Even if you’re not registered with a doctor, a practice cannot refuse you if you are experiencing an acute and serious medical issue, such as severe pain. This, interestingly, also applies to dentists. 

However, under normal conditions, the law allows doctors to refuse to register or admit a patient if it exceeds the doctor’s “tolerable workload” or if admission is prevented by operational and logistical reasons, such as living too far from the doctor’s office.

Czech Health Minister Vlastimil Válek has spoken out against the rogue fees, promising an end to them. His plan is to establish a clear, definitive list that details what types of services doctors can—and cannot—charge for.

“I want to put an end to what has been happening spontaneously for the last 10 or 15 years; money being collected for nothing. Everyone has turned a blind eye to it,” he added.

Válek wants to punish violations with a fine of up to CZK 1 million for inappropriately charging extra fees. Válek says that he wants to have a “solid legislative basis” for the list by the end of the government’s current term (around October 2025).