Regulatory Fees for Health Care Services
The regulatory fees for health care services are set out in Act No. 48/1997 Coll., on public health insurance and on changes to certain related laws, as last amended.
The obligation to pay these fees applies to all participants in the public health insurance program (or their guardians or legal representatives). This obligation also applies to insured persons from other EU member states, from the European Economic Area and from Switzerland and from those countries with which there is a bilateral international treaty on social security or another type of applicable international treaty.
Basic Types of Regulatory Fees
The insured or his/her guardians on behalf of him/her is obliged to pay health care providers the regulatory fee of CZK 90 for using the first aid medical service or the first aid dental service (hereinafter referred to as the “first aid service”).
The regulatory fee is not to be paid:
- if the insured is placed in an orphanage for children of up to the age of 3, in school facilities for institutional education or protective education, or placed for institutional education purposes in homes for the disabled, or if the insured are, under a court decision, placed in facilities for children that require immediate assistance, or if the insured are, under a court decision, entrusted in foster care, guardian’s care or other person’s care under different legislation,
- if the insured produces a decision, notification or confirmation, issued by a material poverty assistance authority and not older than 30 days, on an allowance provided to the insured under different legislation,
- if the insured is provided with residential social security benefits in homes for the disabled, retirement homes, nursing homes with special regimes or in inpatient healthcare institutions and the insured person’s defined balance of at least 15% of the person’s income is less than CZK 800 after paying the accommodation and food or the insured has no income; the insured shall prove this by a confirmation not older than 30 days, which the social service provider is obliged to issue on the insured person’s request,
- if the treating physician finds during the first aid service that the condition of the insured requires hospitalization.
The way the regulatory fee is to be paid by the insured: the regulatory fee is to be paid by the insured immediately or as agreed upon with the healthcare institution of the healthcare provider. The healthcare provider is obliged to issue a regulatory fee payment receipt to the insured or his/her guardian on request from them.
Deadlines for the Payment of Regulatory Fees
- Immediately - if the regulatory fee is being paid along with a payment for the purchase of a prescription medication (partially covered by insurance) or a special, medically prescribed food at a pharmacy.
- Immediately or by agreement - with the provider of healthcare services in connection with their providing of these services.