Foreigners who do not participate in a public health insurance program
Their health care services are covered for them by the Czech Ministry of the Interior
This provision applies to applicants for temporary asylum and their children. In accordance with the provisions of Act No. 221/2003 Coll. on the temporary protection of foreign nationals, as last amended, these applicants staying in the territory of the Czech Republic are provided with free health care that falls within the range of healthcare services covered by the insurance described in Act No. 48/1997 Coll. on public health insurance, as last amended. This free care is provided for the period of time required for the applicant to file a motion against a decision of the Ministry of Interior (Section 17, Subsection 1) and for the period of time required to render a judgment on this application – provided the application is granted a suspensory effect. Such persons will also be similarly provided with healthcare in the case of mandatory quarantine or other measures related to the protection of public health.
A child born to a foreigner, who is under temporary asylum and is residing in the Czech Republic, is provided with free health care in the Czech Republic as discussed in the preceding paragraph – until a decision is made on granting temporary asylum (Section 28 of the Act on Temporary Protection).
In the Czech Republic, health care services can also be provided to foreigners on the basis of bilateral international treaties on social security, including also health care services providing, made between the Czech Republic and the respective foreign country. Health care can also be provided on the basis of bilateral agreements on cooperation in the field of health care, which contain provisions covering the providing of such free healthcare, by which the Czech Republic is bound.
Bilateral Agreements on Cooperation in the Healthcare Sector
These are mainly cooperation agreements, which among other things provide for the reciprocal providing of free health care during each country’s citizens’ temporary stay in the territory of the other country in the event of an acute illness or injury. This type of an agreement has been entered into with the following third countries – Yemen and Cuba. To receive health care on the basis of these agreements, it is sufficient for a person to prove that they are a citizen of either of these countries (e.g. by a passport). The cost of health care provided to the respective foreigner is covered by the Czech Ministry of Health.
Upon request, additional information on these respective agreements may be obtained from the Czech Ministry of Health and the Czech Ministry of Foreign Affairs.
Bilateral Agreements on Social Security
The second type of agreement is a social security related agreement, which also include provisions on healthcare. On the basis of such agreements, claims for the payment of healthcare services can be transferred to the health insurance program, which is in place in the country that is the counterparty to the respective agreement. The level of healthcare provided under these agreements is limited, often consisting of just emergency and urgent care. With the prior approval of the relevant health insurance company, a wider range of healthcare services may be provided.
On the basis of the convention on social security with states such as Montenegro, Macedonia, Serbia, Turkey and Israel, the appropriate form issued by the foreign entity providing the foreigner with health insurance has to be submitted first to claim health care provision at a Czech insurance company. A Czech health insurance company will then issue the foreigner with a so-called “confirmation of registration” (or a card), which the insured person from a country with such a bilateral agreement, who is residing in the Czech Republic, can then use to identify himself/herself when seeking care from a provider of health care services in the Czech Republic.
Based on the currently valid bilateral agreement between the Czechoslovak Republic and the Federative People's Republic of Yugoslavia on social insurance (No. 3/1958 Coll.), health care is provided free-of-charge to authorized persons from Bosnia and Herzegovina (BiH). To obtain this beneficial care, the foreigner needs to be able to verify that he/she is entitled to such health care in BiH. The reason for this requirement is that BiH citizens are not automatically entitled to such free health care. Proof of entitlement can include any of the following types of documents: a medical certificate, proof of employment or proof of entitlement to a pension. The provided health care is covered by the Czech Ministry of Health.
Upon request, additional information on the above-discussed contractual relationships can be obtained from the Ministry of Health, the Ministry of Labor and Social Affairs (for a list of international agreements on social security visit: http://www.mpsv.cz/cs/1275) and from the Centre for International Settlements.
The exact requirements, terms, and conditions (under which care is provided, how it is provided and under what circumstances) can be found in the administrative arrangements that are part of the concluded agreements. The terms and conditions of the individual agreements can vary. Before traveling to the Czech Republic, every foreigner should get information from the relevant authorities whether he/she meets the requirements defined in the international treaty.
If the foreigner does not identify himself/herself to a doctor using the relevant medical documentation, which will be used to verify the coverage for the care being requested or received, the foreigner will be required to pay for the care on his/her own. In case of emergency or urgent care, the price to be paid for the care is regulated by a maximum price per point, i.e. CZK 1.12 / point (see the pricing regulation of the Ministry of Health 1/2014/DZP in the Bulletin of the Ministry of Health dated December 2, 2013 (effective from January 1, 2014).
Travel Health Insurance
This section provides information on circumstances under which travel health insurance starts and terminates, the usual terms, conditions and consequences of the use of such an insurance product to obtain health care services.
Act No. 326/1999 Coll. on the Residence of Foreign Nationals in the Czech Republic, as last amended, requires foreigner to prove he/she has insurance to cover the cost of health care. This obligation can be fulfilled by having travel health insurance coverage (see Sections 180i and 180j of Act No. 326/1999 Coll. for what qualifies as acceptable proof of travel health insurance coverage) unless the cost of providing health care services is covered under an international agreement or covered under a public health insurance program or if the foreigner can prove the costs associated with the providing of health care services would be covered in another way.
If a foreigner comes to the Czech Republic for the purpose of employment, the above-described obligation is fulfilled on the day the individual becomes an employee of an employer with a registered address or permanent residence in the Czech Republic. In other circumstances, the foreigner needs to have travel health insurance or prove that the reimbursement of health care services will be done in another way. If the foreigner is staying in the Czech Republic without insurance, the person is violating Czech or European legislation and the person is under threat of prosecution. In case the foreigner needs health care services, he/she will be required to pay for such services in cash. Such care, beyond necessary and urgent care, can be quite expensive.
Proof of travel health insurance (among other things) is not required for foreigners from Cuba and Bosnia and Herzegovina. A foreigner from these countries is provided with any necessary and urgent healthcare out of the state budget on the basis of bilateral international treaties upon showing proof of citizenship in one of these countries (e.g. a valid passport).
Proof of travel health insurance is also not required from individuals who are insured in a state with which the Czech Republic has signed an international social security agreement (Montenegro, Macedonia, Serbia and Turkey).
Also, foreigners of these countries have to prove their citizenship (e.g. with a valid passport). However, this does not apply to citizens of Bosnia and Herzegovina – citizens of these countries are not automatically provided with healthcare on the basis of citizenship but they need to verify health insurance in their country of origin (i.e. Bosnia and Herzegovina). They can do this using any of the following documents: a medical certificate, proof of employment or proof of entitlement to a pension.
Foreigners without permanent residency in the Czech Republic who are not employed in the Czech Republic cannot participate in the public health insurance program. In most such cases, these individuals will need to arrange travel health insurance which is independent of the Czech public health insurance program and is based on a contractual relationship entered into between the insured person and the commercial insurance company. Such insurance is not offered by health insurance companies, but rather by insurance companies according to the Act No. 277/2009 Coll. on insurance.
The requirements for proof of travel health insurance in the case of stay of up to 90 days are set out in the European Parliament and Council Regulation (EC) No. 810/2009 on the Community Code on Visas (Visa Code). This regulation requires travel health insurance to cover any costs that might arise during the stay of a foreigner in connection with his/her repatriation for medical reasons or in connection with the providing of emergency medical care, emergency hospital treatment or death. The insurance must be valid throughout the territory of the member states and cover the entire period of the person’s intended stay. The minimum required insurance coverage is EUR 30,000.
According to the Act on the Residence of Foreign Nationals in the Czech Republic, for a stay over 90 days, the individual’s travel insurance must cover the costs the foreigner would be obligated to pay during his/her stay in the country for any necessary and urgent medical care that might be needed, including the cost of his/her return or in case of death, the costs associated with transporting the individual’s bodily remains, to the country represented on the individual’s travel document (or to another state in which the individual is allowed to stay). The agreed limit of coverage per claim is at least EUR 60,000 (excluding the participation of the insured in the above costs).
Travel health insurance is also required when an individual is applying to the Czech Republic for a visa for a stay of over 90 days or for an extension of a stay in the Czech Republic. Such health insurance must be purchased from an insurance company authorized to provide such insurance in the Czech Republic and the policy must include comprehensive health care coverage. The term “comprehensive health care” means health care provided to the insured person by the insurer's contractual providers of health care services, without the insured being required to directly pay for the cost of treatment, for the purpose of maintaining the health condition of the insured person during the period preceding the expiration of the insurance contract. This insurance shall not exclude preventive or dispensary health care or health care related to pregnancy of an insured mother and childbirth of her child. When arranging for an insurance contract, it is important to pay proper attention to these requirements.
The above obligations do not apply to persons covered by Regulations of the European Parliament and Council Regulation (EC) No. 883/04 and No. 987/09 or the European Parliament and Council Regulation (EU) No. 1231/2010.