Health care

When you are staying in the Czech Republic in a long-term manner or permanently, it is highly probable that sooner or later, you or your children will need to be treated by a doctor, or you will need to stay hospitalized.

Except for very few cases, you will need to be insured for these purposes (enter into an insurance relationship) with some of the health insurance companies which operate in the Czech Republic. Any treatment without health insurance will only be provided in very extraordinary cases – i.e. in life-threatening cases or if you are the so-called self-payer which means that you will have to pay for the treatment or medical performance or hospitalization yourself, and the amounts which are charged in such cases are rather high, and if they are not paid, the authorities enforce their payments, of you even have to pay for the medical performance in advance. For these reasons, it is very important and responsible to be insured and have your own card specifying your health insurance company (health insurance card).

In order to have the health insurance card issued, you will need to personally come into a branch office of your chosen health insurance company and present a valid identification document. The branch offices of health insurance companies are usually located in larger towns.

• during the registration, the client shall prove the existence of his/her permanent residence on the territory of the Czech Republic or the continuation of employment with an employer with its registered office on the territory of the Czech Republic
• if the client is a person for whom the state is paying the insurance amounts (a student-a dependant child, a retired pensioner, an unemployed person registered with the Labour office, etc.), these facts shall also be proven
• the registration sheets of the insurance company (Registration sheet with a health insurance company, Registration and record sheets for the insured person from the previous health insurance company, etc., based on the relevant health insurance company)

 

There are the following health insurance companies operating in the Czech Republic:

• Všeobecná zdravotní pojišťovna (111)
• Vojenská zdravotní pojišťovna České republiky (201)
• Česká průmyslová zdravotní pojišťovna (205)
• Oborová zdravotní pojišťovna zaměstnanců bank, pojišťoven a stavebnictví (207)
• Zaměstnanecká pojišťovna Škoda (209)
• Zdravotní pojišťovna ministerstva vnitra České republiky (211)
• Revírní bratrská pokladna (213)

How to change a health insurance company:

1. Check with your doctors whether they have concluded an agreement with the health insurance company to which you would like to transfer.
2. Read carefully through the bonuses offered by your current health insurance company and those offered by your new insurance company. Our experience shows that several clients change their health insurance companies without properly knowing all the advantages which the current health insurance company may offer to them. 
3. You can only change your health insurance company once a year. Based on the date on which you apply for the change, you will either become the client of the new insurance company as of 1st July (if you apply for preregistration between 1st January and 31st May) or as of 1st January (if you apply for preregistration between 1st July and 30th September).
4. For the transfer to the new insurance company, you will have to complete and manually sign a paper application. No electronic forms can replace it. (Self-employed people shall also submit the confirmation on the amount of advance payments paid to the previous health insurance company, and people for whom the insurance is paid by the state, shall prove their status of belonging to the given category – e.g. student, pensioner, etc.).
5. The deregistration at the current health insurance company is performed by your new health insurance company. Your chosen new health insurance company will send you the new health insurance card which you will then present during appointments with doctors.
6. You shall inform each of your doctors during the next appointment at the latest about the change in your health insurance company. If you are employed, don’t forget to also inform your employer of such a change.

We cannot recommend to you any changes of health insurance company by accepting offers made to you on the street, as these practices occur from time to time. The change in your health insurance company is an important decision and it shall only be done based on proper consideration and with enough time to think about it. Any changes which are not properly thought trough based on promised bonuses and advantages may lead to the worsening of your position as a patient in the relation to doctors and medical facilities.

 

Treatment of a client with permanent residence in Great Britain by doctors in the CR

Even though Great Britain has left the EU as of the end of January 2020, there is an interim period up to 31st December 2020 during which the previous rules for the relations between the EU and GB still remain in validity, i.e. that clients with permanent residence in GB will be examined by doctors in the Czech Republic upon presenting the European Health Insurance Card (EHIC). You shall request this card at your insurance company in the location of your permanent residence and wait until it is delivered to you.

Debt with health insurance companies

If you have any debts with any of the health insurance companies, we recommend you to start resolving it as soon as possible. Even if you have a debt with your health insurance company, provided that your start resolving it early on, the insurance company is still will to keep you as its insured individual and enable you to be treated by doctors. Therefore, you shall contact your health insurance company and ask them whether there is any debt on your part, what amount it is and make an agreement regarding the repayment schedule. Very often, the insurance companies are willing to exempt you from any penalties which arose during the non-payment of the debt, after you properly pay the debt itself; we have particularly good experience with VZP in this matter.)

The necessary documents for the solution of debts with health companies:

• identification document
• health insurance card
• based on the chosen procedure of resolving the matter, you will need, for example, a prove of your income, documents proving the period of employment, or periods of being registered with the Labour Office as an applicant for employment, request for lowering or being exempted from the penalties

 

The health topic also includes the Benefits and advantages for people with disabilities. These include:

Care allowance

This is a financial allowance for people who need every-day assistance, supervision or care of another person, since they are unable to handle usual daily activities by themselves – the so-called basic life needs due to their long-term adverse health condition. The allowance is meant for the payment of such assistance.

• The person of whom another one should take care is the one who applies for the allowance, or potentially his/her guardian or legal representative if the person under care is younger than 18 years of age. The application shall be submitted to the Labour Office (Department of Social Services) in the location of permanent residence which is under care. You can apply for it in person or alternatively deliver the application to the Labour Office in a form of a letter by postal services.

This application shall include:

• Application for the care allowance (form)
• Specification of the provider of assistance (form)
• Further, it is necessary to present an identification document of the person which shall be under care and the person who will take care of that person (if the care taker is an individual, but the care taker may also be a legal entity, such as a retirement home, a care service or other social services)
  • If the person under care is younger than 15 years of age, his/her birth certificate shall also be provided, or the care taker sheet

Upon the delivery of the application for care allowance to the Labour Office, the Labour Office shall perform its basic processing and asks you to provide written medical reports from the general practitioner of the person which shall be under care, or medical reports from expert doctors. This is required because a medical assessment committee shall review the application. You will be informed by phone when you can expect a visit by an employee of the Labour Office which shall perform social inspection in the location of residence of the person which should be under care and for which the application is filed. After meeting all these requirements, you shall wait for the decisions which will be delivered in writing. If the care allowance is not granted, it is possible to file an appeal specifying that you do not agree with the verdict of the medical assessment committee, the instructions for which you shall find in the decision which you will receive. If the care allowance is granted, it will be specified in one of the 4 degrees each of which provides a different amount of the care allowance.

Link to the forms provided by the Ministry for Work and Social Affairs: https://www.mpsv.cz/web/cz/formulare#prispevek-na-peci

 

Card for people with disabilities

The ZTP (disability card) is the most frequently used abbreviation for the card for people with disabilities. However, in fact, the ZTP only represents one of the three variations of the card and their current collective title is cards for people with disabilities, which is abbreviated to the OZP card.

This is a card which is issued by the relevant contact branch of the Labour Office to people who have been acknowledged as long-term physically, sensorially or mentally disabled, and it provides an entitlement to certain advantages for these people. These are mainly the benefits in the field of transportation, but also other benefits.

TP card

• a reserved seat for sitting in public transportation
• a priority during arrangements with authorities

ZTP card

• it includes all the advantages of the TP card and then also:
• free-of-charge local public transportation (streetcars, trolleys, buses, metro)
• a discount of 75% in trains (in the second class) and in buses in the Czech Republic
• a parking card valid in the entire European Union
• exemption from the real estate tax and some administrative fees
• you do not need the highway toll sticker in the Czech Republic
• you do not pay radio and television fees
• based on the consideration of the organizer, you can receive discounts to theatres, cinemas, concerts or other events
• further discounts based on the consideration of suppliers of gas, electricity or mobile operator

ZTP/P card (P – means a guide and it includes all the advantages of the TP and ZTP cards and also:)

• free-of-charge transportation for guides for local and whole-state public transportation
• free-of-charge transportation for guide dogs for fully or practically blind people without a guide
• discounts on the income tax

The application shall be submitted via a predefined form at the Labour Office (Department for benefits for people with disabilities). Besides the completed form, you shall also present an identification document and a birth certificate for under-age children. The legitimacy of the application is assessed by the Ministry of Work and Social Affairs (Department for assessment services).

 

Furthermore, a disabled person may apply for an Allowance for a special aid-tools

Small tools are usually at least partially subsidized by health insurance companies, which requires that the orthopaedist, neurologist, etc., issue a voucher or similar document in this matter. The Labour Office will pay for more expensive tools which are harder to acquire and which are not subsidized by the health insurance company. Such as: for a rehabilitation bed with a mattress, you will need a voucher which will be presented at the health insurance company and assessed by a review doctor; it is similar for wheelchairs, or example.

A special tool serves the purpose of lowering social consequences of disability. These are, for example, the following tools: runways, portable ramps, stair climbers, lifting platforms, calculators with voice outcome, guide dogs, typewriters for blind people, camera magnifying glass, phone amplifier …. (see more in the annex to Decree No. 388/2011 Coll.). These also include subsidies for the purchase and operation of a motor vehicle + subsidies for guide dogs + subsidies for a modification of a flat.

The applications for this allowance shall be submitted at the Labour Office (Department for benefits for people with disabilities). You shall present together with the application:

• identification documents (a birth certification for children up to 15 years of age, the guardian sheet for people with limited capacity to perform legal acts)
• if you are applying for a subsidy to modify a flat, you will also need a consent of the real estate owner regarding the performance of installing such equipment and its operation (unless the applicant is the owner of the real estate)
• documents proving the income and pensions of all people living in the joint household (Declaration on property conditions via a form provided by the given authority)
• the relevant worker may specify further documents necessary for the application based on the individual situation of the applicant

 

A disabled person or his/her legal representative or guardian may also ask for a mobility allowance. The application shall be filed at the Labour Office (Department for benefits for people with disabilities).

The mobility allowance is a repeated benefit to which a claim may arise and is intended for people older than 1 year of age:

• who is entitled to use the ZTP or ZTP/P card under the rules as of 1st January 2014,
• who is repeatedly in a calendar month transported or transports himself/herself for a fee,
• who are not provided with accommodation social services under the Act on Social Services in a house for disabled people, in a retirement house, in a house with a special regime or in a medical facility of institutional care,
• for reasons worthy of special attention, the mobility allowance may be granted to a person to whom the accommodation social services specified in the previous point are being provided,
• the claim to be paid this allowance for a calendar month does not apply, if the beneficiary was hospitalized for the entire calendar month and health care in a hospital was provided to him/her,
• the mobility allowance amounts to: CZK 550 per month

The application shall be submitted at the Labour Office via a predesigned form and it shall be accompanied by an identification document, or a birth certificate for children of less than 15 years of age / the guardian sheet for people with limited capacity to perform legal acts.

 

Disability pension

Basically each citizen who believes that his/her aggravated health condition limits his/her ability to work may apply for the disability pension. However, the believe itself is not enough.

In order to be granted the disability pension, you will need to fulfil established conditions. One of these is the so-called establishment of disability which is preceded by the process of assessing the health condition. Another necessary condition is the period of insurance which is examined for the period prior to the emergence of disability. The period of insurance is not required only if the disability had emerged as a result of a work accident or an occupational disease. The length of the required period of insurance for the entitlement to disability pension depends on the age of the citizen. The application for the pension shall be submitted by the citizen himself/herself. It is useful when the person does so after consulting his/her attending physician who knows his/her medical condition. The application is completed by the citizen at the District Administration of Social Security (OSSZ) based on the location of the permanent residence, you can choose any local branch office of PSSZ in Prague.

The application for the pension shall be submitted in person, or it is alternatively possible to empower another person to do so by granting a power of attorney to such representative (the power of attorney does not have to be officially verified). An employee in the Department for Pension Insurance shall complete the application with the applicant. If the citizen is unable due to adverse health condition apply for the pension by himself/herself, then also his/her family member is entitled to do so on his/her behalf. However, it shall present a consent of the beneficiary to be applying on his/her behalf and a doctor’s confirmation that a serious health condition prevents the applicant to apply for the pension himself/herself.

What do you need for the completion of the application and which institutions can you contact?

You shall present the following documents and certificates:

• identification document
• proof of studies (even those still proceeding)
• proofs of the period of employment or alternatively the period of being registered as an employment application with the Labour Office (if no such documents are in your possession, the data of employment periods are specified, or the client may apply at the ČSSZ in Prague for the Informative Sheet of Retirement Insurance)
• proofs of performance of a military service (civil service)
• birth certificates of children (if the applicant request the inclusion of her/his care for children)
• certificate from the Labour Office on potential provision of care to a close person (care allowance)

The medical reports are presented in front of the assessment committee, but ideally you shall inform your general practitioner in advance that you are asking for the ID and the physician shall provide the reports.

 

Registration at doctors (general practitioner, general practitioner for children and adolescents, dentists, gynaecologist)

Required documents:

• health insurance card
• identification document
• excerpt from the medical documentation (it is not a necessary condition; however, it is possible to access medical documentation online in some cases in Great Britain)

The content of a preventive examination at a general practitioner for adults includes the completion of the anamnesis, focusing on its changes, risk factors and professional risks. The doctor will mainly be interested in the occurrence of cardiovascular diseases, hypertension, diabetes, disorders of fat metabolism and cancer in the family as well as the incidence of any addictions. The doctor shall always perform a complete physical examination including the measuring of blood pressure, calculating your BMI and orientationally examining your vision and hearing. At each preventive examination, the doctor shall also perform an orientational inspection of your urine by a diagnostic paper and make sure that your vaccination is up to date.

When it comes to the general practitioner for children and adolescents (paediatrician), a child undergoes the first general preventive examination in about 2 days after being released from the maternity hospital, and it usually takes place at the child’s home ideally (in his/her social environment). By the end of the first year, the child shall undergo preventive examination at the general practitioner for children and adolescents at the age of 14 days, 6 weeks, 3 months, between 4-5 months, and then at the age of 6, 8, 10-11 and 12 months. Thereupon, there is an examination with a period of half a year – i.e. at the age of 18 months, and starting with 3 years of age, the child shall attend examinations every two years up to the age of 17. The last general preventive examination is the performed prior to terminating the care at the general practitioner for children and adolescents, but no later than before reaching the age of 19 years.
The doctor shall complete a detailed report about each examination which is included in the file with the medical documentation.

Dental preventive examinations are performed with children of up to 18 years of age twice a year (with 5-month periods in between), while the child should undergo the first examination in the first year of his/her life between 6 and 12 months of age. (Adults also attend examinations twice a year, or each 5 months).

Preventive examinations at a gynaecologist shall start at the age of 15 years and then be attended once a year (or each 11 months).

Preventive examinations, their frequency and content are governed by the provisions of the Decree No. 70/2012 Coll., on preventive examinations, as amended.