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The Czech Republic is a popular destination for English speakers. Not only will you find that a lot of the Czech people speak very good English, but amenities like health care and education are highly rated. In fact, the health care system is so well respected that many people from outside the country visit the Czech Republic to access it. In a 2016 Euro Health Consumer survey, it was placed 13th in the world, two places above the UK.
As with all countries, accessing the health system is dependent on certain conditions being met. If you are planning to live, work or travel within the Czech Republic, there are some basics which you will need to know about the Czech healthcare system before departing.
Czech law states that everyone in the Czech Republic must have health insurance, to cover the costs of medical treatment. This can be obtained through a public or private insurance provider. If you’re a Czech citizen, a registered foreign resident, or the employee of a Czech company, you’ll automatically be enrolled in the public healthcare system, which is usually VZP (Všeobecná Zdravotní Pojišťovna), the largest provider. However, there are 7 providers who you can choose from:
1. Vseobecna zdravotni pojistovna
2. Vojenska zdravotni pojistovna
3. Ceska prumyslova zdravotni pojistovna
4. Oborova zdravotni pojistovna
5. Zamestnanecka pojistovna Skoda
6. Zdravotni pojistovna ministerstva vnitra CR
7. Revirni bratrska pokladna, zdravotni pojistovna
You will receive a card to prove your membership, which you will be asked to provide whenever you need medical treatment. Monthly deductions will be made from your wages to cover your health insurance, and these will entitle you to medical care. You will pay a percentage of this, and your employer will pay the remainder. If you’re an expat, you may also be asked to pay a small additional sum if you receive treatment. Check with your insurer for more information on this.
Some people are exempt from payments, including pensioners, students who are less than 26 years old, and dependent children. Adults classed as vulnerable might be classed as exempt, but you would need to check your insurer’s definition of a vulnerable person as these can vary.
British citizens planning to settle permanently in the Czech Republic will need to prove that they have paid National Insurance contributions, which will entitle them to join the public health insurance scheme, rather than being forced to take private health insurance. To do this, you will need a Form S1 (Previously called the E106) from the NHS Business Services Authority which will show your entitlement and allow you to register for the public health insurance schemes. Obtain this form as soon as you can, as you will not be allowed to apply for public health insurance without it, and will have to purchase private insurance.
If you’re visiting the Czech Republic for a long period of time (over 90 days), or you’re not working for a Czech company, you must purchase health insurance through a private insurer before you travel. Expats relying on the EHIC without having permanent Czech residency are not allowed free medical care. People who need a visa for their stay must have insurance which fulfils the following criteria:
- It must provide complex health insurance – not just emergency care
- Cover level must be at least €60,000
- Cover must be provided by an approved Czech health insurer
- Whoever you purchase from should be an official agent registered with the Czech National Bank
Holiday visitors are strongly advised to take out travel insurance to help cover the costs of any medical treatment which they may need. You will receive basic cover through your EHIC, but this may change depending on the outcome of the Brexit negotiations. Currently, EHIC holders are only asked to pay the same standard fee as locals for seeing a physician, which is 30 Czech Koruna for a non-emergency appointment, and 90 Czech Koruna for an emergency.
If you do not have any form of insurance, not only are you in breach of the law, you’ll be expected to foot the cost of any bill from your own pocket, which can be many thousands of pounds.
Do your due diligence when purchasing health insurance. Sadly, the health insurance industry is just as prone to scams and fraudsters as any other, and this is one policy on which your life may depend, so you’ll want to be sure that you’re properly covered.
Public or private health care facilities?
If it’s not an emergency, just like in the UK, you can choose to use public healthcare facilities, or you can pay to be treated privately.
The public healthcare system is well respected and well subsidised, with many of the doctors trained in English speaking countries and fluent in English. There are more doctors per head in the Czech Republic than there are in the whole of the United States! As with our own healthcare system, doctors are in high demand, and as such, patients can expect to wait for appointments with GPs and for out-patient treatment.
Much like private health care in the UK, private medical care in the Czech Republic is expensive but excellent. Doctors are well qualified and experienced. Visitors from English speaking countries report that there are more English speaking staff in private facilities, and you’ll receive more time and attention from your physician than you would in the public system. As you would expect, there are shorter waiting times for private treatment as well. However, you will be faced with a large bill at the end of your treatment, which is why private hospitals tend to be used mostly by people with generous insurance which specifically covers private treatment and the wealthy.
Pharmacies and prescriptions
There are over 2,000 large pharmacies (“lékárna”) across the country and plenty of smaller chemists in rural areas. You’ll be able to identify them by the green cross symbol over their frontage. Pharmacies in the Czech Republic are very similar to those in the UK. If you have a prescription or need health advice, a pharmacy is a good place to start. There are a few quirks which make them different to British pharmacies though, particularly when it comes to prescriptions. Depending on who issued them, or what they were issued for, prescriptions have limited validity and must be used within the specified timeframe. If your prescription times out, you’ll need another doctor’s appointment to obtain a replacement, and you’ll need to pay the standard fee of 30 Czech Koruna again. Current validity periods state:
- Prescriptions from a doctor are valid for one week
- Prescriptions from the emergency services are valid for 1 day
- Prescriptions for antibiotics are valid for 3 days
If you require a prescription, it must be issued by a doctor or qualified healthcare professional. When it comes to choosing a medication for you, their hands are somewhat tied by the system. Medicines are usually covered by your health insurance, although you may find that your insurer will only pay for a certain percentage of the cost, leaving you to pay the rest. There is a government-issued list of every sort of drug available, and its cost. Only the cheapest in each category will be paid for by your insurer unless your doctor can prove that a more expensive drug is the only one which will work for you. You will be either be issued with a paper prescription to take to a pharmacy, or you may find you’re with a tech-savvy doctors’ surgery who do things electronically. An increasing number of tech-savvy doctors are now signing up for the electronic prescription service which emails your prescription over to a pharmacy of your choosing, saving paper and the chance of the precious piece of prescription paper going missing.
When you arrive at a pharmacy, you may find there are two queues to choose from. “Bez receptu”, which means “I have no prescription”, and “Na recept”, which means “I have a prescription.”
Calling emergency services
Dialling the international emergency services number, 112, will connect you to an emergency services operator. If you know which of the emergency services you require, you can dial their number directly:
- 150 for the fire brigade
- 156 for municipal police
- 158 for police
You will find that English is widely spoken by the operators. You can call emergency numbers free of charge from your mobile phone, or from a landline.
When the emergency services arrive, do not be surprised if they ask to see some form of identification. Visitors are legally expected to keep their passport with them at all times, and this will work fine as identification. In fact, if you do not have your identification document with you, you may receive a fine from the police.
If you require emergency medical treatment and relying on your EHIC or public insurance, make sure that you are transported to a public healthcare provider (Referred to as an HIF), and not a private medical facility. If you have private medical insurance, it doesn’t matter whether you visit a public or private hospital. There should not be a charge for using an ambulance (Air ambulance or road ambulance) to transport you to a medical facility, as long as your condition requires it.
If you need hospital treatment
Regardless of whether you’re relying on your EHIC, travel insurance, or health insurance, it’s important to request and keep all receipts relating to your health care. These will be useful for reclaiming costs, as well as evidencing your treatment. For public health service treatment, you will be given your bill at the end of your treatment. If you’re asked to pay before seeing a physician, you are being treated at a private facility. Remember that your EHIC will not cover treatment at private facilities. The standard fee for emergency treatment at a Czech public hospital is 90 Czech Koruna.
As with hospital treatment, dentists operate from both public and private facilities. There’s currently a 50/50 split between dentists offering public treatment and dentists offering private treatment. Very rarely will you find a dentist who offers both, as it is apparently a bureaucratic minefield for them offer both, hence they choose one or the other.
Public insurance works more on the basis of preventative treatment, such as a simple check-up, basic fillings, and extractions. Orthodontic treatment is offered for children up to the age of 18, For anything more complex, private dental insurance plans are recommended. The general consensus is that the quality of the products used in private treatment is superior – for example, a filling done under public insurance will be standard silver. Private dentistry will offer you the choice of other materials. About 35% of the Czech population have opted for private cover. However, this low percentage doesn’t seem to worry the private dentists, as there is an increasing quantity of custom from visitors coming to the Czech Republic for “health tourism”. Compared to the UK, treatment prices in the Czech Republic can be a quarter of what they would be at home.
If you’re relying on your EHIC for emergency dental treatment, remember that you will be expected to pay the emergency treatment fee of 90 Czech Koruna, just as the locals do.
General enquiries about the Czech medical system
If you need advice or further information about health care in the Czech Republic, the best place to seek information is from the Czech Health Insurance Bureau (Kancelar zdravotniho pojisteni), who are located in Prague.
Kancelar zdravotniho pojisteni (HIB)
Nam. W. Churchilla 2
130 00 Prague 3
Telephone: 00420 236 033 411
Quite understandably, if you’re planning on a visit, or even a relocation to the Czech Republic, healthcare is sure to be one of the things you’re going to be most concerned about. Generally, though, you will find that you’ve got nothing to worry about. The system is accessible and modern and continues to rank highly in worldwide league tables. Its reputation is excellent and well deserved.