|Claim on the health care during a temporary stay in the Czech Republic (students, tourists)|
Where to get information?
Information about contracting medical providers in the place of stay and other informations concerning health care during the temporary stay in the Czech Republic are available by the health insurance funds (HIF).
In case of emergency call the Ambulance. Central extension for emergency calls is 112 (international, communication in foreign languages) and 155 (local, usually communication in czech language only).
General informations and administrative procedures
To obtain treatment under the provisions of the European regulation it is important to contact medical institution (doctor, dentist, hospital), which is covered by the contract with the public health insurance system (most of them do).
Your European health insurance card or Provisional certificate has to be submitted to attending physician. If no of above mentioned documents is presented, the physician can ask for cash payment.
For purposes of costs reimbursements from contracting Czech health insurance fund doctor needs to see your EHIC card, Provisional certificate and write included informations to specific internal form, so called „Potvrzení o nároku“ (Certificate of entitlement). Doctor should also check your ID dokument (passport, ID card, driverś license)
He should also ask you to confirm expected length of stay in the territory of the Czech Republic and choose one of Czech contracting health insurance funds . You will confirm your choice and expected length of your stay by signature in above mentioned „Potvrzení o nároku“ (Certificate of entitlement).
If any medicines, laboratory examinations, or any other examinations were prescribed, doctor should give you appropriate number of copies of „Potvrzení o nároku“ (Certificate of entitlement). The copy should by then submitted in pharmacy, laboratory or surgery.
If European health insurance card (EHIC) or Certificate provisionally replacing EHIC is presented, the costs of treatment are covered by any Czech health insuramce fund chosen.
In case you have to pay treatment by yourself in cash (e.g. if you don´t present appropriate documents), the costs would not be reimbursed by Czech health insurance fund during you stay in the Czech Republic.
If you travel to the Czech Republic in order to obtain specific health care, ask your competent institution for authorisation ( form E112 ). This form should be sumbitted before provision of health care to chosen Czech health insurance fund. Without E112 cost of health care can´t be beared by helping Czech heaalth insurance fund.
Posibility of previous registration
When staying in the CR for longer time, e.g. the posted workers or students, it is always possible to choose and contact one of the health insurance funds (HIF).
The standard dental care is generally covered by the health insurance system, only for some extra dental manipulation and materials a participation is to be paid in particular amounts.
When requiring the treatment by a specialist, attending physician issues a recommendation.
In urgent cases visitors can go to the hospital with the EHIC directly. In other cases the practitioner issues a recommendation for acces to the hospital.
Transport to the hospital is covered by the insurance system and is provided free of charge. In case of urgent medical transport or in case of treatment by doctor of emergency service it is also neccessary to present your European health insurance card, or Provisional certificate.
If the doctor decides to prescribe medicines, he issues a prescription. He should also give you one copy of „Potvrzení o nároku“ (Certificate of entitlement). Medicines are available at the pharmacies. For some drugs and medicines compulsory participation is to be paid – there are groups, which are fully reimbursed, partially and not covered groups of drugs and medicines as well.
Every insured person (or his/her legal representative) is obliged to pay the regulation charge to the health care provider for the medical treatment provided by him. There are three levels of the regulation charges:
1) 30 CZK
2) 100 CZK
3) 90 CZK
The legal act also exhaustively mentions the exceptions from this rule, when the insured person does not have the obligation to pay the regulation charges – for example for some preventive examinations (inspections), dialysis, protective treatment ordered by a court, obligatory treatment of an infectious disease etc.
The overall limit of 2.500 and 5.000 CZK
If the total amount of regulation charges covered by the insured person (or his/her legal representative) exceeds 5.000 CZK per a calendar year, the health insurance fund is obliged to pay the insured person (or his/her legal representative) back the exceeding amount no later than 60 days after the end of the calendar quarter in which the limit was exceeded.
The overall limit for children under the age of 18 and for pensioners above the age of 65 is 2.500 CZK per a calendar year.
There are only the following regulation charges counted into the overall limit: regulation charges of 30 CZK and supplementary payments for prescribed medicaments and nourishments fully or partially covered by the health insurance that were issued on the territory of the Czech Republic.
The health care provider has to issue a document confirming payment of the regulation charge only on request of the insured person (or his/her legal representative).
|Aktualizováno ( Čtvrtek, 02 únor 2012 15:31 )|