A Brief Summary of the Czech Health Care System:

1. Who is insured?

The Czech system is founded on an obligatory health insurance where insured people, employers and the State contribute to.

People with the residence in the territory of the Czech Republic and employees of employers with their seat in the territory of the Czech Republic are insured by law.

People undertaking business from other EU-countries have had to be insured by law since 1st May 2004 too who undertake their business in the Czech Republic as well as the employees of employers with the seat in other EU-country.

Each insured can change his/her health insurance company once a year.

2. Who pays the contributions?

1. The employee and employer pay altogether 13.5% of the gross income. The employee pays 4.5% and the employer 9% out of it.

2. People undertaking business pay 13.5 % of 50% of their profit. The minimal contribution is 1360 CZK in a month.

3. People without a taxable income (f.e. housewives) pay their contributions themselves. The monthly contribution is 1080 CZK.

4. The State pays the contributions for unemployed, pensioners, students, women on the maternity leave, women taking care of one child less than 7 years old or more children less that 15 years old, prisoners, soldiers and people receiving social security benefits.

The State pays the contributions for 53% of  the population. The contribution makes up 13.5 % of 80% of the minimum wages. At present the State pays for the state insured about 500 CZK in a month.

The individual health insurance companies are collecting the contributions directly from employers, employees and people undertaking business and people without a taxable income. The State pays the contributions to the so called Redistribution Fund. The collected contributions are devided to the individual health insurance companies from there.

3. Health Insurance Structure:

The Czech health insurance system is administered by nine health insurance companies. The biggest one, Všeobecná zdravotní pojišťovna /The General Health Insurance Company/, covers with its insurance 66% of the population. Its ability to pay is guaranteed by the State. Its activities are governed by a special law called Act on the General Health Insurance Company. The other eight health insurance companies are governed in their activities by the Act on Employee Insurance Companies.

Six health insurance companies are active in the whole territory of the Czech Republic, the rest is focused on certain regions only.

Health insurance companies are not allowed to make profit.

Although it was the original intention that health insurance companies should be competitive in their various services, they have not much space for their competition at present.

4. Health Care Paid from the Health Insurance

• preventive care
• diagnostic care
• ambulant and hospital care, including rehabilitation and care of chronical diseases
• dental care
• medicaments and medical aids
• patient transport
• spa care

There are three lists of medicaments. The medicaments stated in the first one are fully paid for by the health insurance company. The medicaments stated in the other two lists must be partially or fully paid for by the patient.

Only the basic material and treatment is paid in the case of a dental treatment.

Only a small part of health care is not paid from the health insurance, for example cosmetic surgery without any health reason.

Medical aids are paid from the health insurance fully or partially.

The financial participation of patients in the costs of the Czech system of health care is about 8 % in average. It concerns medicaments and dental care above all.

5. Contracts with Health Care Providers

There are regular frame dealings among the representatives of health care providers, health insurance companies, hospital associations, scientific organisations and patient associations. The result of these dealings are the so called frame contracts. The health insurance companies make their contracts with the individual health care providers based on them. The conditions of the individual contracts can be partly different.

The health care provider can make a contract with more or even with all health insurance companies.

Only a very small procentage of health care providers has not made a contract with any health insurance company.

6. Other Financial Sources

Besides the system financing from the system of the compulsory health insurance there are other, less important financial sources. These are mainly the contributions from state or regional budgets, patients´ financial participation or donations.

7. Expenses

The overall yearly expenses of the Czech system of the health insurance are about 6 billion EUR.

The average yearly expenses for a person insured are about 500 EUR.