Rights and liabilities of Participants in Public Health Insurance
Rights and liabilities of Participants of Long-term Contractual Insurance

Rights & Obligations of Foreign Nationals Receiving Healthcare in the CR

Participants in Public Health Insurance

A foreign national who is a participant of the system of public health insurance has the following rights:

• choice of health insurer - the health insurer can be changed once every 12 months, but only by the first day of each calendar quarterly,

• choice of doctor and healthcare facility (with the exception of company health services), which are in contractual relations with the relevant health insurer - the policy-holder may exercise this right once every three months,

• choice of health transport services in contractual relations with the relevant health insurer,

• to healthcare without direct payment (with the exception of procedures which, by law, are not covered by public health insurance) - the health insurer may also cover the costs of health operations or treatments which are otherwise not covered by the resources of public health insurance, if it is proven that in the given case they are the only possibility for healthcare,

• to be issued with medicaments without direct payment, if it concerns preparations covered by public health insurance,

• to make complaints when there are doubts as to whether care was provided in a proper way - the policy-holder can turn to the management of the healthcare facility or to its founder, to the Czech Medical Chamber, Czech Dental Chamber, Czech Pharmaceutical Chamber or to the health insurer.

If in doubt on the proper complaint procedures you can turn to an ombudsman (you can find contact in Adress Book-“Kancelář veřejného ochránce práv”-The Office of the Ombudsman).

The policy-holder has the following liabilities:

• to pay premiums to the relevant health insurer,

• to cooperate during treatment,

• to submit to, as required, the given preventative measures,

• to avoid activities that can endanger personal health,

• to provide a valid health insurance card or alternative document for the provision of healthcare, with the exception of the provision of medicaments and medical technical means,

• to fulfil the liability to inform the health insurer (in the case of a lost insurance card within 8 days, in the case of a change in personal circumstances within 30 days).

Participants of Long-term Contractual Insurance

Foreign nationals insured on the basis of long-term contractual health insurance have the following rights:

• to healthcare, to the extent established by the General Insurance Conditions, from doctors and healthcare facilities which have contracts with VZP in the area of contractual health insurance,

• to a refund of the cost of the preliminary medical check-up for the purpose of concluding insurance, on condition that the contract is concluded,

• to coverage of provided healthcare to a maximum of 1,000,000 CZK,

• share in the regulation of provided healthcare and, in the case of ambiguity, the right to seek a second opinion,

• to information on the part of the insurer.

Long-term contractual health insurance policy-holders have the following liabilities:

• to submit to preventative check-ups, anti-epidemic and hygiene measures set by public health protection authorities,

• to present true and timely information on contractual health insurance.