Everything you need to navigate care in Czechia.

The participant chooses one public health insurance company, proves himself with a valid ID and reports changes important for participation and payment of insurance premiums. Depending on the situation, the insurance premium is paid by an employer with an employee, a self-employed person, a self-payer or a group defined by law. In the event of a change of job, residence, birth of a child or the end of another insurance relationship, contact the insurance company without delay.

Indicated prevention, examination, diagnosis and treatment are reimbursed in the public system to the legal extent, usually by a contracted provider. Some dispensaries require a referral or have limited capacity. An administrative act without a medical purpose, an unpaid performance or the chosen variant may be paid.

The insurance company fully pays for preventive examinations and screenings to the extent and frequency set by regulations. For adults, a general preventive check-up with a registering general practitioner is standard once every two years; other programs depend on age, gender and risk. As a rule, the patient keeps track of the appointment and makes the order himself.

Indicated acute and inpatient care is covered by the public insurance network. During hospitalization, necessary medicines and medical devices are paid for by the hospital. A statutory regulatory fee may apply for use of the emergency medical service; check the specific mode with the workplace. Extra personal service may be charged.

Reimbursement depends on the specific drug, indication and prescription. Some medicines are fully reimbursed, others have deductible or non-deductible co-payments or are not reimbursed. At least one fully paid option should be available in the therapy group. eRecept tracks creditable co-payments against the protective limit; consult a pharmacist about an interchangeable variant and do not change the treatment without a doctor.

Reimbursement of the aid, rehabilitation, spa care or medical transport depends on the diagnosis, indication, prescription, possible approval by the insurance company and legal limits. The eVoucher is not a substitute for approval where required. A routine trip to the doctor is not automatically covered; medical transport must be justified by the medical condition.

Preventive and basic dental care provided by law is covered. Material, product or method chosen above the covered range may have a surcharge or full price. Before the procedure, ask the dentist to distinguish between paid and paid options and the written price.

Get an explanation of which performance, material or service was billed and why. Request item receipt and medical report. Verify reimbursement with your insurance company; start a complaint about the provider's procedure with him, then the relevant administrative authority can be used. Don't delay needed acute care because of an administrative dispute.