One of the first things everyone faces when moving to the Czech Republic is the issue of health insurance. Not out of curiosity, but because it is essential for both processing residence documents and for the very first doctor's visit. The Czech healthcare system is logical and generally works well, but it has its own rules — especially for foreigners. This article will help you understand how everything works, what you are entitled to, and what to pay attention to first.
How the Czech Healthcare System Works
The Czech Republic has one of the strongest healthcare systems in Central Europe. According to the World Health Organization, the country has surpassed Germany and Austria in the quality and accessibility of medical services. This is evident in the well-functioning hospitals, qualified doctors, and clear patient pathways.
The system is based on the principle of mandatory insurance: all citizens and foreigners residing in the country are required to have health insurance. There are no exceptions — only different types of insurance depending on your status.
Czech medicine operates on a three-tier system:
Praktický lékař (general practitioner) — this is the first point of contact. In English, this can be called a primary care physician or family doctor. This is the person you should contact for any non-emergency health problems: colds, chronic illnesses, or for referrals to specialists. Without a referral from a general practitioner, you usually cannot see a specialist under insurance.
Specialists (specialisté) — cardiologists, neurologists, orthopedists, etc. They see patients with referrals. In some private clinics, you can make an appointment without a referral, but you will have to pay for it yourself.
Hospitals (nemocnice) — inpatient treatment, surgeries, intensive care. Referrals are made by either a general practitioner or a specialist. In emergencies, you can go directly through the emergency services.
A separate mandatory point for women is the gynecologist (gynekolog), whom you must choose just like your general practitioner, and separately — the dentist (zubař). After obtaining insurance, you must first register with a general practitioner and a dentist; for women, also with a gynecologist.
Insurance
Insurance in the Czech Republic is divided into two fundamentally different types: public (veřejné zdravotní pojištění) and commercial (komerční pojištění). The difference between them is significant — both in coverage and in who is eligible for each type.
Public Health Insurance (veřejné zdravotní pojištění)
This is comprehensive insurance that covers most medical services: doctor visits, tests, hospitalization, surgeries, prescription drugs (partially), childbirth, and emergency care. In terms of coverage, it is practically identical to what Czech citizens have.
Foreigners are eligible for public insurance if they have permanent residency in the Czech Republic (trvalý pobyt) — regardless of citizenship, or if they are employed by an employer registered in the Czech Republic.
EU citizens with permanent residency in the Czech Republic and family members of employed and self-employed individuals are also eligible for public insurance. However, there is an important caveat: family members of employed foreigners from outside the EU are generally not eligible for public insurance.
Contributions for public insurance are paid either by the employer or by the insured person themselves. In 2025, the monthly contribution for individuals without taxable income is 2,808 CZK per month.
Several insurance companies operate within the public insurance system. The largest is VZP (Všeobecná zdravotní pojišťovna České republiky): almost seven million residents trust it with their health care. Besides VZP, there are OZP, ČPZP, ZP MV ČR, and others. The insured person has the right to choose any of them and change if necessary — but no more than once a year.
Commercial Insurance (komerční pojištění)
If you are not eligible for public insurance, you are required to obtain commercial insurance. This applies to most foreigners in the initial stage — students, those who came for family reunification, self-employed individuals without Czech registration, and other categories.
According to amendments to the Act on the Residence of Foreigners, which came into force in August 2021, foreigners intending to reside in the Czech Republic for more than 90 days and not eligible for public health insurance are required to obtain insurance from Pojišťovna VZP, a.s. This regulation is extended until August 2, 2026.
Commercial insurance comes in three levels:
Základní (basic) — covers only emergency care. It is cheaper but not suitable for long-term stays.
Komplexní PLUS — specifically designed for long-term stays in the Czech Republic exceeding 90 days and covers the costs of most medical needs. This is the product accepted by the Ministry of Interior when applying for a residence permit.
Exclusive — a premium product, similar in coverage to public insurance. It also covers illnesses that arose before the insurance began — provided they were declared when the policy was issued.
Health insurance directly affects the validity period of your residence permit: if the policy is issued for only one year, your residence permit will not be granted for longer than that year. This means that when applying for a multi-year residence permit, it is better to obtain insurance for the corresponding period — up to 60 months inclusive.
Medicine for Migrants: What Depends on Your Status
The scope of available medical care and the type of insurance are directly determined by your residence status in the Czech Republic. Let's look at the main situations.
Long-Term Residence Permit (dlouhodobý pobyt / VNP)
This is the most common status for recent migrants. Most of them are employed, students, or family members of a resident.
Employed individuals (with an employment contract with a Czech employer) are automatically included in the public insurance system. Contributions are paid by the employer.
Students and family members are required to obtain commercial insurance (Komplexní pojištění). Family members of employed foreigners from outside the EU are not eligible for public insurance — they need commercial insurance.
Minors — a special case. All foreigners under 18 with a valid long-term residence permit automatically become participants in the public insurance system. Upon reaching the age of 18, they must obtain commercial insurance.
Permanent Residence Permit (trvalý pobyt / PMP)
Upon obtaining permanent residency, you automatically become a participant in the public health insurance system and are entitled to free medical care on par with every Czech citizen.
This is one of the key benefits of permanent residency: you no longer have to pay for a commercial policy annually, and access to healthcare becomes as comprehensive as possible. Permanent residency is usually granted after 5 years of continuous residence on a long-term permit (or earlier if there are grounds — marriage to a Czech citizen, Czech origin, etc.).
Temporary Protection (dočasná ochrana)
Citizens of Ukraine who arrived in the Czech Republic due to the war have received a special status — temporary protection. This grants access to the public health insurance system, but with important changes that occurred in 2025.
From February 11, 2025, individuals aged 18 to 64, after 90 days from the date of receiving temporary protection, are no longer automatically considered public insurance payers. In other words, the state no longer pays for adults by default after this period. After 90 days, you must independently inform your insurance company who is now the payer: your employer (if you are employed), the Labor Office (Úřad práce) (if you are registered as unemployed and receiving benefits), or yourself as a person without taxable income (OBZP). In the latter case, the monthly contribution from 2025 is 2,808 CZK.
For those whose temporary protection was granted before February 10, 2025, the period of public funding remains unchanged — 150 days.
Children under 18 and seniors over 65 are not affected by these changes — the state continues to pay their insurance contributions.
If You Don't Have Legal Status
Without a residence permit, a foreigner is not entitled to either public or long-term commercial insurance. The only thing guaranteed in any case is emergency medical care in life-threatening situations. You will have to pay for this yourself, and the costs can be very significant.
Medical Certificate for Obtaining Residence Status
This issue causes a lot of confusion: is a medical examination required when applying for a long-term or permanent residence permit? The answer is yes, but not always, and it's not a standard medical commission in the sense that people are used to.
When applying for permanent residence, the Ministry of the Interior of the Czech Republic may request a document confirming compliance with measures to prevent the spread of infectious diseases. This same document may be required for certain types of long-term visas. When applying for long-term residence, the document is provided upon request.
This is not a full medical examination, but confirmation that you are not a carrier of dangerous infectious diseases — primarily tuberculosis. Typically, this involves a chest X-ray or another examination prescribed by an authorized doctor.
The document is most often requested from citizens of countries with a high incidence of tuberculosis and a number of other infectious diseases. For citizens of most European and EU countries, this document is usually not required. For citizens of Ukraine, Russia, Kazakhstan, Uzbekistan, and other post-Soviet countries, it may be requested.
Where and How to Obtain This Document
If the document is indeed required, its issuance proceeds as follows:
If you are still abroad — you can obtain the certificate from an authorized doctor or a medical facility in your country, after which it must be translated into Czech and notarized.
If you are already in the Czech Republic — you need to contact an infectious disease specialist or the hygiene service (krajská hygienická stanice) at your place of residence. These authorities are authorized to issue the relevant certificates for the purposes of migration legislation.
In both cases, the document must be submitted within its validity period — its relevance is important.
You can clarify whether the certificate is needed in your specific case and where to obtain it directly from the migration department of the Ministry of the Interior of the Czech Republic (Odbor azylové a migrační politiky MV ČR) or on the website mv.gov.cz.
How to Use Czech Medicine
First of all, you should find and register with a general practitioner. You can find a doctor in your area through the National Register of Healthcare Providers (Národní registr poskytovatelů zdravotních služeb), where you can specify the required specialization and place of residence. Another convenient resource is registrlekaru.cz, which contains over 22,000 active medical practices with updated data.
Registration with a doctor is only possible after a personal visit and filling out a registration form at the doctor's office. Whether a new patient is accepted is always decided by the doctor themselves, based on their practice's capacity. Therefore, you may sometimes need to call several offices before finding an available spot. If you have been registered with another doctor for more than 3 months, you have the right to switch to a new one; the law does not allow this earlier.
Practical advice: when looking for a doctor, it makes sense to check if the doctor speaks Russian or Ukrainian. In large cities, especially Prague and Brno, such specialists exist, and insurance companies (mainly VZP) have relevant lists.
Pharmacies and Prescriptions
In the Czech Republic, many medicines are only available with a doctor's prescription (na recept). The prescription is issued on a special form or electronically (eRecept), which is the common standard. If you have public health insurance, part of the cost of prescription medicine is covered by the insurance company; the patient pays the rest. Pharmacies (lékárna) are in every district, most operate during standard business hours, and on-call pharmacies are open 24/7.
Ambulance: 155
Ambulance services (záchranná služba) in the Czech Republic are free. The emergency number is 155 (or the single European emergency number 112). You should only call an ambulance in truly emergency situations – life-threatening conditions, serious injuries, heart attack, stroke, etc. There may be a fine for an unjustified call.
Useful Resources
mv.gov.cz — official website of the Ministry of the Interior of the Czech Republic, information on visas, residence permits, permanent residence
vzp.cz — the largest insurance company, has sections in Russian and Ukrainian
pvzp.cz — Pojišťovna VZP, insurance for foreigners
nrpzs.uzis.cz — registry of medical facilities for finding a doctor
registrlekaru.cz — directory of doctors with ratings and contacts
Ministry of Health helpline: 1221
Czech healthcare is not a maze, but a completely understandable system if you know its logic. The main rule: your type of insurance and the scope of available care depend on your residency status. If you have a job with a Czech employer, you are welcome to the public system. If you are in the process of obtaining a residence permit without employment, get commercial insurance and do not skimp on its level. If you have received permanent residence, you can use healthcare at the same level as citizens of the country.
Do not postpone getting insurance; it is real protection that may be needed at any moment. And remember that conditions – especially for Ukrainians with temporary protection – change, so always check the current information on the official websites of VZP, the Ministry of the Interior, and the Ministry of Health of the Czech Republic.
