Health Insurance

Like social security, health insurance is subject to the national legislation of each individual country.

In the EU, the EEA, and Switzerland, the national health insurance systems of individual Member States are not harmonised, but merely coordinated. In some cases, coordination replaces the national rules that are disadvantageous for migrating citizens. The principles of posting of employees and self-employed persons who are EU citizens to another EU country are governed by Regulation (EC) No 883/2004 of the European Parliament and of the Council. Under the coordination regulations, you are subject to the legislation of only one Member State. You have health coverage in that country and pay regular health insurance contributions to the country’s scheme, as well as social security contributions, even from income generated from activities you carry out in another Member State.

The right of EU citizens to use health care in other EU countries is also based on Directive 2011/24/EU of the European Parliament and of the Council on the application of patients’ rights in cross-border health care, which supplements the EU’s coordination regulations.

In countries outside the EU, the EEA, and Switzerland, health insurance is regulated by international social security agreements, which have mostly the form of bilateral agreements between two countries and contain also provisions concerning health insurance of migrating persons and the scope of its coverage. A complete and updated list of the existing international agreements is available on the website of the Ministry of Labour and Social Affairs.

As regards countries that have no social security agreements with the Czech Republic, it is important to inquire about the regulations of the particular country and follow them. Taking out a travel health medical policy is also very important.

Example

I am an artist paying health insurance contributions as a self-employed person in the Czech Republic. I am leaving for France to stage a three-week exhibition. What are my duties towards the health insurance company? Do I have to continue paying the contributions to my health insurance company in the Czech Republic if I am going to work outside the Czech Republic?

Health insurance in the EU, the EEA, and Switzerland

If you are going to work temporarily (such temporary period is specified in the Czech legislation and may be regulated by a coordination regulation of the EU) in a Member State of the EU, the EEA, or Switzerland – which applies to France in this example – you will be subject to its social security legislation, which also governs health insurance, according to Regulation (EC) No 883/2004 of the European Parliament and of the Council.

If you work abroad temporarily (for up to 24 months), you are not required to deregister from health insurance in the Czech Republic. As a citizen of the Czech Republic having health insurance with one of Czech health insurance companies you are the holder of the European Health Insurance Card (EHIC), which is valid in the 28 EU Member States as well as in Iceland, Liechtenstein, Norway (EEA), and Switzerland.

If you need medical treatment in another Member State, you are entitled to medical treatment that will be provided and covered to the necessary extent under the same conditions as local citizens, including the level of the patient’s co-payment. Such care will be provided at the expense of your health insurance company in the Czech Republic. To prove that you are insured in the Czech Republic you can submit the European Health Insurance Card (EHIC) or its Provisional Replacement Certificate issued by your health insurance company. Since the care is only provided to the necessary extent, it is advisable to take out a travel medical insurance policy before your departure abroad.

Example

I am an employee in the cultural sector working for an organisation with a registered office in the Czech Republic which has posted me to Israel for 24 months. Where am I obliged to pay health insurance contributions?

Health insurance outside the EU, the EEA, and Switzerland

 

The Czech Republic and Israel have an international agreement on social security, which also relates to health insurance and stipulates that if an employee is posted by his/her employer having its registered office in the territory of one contracting party to the territory of the other contracting party to perform work for the same employer, the employee is subject to the legislation of the former contracting party until the end of the 36th calendar month after the posting as if he/she was still employed in its territory.

Your employer will therefore pay the social security and health insurance contributions in the Czech Republic for you. Since health care covered by your health insurance will be provided abroad only to the necessary extent, it is recommendable to take out a travel medical insurance policy before your departure abroad.