A foreigner from the EU, the EEA, or Switzerland who does not have permanent residence in the Czech Republic may be insured in the Czech public health insurance scheme either by law as an employee or on the basis of European regulations (e.g. as a self-employed person pursuing independent gainful activities on a long-term basis solely in Czech Republic).

A foreigner with permanent residence in the Czech Republic is obliged to register for health insurance in the Czech Republic as soon as he/she obtains the Czech citizenship.

The duties of foreigners posted to the Czech Republic from countries outside the EU, the EEA, and Switzerland are governed by bilateral international agreements.

Citizens of another Member State of the EU or the EEA or Switzerland working in the Czech Republic have the same duties in the area of health insurance as Czech citizens (see Employees in the Czech Republic; Self-employed Persons in the Czech Republic). With regard to the mobility and free movement of employees, self-employed persons and all EU citizens, special provisions of Regulation (EC) No 883/2004 on the coordination of social security schemes apply.

Example

I am a Belgian dancer. I have been working as a self-employed person in a theatre in the Czech Republic for a long time, but I am moving back to Belgium now. I pay health insurance contributions to a Czech health insurance company at present. How should I proceed now?

If you decide to terminate your activities in the Czech Republic and return to Belgium, i.e. a Member State of the EU, the EEA, and Switzerland, on a long-term basis, you will become subject to the Belgian social security and health insurance scheme from the moment you start your activities in Belgium. This entails the duty to get re-registered for these schemes in Belgium, which means to notify relevant authorities of your resumption of self-employment activities in Belgium. This also means that you will no longer be subject to the Czech system and you will have to notify Czech authorities (the social security administration, the health insurance company, or the labour office) of this fact before your departure.

Along with terminating your insurance in the public health insurance scheme in the Czech Republic you cease to be obliged to pay the insurance contributions as of the day stated in the written notice, but not earlier than the day following the day when the notice was delivered to the health insurance company. On the other hand, the duty to pay the contributions arises on the day you gets re-registered with your health insurance company after your return from abroad. After the return, you are obliged to provide the health insurance company with a proof of your health insurance abroad and the length of the insurance. This duty is essential, because if you failed to submit this document, you would be obliged to pay premiums to the health insurance company in such an amount as if you had not proceeded according to the above-cited provisions on a long-term stay abroad. Citizens of the EU, the EEA, or Switzerland usually have to submit a proof insurance abroad to their health insurance company even if they were subject to the regime of the “European” coordination regulations.

For this purpose, ask the Czech health insurance company for the E104 form before your departure from the Czech Republic or for another certificate proving that you were insured under the health/social scheme of another country while being deregistered in Belgium.