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Czech Republic’s Private Health Insurance Issues

Czech Republic’s Private Health Insurance Issues

Unhealthy system of private cover might not cover all you need

Czech Republic’s Private Health Insurance Issues

Czech Republic’s Private Health Insurance Issues

Unhealthy system of private cover might not cover all you need


Published 26.11.2012
Last updated 13.05.2013
COMMENTS (16)

VIEWS (16541)


About 100,000 foreigners with long-term visas are required by law to have Czech private health insurance. The group includes foreign students, self-employed people, and the spouses of foreigners working here. But according to the Campaign for Health Insurance for Migrants all foreigners should participate in the public health care system.

The requirement to take out private insurance for these people was part of legislation brought in 2010. The product needed for a visa was comprehensive health insurance (komplexní zdravotní pojištění) which should cover visits to the doctor and hospital care as well as emergencies.

A justification given for new requirement was to ensure that doctors and health professionals would be paid. The implication being that foreign insurance companies didn’t pay or the money was too difficult to obtain.

Personal Care?

For some foreigners who are clients of these private companies, this rationale must ring with the bitterest irony. The Campaign for Health Insurance for Migrants has been collecting testimonies from people from Ukraine, Uzbekistan, Australia, and Mongolia. The individuals concerned had complex health insurance from a range of companies. The accounts are cause for concern.

One woman from Uzbekistan followed the regulations and took out insurance with PVZP – the private arm of VZP which provides insurance to foreigners. According to her story, many doctors refused to accept this insurance. A Ukrainian woman attempted to visit doctors on the list provided by her insurer UNIQA. None of the listed doctors would treat her without cash up front, which she eventually had to pay. A fellow countryman of hers was told at Motol that he was “another Ukrainian with the wrong insurance”.

The lack of proper coverage has touched at least one Czech. “Jan”* has a wife from South America. Though they’re married, she still requires private health insurance because she hasn’t been granted residency. Jan has spoken up because of the poor nature of the conditions provided by private insurance, the poor service for foreigners, and the discriminatory nature of the policy.

“We’re scared of a situation in which my wife needs treatment,” he said.
(*He has asked us to not reveal his identity for fear of problems for his partner.)

Unhealthy System

Maybe irony is the wrong word. Irony (at least in the historical sense) implies an unintended or opposite outcome. Maybe the companies never planned to ensure that medical treatment was paid, at least not by them, or so alleges Linda Janků of SEHNUTÍ, one of the groups who are a part this campaign.

“The reality is that the health insurance companies enter into the contract many conditions so that basically when the migrant needs the health care to be paid, it’s not paid,” she said.

The campaign explains that one reason for the inadequate coverage is the exceedingly high running costs of the private insurance companies. An analysis compiled for the Campaign for Health Insurance for Migrants shows running costs for the five Czech insurance companies averaging 63% with 22% going towards health care. In one instance, an insurer only paid 11% of its earnings toward insurance.

Spokespeople from some of the companies responded to these figures. Maxima didn’t deny the figure but their spokesperson Olga Herko said in an email, “Total operating expenses include a wide variety of items, one of which is commission for the acquisition of contracts.”

Slavia rejected the figure included in the analysis. Spokesperson Aleš Povr said, “Commercial health insurance for foreigners with lower cover but higher rates of claims can’t have a claim amount of 11%.” However, they would not provide the figure of how much their claims came to.

PVZP’s spokesperson Robert Kareš also rejected the figure included in the analysis. He went on to add that PVZP’s mother company VZP doesn’t agree with the inclusion of migrants here on long-term visas to be included in the insurance system.

Kareš added, “The problem of the whole of this campaign is the sheer ignorance about these systems and subsequent erroneous presentation of knowledge.”

Suffer the Children

Age is no guarantee of care. Another case provided by the campaign concerns a young girl who had to have surgery. The surgery was covered by the insurer – until a second doctor changed the diagnosis. The girl’s family had to fight to have the original diagnose recognized in order for the surgery to be covered.

Even when the company covers a child’s treatment, the fact that foreign children don’t participate in the public medical system is a particularly thorny one for the Czech state. The Czech Republic is a signatory to the Convention on the Rights of the Child [http://www2.ohchr.org/english/law/crc.htm]. Article 24 of that document states a signatory’s obligation is regarding the provision of health services to children.

Elena Tulupová, a lecturer in public health at Charles University, is another member of this campaign. She said, “In the questions regarding health it is absolutely inappropriate that in a European state children can’t get proper health care.”

The Ministry of Health interprets the Czech Republic’s obligation differently. “The said obligation does not mean that it has to be borne by public health insurance,” their spokesperson Libuše Bořská wrote via email.

The reasoning is that the health system, in the Ministry’s view, is inherently designed ‘for those who fund it.’

Turning Away Business

The problems with the private insurance system for foreigners affect practitioners as well. Tim Young is from Young and Co. a private medical practice in Dejvice. They have a number of patients from the expat community, and while this should be good for business, they have to turn people away.

“Our problem is that we have about a third of our patients who are non-Czech but who consume maybe half of our time whilst bringing no more revenue than Czech patients (being covered under public health insurance),” he said.

An additional problem is the unreliability of the insurance.

“There are also frequent problems with VZP retroactively cancelling insurance for foreigners after our services have been provided, in which case we do not get paid,” Young added.

Ministerial Response

According to the campaign, the Ministry of Health’s argument against including foreigners who have long-term visa is that they fear “health tourism.”

Ministry spokesperson Bořská, wrote, “This possibility [medical tourism] must be envisaged and, of course, must be taken into account because it cannot be ruled out.”

Bořská points to the general concern of “social tourism” in the EU as justification for concern. However, she claims that this concern is not “the driving force in deciding on the possibility of extending the personal scope of the law.”

The Campaign for Health Insurance for Migrants counter this argument by pointing out that most foreigners who come are between 18 and 65, the very age group which draws on health care the least.

Are the cases above isolated? One way to find out is from your responses. Are you getting the health care you’ve paid for? Should migrants participate in the state health care system?

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Rita(Guest) Published: 07:40:34 07.07.2013
Hello me and my husband moving to CR from Israel we would like to know which health insurance is the best and the real one with no problems ????please it's very important for me because I would like to have a baby in CR I'm 23 and my husband is 30
DR. L(Guest) Published: 08:21:02 14.05.2013
I am leaving the CR because of this law. My husband and I came here 6 years ago. He is retired and is fully covered by insurance in our home country. We purchased what was called "travelers" insurance for him for the first few years. It's basic purpose was that it would stabilize him and ship him back to our home country if there was a problem. I was working as a instructor at the University. With a JUDr, many years of experience and being a native speaker, the University was happy to have me. Even with the terrible salary, we were enjoying our stay and this wonderful country. Then the law changed and my husband now had to buy "complex" insurance,..that would "stabilize him and ship him home if there was a problem." The only difference was the price. It was now going to take 1/3 of my take home pay as a full time instructor, just to pay this insurance. We didn't come here to make money, but we can not justify loosing money just to stay. So bye, bye Czech Republic,...what a terrible law.
Comment from: Published: 11:25:52 27.03.2013
"Where to start? At the top and work down? Quote: "A justification given for new requirement was to ensure that doctors and health professionals would be paid. The implication being that foreign insurance companies didn’t pay or the money was too difficult to obtain." Please cite where this is from. This is incorrect. The legistaion was brought in to stop fraud. Namely people coming to CR with fake health insurance. There was a LOT of fake health insurance used by immigrants before this legislation was brought in. The Czech tax payer was having to pay for a lot of health care for people who had fake insurance. "For some foreigners who are clients of these private companies, this rationale must ring with the bitterest irony. " You do not say why this is irony. "One woman from Uzbekistan followed the regulations and took out insurance with PVZP – the private arm of VZP which provides insurance to foreigners. According to her story, many doctors refused to accept this insurance" Heresay and a "story" "A Ukrainian woman attempted to visit doctors on the list provided by her insurer UNIQA. None of the listed doctors would treat her without cash up front, which she eventually had to pay" Uniqa does not have a "list of doctors". Uniqa has a list of contracted hospitals where the insurance can be used. With Uniqa if you use a doctor that is not at one of the hospitals, a patient would pay and then claim the money back from Uniqa. " A fellow countryman of hers was told at Motol that he was “another Ukrainian with the wrong insurance”. Heresay. She said someone siad that.... Should not be used as a source. " Jan has spoken up because of the poor nature of the conditions provided by private insurance, the poor service for foreigners, and the discriminatory nature of the policy." Again. Someone said that someone said something. (*He has asked us to not reveal his identity for fear of problems for his partner.) Yes. he should be careful. Health insurance compnaies often check expats cz to see what people say about them and always cancel the eprsons contract in such a case. Not. “The reality is that the health insurance companies enter into the contract many conditions so that basically when the migrant needs the health care to be paid, it’s not paid,” she said." The reality is that: prexisting conditions are not covered by Czech private health insurance. That is most of what you should be saying. "Age is no guarantee of care. Another case provided by the campaign concerns a young girl who had to have surgery. The surgery was covered by the insurer – until a second doctor changed the diagnosis. The girl’s family had to fight to have the original diagnose recognized in order for the surgery to be covered." But the child got the care! What is the point of this parafraph? This could happen anywhere with any helath insurance. This is about doctors disagreening on a treatment. Which the child got after all. Young and co as far as I am aware do not accept PVZP. They do however accept VZP. So this section is eronious. This section is talking about STATE health insurance and... That is where I give up with this article. I could go on but.... This artcile is false and misleading. The author did not understand the subject and should have spent more time in this. Is Expats.cz is trying to be a "newspaper" ? if you are pls. Pay more and employ a journalist. So one who knows the rules on citation." This person is clearly Czech. Blindly defending flawed and often discriminatory practices without any actual experience in obtaining insurance as a foreigner. Do yourself a favor and stop reading the local news sources. Most media outlets here are blatantly controlled propaganda machines whose purpose is to shift the pressure of failed government policies on to migrant workers. State failing? Blame immigrants. "What is the point of this parafraph? This could happen anywhere with any helath insurance. " Ah, the timeless defense of bad Czech service. It's probably crappy somewhere else so we won't bother to try and improve the situation here.
Comment from: Africanwoman Published: 01:54:00 27.02.2013
l have been using UNIQA for sometime now. l have never had a problem. The one that beat my mind was when l was pregnant every was fine including major surgery with comprehensive policy; they paid till the last korona, though that clause has been expunged now. The secret is that if you are going to hospital motol and the rest call Coris they will inform foreigners dept that you are coming or if you need a GP, GYN-OB they can make provision for you. l have used some doctors that do not accept UNIQA, l paid cash upfront later insurer paid without stress so long as you give them copies of the medical reports and within a time frame too.
me(Guest) Published: 10:02:50 27.02.2013
Where to start? At the top and work down? Quote: "A justification given for new requirement was to ensure that doctors and health professionals would be paid. The implication being that foreign insurance companies didn’t pay or the money was too difficult to obtain." Please cite where this is from. This is incorrect. The legistaion was brought in to stop fraud. Namely people coming to CR with fake health insurance. There was a LOT of fake health insurance used by immigrants before this legislation was brought in. The Czech tax payer was having to pay for a lot of health care for people who had fake insurance. "For some foreigners who are clients of these private companies, this rationale must ring with the bitterest irony. " You do not say why this is irony. "One woman from Uzbekistan followed the regulations and took out insurance with PVZP – the private arm of VZP which provides insurance to foreigners. According to her story, many doctors refused to accept this insurance" Heresay and a "story" "A Ukrainian woman attempted to visit doctors on the list provided by her insurer UNIQA. None of the listed doctors would treat her without cash up front, which she eventually had to pay" Uniqa does not have a "list of doctors". Uniqa has a list of contracted hospitals where the insurance can be used. With Uniqa if you use a doctor that is not at one of the hospitals, a patient would pay and then claim the money back from Uniqa. " A fellow countryman of hers was told at Motol that he was “another Ukrainian with the wrong insurance”. Heresay. She said someone siad that.... Should not be used as a source. " Jan has spoken up because of the poor nature of the conditions provided by private insurance, the poor service for foreigners, and the discriminatory nature of the policy." Again. Someone said that someone said something. (*He has asked us to not reveal his identity for fear of problems for his partner.) Yes. he should be careful. Health insurance compnaies often check expats cz to see what people say about them and always cancel the eprsons contract in such a case. Not. “The reality is that the health insurance companies enter into the contract many conditions so that basically when the migrant needs the health care to be paid, it’s not paid,” she said." The reality is that: prexisting conditions are not covered by Czech private health insurance. That is most of what you should be saying. "Age is no guarantee of care. Another case provided by the campaign concerns a young girl who had to have surgery. The surgery was covered by the insurer – until a second doctor changed the diagnosis. The girl’s family had to fight to have the original diagnose recognized in order for the surgery to be covered." But the child got the care! What is the point of this parafraph? This could happen anywhere with any helath insurance. This is about doctors disagreening on a treatment. Which the child got after all. Young and co as far as I am aware do not accept PVZP. They do however accept VZP. So this section is eronious. This section is talking about STATE health insurance and... That is where I give up with this article. I could go on but.... This artcile is false and misleading. The author did not understand the subject and should have spent more time in this. Is Expats.cz is trying to be a "newspaper" ? if you are pls. Pay more and employ a journalist. So one who knows the rules on citation.
Comment from: Published: 06:53:14 08.12.2012
There seems to be compelling arguments from both sides here. However, I have had Private Health Insurance from PVZP (via vzpforforeigners.cz) for the past 3 years and I have never had a problem locating an English doctor who accepted my insurance. I also like the fact that with private health insurance, I can easily terminate coverage if I leave the country without having to pay penalties or interest. I have heard horror stories of foreigners who had public health insurance and were hit with hugh penalties because they didn't properly terminate their coverage.
Comment from: Published: 12:02:54 29.11.2012
@Curus10 You might be right that under a study visa you have to have private health insurance. As far as your dental goes, I cannot tell you but it sounds like you are being taken for a ride which happens often here. When they see a foreigner they see money. All I can tell you is to check your policy and see what it covers. As far as seeing a certain health professional - I cannot say this often enough, it really helps if a Czech recommends you or goes with you and this is not just for health issues. If you have VZP insurance, the office in Vinohrady has a lady that speaks really good english (and sorry but do not remember her name). Just ask if someone speaks english, you might have to wait longer but it is worth it. By the way, anybody who works here legally, either on HPP or ZL has to have health insurance, it has nothing to do with being a permanent resident. You can work here on a temporary resident visa. I would recommend VZP if this is the case, even my CZ wife changed to VZP because they cover more health issue than other companies even pregnancy issues and psychological issues if diagnosed through a health professional.
Klo(Guest) Published: 03:30:08 28.11.2012
Everybody complain about but what will be the real solution?? why we should pay in one the total amount and not monthly completely unfair.. we pay in front desk and the doctors ask for more money than normal and insurance dont pay it because..they always find a because.. also private insurance say that you can go to every doctor and when you go to "any " doctor,, doctors say the dont acept it...
Helena(Guest) Published: 10:21:52 28.11.2012
To mariapapax: There is substantial difference between public health insurance and private health insurance for foreigners. Public health insurance is mandatory for all entitled persons ( Czech residents )and all needed care to all insurers is covered. Co-payment exists but it is on an accepatble level. ) Private health insurance is another story. Who will be insured and for what ( i.e. covered health services) - it depends on health insurance companies themselves. Law regulation is minimal. In comparison to public health insurance - scope of covered health care is limited and cash payment is usually required- Later on, money is reimbursed by private insurance compan\y. This procedure is not possible to apply in public health insurance.
Comment from: Published: 04:23:48 27.11.2012
@fld: I did not expect neither do I ask for any special treatment! All I asked for is fair dealing which is also normal. I have not been here as long as you but I was told that I cannot pay monthly like you because I am NOT a permanent resident like you, so the issues may be a bit different. As for dental care; why do locals pay half price in comparison to what I pay when I am actually on 'comprehensive insurance?'
Comment from: Published: 12:46:59 27.11.2012
The new private insurance companies targeted at compliance with the labor law for foreigners are nothing but a scam. You may need legal representation to force a payout for anyone that can be a preexisting condition. Being a mortal human is a preexisting condition. Everyone has hidden flaws in their body.
Comment from: Rev_Katz Published: 08:44:00 26.11.2012
We have Maxima. While they don't cover at any of our regular doctor appointments...mostly because our doctors have no idea how to bill them, they have covered without any problems at our local hospital for a variety of hospitalizations we have had over the past year including appendectomy, and a week-long stay due to pneumonia for our young son.
Comment from: Published: 04:28:45 26.11.2012
I have been here for 6 years now and have VZP insurance. I have frequented the doctor very regularly here, including a two week stay in hospital for a collapsed lung. I have had the same service, benefits and charges as Czech's. I work on ŽL and pay my health insurance every month (about 1650CZK). In my opinion the Czech health is extremely good value for money compared with other western countries (in NZ for example you pay 900 CZK for a doctors visit up front and if you have health insurance you get 80% back, here i pay 30 CZK), however the services and attitude of the health care givers is another thing. Let's just say it is below average (being kind, aldo it helps very much if you have a CZ friend or partner who recommends you). As for dental - not sure what you used to Curus 10 but in most countries your basic health insurance does not cover dental. This is the same for Czech's, your not special and as far as studying here and having to abide by the rules of the land - I would have thought that normal as well.
Comment from: Published: 12:58:35 26.11.2012
This debate will properly end just like all the other discriminatory rules in C.R. I applied for my study visa with an health insurance company accepted by the Czech embassy but when my visa was approved, the embassy insisted I must get an insurance from the Czech republic or forfeit my study visa simply because the law has been changed and it acts retroactively! A year later, when I want to renew my visa, the law was changed again, now, I need to get a 'comprehensive insurance' which cost me 18,000czk but my dentist refused to accept it even though it was PVZP. I am paying out of pocket for my dental care. I simply been robbed yearly with the funny comprehensive insurance that does the same thing as the basic I had previously which is provide nothing! Of course, I would prefer not to buy them but then my visa renewal is based on me having this useless comprehensive insurance! This is not only discriminatory but criminal that am paying so much at once but still get no service for my money!
Comment from: Kraig Published: 11:30:17 26.11.2012
Another major problem with foreign insurance is that it does not cover pre-exisitng conditions because you have to constantly renew your insurance to coincide with your visa . From what I can know pre-exisitng conditions will not be covered for foreigners ... at least self employed foreigners ... until they are here long enough to obtain permanent residency.
Comment from: Published: 11:10:14 26.11.2012
The article is so write.I myself have experienced the same thing, I have VZP insurance and when I tried to visit an ob-gyn from the list provided by Vzp doctor told me that he does not have any time for me. If I had another kind of insurance he would make time for me. I was so angry and frustrated. I am a foreigner, but I contribute to the Czech health system. Private or Public health insurance is the same, the conclusion is that you can not find good treatment and health care unless you pay cash upfront.