Sweeping changes to Czech health insurance: here’s what you need to know

The biggest amendment to the Public Health Insurance Act for fifteen years includes some important changes.

Expats.cz Staff

Written by Expats.cz Staff Published on 18.01.2022 10:57:00 (updated on 18.01.2022) Reading time: 4 minutes

The Czech healthcare system has been put in the spotlight like never before in the last two years. The Covid pandemic has put the system under unprecedented strain, leading to an examination of which areas are working and which need reform.

As a result, a significant reform of the Public Health Insurance Act came into effect at the start of this year. The reform, drawn up by the previous Ministry of Health under former minister Adam Vojtěch, contains dozens of changes to the 61 sections of the law. These changes touch on the provision of standard vaccinations, the use of new medicines, the provision of home care and reproductive medicine.

Here are four key areas of change which you should be aware of as the new system comes into effect.

Health insurance companies to cover more vaccines

  • From January, people over 65 are entitled to free influenza vaccination. All health professionals will also be entitled to a free flu jab. The move is an attempt to rectify the Czech Republic’s low uptake of flu vaccination: only 7-8 per cent of the population is vaccinated against flu each year. The World Health Organization sets a target of 75 per cent vaccination among at-risk people; in the Czech Republic, coverage is currently only 21.8 per cent.
  • HPV vaccines will also be fully paid for by the state, preventing cervical cancer and other related problems. Public health insurance will now cover vaccines providing broader protection against HPV than previous kinds which only protected against the two most common virus forms. HPV vaccines have been provided in the Czech Republic since 2012 but vaccine coverage has declined in recent years, falling to 64 per cent among 13-year-old girls in 2020.
  • Vaccination against tick-borne encephalitis is also now covered by health insurance companies for everyone over the age of 50. The Czech Republic reports more cases of this disease than any other EU member state, but vaccine coverage is the lowest of all countries where the disease is common, with vaccine coverage at only 33 per cent in 2020.
  • Finally, vaccination against meningococcal diseases caused by group B meningococcus is covered by health insurance if the recipient is less than 12 months old or between the ages of 14 and 15. Other meningococcal vaccine subtypes are free for those who received a single dose between the ages of 1 and 2 or between 14 and 15.


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A simpler system for obtaining specialist drugs

  • Greater attention will be devoted to the use of innovative drugs in treating rare diseases. People who use such drugs have previously experienced complex reimbursement procedures, but now an advisory body of the Ministry of Health is to hold discussions with specialist medical companies, health insurers and the Ministry of Health on reimbursements. Joint decisions reached by this panel will lead to all patients who meet the criteria receiving the drug in question, meaning they will no longer have to go through lengthy individual application processes.

Reproductive health reforms

  • Health insurance companies will now pay for cancer patients to freeze their eggs so that they can still have children after the end of oncological treatment, which can affect female fertility. Until now, patients had to pay to freeze their eggs, costing up to CZK 60,000. Between 150 and 200 women diagnosed with cancer in the Czech Republic choose to have their eggs frozen each year.
  • Payments from health insurance companies for artificial insemination procedures have been expanded to include treatment given until the patient’s 40th birthday. Until now, treatment was only paid for among women under the age of 39, with four attempts at in vitro fertilization covered.

More powers for home care nurses

  • The new Health Insurance Act expands the competencies of home care nurses, who may now prescribe certain medical products as specified by an attending physician. Nurses may now prescribe bandages and other products to promote wound healing and cleaning, aids for incontinence and intestinal problems, and other use-at-home medical products.

Changes when visiting the dentist or orthodontist

  • A wide range of dentist procedures will now be covered by health insurers. These include the provision of higher quality dentures, false teeth, and braces for children and adults, although health insurance coverage may vary depending on the specific procedure or product required. For example, braces will be fully covered for adults whose teeth are causing them serious health problems, while a smaller contribution will be made for adults requiring braces for aesthetic reasons.
  • From January, orthodontist procedures are covered for those under 22 years of age.

Free lung cancer screening for those quitting smoking

  • Health insurance companies are newly offering free lung cancer screenings for heavy smokers over 55 years old. The only condition is that the patients will try to quit smoking.
  • Free screenings for rare diseases detected in blood samples from newborn babies will also be provided, with an expanded list of tested-for diseases. This free screening is currently being offered in a two-year pilot project, with the possibility of becoming a standard procedure if it proves successful.
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