On May 1st 2016 The US and CZ governments signed an agreement for Public Health Care for US citizens on a Zivno / Trade License (but without permanent residence permit). For many years these US citizens could not enroll into Public Health Care, but from 1.5.2016 they have the obligation to do so. There is no longer the choice to pay (in advance) for commercial health insurance. Instead, monthly contributions, which height depends on the income, have to be made.

Note that many people think that Public Health Care is VZP. This is not entirely the case. VZP is just one of the companies through which Public Health Care can be obtained, but there are others, such as OZP or VOZP.

To make it more confusing: many people purchased a commercial health insurance, thinking it is from VZP, but in reality it is from PVZP (a blue widget under the red trianglular logo is the definite proof it is PVZP, not VZP - the VZP has the red triangular logo *without* the blue thingy, and VZP does not issue printed paper insurance cards - only hard plastic ones.)

Very, very annoying is that nor the public neither the personnel at the insurance companies was notified of this important change.

In the mean time (2017) it has become clear that VZP and OZP respond differently (important!).


When joining VZP, one can expect to pay monthly contributions and penalties for late payment, starting from May 2016 (so not from the moment you register at Public Health Care) and to make matters worse: expect no or only partly refund for the already paid commercial health insurance (see text below).

At least at VZP it is possible to file a request for waiving the penalties for late payment - but we do not have enough data from the field to be able to determine how well this works.

PVZP has agreed to refund the fee for the unused part of the commercial insurance (with subtraction of a 20% handling fee) in case of switching to VZP.


When joining OZP, it does not charge monthly contributions or penalties from 1.5.2016 - with OZP one pays monthly contributions from the month one signed up. That seems to be a better deal than with VZP.

What to do with the commercial insurance once you have the Public Health Care

Some, but not all, commercial insurances are willing to refund part of the insurance once you have joined public health care - note that conditions very per company and insurance type. We have no further information, it is best to ask at source.

New Visa Applications

Generally speaking, (Business) Visa applicants need to provide proof of health insurance at the embassy for the entire duration of their stay, but can't get the Public Health Care before the visa is approved and the person has taken residence in Czech Republic, and therefore are forced to take the commercial health insurance in order to get the visa.

Newcomers on a Trade License / Zivno used to have the same problem of having to buy the commercial health insurance, only to change later to public health care. In the mean time most embassies seem to accept applications without proof of health insurance if the applicant will be entitled to enroll later in to public health care. Our advice: CHECK at the embassy, mileage may vary.

Family members, other purpose of stay

Family members of US citizens are still not able to get Public Health Care - it is *restricted* to self-employed persons on a Trade License. Family members or people without zivno will continue to pay for commercial insurance (unless they are employee or have a permanent residence permit, then again there is the obligation to join).

Note that information is scare and incomplete (neither on the wepages of the ministry, embassies nor insurance companies is a decent explanation)- as we get more answers we'll publish them here.

This text was first published 18/10/2016 and updated on 21/03/2017 and 03/12/2019 - in the mean time things may have changed. Contact us before getting health insurance.