Public Health Care for EU Citizens, Employees, US Citizens on a Business Visa and Permanent Residents

The height of Public Health Care contributions is not age-independent, but instead depends on income.

For working persons it is a fixed percentage of the income (with a minimum of 1.748 CZK / month).

Therefore, for employees and people on a Trade License, the Public Health Care contribution can be 1000's of CZK / month. A company is withholding health- and social charges automatically from the employee's salary, but a self-employed trade license holder has to make the monthly payments by himself.

Selecting the right way to be registered in Public Health Care can be very complex, unlike taking out a commercial Health Insurance, especially when you have a mixed EU / non EU family, or when you are (still) registered in another EU country.

When registering an adult into Public Health Care, we usually can enroll the children as well (even if they are non-EU) under the same insurance. Also spouses may be able to get Public Health Care - this is so complex that we have to look at each individual case what is possible.

VERY IMPORTANT: If you have a Czech (temporary) residence permit already for a longer period of time (months / years) and have no gainful activity (employment or self-employment) and you cannot prove you have paid Public Health Care or Commercial Health Insurance somewhere else, you will be liable for Public Health Care payments from the issue date of the (temporary) residence permit.

Common Issues:

  • unlike the wrong / incomplete information on the website, not only EU-Citizens with a permanent residence permit, but also EU Citizens with a TEMPORARY residence permit can be enrolled in to Public Health Care (as long as they are employed or self-employed),
  • Commercial 'Emergency Health Insurance' or 'Complex Care Health Insurance' is not meant for EU Citizens, unless is it to bridge the period until they get the (temporary) residence permit, or have no gainful activity,
  • Non-compliance, as EU-citizen you have to be insured always, if you do not have a valid insurance in CZ, you risk having to pay upon return to your home country for the missing years,
  • Paying Public Health Care in the wrong country; an EU-Citizen resident must pay into the czech Public Health Care, if he is employed / self-employed in CZ.
  • If you were registered before as employee in an EU country, we still may be able to register you in the Czech Public Health Care - even if you are no longer emploeyee.
  • In case you are registered as employee of a czech company or as director of a czech sro, taking out a salary, you will be automatically in Public Health Care.
  • If you are citizen of Croatia, Macedonia, Montenegro, Serbia, Israel, Turkey or Japan and have a trade license (working as independent contractor / freelancer), you are entitlded to enroll into the Public Health Care system(!)
  • If you have a czech Permanent Residence Permit you must be in Public Health Care,
  • In case of a temporary EU Residence Permit you are usually not eligable, unless you are employee or director in CZ, or have a trade license (see next point),
  • If your Trade License is the only source of income in the household, and your spouse is EU and not providing income, you may be entitled to Public Health Care.


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.

Registration Service

We charge 2500 CZK per person (dependent children for free) for registering into the VZP Public Health Care system.

Our fee includes:
  • an (email) consultation on your specific situation,
  • the actual registration process (you do not need to go anywhere, we'll represent you),
  • a second (email) consultation in which we explain how to pay to which account,
  • and handover of the paper temporary proof of insurance,
  • a plastic EHIC card will be sent to your address after 3 monthly payments

The monthly Public Health Care contributions you will pay directly to the VZP.

VZP is the largest organisation, with very good support throughout Czech Republic. We like the VZP, because our experience with them in dealing with questions and international issues is very good, and alternatives are not any cheaper or better. However, if you wish to register somewhere else (at OZP, for example) just indicate this, because by default we register at VZP.

The registration will take at least a couple of days, sometimes weeks for complex cases. It is not immediate, as commercial Health Insurance, especially when you will need to be de-registered from another EU country.

EHIC Card and coverage in another EU country

Despite the fact that with the Public Health Insurance card one should be able to get medical attention in each EU country, regulations for what is paid for / refunded varies per country. So, to avoid expensive surprises it will be necessary to hsave a travel insurance in addition to the Public Health Care (!)

Alternative: Registering as self-employed on a czech Trade License

If you plan to work as independent contractor / self employed, it is not enough to just register at the Public Health Care. Instead you will have to register a so-called Trade License, and at the tax office, at the social security and the Public Health Care.

This is quite complicated (nearly impossible) for a foreigner, but we offer a package with all 4 registrations, including 2 hours of business / accounting consultation. Benefit is that we'll do everything for you (you do not need to go to any authority) and we'll provide you with solid advice on all aspects of being a self-employed person / freelancer in Czech Republic. For an in-depth explanation of our service see the Trade License section on this website.