By law, every person who is a permanent resident of the Czech Republic, i.e. even foreigners, is compulsorily insured in the Czech Republic, unless they are subject to the legislation of another EU/EEA/Switzerland/UK Member State under European regulations or subject to the legislation of another Contracting State under an international treaty. Health insurance is established for these persons upon acquiring permanent residence in the Czech Republic and ceases upon the death of the insured person or his/her declaration of death or the end of permanent residence in the Czech Republic.
a) A foreigner not from the EU/EEA/Switzerland/UK without permanent residence may participate in public health insurance in the Czech Republic according to the law as an employee of an employer who has its registered office or permanent residence in the Czech Republic, or if he/she meets the criteria set out in European regulations (e.g. he is a dependent family member of a breadwinner insured under the regulation in the Czech public health insurance system), or he is a citizen of one of the countries with which the Czech Republic has concluded an international social security treaty that also regulates the area of health insurance (a list of these treaties can be found on the website of the Health Insurance Office.
The health insurance company will issue a green card or a paper certificate for the insured person to replace the card.
Just like in the case of the commencement and termination of employment of other employees, the employer is obliged to notify the health insurance company of the commencement and termination of participation in health insurance of an employee who is a foreigner without permanent residence.
Non-resident foreigners have the option of taking out contractual health insurance in the months when they are not covered by public health insurance from employment.
b) A foreigner from the EU, EEA and Switzerland without permanent residence in the Czech Republic can participate in Czech public health insurance both according to the law on the basis of employment and on the basis of European regulations (e.g. as a self-employed person carrying out self-employment only in the Czech Republic, dependent family members of a person from the EU who carries out gainful employment in the Czech Republic or receives income replacement benefits, e.g. a pension, in exceptional cases also economically inactive persons who can sufficiently prove their actual residence and centre of interests in the Czech Republic, etc.).
c) In the context of gainful employment, it should be mentioned that under the Czech Republic's agreements with the USA, Japan, Turkey, Northern Macedonia, Serbia, Montenegro, Albania, Tunisia and Syria, an insured person employed or doing business in the Czech Republic becomes a participant in the Czech health insurance system(and vice versa). This also means they must opt out of health insurance in their country of origin. A similar procedure applies in the case of the association agreement with the Maghreb countries (Algeria, Morocco, Tunisia) – if a person from these countries is employed in an EU Member State (including the Czech Republic), he/she is covered by the health insurance system of that EU country (and vice versa). A similar principle is established by the international treaty between the Czech Republic and Israel, which, however, applies only to citizens (not all insured persons) of the Czech Republic and Israel. Please note that these procedures do not apply to tourist stays, including studies.
With regard to children born in the Czech Republic to foreign women with long-term residence permits, the birth of the child is required by law to be notified by the child's legal representative, guardian or custodian within 8 days of the date of birth to the health insurance company with which the child's mother is insured on the date of the child's birth. If the child's mother is not insured in the Czech Republic, she notifies the child's birth to the health insurance company with which the child's father is insured on the day of the child's birth. If the parents are not insured in the Czech Republic, they must notify the General Health Insurance Company of the Czech Republic of the birth of the child.
The insurance premiums for these newborn children are paid by the legal representative, guardian or custodian to the account of the relevant health insurance company in a single lump sum for the entire reference period.
The premium is payable from the first to the last day of the reference period. The assessment base is twice the minimum wage for the relevant period.