Foreign nationals* and health insurance
This chapter provides information on the conditions under which travel insurance is contracted and terminated and the usual terms and consequences of the use of health care under an insurance contract.
Act 326/1999 Coll., on the stay of foreign nationals on the territory of the Czech Republic imposes on foreign nationals the obligation to supply proof of having their insurance covering possible medical expenses. This obligation can be fulfilled by a foreign national with travel insurance (see provisions of § 180i and 180j of Act No. 326/1999 Coll. regulating in detail what is meant by a proof of travel health insurance), if health care is not covered under an international agreement or by public health insurance or if the foreign national proves that health care is paid by other means.
If a foreign national comes to the Czech Republic to take up employment, this condition is satisfied on the day when he or she becomes an employee of an employer with registered office or permanent residence in the Czech Republic. Under other circumstances one must have travel insurance or supply proof that the payment of medical expenses is assured in another way. Staying on the territory of the Czech Republic without insurance is a violation of Czech law and the person doing so faces prosecution. If he or she then needs health care, payment is demanded in cash, which in case of health care exceeding the extent of necessary and urgent health care can reach rather high amounts.
Proof of travel health insurance is not demanded from foreign nationals from Cuba and Yemen. Necessary and urgent health care is reimbursed to nationals of these states from the state budget under a bilateral agreement. (Please note that the Article 9 of the Agreement between the Government of the Czech Republic and the Government of Afghanistan on cooperation in the field of health and medical science, providing free health care in case of an acute illness or injury, is not valid as of 1st April 2009 and its provisions can not be applied as of 1st September 2010. Furthemore, as of 10th November 2011, the Agreement on Cooperation in the Field of Health care between the Czechoslovak Socialist Republic and the Socialist People´s Libyan Arab jamahiriya will cease its validity. Please note that the article 10 letter d of the above-mentioned Agreement providing for free health care in case of an acute ilness or injury, will not be valid from this date on and so its provisions can not be applied as of 11th November 2011. And concerning the Agreement on Cooperation in the Field of Health care between the Czech and Slovak Federal Republic and the Kingdom of Morocco, it will cease its validity the 23rd of January 2012 and so its article 8 providing for free health care in case of an acute ilness or injury will be no more applicable as of 24th of January 2012). Proof of travel health insurance is not demanded from foreign nationals from countries, with which the Czech Republic has concluded a social security agreement (Montenegro, Croatia, Macedonia, Serbia, Turkey and Bosnia and Herzegovina).
Foreign nationals without permanent residence in the Czech Republic who are not employed in the Czech Republic cannot participate in public health insurance and in most cases must have travel health insurance cover, which is independent of public health insurance and is based on a contract between the insured person and an insurer. This insurance is not administered by health insurance companies but by insurance companies under Act 277/2009 Coll., on insurance. Requirements on the proof of adequate and valid travel health insurance during the stay up to 90 days are set up by Regulation no. 810/2009 of the European Parliament and of the Council of 13 July 2009 establishing a Community Code on Visas (Visa Code). This Regulation stipulates that travel health insurance has to cover any expenses which might arise in connection with repatriation for medical reasons, urgent medical attention and/or emergency hospital treatment or death, during the stay on the territory of the Member State and has to cover the entire period of the intended visit. The minimum coverage shall be EUR 30 000. Unlike public health insurance, non-payment of contributions invalidates one’s entitlement to reimbursement of medical expenses.
Under the Act on the stay of foreign nationals on the territory of the Czech Republic, travel health insurance in case of stay exceeding 90 days means assurance of payment of costs in connection with an acute and indispensable health care treatment in the territory of the Czech Republic, including costs of transport of the sick (or in case of death of the person the transport of earthly remains) to a country whose travel documents he or she holds, or to another country in which he or she has permitted residence, up to min. of EUR 60,000 per one insured accident (not included the co-insurance payment of the insured foreign).
The amount of the insurance payout depends on the specific terms of the insurance contract. One should pay close attention to the terms when negotiating an insurance contract, as follows:
- insurance coverage does not usually apply to the treatment of a disease contracted before the insurance contract was signed;
- a limit is usually set for the insurance cover, over which medical expenses are not paid;
- this scope of health care covered by the insurance contract is limited (dental care is often excluded, for example)
When applying for a visa on the territory of the Czech Republic for the period exceeding 90 days, the travel health insurance can be purchased only at those insurance funds which are licensed to provide travel health insurance in the Czech Republic and has to cover complex health care, including preventive and dispensary health care as well as health care related to pregnant mothers and their subsequent delivery. One should pay close attention to the terms when negotiating an insurance contract.
It is necessary to buy travel health insurance for a child born in the Czech Republic to a foreign national without permanent residence. The contract can be usually concluded after the child’s birth and no insurance payout can be demanded in arrears from the date of birth. In anticipation of such cases some insurers offer products applicable to pregnant mothers and to health care provided to the child in the first days after birth.
A child born to parents who are foreign nationals and participants in public health insurance merely through employment is not a participant in public health insurance, and it is therefore necessary for him or her to contract travel insurance. It is recommended to a pregnant mother in this case to conclude an insurance contract that covers health care provided to the child in the first days after birth.
*It is NOT a person covered by Council Regulations No 1408/71 and No 574/72, Regulation of the European Parliament and Council No 883/04 and 987/09, and Council Regulation 859/2003