Expat insurance and health insurance in Czechia

Czechia has no single fund: seven health insurance funds manage mandatory insurance, the main one being the Všeobecná zdravotní pojišťovna ČR (VZP ČR), with the six others being competing funds subject to the same regulation. Every resident freely chooses their fund and can switch; all must accept any applicant, as risk-based selection is not allowed. Contributions are based on salaries and income, paid by employers, employees, self-employed workers, and by the state for certain inactive groups (children, retirees, jobseekers in particular). Once affiliation is complete, the chosen fund issues an insured person's card, presented at every treatment.

The package of care funded by the funds covers preventive and curative care, emergencies, long-term care, outpatient and inpatient care, rehabilitation and psychotherapy, dental care (basic materials and treatment only), and medicines and medical devices on the reimbursement list. Beyond this base — high-end dental materials, optical care, some non-listed reimbursed medicines — costs remain the insured person's responsibility, regardless of their fund.

• EU citizen: no visa required for a stay of less than 3 months, as Czechia is a member of the Schengen area; entry with a valid ID card or passport.
• Registration with the foreigners' police: mandatory within 30 days of arrival for any stay longer than 30 days (exemption for children under 15 and staff of accredited international organisations).
• Affiliation to a health insurance fund: mandatory from the start of salaried activity, with the employer registering the employee and deducting the contribution (13.5% of gross salary, of which 9% is the employer's share and 4.5% the employee's) to the fund chosen by the latter.
• Self-employed: direct affiliation and contribution to the chosen fund, calculated on declared income; the precise calculation methods and minimum contribution amount vary and are not communicated uniformly by the official sources consulted.
• Without affiliation or European cover: care is billed in full by the facility, public or private, at a rate that varies by facility and is not publicly disclosed in a uniform way.
• Student: the EHIC is enough for a temporary stay (Erasmus-type); beyond that, local affiliation or supplementary student insurance remains recommended during the administrative transition period.
• Seconded employee : for up to 24 months (extendable), stays on the French scheme via form A1, exempt from local affiliation.
• Retiree: form S1 with their French pension fund before departure, for cover by the Czech system without a new contribution of their own.

No individual fine is provided for as such in case of failure to affiliate, but the employer has a legal obligation to register their employee; for the expat themselves, the risk remains above all financial, with no help from the French embassy for uncovered care.

As Czechia has been an EU member since 2004, there is no classic bilateral agreement with France: coordination runs through EU regulations 883/2004 and 987/2009, as for other member states.

• Temporary stay: the EHIC (to request from your French fund at least 15 days before departure) grants the same cover as a local insured person with providers contracted by the Czech funds; if the card is forgotten or lost, a provisional replacement certificate (PRC) grants the same rights.
• Secondment: form A1, staying on the French scheme for up to 24 months (extendable), exempt from local affiliation.
• Long-term move: direct affiliation to the chosen health insurance fund (via the employer for an employee, directly for a self-employed person); form S1 for a retiree, covered by the Czech system without a new contribution of their own.
• The EHIC covers neither repatriation, nor planned care, nor a long-term move; on return, a stay not covered in advance can be reimbursed retroactively via form S3125, within the limit of actual costs.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Seconded employee: request form A1 from your French fund before departure.
3. Retiree: request form S1 from your pension fund before departure.
4. Before departure, at least 15 days in advance: request the European Health Insurance Card (EHIC) from your French fund to cover the transition period.
5. On arrival, for a stay longer than 30 days: register with the foreigners' police.
6. Employee: check with your employer that registration and affiliation to the chosen health insurance fund happen as soon as the employment contract is signed.
7. Self-employed: affiliate and contribute directly to the fund chosen among the seven available.
8. Register with the roll of French nationals living abroad (French embassy in Prague).