Foreigners, who are citizens of non-EU countries and stay in the Czech Republic for more than 90 days, are obliged to have valid comprehensive health insurance for the entire period of their stay. Since 2021, only one insurance company has been entitled to establish such insurance, the VZP Insurance Company (PVZP). It was originally supposed to have a monopoly for 5 years, which did not fully respect European and constitutional law. As of 20 September 2023, applicants for long-term visa and long-term stays can now obtain insurance from any Czech insurance company authorised to provide this type of insurance. At the same time, previously contracted insurance with PVZP can be terminated within three months from the effective date of the amendment. However, there is no right to a refund of premiums already paid.

The end of the monopoly is intended ensure a level playing field on the insurance market. The restoration of competition might also have a positive impact on price levels. Expanding the options will allow foreigners greater variability in their choices, taking into account their needs and personal preferences.

Another positive change for foreigners is the increase in the limit of insurance benefits from the original EUR 60 thousand to EUR 400 thousand, still without co-payments from the insured. Although this change could lead to an increase in premiums, PVZP has been reluctant to do so and will not increase premiums for existing contracts.

One of the innovations is the establishment of the so-called foreigners’ health insurance register, which aims to increase transparency and improve health insurance coverage. The register will probably be established by the Czech Insurers’ Bureau within a year after the amendment comes into force. The costs of maintaining the register will be covered proportionally by the insurance companies, with which the foreigners have insurance.

The changes will also affect foreigners under the age of 18 from 1 January 2024. They are compulsorily enrolled in public health insurance, without the option of replacement with commercial insurance. Foreigners do not necessarily have to cancel their expiring commercial insurance, but renewal will no longer be possible. They become a participant in the public health insurance on the day following the end of the current insurance. At the same time, they are obliged to notify the selected health insurance company of the transfer to public insurance within 8 days before the end of the original insurance. Participation of foreigners ends when they attain majority or when their residence permit expires. They are then obliged to establish private health insurance for comprehensive health care.