Social security is the same for everyone. Health insurance is not: whether you can join Czech public health insurance depends on your nationality, your residence permit, whether you are also employed, and agreements between countries. If you cannot, you need commercial health insurance instead.
Who is in public health insurance
- EU, EEA and Swiss citizens working in the Czech Republic, including on a trade license.
- Anyone with permanent residence in the Czech Republic.
- Employees of a Czech employer, whatever their nationality.
- Citizens of the USA, Japan, Israel, Turkey, Serbia, Montenegro, North Macedonia, Albania and Tunisia who work or run a business here, also on a trade license, because of social security agreements with these countries. They pay monthly contributions like EU citizens, instead of the commercial insurance other non-EU citizens need, and must leave the health insurance of their home country.
There are several public health insurers (zdravotní pojišťovny). VZP (Všeobecná zdravotní pojišťovna) is the largest, and for foreigners usually the easiest choice; OZP, ČPZP and ZP MV are others.
Do not confuse VZP with PVZP. PVZP sells commercial health insurance, not public health insurance. We regularly meet people who were sold PVZP by a broker when they could have had public insurance.
Monthly contributions
When the trade license is your main activity, you pay at least the minimum from your very first month, whatever revenue you expect:
- 2026: 3,306 CZK a month
- 2027: 3,488 CZK a month
Each payment is due by the 8th of the following month. Above the minimum, it depends on last year's profit: 13.5% of 50% of your profit, so about 2.7% of your revenue with the 60/40 method.
Also employed? Then your trade license is a secondary activity, and there is no monthly minimum: you pay what you owe once a year, after the overview. If you earn well through your trade license, paying something monthly avoids one large bill.
A student under 26? If you are in Czech public health insurance, the state pays your health insurance while you study (until your 26th birthday). Your trade license then has no monthly minimum either: you only pay 13.5% of half your profit, once a year after the overview. The same applies to pensioners and parents on parental leave.
Mixed EU and non-EU families
A non-EU spouse or registered partner of an EU citizen has almost all the rights of an EU citizen, but not automatic access to public health insurance, even with a temporary residence permit. Under certain conditions, a non-EU spouse and children can be covered through the EU partner. The rules are complex and depend on your situation.
Pregnancy
With public health insurance you do not need to arrange anything special: check-ups, the birth and your newborn are covered.
With commercial health insurance it is different: usually nothing is covered, and you need a separate, expensive pregnancy insurance, taken out very early in the pregnancy.
Maternity benefits are a separate matter: they need voluntary sickness insurance, paid to social security. See sickness insurance.
Once a year: the overview
After your tax return, the overview for your health insurer calculates what you really owe for last year. The difference is due within 8 days of filing. It is always much less than for social security, but can still be tens of thousands of CZK. The overview also sets your new monthly payment. We prepare and file it together with your tax return.
With the flat-tax method, health insurance is part of your one monthly payment and there is no overview: see 60/40, real expenses or flat tax.
