Czech Republics Private Health Insurance

About 100,000 foreigners with long-term visas are required by law to have Czech private health
insurance. The group includes foreign students, self-employed people, and the spouses of foreigners
working here. But according to the Campaign for Health Insurance for Migrants all foreigners
should participate in the public health care system.

The requirement to take out private insurance for these people was part of legislation brought in
2010. The product needed for a visa was comprehensive health insurance (komplexn zdravotn
pojitn) which should cover visits to the doctor and hospital care as well as emergencies.

A justification given for new requirement was to ensure that doctors and health professionals would
be paid. The implication being that foreign insurance companies didnt pay or the money was too
difficult to obtain.

Personal Care?

For some foreigners who are clients of these private companies, this rationale must ring with the
bitterest irony. The Campaign for Health Insurance for Migrants has been collecting testimonies
from people from Ukraine, Uzbekistan, Australia, and Mongolia. The individuals concerned had
complex health insurance from a range of companies. The accounts are cause for concern.

One woman from Uzbekistan followed the regulations and took out insurance with PVZP the
private arm of VZP which provides insurance to foreigners. According to her story, many doctors
refused to accept this insurance. A Ukrainian woman attempted to visit doctors on the list provided
by her insurer UNIQA. None of the listed doctors would treat her without cash up front, which she
eventually had to pay. A fellow countryman of hers was told at Motol that he was another
Ukrainian with the wrong insurance.

The lack of proper coverage has touched at least one Czech. Jan* has a wife from South America.
Though theyre married, she still requires private health insurance because she hasnt been granted
residency. Jan has spoken up because of the poor nature of the conditions provided by private
insurance, the poor service for foreigners, and the discriminatory nature of the policy.

Were scared of a situation in which my wife needs treatment, he said.

(*He has asked us to not reveal his identity for fear of problems for his partner.)

Unhealthy System

Maybe irony is the wrong word. Irony (at least in the historical sense) implies an unintended or
opposite outcome. Maybe the companies never planned to ensure that medical treatment was paid,
at least not by them, or so alleges Linda Jank of SEHNUT, one of the groups who are a part this
campaign.

The reality is that the health insurance companies enter into the contract many conditions so that
basically when the migrant needs the health care to be paid, its not paid, she said.

The campaign explains that one reason for the inadequate coverage is the exceedingly high running
costs of the private insurance companies. An analysis compiled for the Campaign for Health
Insurance for Migrants shows running costs for the five Czech insurance companies averaging 63%
with 22% going towards health care. In one instance, an insurer only paid 11% of its earnings
toward insurance.

Spokespeople from some of the companies responded to these figures. Maxima didnt deny the
figure but their spokesperson Olga Herko said in an email, Total operating expenses include a wide
variety of items, one of which is commission for the acquisition of contracts.

Slavia rejected the figure included in the analysis. Spokesperson Ale Povr said, Commercial
health insurance for foreigners with lower cover but higher rates of claims cant have a claim
amount of 11%. However, they would not provide the figure of how much their claims came to.

PVZPs spokesperson Robert Kare also rejected the figure included in the analysis. He went on to
add that PVZPs mother company VZP doesnt agree with the inclusion of migrants here on long-
term visas to be included in the insurance system.

Kare added, The problem of the whole of this campaign is the sheer ignorance about these
systems and subsequent erroneous presentation of knowledge.

Suffer the Children

Age is no guarantee of care. Another case provided by the campaign concerns a young girl who had
to have surgery. The surgery was covered by the insurer until a second doctor changed the
diagnosis. The girls family had to fight to have the original diagnose recognized in order for the
surgery to be covered.

Even when the company covers a childs treatment, the fact that foreign children dont participate in
the public medical system is a particularly thorny one for the Czech state. The Czech Republic is a
signatory to the Convention on the Rights of the Child
[http://www2.ohchr.org/english/law/crc.htm]. Article 24 of that document states a signatorys
obligation is regarding the provision of health services to children.

Elena Tulupov, a lecturer in public health at Charles University, is another member of this
campaign. She said, In the questions regarding health it is absolutely inappropriate that in a
European state children cant get proper health care.

The Ministry of Health interprets the Czech Republics obligation differently. The said obligation
does not mean that it has to be borne by public health insurance, their spokesperson Libue Bosk
wrote via email.

The reasoning is that the health system, in the Ministrys view, is inherently designed for those who
fund it.

Turning Away Business

The problems with the private insurance system for foreigners affect practitioners as well. Tim
Young is from Young and Co. a private medical practice in Dejvice. They have a number of patients
from the expat community, and while this should be good for business, they have to turn people
away.

Our problem is that we have about a third of our patients who are non-Czech but who consume
maybe half of our time whilst bringing no more revenue than Czech patients (being covered under
public health insurance), he said.
An additional problem is the unreliability of the insurance.

There are also frequent problems with VZP retroactively cancelling insurance for foreigners after
our services have been provided, in which case we do not get paid, Young added.

Ministerial Response

According to the campaign, the Ministry of Healths argument against including foreigners who
have long-term visa is that they fear health tourism.

Ministry spokesperson Bosk, wrote, This possibility [medical tourism] must be envisaged and, of
course, must be taken into account because it cannot be ruled out.

Bosk points to the general concern of social tourism in the EU as justification for concern.
However, she claims that this concern is not the driving force in deciding on the possibility of
extending the personal scope of the law.

The Campaign for Health Insurance for Migrants counter this argument by pointing out that most
foreigners who come are between 18 and 65, the very age group which draws on health care the
least.

Are the cases above isolated? One way to find out is from your responses. Are you getting the
health care youve paid for? Should migrants participate in the state health care system?

Please log in to leave a comment or leave comment as guest

Rita (Guest)Published: 07:40:34 07.07.2013
Hello me and my husband moving to CR from Israel we would like to know which health insurance
is the best and the real one with no problems ????please it's very important for me because I would
like to have a baby in CR I'm 23 and my husband is 30
DR. L (Guest)Published: 08:21:02 14.05.2013
I am leaving the CR because of this law. My husband and I came here 6 years ago. He is retired and
is fully covered by insurance in our home country. We purchased what was called "travelers"
insurance for him for the first few years. It's basic purpose was that it would stabilize him and ship
him back to our home country if there was a problem. I was working as a instructor at the
University. With a JUDr, many years of experience and being a native speaker, the University was
happy to have me. Even with the terrible salary, we were enjoying our stay and this wonderful
country. Then the law changed and my husband now had to buy "complex" insurance,..that would
"stabilize him and ship him home if there was a problem." The only difference was the price. It was
now going to take 1/3 of my take home pay as a full time instructor, just to pay this insurance. We
didn't come here to make money, but we can not justify loosing money just to stay. So bye, bye
Czech Republic,...what a terrible law.
Comment from: AfricanwomanPublished: 01:54:00 27.02.2013
l have been using UNIQA for sometime now. l have never had a problem. The one that beat my
mind was when l was pregnant every was fine including major surgery with comprehensive policy;
they paid till the last korona, though that clause has been expunged now. The secret is that if you are
going to hospital motol and the rest call Coris they will inform foreigners dept that you are coming
or if you need a GP, GYN-OB they can make provision for you. l have used some doctors that do
not accept UNIQA, l paid cash upfront later insurer paid without stress so long as you give them
copies of the medical reports and within a time frame too.
me (Guest)Published: 10:02:50 27.02.2013
Where to start? At the top and work down? Quote: "A justification given for new requirement was
to ensure that doctors and health professionals would be paid. The implication being that foreign
insurance companies didnt pay or the money was too difficult to obtain." Please cite where this is
from. This is incorrect. The legistaion was brought in to stop fraud. Namely people coming to CR
with fake health insurance. There was a LOT of fake health insurance used by immigrants before
this legislation was brought in. The Czech tax payer was having to pay for a lot of health care for
people who had fake insurance. "For some foreigners who are clients of these private companies,
this rationale must ring with the bitterest irony. " You do not say why this is irony. "One woman
from Uzbekistan followed the regulations and took out insurance with PVZP the private arm of
VZP which provides insurance to foreigners. According to her story, many doctors refused to accept
this insurance" Heresay and a "story" "A Ukrainian woman attempted to visit doctors on the list
provided by her insurer UNIQA. None of the listed doctors would treat her without cash up front,
which she eventually had to pay" Uniqa does not have a "list of doctors". Uniqa has a list of
contracted hospitals where the insurance can be used. With Uniqa if you use a doctor that is not at
one of the hospitals, a patient would pay and then claim the money back from Uniqa. " A fellow
countryman of hers was told at Motol that he was another Ukrainian with the wrong insurance.
Heresay. She said someone siad that.... Should not be used as a source. " Jan has spoken up because
of the poor nature of the conditions provided by private insurance, the poor service for foreigners,
and the discriminatory nature of the policy." Again. Someone said that someone said something.
(*He has asked us to not reveal his identity for fear of problems for his partner.) Yes. he should be
careful. Health insurance compnaies often check expats cz to see what people say about them and
always cancel the eprsons contract in such a case. Not. The reality is that the health insurance
companies enter into the contract many conditions so that basically when the migrant needs the
health care to be paid, its not paid, she said." The reality is that: prexisting conditions are not
covered by Czech private health insurance. That is most of what you should be saying. "Age is no
guarantee of care. Another case provided by the campaign concerns a young girl who had to have
surgery. The surgery was covered by the insurer until a second doctor changed the diagnosis. The
girls family had to fight to have the original diagnose recognized in order for the surgery to be
covered." But the child got the care! What is the point of this parafraph? This could happen
anywhere with any helath insurance. This is about doctors disagreening on a treatment. Which the
child got after all. Young and co as far as I am aware do not accept PVZP. They do however accept
VZP. So this section is eronious. This section is talking about STATE health insurance and... That is
where I give up with this article. I could go on but.... This artcile is false and misleading. The author
did not understand the subject and should have spent more time in this. Is Expats.cz is trying to be a
"newspaper" ? if you are pls. Pay more and employ a journalist. So one who knows the rules on
citation.
Comment from: GlobetrotterPublished: 12:10:18 05.02.2013
This article quotes a Slavia health insurance representative. I had a terrible experience with Slavia
getting them to pay out on a claim that was covered in my health insurance contract with them. Do
not buy health insurance from Slavia, they are scammers. It was amazing to see how the happy,
friendly Slavia staff became surly, unavailable, and for some strange reason would not return phone
calls/emails when dealing with my submitted claim. Terrible people. Getting health insurance as an
expat in Prague is a royal pain in the ass.
Comment from: ChavaPublished: 06:53:14 08.12.2012
There seems to be compelling arguments from both sides here. However, I have had Private Health
Insurance from PVZP (via vzpforforeigners.cz) for the past 3 years and I have never had a problem
locating an English doctor who accepted my insurance. I also like the fact that with private health
insurance, I can easily terminate coverage if I leave the country without having to pay penalties or
interest. I have heard horror stories of foreigners who had public health insurance and were hit with
hugh penalties because they didn't properly terminate their coverage.
Klo (Guest)Published: 03:30:08 28.11.2012
Everybody complain about but what will be the real solution?? why we should pay in one the total
amount and not monthly completely unfair.. we pay in front desk and the doctors ask for more
money than normal and insurance dont pay it because..they always find a because.. also private
insurance say that you can go to every doctor and when you go to "any " doctor,, doctors say the
dont acept it...
Helena (Guest)Published: 10:21:52 28.11.2012
To mariapapax: There is substantial difference between public health insurance and private health
insurance for foreigners. Public health insurance is mandatory for all entitled persons ( Czech
residents )and all needed care to all insurers is covered. Co-payment exists but it is on an accepatble
level. ) Private health insurance is another story. Who will be insured and for what ( i.e. covered
health services) - it depends on health insurance companies themselves. Law regulation is minimal.
In comparison to public health insurance - scope of covered health care is limited and cash payment
is usually required- Later on, money is reimbursed by private insurance compan\y. This procedure is
not possible to apply in public health insurance.
Comment from: Curus10Published: 04:23:48 27.11.2012
@fld: I did not expect neither do I ask for any special treatment! All I asked for is fair dealing
which is also normal. I have not been here as long as you but I was told that I cannot pay monthly
like you because I am NOT a permanent resident like you, so the issues may be a bit different. As
for dental care; why do locals pay half price in comparison to what I pay when I am actually on
'comprehensive insurance?'
Comment from: StilichoPublished: 12:46:59 27.11.2012
The new private insurance companies targeted at compliance with the labor law for foreigners are
nothing but a scam. You may need legal representation to force a payout for anyone that can be a
preexisting condition. Being a mortal human is a preexisting condition. Everyone has hidden flaws
in their body.
Comment from: Rev_KatzPublished: 08:44:00 26.11.2012
We have Maxima. While they don't cover at any of our regular doctor appointments...mostly
because our doctors have no idea how to bill them, they have covered without any problems at our
local hospital for a variety of hospitalizations we have had over the past year including
appendectomy, and a week-long stay due to pneumonia for our young son.
Comment from: Curus10Published: 12:58:35 26.11.2012
This debate will properly end just like all the other discriminatory rules in C.R. I applied for my
study visa with an health insurance company accepted by the Czech embassy but when my visa was
approved, the embassy insisted I must get an insurance from the Czech republic or forfeit my study
visa simply because the law has been changed and it acts retroactively! A year later, when I want to
renew my visa, the law was changed again, now, I need to get a 'comprehensive insurance' which
cost me 18,000czk but my dentist refused to accept it even though it was PVZP. I am paying out of
pocket for my dental care. I simply been robbed yearly with the funny comprehensive insurance that
does the same thing as the basic I had previously which is provide nothing! Of course, I would
prefer not to buy them but then my visa renewal is based on me having this useless comprehensive
insurance! This is not only discriminatory but criminal that am paying so much at once but still get
no service for my money!
Comment from: KraigPublished: 11:30:17 26.11.2012
Another major problem with foreign insurance is that it does not cover pre-exisitng conditions
because you have to constantly renew your insurance to coincide with your visa . From what I can
know pre-exisitng conditions will not be covered for foreigners ... at least self employed
foreigners ... until they are here long enough to obtain permanent residency.
Comment from: mariapapaxPublished: 11:10:14 26.11.2012
The article is so write.I myself have experienced the same thing, I have VZP insurance and when I
tried to visit an ob-gyn from the list provided by Vzp doctor told me that he does not have any time
for me. If I had another kind of insurance he would make time for me. I was so angry and frustrated.
I am a foreigner, but I contribute to the Czech health system. Private or Public health insurance is
the same, the conclusion is that you can not find good treatment and health care unless you pay cash
upfront.