Act No. 48 / 1997 Coll.

Law on public health insurance and on the modification and addition of certain related laws

Valid Law Effective from 01.04.1997
Text versions: 01.01.2029 01.01.2028 01.10.2026 12.06.2026 01.01.2026 All versions (93)
Contents
ČÁST PRVNÍ § 1 § 2 § 3 ČÁST DRUHÁ § 4 § 5 § 6 § 7 § 7a § 8 § 9 ČÁST TŘETÍ § 10 § 10a § 10b § 10c ČÁST ČTVRTÁ § 11 § 11a § 11b § 12 ČÁST PÁTÁ § 13 § 14 § 14a § 14b § 14c § 14d § 14e §14f § 15 § 16 § 16a § 16b § 17 § 17a § 17b § 17c § 18 § 19 § 20 § 22 § 22a § 22b § 25 § 26 § 28 § 29 § 30 § 31 § 32 § 32a § 32b § 32c § 32d § 33 § 34 § 35a § 36 § 37 § 38 § 38a § 39 ČÁST ŠESTÁ § 39a § 39b § 39c § 39d § 39da § 39db § 39e § 39f § 39g § 39h § 39i § 39j § 39k § 39l § 39n § 39o § 39p ČÁST SEDMÁ § 39r § 39s § 39t § 39u § 39v § 39w § 39x § 39y § 39z ČÁST OSMÁ § 39za § 39zb § 39zc § 39zd § 39ze § 39zf § 39zg § 39zh § 39zi § 39zj ČÁST DEVÁTÁ § 40 § 40a § 40b § 40c § 40d § 40e § 41a § 41aa § 41ab § 41b § 42 § 43 § 43a ČÁST DESÁTÁ § 44 § 44a § 44b § 45 ČÁST JEDENÁCTÁ § 46 § 47 § 48 § 49 § 50 § 51 § 52 § 52a ČÁST DVANÁCTÁ § 53 § 53a § 53b § 53c § 53d § 55 § 55a § 55b ČÁST TŘINÁCTÁ § 56 § 57 ČÁST ČTRNÁCTÁ § 58 § 59 „ČÁST PÁTÁ § 22a § 22b § 22c § 60 ČÁST PATNÁCTÁ § 61
48
THE LAW
of 7 March 1997
on public health insurance and amending and supplementing certain related laws
Parliament has decided on this law of the Czech Republic:

ČÁST PRVNÍ

BASIC PROVISIONS
§ 1
(1) This law implements the relevant provisions of the European Union1), following the directly applicable provisions of the European Union51), and provides for
(a) public health insurance (hereinafter referred to as health insurance);
(b) the extent and conditions under which health insurance services (hereinafter referred to as "covered services") are covered under this Law;
(c) the method for determining the prices and reimbursement of medicinal products and foodstuffs for special medical purposes covered by health insurance;
(d) the method for determining the remuneration of medical devices and in vitro diagnostic medical devices (hereinafter referred to as "medical devices") prescribed for the voucher covered by the health insurance.
(2) This law shall apply unless it provides for directly applicable European Union provisions governing the coordination of social security schemes (hereinafter referred to as the "Coordination Regulation '), other than 49.
§ 2
Personal extent of health insurance
(1) The insured person under this Act is the person who:
(a) has a permanent residence in the Czech Republic; or
(b) has no permanent residence on the territory of the Czech Republic if:
1. is an employer's employee who has his registered office or permanent residence in the Czech Republic,
2. it has been granted a long-term residence permit in the Czech Republic for the purpose of scientific research;
3. she has been granted asylum in the Czech Republic,
4. it has been granted additional protection in the Czech Republic,
5. it has been granted a residence permit to provide temporary protection in the Czech Republic under the Act on the Temporary Protection of Foreigners or is considered to be such a person under the Act on the Residence of Foreigners in the Czech Republic,
6. a minor child who has been placed on the territory of the Czech Republic on the basis of an interim measure by a court in a facility for children requiring immediate assistance or in an institution for the care of children or on the basis of an interim measure or a court order in the custody of a natural person,
7. the Czech Republic is responsible for its health insurance under the coordination regulations or under the declared international agreement, which the Czech Republic is bound by;
8. It is a person whose entitlement is derived from directly applicable European Union49), or a person employed, self-employed or retained in such a position and his family members entitled to equal treatment under the European Union69),
9. was born in the territory of the Czech Republic and her mother is allowed a long-term residence in the territory of the Czech Republic until the end of the calendar month in which the person completed 60 days of age, and during the procedure for the application for a long-term residence permit in the Czech Republic submitted for that person, if the application was submitted within 60 days of the date of birth,
10. was born in the territory of the Czech Republic and its legal representative has a permanent residence in the territory of the Czech Republic until the end of the calendar month in which the person completed 60 days of age, and during the proceedings for an application for permanent residence in the Czech Republic lodged for that person, if the application was made within 60 days of his birth; or
11. is a minor who has been granted a long-term residence permit in the Czech Republic.
(2) For health insurance purposes, the employer is a legal or natural person who is the payer of income from dependent activity under special legislation (1a), employs employees and has a registered office or permanent residence in the Czech Republic, as well as an organisational component of the state. (1b)
(3) Employment is for health insurance purposes the activity of an employee [Paragraph 5 (a)], from which the employer receives income from dependent activity taxed under special legislation (1a).
(4) For the purposes of health insurance, the registered office of the employer shall be the registered office of the legal person, as well as the registered office of his or her organisational unit, which is registered in the Commercial Register or, where applicable, in another legally designated register, or is kept in a designated register with the competent authority in the Czech Republic, and the place of his or her permanent residence, or, where applicable, in the case of a foreign natural person, of his or her business.
(5) Health insurance excludes persons who are engaged in illegal work in the territory of the Czech Republic pursuant to § 5 (e) (3) of the Employment Act, and persons who are not resident in the Czech Republic and who are active in the Czech Republic for employers who enjoy diplomatic benefits and immunities, or for employers who are not established in the Czech Republic, and persons who are long-term resident abroad and who are not insured (§ 8 (4)).
§ 3
Establishment and termination of health insurance
(1) Health insurance
(a) the person who has acquired permanent residence in the territory of the Czech Republic by birth, on the date of birth,
(b) a person who has obtained permanent residence in the Czech Republic by means of a permanent residence permit, on the date on which the decision on a permanent residence permit becomes final;
(c) a person who has been authorised to reside in the territory of the Czech Republic by a decision of the competent authority to entrust in replacement education, if at least one natural person to whom that person is entrusted is admitted to permanent residence in the territory of the Czech Republic or if the institution in which that person is located is located in the territory of the Czech Republic, on the date on which the decision to entrust in replacement education is acquired; or
(d) person without permanent residence in the Czech Republic
1. taking up employment;
2. the acquisition of legal power by a decision on a long-term residence permit for the purpose of scientific research;
3. the acquisition of legal power by a decision granting asylum,
4. the acquisition of legal power by a decision granting supplementary protection;
5. the acquisition of legal power of a decision granting a residence permit for the purpose of providing temporary protection in the territory of the Czech Republic or on the date on which it is considered as having been granted temporary protection under the Act on the residence of foreigners in the territory of the Czech Republic,
6. the enforceability of the interim measure or order of the court on the placing or entrustment of the minor;
7. when the Czech Republic became competent for health insurance under the coordination regulations or under the declared international treaty, which the Czech Republic is bound by; This applies mutatis mutandis to a person whose entitlement is derived from directly applicable European Union49), or if he is an employed, self-employed or self-employed person or a person maintaining such status and his family members entitled to equal treatment under the European Union69),
8. registration of a citizen of the Czech Republic for permanent residence in the Czech Republic after his previous stay abroad,
9. Birth, if the person referred to in § 2 (1) (b) (9) or the date on which the long-term residence permit has been applied for,
10. Birth if the person referred to in Paragraph 2 (1) (b) (10) or the date on which an application for permanent residence has been submitted for that person; or
11. the acquisition of a long-term residence permit, if it is a person referred to in § 2 (1) (b) (11).
(2) Health insurance is no longer available
(a) the death of the insured person;
(b) termination of permanent residence in the Czech Republic,
c) Person without permanent residence in the Czech Republic
1st day of employment,
2. the expiry date of the long-term residence permit for scientific research;
3. The date on which the decision on the withdrawal of asylum takes effect or the date on which the asylum ceases,
4. The date on which the decision to withdraw the supplementary protection or the date on which the supplementary protection is terminated becomes final;
5. the date on which the decision to withdraw the residence permit is taken to grant temporary protection in the territory of the Czech Republic, the date on which that authorisation is terminated or the date on which it is no longer considered to be a person with temporary protection69),
6. The date on which the interim measure or decision to place or place a minor in the custody of a minor is withdrawn or terminated,
7. The date on which the Czech Republic has ceased to be responsible for health insurance under the coordination regulations or under the declared international agreement to which the Czech Republic is bound; This applies mutatis mutandis to a person whose entitlement is derived from directly applicable European Union49) or if he is an employed, self-employed or self-employed person or a person maintaining such status and his family members entitled to equal treatment under the European Union69),
8. referred to in § 2 (1) (b) (9) on the last day of the month in which the person reached 60 days of age, or on the date on which the decision to reject the application for a long-term residence permit in the Czech Republic was taken, if this was later;
9. referred to in Paragraph 2 (1) (b) (10), on the last day of the month in which the person reached 60 days of age, or on the date on which the decision to reject the application for a permanent residence permit in the Czech Republic became final; or
10. referred to in § 2 (1) (b) (11) by the expiry of the long-term residence permit in the Czech Republic or by the date of age, if this was previously the case.

ČÁST DRUHÁ

INSURANCE
Health insurance policy payers
§ 4
The payers of health insurance premiums (hereinafter referred to as "the premiums payers') are:
(a) the insured persons referred to in Section 5;
(b) employers,
(c) State.
§ 5
The insured person shall pay insurance premiums if:
(a) is an employee; For health insurance purposes, a natural person shall be considered to be an employee who is or should be the subject of income from dependent activity under special legislation (1a), except:
1. persons who only receive income from dependent activities which are not subject to tax or are exempt;
2. a pupil or student who only receives income from dependent activity for practical training work;
3. persons operating under an agreement to carry out work or, where applicable, several agreements to carry out work with one employer, provided that the sum of the income from such agreements in a calendar month has not reached income equal to the amount which is a condition for the participation of such person in sickness insurance under the sickness insurance law (hereinafter referred to as "deductible income"); the deductible income settled by the employer only after the end of the work agreement shall be considered as income cleared up to the calendar month in which the agreement ended;
4. a member of a cooperative who carries out the work for which he is remunerated for the cooperative and who has not received any deductible income in the calendar month;
5. a member of the community of owners of units, who carries out for the community the work for which he is remunerated and who has not achieved any deductible income in the calendar month;
6. persons operating under a work agreement or, where appropriate, several employment agreements with one employer, provided that the total revenue from such agreements has not been obtained in the calendar month from the deductible income; the deductible income settled by the employer only after the end of the employment agreement shall be considered as income cleared up to the calendar month in which the agreement ended;
7. members of the representatives of the local authorities and of the municipal or urban districts of the territorial subdivided statutory cities and of the capital of Prague, who are long-term vacant for the performance of their duties or who, before being elected to office as a member of the council, have not been in a position of employment, but who perform the function to the same extent as the long-term release members of the council;
8. a member of the District Election Commission or a special District Election Commission who performs tasks under the electoral laws,
9. Persons who have been awarded, under other legislation, a statement of evidence or compensation for loss of earnings for lodging a statement in court, administrative or other proceedings;
(b) is a self-employed person who, for the purposes of health insurance:
1. a person who derives revenue from a separate activity under the Income Tax Act or who carries out an activity from which income from a separate activity under the Income Tax Act;
2. the cooperating person of the person referred to in point 1, provided that the income and expenditure to be achieved, secured and maintained can be distributed to him under the Income Tax Act;
(c) has a permanent residence on the territory of the Czech Republic, but is not listed under the preceding letters and is not followed by a paying member of the insurance company, provided that the information lasts for the whole calendar month;
(d) is the person referred to in Article 2 (1) (b) (9) or (11).
§ 6
The employer shall pay part of the insurance premiums for its employees, except for employees who proceed under Paragraph 8 (4). The employer shall be the payer of part of the income from dependent activities under special legislation (3) settled on the former staff member after his employment.
§ 7
(1) The State is an insurance payee through the State Budget for the following insured persons:
(a) uninsured children, except those referred to in Article 2 (1) (b) (9) or (11); the child's inprovision shall be assessed in accordance with the State Social Support Act; 7)
(b) the pensioner of pension pensions who was awarded pension before 1 January 1993 under the regulations of the Czech and Slovak Federal Republic and after 31 December 1992 under the regulations of the Czech Republic. For the purposes of this Act, a person shall be regarded as a pensioner in accordance with the preceding sentence even in months when the pension payment is not due under the pension scheme;
(c) the beneficiary of the parental contribution; 7)
(d) women on maternity leave and persons on parental leave and persons receiving maternity assistance under sickness insurance legislation (8);
(e) job seekers, including job seekers, who have accepted short-term employment; 9)
(f) persons receiving a benefit from State social assistance, which is part of a livelihood component and members of their household under the State Social Assistance Benefit Act;
(g) persons who are dependent on the care of another person in grade II (moderate dependency) or stage III (severe dependency) or stage IV (total dependency) 11), and those who are caring for persons under 10 years of age who are dependent on the care of another person in grade I (dependency),
(h) persons in the exercise of security detention or detention, persons in the execution of a custodial sentence or persons in the exercise of constitutional protection;
(i) persons referred to in Section 5 (c) who receive sickness insurance benefits; 14)
(j) persons who have reached the age required for entitlement to an old-age pension but who do not fulfil the additional conditions for the old-age pension and are not employed or self-employed under § 5 and do not receive any foreign pension, or that pension does not exceed, per month, a minimum wage of 15), and persons who are disabled in the third degree;
(k) persons personally and properly caring for at least one child under the age of 7, if not persons referred to in (c) or (d), or if the child is not present in an establishment with a weekly or annual stay; only one person, either the father or the mother of the child, or the person who has taken the child into permanent care replacing the care of the parent (16), shall be regarded as such, from the date on which the person entered the notification, but not before the day following the date on which the notification was delivered to the competent health insurance undertaking; in the case of an additional determination of Czech legal status under the coordination regulations, the insured person shall become a person in person and duly care for at least one child under 7 years of age from the date indicated in the notification; the insured person is a person personally and properly caring for at least one child under 7 years of age at least until the end of the calendar month in which the notification was received to the relevant health insurance undertaking;
(l) persons in the exercise of protective custody;
(m) persons performing a long-term voluntary service under a contract with a sending organisation which has been granted accreditation by the Ministry of the Interior to an extent that exceeds, on average, at least 20 hours in a calendar week, unless the volunteer is a premium payer in accordance with § 5 or a Member State as referred to in (a) to (l) above;
(n) spouses, partners or registered partners of civil servants under the Civil Service Act or other employees in the organisational units of the State, if they follow them to the place of secondment to work abroad or to work abroad, with the agreement of that branch of the State, and do not have income from dependent activities or are not self-employed under § 5 or are not persons engaged in similar activities under the law of a foreign State to which their spouses, partners or registered partners have been seconded to work abroad or to serve abroad;
(o) persons referred to in § 2 (1) (b) (3) to (5) and (10) if they are not employed or self-employed under § 5;
(p) the applicant for international protection and his child born in the territory of the Czech Republic, a foreigner to whom a certificate of residence in the territory of the Czech Republic has been issued and his child born in the territory of the Czech Republic 16b), unless they are employed or self-employed pursuant to § 5,
(q) the recipients of an old-age pension for a specified period, a life-long pension or a specified period, with a specified amount of pension under the Act governing supplementary pension savings until the age required for the entitlement to an old-age pension under § 32 of the Pension Insurance Act, provided that the conditions laid down in § 22 (4) or § 23 (6) of Act No. 427 / 2011 Coll., on supplementary pension savings are met; in determining this age, women shall be treated in the same way as men at the same date of birth;
(r) persons over 26 years of age first to study in a doctoral study programme carried out by a university in the Czech Republic at a standard time in the presentation form of a study, unless they are employees or self-employed under § 5; for the purposes of this point, the calendar month in which the person completed that study shall also be considered as the period of study;
(s) persons providing unbrokered foster care to a child to whom a foster allowance is paid under the Child Protection Act 70), provided that they were entitled to a foster child's remuneration under the Child Protection Act on 31 December 2021,
(t) persons taking care of minors who are not dependent on a child providing unbrokered foster care, and persons having a child under the Civil Code under Paragraph 953, if the child is entitled to a allowance for the reimbursement of the child's needs under the Child's Social Protection Act (71), for a maximum period of 2 years from the first day of the calendar month for which the child's first contribution is due; the condition of entitlement to a child's pension shall be deemed to have been fulfilled for a period for which that allowance is not due to a pension or maintenance obligation laid down by the court,
(u) a wife (spouse), partner (partner) or registered partner (registered partner) under another law of the President of the Republic (President of the Republic).
(2) Where the persons referred to in paragraph 1 (a) to (e), (g), (h), (j) are persons who are disabled in the third degree, (k), (q), (s), (t) and (u) employed or self-employed persons, the insured person shall be paid by the State and those persons.
§ 7a
The legal representative, guardian or guardian of the person referred to in Article 2 (1) (b) (9) or (11) shall be the payer of the insurance premiums for that person.
§ 8
Obligation to pay insurance premiums
(1) Insurance shall be paid to the health insurance undertaking with which the insured person is insured (hereinafter referred to as the relevant health insurance company), with the exception of advances for self-employed persons who are a taxpayer in the flat-rate scheme and for self-employed persons whose income tax is equal to the flat-rate tax, the payment of which is governed by the Income Tax Act. The insurance obligation shall be incurred by the insured person on:
(a) recruitment (Section 2 (3));
(b) the establishment of a self-employed activity (§ 5 (b));
(c) when he became an insured person under § 5 (c);
(d) to which the insured person has applied to the relevant health insurance undertaking in accordance with paragraph 4 on his return to the Czech Republic;
(e) when he became an insured person under § 5 (d);
(f) return to the Czech Republic after a continuous stay abroad, which began before 1 January 1993 if the return date falls after 30 April 1995; the insured person is obliged to provide evidence to the relevant health insurance undertaking;
(g) return to the Czech Republic after a continuous stay abroad, which began between 1 January 1993 and 1 July 1993, if the return date falls after 30 April 1995 if the insured person:
1. has been insured abroad,
2. He has not received paid services during that period,
3. Asked retroactively the competent health insurance undertaking for the procedure referred to in paragraph 4.
This is without prejudice to the obligation to pay insurance premiums for the period preceding the stay abroad.
(2) The employer's obligation to pay part of the insurance premiums for his employees arises on the day of the staff member's recruitment (Section 2 (3)) and ceases to exist on the day of termination of employment, with the exceptions set out in Section 6. The day on which the staff member takes up employment shall be deemed to be:
(a) in the case of an employment relationship, including an employment agreement under foreign law, the date on which the staff member entered into employment and the date of termination of employment shall be deemed to be the date of termination of employment;
(b) in the case of a service, the date on which the staff member took up the service, if he is a civil servant, the date on which the service is taken up, and the day on which the service is terminated,
(c) in the case of cooperative members in cooperatives where membership is a condition for their working relationship with the cooperative, if, outside the employment relationship, they perform for the cooperative the work for which they are remunerated, the starting date of the work for the cooperative and the termination date of the membership of the cooperative shall be deemed to be the date of termination;
(d) in the case of staff working under an agreement on employment, the date on which the staff member first began to work after the conclusion of the agreement on employment, and the day on which the period for which the agreement has been concluded has expired, the staff working under the agreement on employment shall be treated mutatis mutandis;
(e) in the case of judges, the date on which the Judge takes up his duties and the date on which he ceases to be a judge;
(f) in the case of representatives of local and local authorities and of urban areas or urban districts, the term from which the member is remunerated for the performance of a function which is long-term vacancy or which, before being elected to the post of a member of the local or local authorities, has not been in employment but has been in employment to the same extent as a member of the local or local authorities, and the day of termination of employment shall be deemed to be the day from which such remuneration shall not be paid. If the current mayor or mayor performs the duties after the expiry of the term of office until the date of the opening of the meeting of the newly elected representative and receives the remuneration referred to in the first sentence, he shall be considered as staff member for the period during which such remuneration is due; this applies mutatis mutandis to the county captain and mayor of the capital city of Prague,
(g) in the case of Members of the Chamber of Deputies and Senators of the Senate of the Parliament of the Czech Republic and Members of the European Parliament elected on the territory of the Czech Republic, the date of election shall be deemed to be the date of expiry of the term of office or the date of expiry of the mandate,
(h) members of the Government, the President, the Vice-President and the members of the Supreme Audit Office, the members of the Broadcasting Council, the members of the Council of the Czech Telecommunications Office, the Financial Arbiter, the representative of the Financial Arbiter and the Ombudsman, the Ombudsman of the children and their representative shall be deemed to be the date of termination of their duties;
(i) in the case of natural persons not referred to in points (e) to (h) who have been appointed or elected to office and whose appointment has not given rise to an employment or service relationship, the date on which they take up their duties and the day on which they cease to work shall be deemed to be the date on which they cease to work;
(j) for voluntary care workers, the date on which the volunteer began to provide the care service and the day on which the worker ceased to be a volunteer care service shall be deemed to be the day on which he ceased to be a volunteer;
(k) in the case of a child-care person and persons who are kept in the register of persons who may pursue foster care for a transitional period, provided that they are paid by a foster child's remuneration under the Social Protection Act (16c), the day from which such remuneration is due and the day of termination of employment is considered to be the day from which such remuneration does not belong for reasons other than temporary incapacity for work;
(l) in the case of convicted persons in the exercise of a safeguard measure, the detention and detention sentences assigned to work on the date of entry into work and the date of removal from work shall be deemed to be the date of termination of employment;
(m) in the case of persons engaged in a relationship having an employment relationship but not having an employment relationship, since the conditions laid down in the labour law for its establishment have not been fulfilled, the date on which the work begins and the day on which the work is terminated is deemed to be the date on which the work is terminated;
(n) for staff not referred to in points (a) to (m), the date on which the staff member began to carry out the work on the basis of which the income from the dependent activity derives and the day on which the employment is terminated shall be deemed to be the date on which the work is completed.
(3) The State's obligation to pay insurance premiums for insured persons arises on the day on which the State becomes the payer of insurance premiums pursuant to Article 7. This obligation expires on the date on which the State ceased to be a payer of insurance premiums pursuant to Paragraph 7.
(4) The insured person shall not be obliged to pay insurance premiums for the duration of his or her long-term abroad if he / she is insured abroad and has made a written declaration to that effect with the relevant health insurance undertaking. However, the obligation to pay the premium shall expire only on the date on which the insured person stated in the declaration referred to in the first sentence, but not before the day following the date on which the declaration was delivered to the relevant health insurance undertaking. From the same day until the date on which the insured person has re-registered with the relevant health insurance undertaking, the insured person shall not be entitled to the provision of the services paid. At the same time as re-registration with the relevant health insurance undertaking, the insured person shall submit to that insurance undertaking an additional proof of the insured health insurance abroad and its length. If the insured person does not submit to the competent health insurance undertaking a proof of the insured health insurance abroad and its length, he shall be obliged to pay back the insurance in such a way that no cancellation takes place; the penalty payment is not enforced in such a case. If the insured person submits a proof of insured health insurance abroad which does not cover the entire period when he was not obliged to pay the premiums in the Czech Republic according to the first sentence, he shall be obliged to pay back the premium for each calendar month in which the health insurance abroad did not last for the whole calendar month; the periodic penalty payment is not enforced in such a case. Further statements according to the first sentence may be made to the health insurance undertaking not earlier than 2 full calendar months following the date of re-entry. A continuous stay of more than six months shall be considered as a long-term stay abroad.
(5) If the insured person does not pay the premium at the specified amount and on time, the competent health insurance undertaking shall enforce the payment of the premium to the debtor, including periodic penalty payments.
(6) Penalties shall not be enforced in the case of a long-term foreign insured person who has not made a written declaration in accordance with paragraph 4, has not paid premiums and has not benefited from paid services throughout his stay abroad. In such a case, the insured person shall be required to submit a proof of the insured health insurance abroad and its length covering the whole long-term stay abroad. In such cases, the duration of the long-term stay abroad shall be calculated from the date indicated as the beginning of the insurance in the proof of the closure of health insurance abroad.
(7) The obligation of the legal representative, guardian or guardian to pay the insurance premium for the person referred to in Paragraph 2 (1) (b) (9) arises from the birth of that person and expires at the end of the calendar month in which that person completed 60 days of age or, where an application for a long-term residence permit has been submitted for that person in the territory of the Czech Republic, expires at the end of the calendar month in which the procedure was final.
(8) The obligation of the legal representative, guardian or guardian to pay the insurance premium for the person referred to in § 2 (1) (b) (11) arises on the date of the granting of a long-term residence permit in the Czech Republic and expires at the end of the calendar month in which the long-term residence permit in the Czech Republic expired or in which that person reached maturity, if this was earlier.
§ 9
Amount and method of payment of premiums and periodic penalty payments
(1) The amount of premiums, periodic penalty payments and the manner in which they are paid are laid down in a separate law. 17)
(2) Employees' premiums are paid from one third to an employee, from two thirds to an employer.

ČÁST TŘETÍ

RIGHTS AND OBLIGATIONS OF INSURANCE PLANS
§ 10
Reporting obligation for payers
(1) The employer is obliged to notify the competent health insurance undertaking of:
(a) the recruitment and termination of a staff member (Paragraph 2 (3)), unless the staff member is acting solely on the basis of an agreement on the performance of a job or an employee acting solely on the basis of an agreement on employment, for which the notice of taking up or leaving the employment is made by the 20th day of the calendar month following the month in which the insurance payers have become or have ceased to be insured under § 5 (a) (3) or (6);
(b) the change of the health insurance undertaking by the employee, if that fact has been communicated to him; the notification shall be made by means of a write-off from the insurance premiums paid by the original health insurance undertaking and an insurance claim made by the health insurance undertaking chosen by the staff member;
(c) the facts relevant to the State's obligation to pay insurance premiums for women on maternity and parental leave pursuant to Article 7 (1) (d), for the entire calendar month at the latest on the due date of insurance premiums for that month under the Public Health Insurance Act.
The employer shall keep records and documentation of the facts notified. When fulfilling the notification requirement, the employer shall communicate the name, surname, permanent residence or, where applicable, the address of the place of residence, if it is a non-resident alien, and the birth number of the employee, or any other number of the insured person.
(2) An employee shall notify the relevant health insurance undertaking of the facts referred to in the preceding paragraph without delay if he finds that his employer has failed to fulfil that obligation or if he has not communicated the information referred to in paragraph 1 (b) to his employer.
(3) An insured person who has become or has ceased to be a self-employed person is obliged to notify the competent health insurance undertaking of that fact no later than eight days after he has become or has ceased to be a self-employed person. The insured person who has a business licence shall fulfil this obligation even if the notification is made to the competent trade authority 17b). The insured person shall fulfil the obligation according to the first sentence, even if such notification, together with a notification of entry into the flat-rate scheme or a notification of termination of the flat-rate scheme through the Financial Administration of the Czech Republic, is made by the administrator of the register of all public health insurers; the obligation is fulfilled by the date of the notification to the Financial Administration of the Czech Republic.
(4) The insured person shall notify the relevant health insurance undertaking within eight days of the date on which he became insured under Section 5 (c).
(5) The insured person shall notify and document to the competent health insurance undertaking no later than 8 days after the date on which they occurred the facts relevant to the formation or termination of the obligation of the State to pay the insurance premiums under Article 7 (1) (i), (j), (k), (m), (n), (r), (s) and (t). For persons who are not fully qualified, this obligation shall be fulfilled by their legal representative, guardian or guardian.
(6) The birth of the insured person shall be notified by his legal representative, guardian or guardian within eight days of the date of birth to the health insurance undertaking with which the mother of the child is insured on the day of birth; If the mother of the child is not insured under this law, the legal representative, guardian or guardian of the child shall notify the health insurance undertaking in which the child's father is insured on the day of his birth.
(8) The birth of the insured person referred to in § 2 (1) (b) (9) or (10) shall be notified by his legal representative, guardian or guardian within 8 days of the date of birth to a health insurance undertaking with which the mother of the child is insured on the day of birth; If the mother of the child is not insured under this law, the legal representative, guardian or guardian of the child shall notify the health insurance undertaking in which the child's father is insured on the day of his birth. If parents are not insured under this law, the legal representative, guardian or guardian of the child will notify the General Health Insurance Company of the Czech Republic.
(9) The issue of a long-term residence permit to the insured person referred to in Article 2 (1) (b) (11) shall be subject to notification by his legal representative, guardian or guardian to the competent health insurance undertaking within 8 days of the date of receipt of the authorisation.
§ 10a
Trade offices
(1) The trade authorities which have accepted the notification provided for in the second sentence of Article 10 (3) shall transmit these data within the prescribed timelimit 18a) to the health insurance undertaking indicated in its notification by the insured person (hereinafter referred to as "the competent insurance undertaking").
(2) The trade authorities shall inform the competent insurance undertaking concerned, within five working days at the latest, of the establishment of the first or the expiry of the last authorisation to conduct the trade and of the suspension of the exercise of the trade, indicating the date on which such events occurred.
(3) The trade authorities shall, upon request, transmit to the health insurance undertaking copies of the documents which the insured person has attached to his notification under paragraph 1.
(4) Within the limits of their competence, the trade authorities and health insurance undertakings shall transmit to each other the information necessary to carry out the public health insurance of self-employed persons who carry out business on the basis of a trade licence.
§ 10b
The information notified by a person other than the insured person pursuant to Article 10 (1) (a) and (b) and the facts relevant to the State's obligation to pay the insured person's premiums under Article 7 (1) may also be notified to the relevant health insurance undertaking by the insured person. In that case, the notification provided for in Article 10c shall not apply.
§ 10c
(1) The notification referred to in Articles 10 (1) and 10 (a) may be made only by electronic data message in the format and structure established by the relevant health insurance undertaking.
(a) using the guaranteed identity of the feeder in a manner specified by the relevant health insurance undertaking; or
(b) by means of which other legislation links the effects of handwritten signature 74).
(2) The health insurance undertaking concerned shall publish the format and structure of the submission referred to in Articles 10 (1) and 10 (a) in a manner enabling remote access.

ČÁST ČTVRTÁ

RIGHTS AND OBLIGATIONS OF THE INSURANCE
§ 11
(1) The insured person has the right
(a) the choice of health insurance undertakings, unless otherwise provided for in this law;
(b) the choice of the health service provider (hereinafter referred to as the "provider") which is under contract with the relevant health insurance undertaking and the choice of the health service provider; in the case of a registrant, it may exercise that right once every 3 months;
(c) the time and local availability of paid services provided by the contracting providers of the relevant health insurance undertaking;
(d) the provision of paid services to the extent and under the conditions laid down in this Act and the Act on the categorisation of medical devices, the provider may not accept any payment from the insured for such services;
(e) for the issue of prescribed medical devices, medicinal products and foodstuffs for special medical purposes, if they are medical devices, medicinal products and food for special medical purposes wholly or partly covered by health insurance, to the extent and under the conditions laid down in this Act and the Act on the categorisation of medical devices; This applies even if the healthcare provider does not have a contract with the health insurance company of the insured person,
(f) the provision of health care paid to the extent and under the conditions laid down by this Act relating to diseases with very low incidence in the population within the meaning of the directly applicable legislation of the European Union19a (hereinafter referred to as "rare diseases"), including orphan medicinal products covered by this Act,
Zobrazit všechna ustanovení (1913)

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Regulation Information

CitationAct No. 48 / 1997 Coll., on Public Health Insurance and on the amendment and addition of certain related laws
Regulation TypeLaw
Author-
CollectionCode of Laws
Date of Promulgation28.03.1997
Effective from01.04.1997
Effective until-
Status Valid
Legal Areas: Banking, Money Taxes Finance Collective negotiations Civil law Civil law substantive Labour law Social security law Administrative law Health
The regulation text is for informational purposes only.

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