This page is for temporary protection holders whose state-paid insurance period is ending or has already ended, and for people moving to special long-term residence. Amounts are for 2026.
From what day does insurance apply?
From the day you were granted temporary protection: from that day you are insured in the state health insurance system. The law also covers medical care you received up to 60 days before protection was granted. A child of a protection holder born in Czechia is insured for the first 60 days after birth.
You can register with the health insurance company VZP (Všeobecná zdravotní pojišťovna) online, at the VZP registration office in Ostrava or at any VZP branch. To register, you show the temporary protection visa issued in Czechia.
How many days of insurance does the state pay for?
For people aged 18 to 64, it depends on when you were first granted protection:
| First protection granted | The state pays for insurance |
|---|---|
| On or before 10 February 2025 | 150 days from when protection was first granted |
| From 11 February 2025 | 90 days from when protection was first granted |
The period is counted from your first protection: being granted protection again does not restart it. After this period, for health insurance purposes the law treats you as a person with permanent residence in Czechia, so your employer, the state (for one of the groups it covers) or you yourself must pay.
If you previously had temporary protection in another EU country or lived in the EU on a permit for more than 90 days, the law treats you as having had protection in Czechia for 6 months already. So, in our reading, you will not have a state-paid insurance period.
Who stays insured at the state’s expense?
After this period, the state continues to pay for:
- children under 18; you do not need to report them to the insurance company;
- people from the day they turn 65; you do not need to report them either;
- pupils and students aged 18 to 26 at a secondary school or university in Czechia or in Ukraine; for study in Ukraine, a simple translation of the certificate is enough, and a certified translation is not needed;
- registered job seekers at the state employment service Úřad práce; you show the registration certificate at a VZP branch;
- people whose serious health condition prevents them from working for a long time (this is confirmed by an extract from their medical records), and one person who cares for them;
- a person who personally cares for at least one child under 7. From 1 January 2026, the condition is that you do not receive parental allowance, are not on maternity or parental leave and do not receive maternity benefit. You must tell the insurance company about this.
Who pays if you are not in these groups?
The payer depends on whether you work:
| Your situation | Who pays | How much in 2026 |
|---|---|---|
| You work under an employment contract | Your employer deducts and pays the contributions; the employee pays one third, the employer two thirds | 13.5% of the base |
| Self-employed (OSVČ) | You yourself, in advance payments | At least 3,306 Kč a month |
| No taxable income (OBZP) | You yourself | 3,024 Kč a month |
The OBZP contribution is paid from the 1st of the month you are paying for and no later than the 8th of the following month. Because protection holders do not have a Czech personal number (rodné číslo), the payment reference is your 10-digit insured person number at VZP.
Your employer tells the insurance company when you start and stop work; for an employment contract, within 8 days.
How do you tell the insurance company about a change of payer?
Every time the payer changes, tell your insurance company within 8 days: when the state-paid period has ended, when you start a job, leave a job, register as a job seeker or start self-employment. VZP warns that otherwise a debt may start to build up.
A debt also gets in the way of a permit: special long-term residence requires 2 years of continuous insurance without arrears.
Will the rule change for people who cannot work because of illness?
Not yet: this change is proposed by a government bill (sněmovní tisk 213), which has not become law. The bill proposes keeping state-paid insurance for adults aged 18 to 64 only if they have officially assessed limited self-sufficiency of at least the second degree, and for the person who cares for them. The assessment is made by the Institute for Health Assessment (Institut posuzování zdravotního stavu). For people who are currently insured on the basis of an extract from their medical records, the bill gives a transition period of 3 months. The changes are to come into force on 1 January 2027, and Amendment No. 1989 proposes moving the date to the fifth day after the law is published.
What happens after protection is extended?
Your insurance continues automatically. Based on the online registration, VZP issued a temporary insurance card valid until 30 September 2026, and after the new visa sticker, a card valid until 31 March 2027. The transfer of data from the Ministry of the Interior can take up to 14 working days.
What changes if you move to special long-term residence?
An adult stays in the state system only if they work for an employer based in Czechia. Anyone who does not work for such an employer at the moment their status changes must take out commercial health insurance. The state no longer pays for children; parents now pay: 3,024 Kč a month in 2026. You must report the change within 8 days.
Are tolerance visa holders insured?
No. Holders of a tolerance visa (vízum strpění) are not part of state health insurance.
Where there is no official explanation, we say so directly, and we mark our own conclusions from the text of the law with the words “in our reading”.
What mistakes should you avoid?
- Not telling your insurance company who pays after 90 or 150 days.
- Assuming that being granted protection again gives you a new state-paid period.
- Moving to special long-term residence without a job and without commercial insurance.
- Paying the OBZP contribution later than the 8th of the following month.