Annual household out-of-pocket payment, current USD per capita (2019): $261

Source: Global Health Expenditure Database. Health expenditure series. Geneva: World Health Organization. Last accessed July 21, 2022.

Out-of-Pocket Spending as Share of Final Household Consumption (%) (2019): 2.4%

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.

Current Health Expenditure Per Capita in US$ (2019): $1,844

Out-Of-Pocket Expenditure As Percentage Of Current Health Expenditure (2019): 14.15%

Out-Of-Pocket Expenditure Per Capita in US$ (2019): $261

“In the Czech health system the introduction of formal user fees in 2008 reduced the depth of coverage, because health providers’ remuneration was adjusted downward to take into account the revenues of user fees directly paid to providers. User fees for prescriptions and certain health services (for example, emergency care or hospital stays), as well as co-payments for pharmaceuticals, were introduced in 2008. The system of user fees and co-payments has been changed several times since its introduction. User fees for hospital stays were abolished by the Czech Constitutional Court in 2013. In mid-2014 there were user fees for doctor visits – CZK 30 (€1.20); the use of ambulatory services outside standard office hours – CZK 90 (€3.60); and per prescription – CZK 30 (€1.20). (For further information see section 3.4.1.) Co-payments other than those specified by law or top-up payments are legally prohibited.”

Source: Alexa J, Rečka L, Votápková J, van Ginneken E, Spranger A, Wittenbecher F. Czech Republic: Health system review. Health Systems in Transition, 2015; 17(1):1–165.

“Until the end of 2007 inpatient and outpatient health services were free of charge at the point of use, with the exception of some prescription pharmaceuticals and medical aids. Starting in 2008, flat user fees of CZK 30 (€1.20) per doctor visit, CZK 60 (€2.40) per hospital day and CZK 90 (€3.60) per use of ambulatory services outside standard office hours were introduced as a method of containing costs by reducing inappropriate demand. A flat user fee of CZK 30 (€1.20) was also introduced for each prescribed pharmaceutical (thus, a patient would pay CZK 60 for one prescription with two prescribed pharmaceuticals on it). This was changed to a flat fee of CZK 30 (€1.20) per prescription in 2012 (thus, the patient pays only one fee even if there is more than one pharmaceutical on the prescription). Since 2009, for pharmaceuticals for which the actual price exceeds the reference price in a particular pharmaceutical group, patients additionally must either pay the difference in price or pay CZK 30 (€1.20), whichever is greater. In 2011 the user fee per hospital day was increased from CZK 60 to CZK 100 (€4.00).”

Source: Alexa J, Rečka L, Votápková J, van Ginneken E, Spranger A, Wittenbecher F. Czech Republic: Health system review. Health Systems in Transition, 2015; 17(1):1–165.

“Some groups were (and are) exempt from the fees, including people living below the poverty line, neonates, chronically ill children, pregnant women, patients with infectious diseases, organ and tissue donors, and individuals receiving preventive services. Moreover, an annual ceiling of CZK 5000 (€200) per insured individual was established for selected user fees (user fees for hospital stays and the use of ambulatory services outside standard office hours were (and are) not included in the individual calculation of ceilings), as well as for co-payments on prescription pharmaceuticals the actual price of which exceeds the reference price in a particular pharmaceutical group. Due to popular and political opposition to the user fees, the annual ceiling was lowered to CZK 2500 (€100) in 2009 for persons under 18 and over 65 years. Patients who exceed this limit are reimbursed for the additional user fees and prescription pharmaceutical co-payments by their health insurance fund. Moreover, children up to the age of 18 years were exempted from user fees for doctor visits. In 2013 the CZK 2500 (€100) ceiling was reached by 228 000 people (approximately 2.2% of the population) (Ministry of Health, 2014a). In July 2013 the Czech Constitutional Court abolished the user fees for hospital days as of January 2015. The main argument behind this decision was that CZK 100 (€4) per day was unfair to certain vulnerable groups. User fees have been politically divisive and controversial as well as unpopular among the population since their introduction (Van Ginneken et al., 2010). Any future developments will heavily depend on who is in power. Before the early elections in October 2013 most political parties (including the Social Democrats, ČSSD) declared they wanted to maintain user fees per hospital day at CZK 60 (€2.40) and fees for the use of ambulatory services outside standard GP office hours. The new coalition (ČSSD, ANO, KDU-ČSL) abolished user fees per doctor visit and for prescription pharmaceuticals in January 2015, therefore only the user fee for the use of ambulatory services outside standard office hours remains in force, at CZK 90 (€ 3.60).”

Source: Alexa J, Rečka L, Votápková J, van Ginneken E, Spranger A, Wittenbecher F. Czech Republic: Health system review. Health Systems in Transition, 2015; 17(1):1–165.

“Direct payments consist of payments for over-the counter pharmaceuticals and medicinal products and non-SHI services and are limited in scope given the broad SHI benefit package. Direct payments are, for instance, payments for treatment by selected senior physicians or more luxurious hotel-related services in inpatient settings.

“Approximately 42% of total expenditure on dental care is funded privately through OOP payments, as the range of dental treatments covered by SHI is limited and restricted to the least expensive options. Most insured individuals choose to pay in full for higher-quality dental materials (although the treatment itself is usually covered by SHI). OOP payments on dental care accounted for 15.6% of total OOP expenditure on health care in the Czech Republic in 2012 (OECD, 2014a).”

Source: Alexa J, Rečka L, Votápková J, van Ginneken E, Spranger A, Wittenbecher F. Czech Republic: Health system review. Health Systems in Transition, 2015; 17(1):1–165.

Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.

Page last updated Oct. 8, 2022 by Doug McVay, Editor.