Story #15

I work as a COVID-19 ICU nurse. Me and my family have been living in the Czech Republic for 2 years. My husband is an engineer, children go to elementary school and kindergarten. As me and my husband are employed – we are entitled to the public health insurance. But not our children, who are left with the limited private health insurance only. We live in a small town in Moravian-Silisean region, where no doctor or hospital accepts private health insurance. This means that we have to pay out of pocket for every examination and then pray that private health insurance finds our claim valid and pays us some money back. This very disturbing situation became an absolute nightmare since COVID-19 outbreak.

Last month my husband, despite being fully vaccinated, got 3 days of fever and a running nose. Being a health worker and a responsible person I insisted he undergoes a PCR test – which turned out to be positive and indicated of a highly infectious delta-mutation. So we followed all of the COVID-19 instructions: registered all our contacts as suspicious ones, informed the doctors and quarantined our son who couldn’t get the COVID-19 vaccine because of his age. Later on we got a call from the Region Health Station – they told us that every non-vaccinated family member should undergo a PCR test to end quarantine early and it’s an absolute must for those who start to exhibit any symptoms.

On the second day of quarantine my youngest son started to show COVID-like symptoms – he also got a running nose and sub febrile temperature. I called his doctor and she sent us an electronic referral for a PCR test, that should have been fully covered by health insurance. I made an appointment with a laboratory at the very same hospital I work. But when we arrived for our appointment the laboratory told me that as my son has private health insurance that is as good as no insurance so I must pay out of pocket. That was a day before my pay was due and I didn’t have another 817 czk, so the laboratory showed us the door. I was sad, angry and afraid at the same time – afraid of being fined for my son not taking the test. Indeed the next day I got a call from the Region Health Station and the woman on the other end of the line was furious and yelling at me as she could see the no-show in the system.

As I said – I am a health worker and a responsible person. The day I got my salary I took my son to the test as samoplátce. Good news – test turned out to be negative, bad news – private health insurance wouldn’t reimburse us for it as the reservation was made as samoplátce and not through the COVID-19 tracing system on basis of a doctor’s referral.

The Region Health Station told us that we must undergo another PCR test to end the quarantine. At the same time they refused to make a referral for a PCR test – we were told that as my son has private health insurance and doesn’t have a Rodné číslo assigned they can’t create a referral in the system. The son’s doctor (who somehow managed to make a referral before) told us he could not do it this time, as my son doesn’t exhibit any symptoms anymore, and in this case only the Health Station could issue a referral. This means me losing another 817 czk I’ll pay for the PCR test as private health insurance won’t reimburse it without a referral.

1 year of private health insurance costs more than 1 full salary of a COVID-19 ICU nurse. And I still need to pay out of pocket for every doctor’s visit and only hope to see part of this money back, or risk my children being denied the health care they require. What can possibly justify the cruelty of this system towards taxpayers’ children?

Story #14

My daughter was born in Feb 2020, and despite the fact that I am a full-time employee in the Czech Republic and have public health insurance myself – I was not allowed to get my newborn a public health insurance. Luckily, she was born healthy, and PVZP company agreed to take her on as a client. I purchased PVZP Plus insurance for 39 months and as every client who was ordering it online from PVZP’s website I got a discount of 25% – all in all I paid 47 000 czk for 3 years and 3 months of insurance. My daughter’s insurance was valid under KZPCP 1/17 conditions – they included full coverage of compulsory vaccination that is fully covered by public health insurance. That was very handy as important meningitis B/ACWY and pneumococcus vaccines would have cost around 15 000 czk.

In July 2021 the Czech Parliament turned down the proposal to enroll children of taxpayers into the public health insurance system on condition their parents pay around 2000 czk monthly on their behalf. Instead they voted for making PVZP the only company who is allowed to sell private health insurance till year 2026.

Last week I decided to check how much does 39 months of insurance for a newborn cost now. I was shocked – now with monopoly in place PVZP is asking 87 300 czk. Not only discounts that have been offered for years in case of online purchase were discarded, but the base price of insurance went up by 30% as well at almost the same time the PVZP monopoly draft was suggested by the head of VZP Board of directors (coincidentally member of ANO party). PVZP insurance terms and conditions have become significantly worse as well – now, according to the most recent KZPCP 2/21, PVZP Plus won’t cover any compulsory vaccination that is fully covered by public health insurance and the parents need to pay around 15 000 czk on top of the outrageous 87 300 czk. That’s the increase of 117%, unbelievable!

Story #13

In spring 2021 I. purchased PVZP Plus insurance. Later this summer she had to travel to her home town in the Ukraine in order to extend the validity of her passport – unfortunately this could not be done in the embassy. Thanks to the direct orders of the Czech Ministry of Health, long-term residents with private health insurance weren’t entitled to COVID-19 vaccination for the first 6 months of vaccination campaign (even paying out of pocket was not an option) – so I. wasn’t vaccinated at the time of her trip. I. was traveling by car and according to travel restrictions in place she didn’t need a COVID-19 test to show upon return – she had to undergo one in the Czech Republic the earliest 5 days after her trip.

4 days after she was back in the Czech Republic I. got diagnosed with COVID-19 (delta mutation) and hospitalized in Fakultní Thomayerova nemocnice. 3 weeks later PVZP declined paying for I.’s COVID-19 treatment, at the same time they refused to provide any explanation but the cryptic reference to “exclusion from coverage according to Oddil B Čl. 2.1 KZPCP 1/20″.
The hospital took the patient’s side and sent a request to PVZP to reconsider the case. At this time the medical bill has already reached 130.000 czk.

3 weeks later I. finally managed to get a formal explanation from the insurance company – according to it PVZP denied paying for COVID-19 as I. didn’t prove that she was healthy upon leaving the Ukraine. By mere chance I. underwent an antigen test a day before her trip as she needed one to attend a local event, and she still kept the result. Only after this evidence was introduced PVZP finally recognized the claim as valid and started to fulfill their obligations.

Story #12

My son has been diagnosed with a functional neurological disorder when he had an insurance with PVZP.
When it was time to prolong my son’s residence permit I went to the PVZP office to get an insurance contract for the next 2 years. From the employee of theirs I learned that my son is on their black list of non-profitable customers and they won’t insure him anymore, because if they do they will have to continue to pay for his treatment.
I had to go to a different insurance company, but with the change of health insurance company my son’s health condition, although discovered for the first time in the Czech Republic, became a pre-existing condition for the new health insurance contract. Neither of his treatments and medicines is now covered by the insurance and we have to pay out of pocket.

Story #11

I am Brazilian, me and my wife have been working in the Czech Republic for almost 2.5 years now. 2 months before relocating to Brno our daughter has been diagnosed with Turner’s syndrome – a genetic disorder which can be substantially improved by growth hormone therapy.

We got a health insurance contract with Uniqa which specifically excluded all Turner-syndrome related health care and medication. When we asked PVZP to calculate the price of the PVZP Exclusive – the only commercial health insurance on the market that actually covers pre-existing conditions and has no limits for prescribed medication – they informed us, that the insurance premium per year in our case will be close to the overall insurance limit of 1 800 000 czk, and we should pay the money upfront.

We managed to bring 2 packs of the growth hormone medicine from Brazil (there the medicine for my daughter was paid by the state), but that was barely enough for 3 months of therapy. Here the medicine alone costs us around 24 000 czk/month and we absolutely can’t stop the treatment as the quality of my daughter’s life is at stake. We tried to arrange shipping the medicine from Brazil – the first and the last shipment was seized by the Czech customs officers, who didn’t let it through claiming it was violating the EU import laws.

Besides hormone therapy my daughter needs regular checkups with a variety of health care specialists – all that we are also paying out of the pocket as it is not covered by the health insurance.

Story #10

My son was diagnosed with Type 1 diabetes when he had a private health insurance with PVZP.

The first thing I did was to call the insurance company for the information what health care directly connected to diabetes will be covered and to what extent. The assistance assured me that as long as the condition was discovered for the first time – everything including diabetes management will be covered up to the general overall limit of 1 700 000 czk.

Only later I found out how ignorant the PVZP assistance was – turned out only emergencies (like diabetic coma), hospitalization and checkups are covered up to the general limit, but not the diabetes management. Other children of the same age who have public health insurance are entitled to an insulin pump, free insulin, substantial amount of test strips – full list can be found here. Not our case: an insulin pump alone costs 100 000 czk, test strips/sensors/insulin for a year is another 30 000 czk of out of pocket expenses. PVZP will pay just 5000 czk for diabetes management for the whole period of insurance (which in our case means we are entitled to get this compensation only once in 2 years) – that is the typical limit of prescribed medication and medical devices for a Czech private health insurance.

The assistance has never apologized for giving me false hopes (not that it would actually change anything of course). To cite their specialist – we should consider ourselves lucky that PVZP has not terminated our insurance contract on the spot.

Story #8

My 5 year old son has a chronic condition which requires annual examinations.

As with every chronic condition and private health insurance in the Czech Republic – you can’t manage it through your health insurance provider, so we have to pay for all the examinations ourselves. And here is the unpleasant finding – it is absolutely legal to charge foreigners several times more for the usual examinations, actually it is up to the hospital how much it will ask you to pay. Yes, you got it right, there are 2 types of prices – Czech public health insurance companies pay the smallest one and foreigners from non-EU countries the greatest. From our practice: once we say we are Russian nationals seeking non-urgent outpatient services that our insurance company doesn’t cover – the price usually triples.

The math of managing my son’s megaureter is cruel – return tickets Prague-Moscow, a week’s stay and examinations in a top-notch Filatov’s Hospital still cost us less than going to a doctor in Prague.

But with the coronavirus outbreak we don’t have the fly back option any longer.

For the time we have been living here I have payed more than 350 000 czk in taxes for my public health insurance with VZP (that I barely use) and about 60 000 czk for my son’s private health insurance with PVZP. And my little one still is not entitled to the care he requires. If that isn’t discrimination – what is?

Story #7

Daniil and his wife Mila were studying in Prague.

In 2017 Mila became pregnant with twins and the spouses got an expensive private health insurance for pregnancy and childbirth with Maxima. Unfortunately, a routine ultrasound showed that the baby boy had developed a life threatening condition and the twins had to be delivered early at 29 weeks.

One day of NICU at the Podoli hospital cost on average 28 000 czk, so the insurance limit of 100 000 czk for the kids’ hospital stay ran out in the first couple of days (the maximum available limit on the market at that time was 300 000 czk or 10 days of hospitalization max). All private health insurance companies refused to insure the preemies, the expenses for the postnatal care from 20/1/2018 to 14/2/2018 quickly escalated to 1 622 548 czk.

InBaze organization helped to organize a fundraiser to partly cover the hospital bill.

Story #6

Ukrainian citizen O.B. has been working in Prague since October 2007 and as every working foreigner was eligible for public health insurance with VZP.

Later that year O.B. got pregnant, but unfortunately her son arrived early and required extensive care in the NICU of the Podoli hospital. O.B. didn’t have permanent residence permit so her son couldn’t be insured by VZP, and the only option for him to get any insurance was through a private insurance provider. But every single private health insurance company refused to insure the newborn because of the existing medical complications.

Hospitalization from birth till 5/5/2008 resulted in a total of 682 158 czk.

Source: Pl. ÚS 2/15

Story #5

Ukrainian citizen O.K. has been employed in Czech Republic since 2008. During 2012 she found out she was expecting a baby, but due to pregnancy complications she had to take sick leave since 17/12/2012. Her medical condition didn’t allow her to work so the employer didn’t prolong her work contract which ended on 31/1/2013.

As O.K. didn’t have permanent residence permit, along with losing her job she lost right to participate in public health insurance system. Her high-risk pregnancy didn’t allow her to find another job and get back the public health insurance with VZP that she has been dutifully paying for the previous 5 years, neither could she fly back to her home town nor get a private health insurance. O.K. applied for the permanent residence permit on 18/3/2013, her application was approved on 19/6/2013 and she and her newborn son became eligible for public health insurance. But the costs of prenatal care since 1/2/2013, delivery and hospital stay for both herself and her son O.K. had to pay herself.

Source: Pl. ÚS 2/15