Sickness insurance
The sickness insurance system is intended for gainfully employed persons and, in the event of loss of income in cases of so-called short-term social events (temporary incapacity to work due to illness, injury, quarantine, caring for a family member, pregnancy, maternity or childcare), provides cash sickness insurance benefits.
General information
Since 1 January 2009, sickness insurance has been governed by Act No 187/2006 on Sickness Insurance, as amended.
Participation in a sickness insurance scheme
Sickness insurance involves employees (this includes members of the armed forces and the security forces) and self-employed persons. Employees must participate in a sickness insurance scheme, in contrast to self-employed persons, whose sickness insurance remains voluntary.
With effect from 1 January 2014, some terms have new definitions:
An exception to this principle applies only to representatives of territorial self-governing units who are not released in the long term for the performance of their function, or who do not perform it to the same extent as long-term released members of the council. Unreleased representatives no longer participate in a sickness insurance scheme; social security contributions are not deducted from their remuneration. Participation in a sickness insurance scheme is compulsory for an employee (with the exception of an employee working on the basis of an agreement on the performance of work), if they meet the conditions stipulated by the Act on Sickness Insurance. These are two basic conditions:
For an employee working on the basis of a work performance agreement, participation in a sickness insurance scheme is mandatory if two conditions are met:
Since 1 January 2014, the implementation of sickness insurance for contract employees was simplified: there are no checks as to whether they are insured in the 'third' country in which their employer has a registered office.
The rules on the conditions of employee participation in a sickness insurance scheme apply, unless otherwise agreed in the EU Coordination Regulations. If an employee meets the conditions for participation in a sickness insurance scheme under Czech law but the EU Coordination Regulations provide otherwise, this employee does not have to participate in a sickness insurance scheme in Czechia. A different procedure under the coordination rules mainly concerns posting to another EU Member State and gainful employment in more than one EU Member State.
The rights and obligations relating to social security in the EU, including the procedure for determining the jurisdiction for legal regulations, can be found on the website of the Czech Social Security Administration
A self-employed person is considered to be participating in a sickness insurance scheme from the moment at which they apply for sickness insurance and pay of sickness insurance premiums.
Since 1 January 2014, a self-employed person who participates in a sickness insurance scheme for self-employed persons is no longer considered to be a self-employed person performing their primary self-employed activity. A secondary self-employed person can also participate in a health insurance scheme as a self-employed person, although they are not required to pay pension insurance advances. The minimum monthly base that a self-employed person can set for paying health insurance premiums was CZK 5 000 from 1 January 2012 to 31 December 2018, since 1 January 2019 it has been CZK 6 000. The premium rate is 2.1% and the minimum sickness insurance premium for 2020 is set at CZK 126.
Due date for sickness insurance premiums
Since 1 January 2019, the due date of the premium for voluntary sickness insurance has changed for self-employed persons: the premium for a calendar month is now due between the first and last days of the calendar month to which it relates.
Further information on participation in a sickness insurance scheme can be found on the website of the Czech Social Security Administration and also at the following address.
Sickness insurance benefit system
The sickness insurance system provides for 6 cash benefits.
All sickness insurance benefits are paid by the district social security administration out of the state budget (from its income from premiums). Sickness insurance benefits are paid by calendar day. An insured person who claims a benefit or to whom a benefit is already being paid must report to the relevant social security administration in good time any circumstances that may give rise to a change in their entitlement to the benefit and its payment. More information can be found on the website of the Czech Social Security Administration.
You can also find basic information for employees and self-employed persons on the website of the Czech Social Security Administration.
1. January Sickness benefit
An employee or self-employed person who is recognised by an attending doctor as being temporarily incapable of working is entitled to sickness benefit from the 15th calendar day of the duration of their temporary incapacity to work, until the end of their temporary incapacity for work, but for no more than 380 calendar days calculated from the onset of the temporary incapacity to work (including offsets for any previous durations of temporary incapacity to work). However, in order to be entitled to sickness benefits, a self-employed person must have participated in a voluntary sickness insurance scheme for self-employed persons for at least 3 months immediately preceding the day of the onset of the temporary incapacity to work.
For the first 14 calendar days an employee (not a self-employed person) who has an employment relationship that includes participation in a sickness insurance scheme is paid sickness leave by the employer, in accordance with the Labour Code. Paid sickness leave is due for working days in the event of temporary incapacity to work from the 1st working day.
The recipient of a retirement or invalidity pension for 3rd-degree invalidity is paid sickness benefit from the 15th calendar day of the duration of their temporary incapacity to work (quarantine) for a maximum period of 70 calendar days, but for no longer than the day on which the insured activity ends.
Sickness benefit is also due in certain defined cases if the temporary incapacity for work (quarantine) occurred after the end of the insured employment in the so-called protection period. The purpose of the protection period is to protect a former employee for a specified period after the end of the insurance period to cover a social security event (temporary incapacity to work) that occurs before resuming further employment. The protection period when claiming sickness benefit is 7 calendar days from the date of termination of the employment that was the basis for participation in the sickness insurance scheme. For periods of employment shorter than 7 calendar days, the protection period lasts only for as many days as this most recent employment.
The protection period does not apply
2. Cash maternity allowance
The basic conditions for entitlement to this benefit are: participation in a sickness insurance scheme, or a protection that is in force on the day from which the benefit is granted, and at the latest 2 years before that date, participation in a sickness insurance scheme must have lasted for at least 270 days. For self-employed persons, a further condition for entitlement to maternity allowance is participation in a sickness insurance scheme as a self-employed person for at least 180 calendar days in the year preceding the start of the period of the allowance.
For women whose insured employment ended during pregnancy, the protection period for the entitlement to maternity allowance is as many calendar days as their most recent employment, however no more than 180 calendar days.
The start of maternity allowance occurs on the day set by the insured person on a date between the start of the 8th week and the start of the 6th week before the expected date of childbirth. The period of the allowance is 28 weeks (or 37 weeks for an insured person giving birth to two or more children at the same time).
Where an insured man takes a child into his care (based on a ruling by a competent authority, due to the death of the mother, due to a long-term serious illness of the mother or under an agreement under this Act), the support period is 22 weeks (or 31 weeks if he takes in two or more children at the same time).
Where the maternity allowance arises due to the birth of a child, it can be received until the child turns 1 year of age. Where the allowance arises due to a child being taken into alternative care, it can be received until the child reaches the age of 7 years and 31 weeks.
The Act allows a child's mother to alternate with her husband or the child's father in caring for the child, on the basis of a mutual written agreement. In this case, the maternity allowance may be paid for the period and under the conditions stipulated by the Act on Sickness Insurance. Alternating care is allowed from the start of the 7th week from the date of birth, for an unlimited time. In the event of the care for a child switching from the mother to the father, the payment of the maternity allowance to the mother is stopped, and is subsequently paid to the man out of his sickness insurance if he meets the conditions for entitlement to payment, and vice versa. In the case of a man, he must fulfil the condition of caring of the child for at least 7 consecutive calendar days.
The cash maternity allowance is paid from the day on which the insured woman has designated as the start of the cash maternity allowance, or from the date on which the child is taken into care.
3. Care allowance
An employee is entitled to care allowance if they cannot work because they must
An employee may not claim the care allowance for a child whose other parent has already claimed the cash maternity allowance or parental allowance; this does not apply if the other person has fallen ill, has suffered an injury, is in a situation covered by the law, has given birth, or has been quarantined, and is therefore unable to care for the child.
The maximum support period for the care allowance is 9 calendar days. In the case of a single employee who has at least one child under the age of 16 in their permanent care who has not completed compulsory schooling, the support period is a maximum of 16 calendar days.
4. Pregnancy and maternity compensatory allowance
The pregnancy and maternity compensatory allowance is due to a female employee who has been transferred to another job as a result of pregnancy, maternity or breastfeeding, and therefore, through no fault of her own, earns a lower income than before the transfer.
The pregnancy and maternity compensatory allowance is paid from the date of transfer to another job until the start of receipt of the cash maternity allowance.
5. Post-natal paternal allowance (paternity allowance)
A child’s father is entitled to this allowance if caring for the child, as is any person (male or female) who has taken a child into parental care, at the discretion of the competent authority. For the purposes of this allowance, the father of a child is considered to be the person registered as the father in the register of births.
Paternity allowance is only payable if the start of the paternity allowance occurred within 6 weeks of the date of the child's birth, or from the date of taking the child into care, if the child has not reached the age of 7 years. Paternity allowance is due only once, even in cases where the insured takes care of more than one child born or taken into care at the same time. There is no entitlement to paternity allowance if the commencement of paternity allowance occurs after the termination of the insurance, i.e. this means that no protection period arises for paternity allowance. For paternity allowance, the maximum support period (i.e. the benefit payment period) is 1 week, cannot be interrupted, and begins on the first day of receipt of the paternity allowance. Fathers take parental leave for time off work.
6. Long-term care allowance
For long-term care allowance, conditions are stipulated for both the person cared for and the carer.
For the person cared for, there must have been a serious deterioration in their health requiring at least 7 days of hospitalisation at a hospital, and on the day of release it must be confirmed that the need for 24-hour care will last at least another 30 days. The person cared for must grant written consent to a specific person to care for them.
A waiting period is required for the carer; employee must have had sickness insurance for at least 90 days over the last 4 months, while self-employed persons must have had sickness insurance for the last 3 months. The carer may not carry out any gainful activity during the care period, even uninsured. Over the 90 days, carers may freely alternate when caring for a person requiring 24-hour long-term care. For alternating and repeating care, the allowance is not double-counted. The allowance is not payable for any periods during which the person cared for is re-hospitalised. A carer is not entitlement to a further long-term care allowance until 12 months after the end of the previous long-term care period.
The maximum support period (benefit payment period) is 90 calendar days, and cannot be extended even if the person cared for is hospitalised during the support period.
An employer may not refuse an employee's absence from work during the provision of long-term care unless serious operational reasons justify the employee's presence; this must be communicated to the employee in writing.
Calculation of sickness insurance benefits
Benefits are calculated from the daily assessment base, which is determined by dividing the eligible income received by the employee in the relevant period (usually 12 calendar months before the calendar month in which the social event occurred) by the number of 'eligible' calendar days for that relevant period. The average daily income so determined is adjusted (reduced) by means of three reduction limits to the daily assessment basis.
Reduction of the daily assessment base
The value of the three reduction limits as of 1 January of a calendar year is announced by the Ministry of Labour and Social Affairs in the form of a Notice in the Collection of Legislative Acts.
In 2024, the 1st reduction limit was CZK 1 466, the 2nd reduction limit was CZK 2 199, and the 3rd reduction limit was CZK 4 397.
Electronic sick leave and payment of sickness benefits
For more detailed information about electronic sick leave, please visit the website of the Czech Social Security Administration.
Claiming other sickness insurance benefits, including sickness insurance due to mandatory quarantine
For more information on benefits visit the website of the Czech Social Administration.