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Organization for Aid to Refugees (OPU) issued an analysis of commercial health insurance companies in the Czech Republic which shows that the system of commercial health insurance for foreigners from third countries often does not work and countless exclusions of insurance companies from indemnification are charged to hospitals, physicians, foreigners themselves and also the Czech state. Only commercial health insurance companies make money in this system. Legislative and systemic recommendations (policy paper) to policy-makers were prepared together with the analysis.

The OPU’s analysis on several specific examples of foreigners from third countries highlights the absurd regulation of commercial health insurance for foreigners who do not hold permanent residency, refugees, and employees in dependent employment. The residency status of these foreigners is by law tied to the obligation to take out commercial health insurance with an insurance company based in the Czech Republic. That often makes them helpless victims of several commercial insurance companies which divided this profitable market among themselves. These are e.g. insurance companies MAXIMA, VZP, UNIQA, Slavia, AXA or ERGO. The consequences of unequal status of insured foreigners are insurance policies full of exclusions, high prices for different age categories of foreigners and thriving business for people who mediate commercial insurance and rely on the fact that foreigners do not know Czech law and Czech legal language well. For many well-integrated foreigners commercial health insurance is an obstacle to their further stay in the Czech Republic, an obstacle to starting a family because they cannot afford to pay high amount of insurance in case of childbirth. In the event of a claim, a foreigner who has paid insurance properly finds out that very often some of the exclusions is applied and the debt for unpaid health care falls upon the hospital, physicians, and foreigners themselves. “We have come across for example absurd all-embracing exclusions such as that ‘the cause of the disease or symptoms occurred before the conclusion of the contract’ or that ‘the insurance does not cover treatment of such diseases and medical conditions in which treatment is appropriate, effective and necessary but can only be provided after the return of the insured to their country’,” say authors of the analysis.

Martin Rozumek, the director of OPU, says the following to the release of the analysis: “It is incomprehensible to me that the state ‘gave away’ this group whose majority comprises of young and healthy foreigners coming to the Czech Republic primarily for work to commercial health insurance companies and does not let their insurance payments go to the public insurance system instead. After a five-year stay in the Czech Republic, foreigners are entitled to a permanent residence permit anyway and thus they are entitled to enter into the public health insurance system. This problem paradoxically also burdens citizens of the Czech Republic whose spouse is from a country outside the EU. When a commercial insurance company does not pay for the health care of its insured foreigner, the debt falls upon the hospital and we organize fundraising campaigns to pay the debt e.g. for newborns’ stay in an incubator over and over. And he adds: “Unfortunately, for women foreigners it often means that after years of paying for health and social insurance they cannot afford to start a family and give birth in the Czech Republic whereby we are, as the state, sending a clear message to women from Ukraine or Vietnam that their integration is not desired and we only want them as a cheap work force. We have pointed out this problem to responsible ministries and deputies but it seems the lobby of commercial insurance companies is winning.”

On the other hand, the OPU’s analysis points out to regulation of health insurance of foreigners in Norway where all foreigners automatically belong to the system of public health insurance after 12 months of stay in Norway regardless of the type of their residence permit. Moreover, Norwegian institutions even support a special medical center in Oslo which provides health care for foreigners without residence permits. For years, Czech NGOs associated in Consortium of Migrants Assisting Organizations in the Czech Republic have been seeking to redress the wrongly set system of commercial health insurance and in our call for a change of this system we have collected a number of supportive statements from e.g. Czech Medical Associations, several hospitals, a number of doctors and medical experts. More information about the Consortium’s call can be found on its webpage—


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