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01 September 2025 | Country Update
Schools are newly required to provide menstrual products for free -
20 May 2025 | Country Update
The National Plan for the Development of Geriatric Care in Czechia until 2035
7.2. Accessibility
As HIFs must accept all applicants with a legal basis for entitlement and risk selection is not permitted, Czechia has virtually 100% population coverage. In principle, all insured individuals are entitled to any medical treatment delivered to maintain or improve their health (see section 3.3.1). All, including Czech citizens and permanent residents, are subject to compulsory SHI enrolment. Individuals without permanent residency are covered if they work for a Czech-based employer. Exemptions exist for EU nationals if they are insured through their country’s system or privately insured in Czechia. Non-EU nationals without permanent residence and not working for a Czech-based employer must purchase PHI (see section 3.5). The range of benefits covered by SHI is broad and includes inpatient and outpatient care; prescription pharmaceuticals; (some) dental procedures; rehabilitation; spa treatments; and over-the-counter pharmaceuticals (the last three if physician prescribed). Patients cannot top up their SHI coverage. Cost-sharing is rare (mostly for pharmaceuticals) and virtually all health services are free at the point of use. This broad range of benefits and services for all helps Czechia have among the lowest levels of unmet needs for medical care in the EU. These are related to waiting times and distances to providers, though waiting times and physicians’ capacities are still not systematically monitored (see below).
The accessibility of care is defined by Governmental Regulation no. 307/2012 Coll., which defines reachability (in minutes) for certain specialties and the maximum time one should wait for chosen medical interventions (in weeks). However, as waiting times in Czechia are not systematically monitored, their estimates are not objective. The main obstacle hindering this is the non-existence of electronic referrals (for requested care), though there are ongoing discussions about their introduction.
The definition of reachability (in minutes) is disputable, as it does not consider physicians’ capacities (nor a definition of transportation methods). HIFs are responsible for ensuring that all members can reach physicians (for certain specialties) within the defined time and for their members’ registration with physicians. To increase their accessibility, HIFs financially incentivize physicians to practise in remote areas and to offer extended hours. Based on VZP’s analysis, the regulation on physicians’ reachability is met for their members in all municipalities (VZP, 2022). Barriers (if any) to accessibility are along Czechia’s borders, and the distribution of acute care hospitals can be approximated by the map of acute inpatient surgery. In 2019, patients near the western and southern borders needed the longest to reach hospitals.
As patients can choose their providers, comparing physician-to-population ratios across regions can be misleading. The high density of health professionals in Prague can be partially explained by patients who formally reside in other regions or who commute (see section 5.3), and there is considerable variation in the availability of services across specializations. Nevertheless, data on actual accessibility, based on providers’ capacities, are scarce. Even though the number of practising physicians and nurses is slightly higher than the EU average (see section 4.2), service utilization is relatively high in comparison to other countries, presumably influencing their capacities. In 2019, the number of physician visits per capita (excluding dentists and telephone/email contacts) in Czechia (8.2) was among the highest (Eurostat, 2022).
There are low levels of self-reported unmet needs for medical care due to financial reasons, distance and waiting times (see Fig7.1). In 2020, only 0.4% of Czechs reported unmet needs for medical examinations, compared with the EU average of 1.9%. In Czechia, these are primarily attributed to waiting lists (0.2%) and distances (0.1%), whereas financial reasons are not seen as a driver of unmet needs for medical examinations (see section 7.3). Unmet needs for dental examinations stood at 0.8% in 2020 and have more than halved since 2013 (1.7%). In contrast to medical examinations, there are significant differences in unmet needs for dental examinations between the lowest and highest income quintiles (1.5% versus 0.4%, respectively) (Eurostat, 2022).
Fig7.1
In August 2025, the Ministry of Health issued an amendment to Directive No. 160/2024 Coll., on hygienic requirements for schools and childcare facilities, which will take effect from January 2026. The reform introduces a legal obligation for all toilets used by girls over the age of nine (including shared facilities) to be equipped with individually packaged menstrual products. The measure, developed in consultation with public health experts, paediatricians, school representatives, parents and NGOs, aims to improve hygiene standards, reduce school absenteeism linked to menstruation, and promote equal access to education. While many schools already provide menstrual products on a voluntary basis, the directive establishes a uniform framework nationwide.
Czechia applies one of the highest VAT rates on menstrual products in Europe, at 21%. Despite the 2023 VAT reform, these products remained classified in the highest VAT category.
Authors
Czechia’s National Plan for the Development of Geriatric Care until 2035 responds to ongoing population ageing. The plan outlines four main strategic goals:
- Creating conditions for healthy ageing and the prevention of disability,
- Ensuring high-quality geriatric care supported by research and education in geriatrics and gerontology,
- Improving the accessibility and systemic organization of specialized geriatric care, and
- Establishing effective integration within the geriatric care system to meet the complex needs of older patients.
The accessibility of specialized geriatric care is to be ensured through four major areas:
- a network of geriatric clinics at all medical faculties,
- the establishment of a basic network of inpatient geriatric care facilities,
- geriatric outpatient clinics, and
- systemic support to guarantee the availability of geriatric health services.
With proper diagnosis and appropriately tailored treatment, patients with frailty, multimorbidity, and sarcopenia can spend more time at home and in community environments to treat conditions appropriately and in a timely manner. This shift can contribute to greater long-term fiscal sustainability and enhance the role of community- and family-based care, while simultaneously supporting the fullest possible return to quality of life and self-sufficiency through adequate follow-up care and rehabilitation. On the other hand, hospitalization in a dedicated geriatric ward has the potential to improve patients’ functional outcomes at discharge, increase the share of patients returning to their home environment, reduce the number discharged to subsequent inpatient facilities, and lower the rate of early rehospitalizations.
The plan furthermore includes detailed sub-goals and is supported by an analytical study conducted by the Institute of Health Information and Statistics (ÚZIS).