Your insurance company must find you a doctor. Hold them to it.

If they don’t manage it, or don’t give it a fair try, you can report them to the Ministry.

Having trouble finding a GP?

You might have been lucky and found a general practitioner in the Czech Republic easily. Most expats would describe a different experience, though,  and some Czechs would, too.

They make calls, write emails, and all they get is another rejection because the tenth doctor they have decided to try has also reached their full capacity of patients. Often, they’re rejected with the recommendation to contact their health insurance company. But the only help they get there is a list of all contractual doctors who they are once again supposed to contact themselves.

And the circle begins anew.

This practice is not correct. Your health insurance company is obliged to help you find a doctor by law. Providing you with a list of all possibilities does not sufficiently follow this law. The Ministry of Health has once confirmed that. To support their claim, the given authority has published a detailed guide on how to look for a doctor correctly. This is the content of this guide, translated to English:

How to find a doctor: a guide published by the Ministry of Health

Who is responsible for providing health care?

The health insurance company you are registered with.

What exactly is the health insurance company responsible for?

The so-called local and temporal availability of health care. In simple terms: that the doctor/medical facility is close enough to your place of residence.

What legislation does the insurance company follow?

Government Regulation No. 307/2012 Coll., on temporal and local availability of health services. The information listed there is binding for insurance companies.

How to find a doctor?

Contact your health insurance company by phone or in person. Alternatively, visit their website.

What should you ask at the insurance company and what can the insurance company ask you?

By phone or in person:

Tell the officer that you cannot find a doctor (GP, dentist, etc.) in the place where you live. Have your identification data (e.g. your health insurance number, date of birth, etc.) prepared as it will be used to prove your identity to the officer.

On their website:

Find a contact email and write your request. Include your identification data (e.g. your health insurance number, date of birth, etc.) in the text.

Websites of some insurance companies also contain a link to the National Registry of Health Service Providers. When using it, you can filter your search to a specific location and specialization of the doctor you are looking for. (it’s only in Czech, though, and doesn’t contain information about the doctor’s ability to communicate in English.)

The official wording of the guide (in Czech) is available here.

What if your insurance company doesn’t try/manage to find you a doctor

Next to the guide above, the Ministry suggests a suitable reaction, should your health insurance company be not willing to cooperate. If you had contacted the insurance company and they had not helped you, it is possible to file a complaint on a special form.

The form is available here. It is in Czech, Ukrainian and Russian only, but you can use Google Translate when working on it.

Do not file the complaint if you’ve been provided with the list of doctors somewhere in the past, before reading this article. If you’re searching for a doctor, try to follow the steps described in the Ministry’s guide first = contact your insurance company anew. In other words, the complaint must be based on a recent case. 

Please, understand that filling up this form doesn’t mean that the Ministry will help you find a doctor instead of the health insurance company. The point of it is that it will be collected and used as evidence, to develop collective pressure on the given companies so they fulfill their legal duty to the fullest.

A solution suggested by VZP, the biggest Czech insurance company

Sometimes, it happens that the insurance company is trying to help, but they have so many clients looking for a doctor that it is not in their capacity to help them individually. In that case, they tend to find a solution, which will enable them to help as many people as they can.

For example, VZP, the biggest Czech insurance company, has established a specific practice for their clients:

They provide them with a link to the list of contractual doctors who have free capacity at the moment. The clients are supposed to contact these doctors via call or email, explain their issue, and ask to be registered as regular patients. However, if the doctors do not register them, VZP offers a “safety net”. If a doctor from the list tells them that they cannot register them, the clients are supposed to ask for their written reasoning for such decision (Písemné vyjádření, že přijetí do trvalé péče u PZS nemohlo být provedeno a z jakého důvodu in Czech) which these clients are then obliged to forward to the insurance company. If you find yourself in such a position, demand this reasoning from the doctor who did not register you. If no doctor from the list answers your calls or emails, inform VZP about it too.

It is true that this still means calling to doctors by yourself, but at least the list is shorter, should be up to date, and the chance of finding a doctor is greater thanks to the written reasoning.

Let’s create pressure together

In conclusion, it’s evident from the statement of the highest Czech authority that it’s indeed your health insurance company who is supposed to ensure the accessibility of health care. When looking for a doctor, follow the given steps and, if unsuccessful, file a complaint so the Ministry can create pressure on the insurance companies.

Just remember that the insurance company’s officers might be at the limit of their capacity too. If that is your case, try to at least get the list of doctors with free capacity, just like what VZP does, don’t accept the endless list of all contractual doctors.

One person might not change these unfortunate circumstances, but if the voices of all Czechs and expats get combined, it’s much more likely that they will be heard.

First published on 16 May 2023. Picture courtesy of Canva.com.