Participation in sickness insurance
Sickness insurance benefits
Daily assessment base
The sickness insurance system is intended for people in remunerative work, for whom it provides security through financial sickness insurance benefits in cases of so-called short-term social events (temporary incapacity to work due to an illness, injury or quarantine, caring for a family member, pregnancy and maternity or caring for a child).
Since 1 January 2009, sickness insurance has been regulated through the Act No. 187/2006 Coll. on Sickness Insurance, as amended. This Act represents a comprehensive regulation of sickness insurance, including the following issues:
- persons participating in sickness insurance (i.e. employees, members of the armed forces and safety brigades, and self-employed people),
- the entitlements to sickness insurance benefits and the stipulation of their amounts,
- health assessment for sickness insurance purposes,
- the organisation of sickness insurance,
- procedures in sickness insurance.
Sickness insurance contributions remained to be regulated by Act No. 589/1992 Coll. on Premiums for Social Security and Contributions to the State Employment Policy, as amended. Contribution rate for sickness insurance amounts to 2.1% of the assessment base as defined by the Act.
Participation in sickness insurance
Participation in sickness insurance is compulsory for employees (including members of the armed forces and safety brigades) and voluntary for self-employed.
Compulsory participation in sickness insurance emerges for an employee in case the conditions set out by the Sickness Insurance Act are met. These are two basic conditions, namely:
- performance of work in the territory of the Czech Republic
- the minimum amount of the agreed income (so-called decisive income)
Specific participation rules apply for persons with low earnings and for persons employed under the agreement to complete a job.
Sickness insurance benefits
Following benefits are provided to insured persons under sickness insurance:
- Sickness benefit
- Maternity benefit
- Paternity benefit (Fathers Post-Natal-Care Benefit)
- Attendance Allowance
- Long-Term Attendance Allowance
- Compensatory Benefit in Pregnancy and Maternity
Sickness insurance benefits are paid out by District Social Security Administrations. Prescribed benefit application forms must be used to claim the benefits.
An employee or self-employed person is entitled to sickness benefit from the 15th calendar day of his or her temporary incapacity for work up to maximum of 380 calendar days from the first day of the temporary incapacity to work or quarantine order. During the first two weeks of the temporary incapacity to work, an employer provides the employee with wage compensation; the wage compensation.
The basic condition for entitlement to sickness benefit is participation in sickness insurance or duration of the protection period (maximum of 7 days after termination of sickess insurance). Self-employed persons are eligible for sickness benefit after three months of insurance.
Conditions of entitlement to the benefit in special cases (for pensioners etc.) are determined by the Sickness Insurance Act.
The sickness benefit (per calendar day) amounts to:
- 60% of the reduced daily assessment base for the first 30 days of temporary incapacity for work or ordered quarantine,
- 66% of the reduced daily assessment base from the 31st day to the 60th day of temporary incapacity for work or ordered quarantine and
- 72% of the reduced daily assessment base from the 61st day of temporary incapacity for work or ordered quarantine
For employees, the main conditions for entitlement to maternity benefit are the participation in sickness insurance at the time of applying for the benefit or duration of the protection period if their sickness insurance has expired (maximum of 180 days for pregnant women or 7 days in other cases) and participation in sickness insurance for at least 270 calendar days over the last two years preceding the start of the maternity benefit supporting period. Self-employed persons need to meet the same conditions as employees and in addition must have participated in sickness insurance for at least 180 days during the year preceeding the start of the maternity benefit supporting period.
Pregnant women may determine the onset of maternity benefit between the 8th and 6th week before the expected due date. The benefit is provided for 28 weeks for a woman who gives birth to a single child and for 37 weeks for mothers who give birth to multiple children.
The maternity benefit can be transferred to the father (conditional to the mother’s written agreement) but only after six weeks from birth.
The maternity benefit (per calendar day) amounts to 70% of the reduced daily assessment base.
Paternity benefit (Fathers Post-Natal-Care Benefit)
Paternity benefit is granted to insured father or foster parent. It is paid for maximum of 7 calendar days and cannot be interrupted and re-used later. Paternity benefit payment should start within 6 weeks after birth or the date the foster care begins.
The paternity benefit (per calendar day) amounts to 70% of the reduced daily assessment base.
An insured employee who is unable to work because she or he takes care of a sick member of the household or a in some cases a child under 10 whose preschool or school facility is closed is entitled to attendance allowance.
Self-employed persons are not entitled to attendance allowance.
The maximum benefit duration:
- 9 calendar days per individual case of care provision;
- 16 calendar days for single parents caring for at least one child under compulsory school age.
The attendance allowance (per calendar day) amounts to 60% of the reduced daily assessment base.
Long-Term Attendance Allowance
Long term attendance allowance is intended for insured persons providing domestic care for their relatives or persons living in the same household.
The main conditions for the benefit entitlement include a serious deterioration of the health of the cared-for person requiring at least 7 days hospitalisation and the need for day-care for at least another 30 days.
An employee providing care must have been insured at least 90 days in the 4 months immediately preceding the need for care. Self-employed persons must have been insured at least 3 months immediately preceding the need for care. A written consent to provide care is required from the cared-for person.
The following insured persons are entitled to the benefit:
Maximum duration of the benefit is 90 days.
- the spouse or the registered partner of the person being cared for; or
- the direct relative of the person being cared for or the sibling, mother-in-law, father-in-law, daughter-in-law, son-in-law, niece, nephew, aunt or uncle; or
- the spouse, the registered partner, or the cohabitant of the person referred to above with the same residence as the cared-for person or
- the cohabitant of the person being cared for, or another person sharing household with the person being cared for.
The long-term attendance allowance (per calendar day) amounts to 60% of the reduced daily assessment base.
Compensatory Benefit in Pregnancy and Maternity
Compensatory benefit in pregnancy and maternity is provided to pregnant women and mothers of new born children who are employed. It compensates for lost earnings if women are reassigned to a lower paid position because of pregnancy or maternity. Self-employed persons are not entitled to the benefit.
Compensatory benefit in pregnancy and maternity is paid to employed pregnant women for the duration of the reassignment to a lower paid position up to the start of the 6th week before the expected due date. In specific cases, it may also be paid after the mother has given birth.
The amount of the benefit is the difference between the daily assessment base before and after job transfer.
Daily assessment base
The daily assessment base is calculated using the applicant's average daily earnings over the past 12 months.
For calculating benefits the daily assessment base is reduced as follows:
- for sickness benefit, attendance allowance and long-term attendance allowance 90% up to the amount of the first reduction limit is taken into account, 60% from the amount above the first reduction limit up to the second reduction limit, 30% from the amount above the second reduction limit up to the third reduction limit, and the amount above the third reduction limit is disregarded;
- for maternity benefit, paternity benefit and the compensatory benefit in pregnancy and maternity 100% up to the amount of the first reduction limit is taken into account; 60% from the amount above the first reduction limit up to the second reduction limit; 30% from the amount above the second reduction limit up to the third reduction limit; and the amount above the third reduction limit is disregarded.
The reduction limits are based on the average wage and are announced every year as a notification by the Ministry of Labour and Social Affairs in the Collection of Laws.
Further information on sickness insurance can be found on the Czech Social Security Administration’s website https://www.cssz.cz/en/sickness-insurance/
Poslední aktualizace: 7. 8. 2019