Regulatory fees

    FAQ : REGULATORY FEES 2008/2009

        1) If a client is a holder of a Medicover membership card (white, blue, silver, gold) – is he/she obliged to cover regulatory fees according to the

Act N. 48/1997 Coll. as amended for a medical examination at all Medicover clinics?

Yes, a client covers all the fees stipulated by this Act. Medicover is obliged to collect these fees from its clients.

        2) Where is it possible to receive complete information about regulatory fees?

The Ministry of Health has produced a comprehensive handbook „ Manual for the usage of the Czech health system in 2008“. This handbook can be found on the website of the Ministry of Health www.mzcr.cz. The information reffered to in this manual are valid from 1.1.2008 to issue a new version of the relevant law.

        3) Are there regulatory fees for treatments and examinations which have already been fully covered by the client? E.g. care of a dental hygienist, HIV tests, vaccination etc.

These examinations and treatments are not covered by the public health insurance and are not subject to regulatory fees. A client then covers only individual treatments. Moreover, vaccination is considered a preventive treatment not being subject to regulatory fees, nevertheless, it is sometimes fully or partially covered by the public health care.

        4) According to the Law the client is not obliged to cover preventive examination fees. Within Medicover the client can use yearly preventive care above the scope of the prevention covered from public health insurance (white, blue, silver, and golden card). Is he/she obliged to pay for this „non-standard“medical check -up?

This medical check-up is not considered a preventative procedure and therefore is not covered by public health insurance.  These procedures are fully covered by Medicover services and the client is not obliged to pay the regulatory fee. It does not apply here.

        5) A client has to go to gynaecological examinations more than twice a year (depending on the laboratory results, for preventive medical exams). Are these examinations considered to be the regular check ups?

No, the purpose of the preventive medical examinations is to ensure an early detection of health risks or problems. If there is a reason for further medical examinations, the examinations are then not   considered to be preventative but instead monitoring. The client is then not obliged to pay the regulatory fee.

        6) Are medical check ups subject to the regulatory fee?

Medical examinations (follow up examinations) may be charged, depending on whether so called clinical examinations have already been made. A clinical examination is a type of examination which has a complex, goal oriented, check up or/and counselling value. It is considered to be a regular examination of a patient.

        7) Is the examination always free of charge within occupational health care?

The client is not obliged to pay for the examinations made by his occupational health care doctor, i.e. for the examinations made within terms of his occupational health care covered by the employer. Additional examinations can be subject to regulatory fees (if they do not comply with the conditions defining them as a clinical examination) For example: if the occupational health care doctor needs an examination by a neurologist when issuing a report of a health condition, the client will not be obliged to pay the fees of the occupational health care doctor but only of the neurologist. This examination is then considered to be as clinical examination.

        8) Do regulatory fees apply also to foreigners?

Foreigners for whom public health care applies (i.e., they have to be permanent residents in the Czech Republic or they are the employees of the companies with an address in the Czech Republic) are subjects to this rule, like the citizens of the CR and are thus obliged to pay regulatory fees according to the law. If they only have contractual insurance from VZP Insurance company (it does not mean VZP ČR), they can be treated only in their contractual facilities. With respect to the fact that   Medicover is a contractual partner to VZP Insurance company, the clients have to ensure full coverage of expenses for medical examinations and are not obliged to pay regulatory fees.  The same condition applies to foreigners who are insured by foreign insurance companies.

        9) Do clients which are provided with the service of direct-billing also have to pay  regulatory fees?

The condition to pay these fees does not apply here. Regular treatments are not covered by public health care.

        10) If the client is sent due to operational reasons (e.g. doctor´s illness) for an examination at a specialist outside Medicover, is he supposed to pay the regulatory fee to the external specialist directly?

Yes, the client of Medicover will pay the fee directly to the doctor (if a clinical examination is done).

        11) Who is charged for the hospitalization in case the client is a holder of gold or silver card?

This regulatory fee is not included in the services pre-paid by gold or silver card. In the case that the client is hospitalized, he/she is obliged to cover the regulatory fee for the hospital stay directly to the hospital. In the case, Medicover is charged for this service, the client will be subsequently charged a fee, together with other expenses.

        12) Will the clients registered in the CR be treated at the Medicover clinic abroad? Do regulatory fees apply to this treatment?

No, the charges apply only for health care provided within the CR.

        13) Which regulatory fee applies to non-registered clients for acute dentist treatment?

Acute treatment is defined as a treatment not provided by a registered dentist of a patient. The treatment of a non-registered patient within or outside the working hours is charged for  90 Kc. In the case the client is treated at the registered doctor within and outside working hours he /she is obliged to pay 30 Kc for specific treatments stated in “Methodical order” by the Ministry of Health.

        14) Which regulatory fee applies to emergency dental care provided at the Medicover clinic in Prague at weekends, holidays and public holidays?

The departure of the Medicover doctor is not covered by the public health care and regulatory fees thus do not apply here.

        15) Which regulatory fee applies in the case of a 24-hour home and work visits  by the Medicover GP/ internist and/or  after hours home visits by pediatrist?

The departures of a Medicover doctor are not covered by public health care and regulatory fees do not apply here.

        16) Is it possible to get the medicine right from the doctor? Is this medicine subject to later charges?

The doctor cannot hand out the medicine with the exception of essential medication that the acute body state requires or in the case that he/she provides sample medicine. The doctor cannot provide the patient with a dose of medicine for the period when he/she will not be able to pick up the medicine in a standard way (e.g. at night). In all these cases the patient will not be obliged to pay for the medicine.  

        17) What is dispensary care?

Dispensary care is provided for chronically ill people children and pregnant women who monitored due to health risk or treated necessarily with  great care. Children are provided with dispensary care from the age of one and pregnant women from the day of finding the pregnancy. Dispensary care is elaborated in the Decree of Ministry of Health which includes corresponding schedule of related diagnosis. A patient is included and excluded from the dispensary care by the attending physician.