Sick Leave and Insurance in Czechia

Health insurance and sickness insurance are separate systems. Health insurance pays for medical care, while sickness insurance (nemocenské pojištění) provides cash benefits during illness, family care, maternity and other qualifying situations.

Eligibility and payment depend on the employment contract, insured income and length of absence. Standard employees are usually insured automatically, while self-employed people must join the sickness insurance system voluntarily.

How to obtain sick leave in Czechia

A treating doctor decides whether the patient is temporarily unable to work. The doctor issues an electronic sick note called eNeschopenka and sends the information to the Czech Social Security Administration.

The employee normally does not deliver a paper certificate to the employer. However, they must inform the employer about the absence without unnecessary delay.

The patient receives information about the registered address, medical checks and permitted time outside the home. The procedure is explained on the official eNeschopenka website.

Payment during the first 14 days

During the first 14 calendar days, the employer pays wage compensation for scheduled shifts and qualifying public holidays that the employee could not work.

Compensation is available from the first missed shift. The former three-day unpaid waiting period no longer applies.

The payment is generally 60% of the adjusted average hourly earnings. It is not simply 60% of the normal gross or net salary because statutory reduction limits are applied before the amount is calculated.

Sickness benefit from the 15th day

If the incapacity continues beyond 14 calendar days, the territorial social security administration begins paying sickness benefit. From this stage, payment covers all calendar days, including weekends and public holidays.

• from day 15 to day 30: 60% of the adjusted daily assessment base;
• from day 31 to day 60: 66%;
• from day 61: 72%.

The standard maximum benefit period is 380 calendar days from the beginning of the incapacity. Current calculation rules for 2026 are published by the Czech Ministry of Labour and Social Affairs.

Rules and inspections during sick leave

A person on sick leave must stay at the address reported to the doctor and follow the prescribed treatment regime. A change of address must be approved in advance.

The doctor may permit the patient to leave home for up to six hours per day, normally between 7:00 and 19:00. The exact permitted period is recorded in the patient’s documentation.

During the first 14 days, compliance may also be checked by the employer. Social security authorities can perform inspections during the benefit period. Breaching the rules may result in reduced or cancelled payments.

Sick leave under DPP, DPČ and self-employment

Employment agreements do not always create sickness insurance automatically. Under an agreement to complete a job, known as DPP, the insurance threshold in 2026 is monthly income of at least 12,000 CZK from one employer.

For an agreement to perform work, known as DPČ, and other small-scale employment, the relevant monthly income threshold is generally 4,500 CZK. Insurance may therefore apply only in months when the employee reaches the required income.

Self-employed persons (OSVČ) participate voluntarily. To qualify for ordinary sickness benefit, they must generally be insured for at least three consecutive months before becoming unable to work. They receive no employer compensation for the first 14 days.

Health insurance for foreign residents

A foreign national employed by a Czech employer is usually registered in the public health insurance system when Czech insurance rules apply. The employer handles registration and payments.

People holding certain long-term visas or residence permits who are outside the public system may need comprehensive commercial health insurance. Requirements depend on nationality and residence status. Official conditions are available on the Information Portal for Foreigners.

Temporary protection holders enter the public health insurance system automatically. The state covers contributions for the first 90 days after protection is granted. Afterwards, the payer may be an employer, the state for an eligible category or the insured person.

What to do if the payment is missing

First ask the employer whether all required information was sent to the social security administration. Check the bank account, validity of the electronic sick note and actual participation in sickness insurance.

If the documents were submitted but payment has not arrived, contact the relevant territorial office of the Czech Social Security Administration. Keep the employment contract, payslips and sick-leave documentation.

Health insurance pays for treatment, but cash sick-leave benefits require participation in sickness insurance. This distinction is especially important for people working under DPP or DPČ agreements and for self-employed residents.