From January 2025, patients in the Czech Republic will benefit from a significant simplification of co-payments for medicines. Senior citizens over 70 and other affected groups will pay less directly at the pharmacy, as co-payments will be automatically offset through the new e-prescription system.
From next year, many people will pay less for prescription medicines in Czech pharmacies. This will particularly benefit senior citizens over the age of 70 who regularly take multiple medications. Currently, part of the co-payment for medicines partially covered by health insurance is paid either by payment slip or bank transfer once the statutory upper limit is reached. However, starting in January, this amount will be deducted directly at the pharmacy.
The amendment to the Public Health Insurance Act was presented at a press conference by representatives from the Ministry of Health, the State Institute for Drug Control, the Czech Chamber of Pharmacists, health insurance companies, and the Czech Social Insurance Institution.
“In the future, deductible co-payments will be registered online in the ePrescription system. The pharmacist will be able to see whether the patient has reached their limit at the time of dispensing. If this is the case, the patient will no longer have to pay the co-payment. This results in both financial and time savings, as the total co-payment is reduced accordingly,” explained Health Minister Vlastimil Válek. He added that patients will still have to pay the non-reimbursable portion of the co-payment and the costs for medicines not covered by statutory health insurance.
The upper limits for co-payments remain unchanged and will continue to depend on the individual groups of insured persons: For people over 70 and those with disabilities, the limit is CZK 500; for children and senior citizens over 65, it is CZK 1,000; and for all other adults, it is CZK 5,000.
“Until now, pharmacies have reported excess payments to the health insurance companies, which reimbursed patients the overpaid amount every quarter if the upper limit was exceeded. From January, the ePrescription system will register the co-payments made online. Patients will be able to view their limit and the amount already paid through the mobile or web application of the ePrescription system. The aim of this change is to enhance user-friendliness,” said Tomáš Boran, Director of the State Institute for Drug Control.
The changes in the registration of co-payments will benefit not only patients but also health insurance companies.
“The planned innovation will reduce the administrative burden on health insurance companies, as they will no longer need to process co-payments for all their policyholders retrospectively,” said Martin Balada, Managing Director of the Association of Health Insurance Companies.
In the future, the ePrescription system, operated by the State Institute for Drug Control, will automatically synchronize information from the Czech Social Insurance Institution, health insurance companies, and pharmacies, thereby considerably simplifying the co-payment process.
