5.34 billion crowns per year: Ukrainian refugees brought record profits to the Czech state insurance company
The health insurance market in the Czech Republic has undergone significant changes in recent years due to the influx of Ukrainian citizens who received temporary protection after the outbreak of the war. Their presence in the healthcare system has affected the workload of medical institutions, as well as the financial performance of the state-owned insurance company Všeobecná zdravotní pojišťovna (VZP), which is the largest in the country. The influence of Ukrainian refugees turned out to be so significant that their participation in the insurance system brought the company multi-million profit, becoming an important factor in the stability of the state-owned operator’s finances.
VZP’s financial result for 2025: the influence of refugees
As reports ČTK, according to VZP, in 2025 Ukrainian refugees brought the company a net profit of 5.34 billion Czech crowns. The total cost of medical services used by Ukrainians with temporary protection reached 4.16 billion crowns, while contributions to the insurance company exceeded 9.5 billion crowns.
The main part of the income was formed due to mandatory contributions paid by self-employed refugees – about 5.5 billion crowns. In addition, the state covered contributions for unemployed persons, including children, pensioners and women with small children, which amounted to approximately 4 billion crowns or 2,127 crowns per person per month.
The impact of Ukrainian refugees on the financial results of VZP has been noted before. The Minister of Health of the Czech Republic, Adam Vojtech, reported that from February 2022 to October 2025, Ukrainian citizens provided the company with a net profit of 10.5 billion crowns. This indicates that their participation in the insurance system has a stable and long-term financial effect, which allows the state-owned company to plan the budget and allocate resources for all insured categories.
As of the end of January 2026, 334 thousand Ukrainians with temporary protection status were registered with VZP. Among them, 138 thousand belonged to the category of state insured, which includes unemployed citizens, as well as persons in need of special social protection, in particular children and pensioners. This structure reflects the social characteristics of the group of migrants and at the same time explains why part of the profit was formed at the expense of state payments.
In addition to the economic effect, the presence of Ukrainian refugees in the Czech insurance system emphasizes the importance of effective management of medical resources. Although the burden on medical institutions has increased, contributions and state payments have ensured the coverage of costs and at the same time generated profit for the insurance company. This balance allows maintaining a high level of health care for all categories of the population and demonstrates how immigration flows can affect the financial performance of state institutions.
State insurance and ZDP: features of health coverage for Ukrainians in the Czech Republic
It should be noted that the Czech Republic provides persons with temporary protection with priority access to the state health care system. During the first 90 days, medical care is provided free of charge, after which the state continues to cover costs only for certain categories: children under 18, students, people with disabilities, registered unemployed, parents or caregivers of young children, as well as people over 65. Transition to long-term residence status (ZDP) changes these conditions, and the guarantees of free insurance cease to apply.
The Czech Ministry of Health explains that after obtaining a ZDP, a person is no longer considered automatically insured by the state. “They will be treated as ordinary foreigners on a long-term stay,” said ministry spokesman Martin Novotny. This means that Ukrainians will either have to find official employment so that the employer pays contributions to the state insurance company, or conclude a commercial health insurance contract. Unemployed persons, in particular pensioners, unemployed students or housewives, must pay for insurance themselves.
Transition to ZDP occurs from the moment of receiving a biometric card, and it is from this date that the current state insurance ceases. Those who do not take out new insurance risk being left without access to medical services, which is a violation of the rules. The Ministry of Health emphasizes that the insurance must be valid for the entire period of stay, and although proof of payment is not required at the stage of applying for ZDP, it may be requested during checks or when consulting a doctor.
For minor children, the law provides an exception: even after receiving ZDP, they remain under the protection of state insurance, and contributions for them must be paid by the father or mother. For 2025, the monthly contribution is 2,808 crowns, which is 13.5% of the minimum wage of 20,800 crowns. There are no discounts or benefits for paying for children’s insurance, regardless of the family’s financial situation.
Students who receive a ZDP are also not entitled to state insurance, even if they study at Czech universities. The exception applies only to officially employed students who receive at least 4,500 CZK for a DPČ or 11,500 CZK for a DPP, in which case the employer pays the contributions.
The Ministry of the Interior emphasizes that the insurance policy must cover the entire period of stay. For example, if the policy is issued for only a year and is not extended, this is considered a violation. There are two types of commercial insurance: limited (only for emergencies, such as travel) and comprehensive, which is recommended for long-term residence.
In fact, the transition to ZDP is associated with new costs and obligations, so Ukrainians should consult with insurance companies in advance and clearly understand their rights and requirements. Before applying for ZDP, it is recommended to check whether you remain in the state insurance system, if necessary, conclude an agreement with a commercial insurance company and notify your current insurance company about the change in status. The lack of valid medical coverage can jeopardize not only your health, but also the right to legal residence in the Czech Republic.
