Health Insurance for the Self-Employed in 2026: Advance Payments and Obligations

Health insurance is one of the three main contributions that every OSVČ in the Czech Republic must pay. Unlike income tax and social insurance, health insurance has no maximum assessment base — the more you earn, the more you pay. In 2026, minimum advance payments increased as a result of rising average wages. This guide provides a complete overview of everything you need to know about health insurance as a self-employed person: from calculating advance payments to overview submission deadlines, through to specific situations such as secondary activity or changing your insurer.

The information in this article is based on official sources from the General Health Insurance Company (VZP) and other health insurers.

Basic Principles of Health Insurance for the Self-Employed

The Czech public health insurance system is based on solidarity — every insured person pays premiums according to their income and receives healthcare according to their needs. For OSVČ, this means:

• The premium is calculated as 13.5% of the assessment base
• The assessment base is 50% of profit (income minus expenses)
• There is a minimum assessment base — you cannot fall below it (for primary activity)
• The maximum assessment base was abolished in 2013 — there is no upper cap

Minimum Advance Payments in 2026

The minimum advance payment for health insurance in 2026 is derived from the average monthly wage in the national economy, which for 2026 is set at 48,967 CZK.

Who Pays the Minimum Advance Payments

You pay the minimum advance payments if:

• You are self-employed with primary activity
• Your calculated assessment base (50% of profit divided by 12 months) is lower than the minimum assessment base of 24,483.50 CZK/month
• In practice, this corresponds to an annual profit of up to approximately 587,604 CZK

If your profit exceeds this threshold, you pay advance payments calculated from your actual profit — these will be higher than the minimum.

Calculating Advance Payments Based on Actual Profit

After submitting the income and expenses overview, your health insurer will calculate a new advance payment amount based on your previous year's profit.

Primary vs. Secondary Activity

The rules for paying health insurance differ significantly depending on whether your self-employment is your primary or secondary activity.

When Activity Is Considered Secondary

Self-employment is treated as secondary activity for health insurance purposes if you are simultaneously:

• An employee (your employer pays health insurance on at least the minimum assessment base)
• A student up to age 26 (the state pays health insurance)
• On maternity or parental leave (the state pays the premium)
• A pensioner (the state pays the premium)
• A job seeker registered at the Labour Office

Advance Payment Due Dates and Payment Methods

Due Date

Advance payments for health insurance are due from the 1st day of the calendar month for which they are being paid, until the 8th day of the following month.

Example: The advance payment for February 2026 is due between 1 February and 8 March 2026.

Where to Pay

You pay the premium to your health insurer's bank account. Each insurer has its own account:

• VZP ČR (111): Account details at vzp.cz
• OZP (207): Information at ozp.cz
• ČPZP (205): Information at cpzp.cz
• ZP MV ČR (211): Information at zpmvcr.cz
• VoZP (201): Information at vozp.cz
• ZP Škoda (209): Information at zpskoda.cz
• RBP (213): Information at rbp-zp.cz

Use your personal identification number (without the slash) or the payer number assigned by your insurer as the variable symbol.

Payment Methods

• Bank transfer (most common)
• Standing order (recommended — you won't forget)
• SIPO direct debit
• Cash at the insurer's branch (at selected locations)

Annual Income and Expenses Overview for OSVČ

Every OSVČ is required to submit an Overview of Tax Base and Paid Advance Payments to their health insurer once a year. Based on this overview, the insurer settles your premium for the previous year and sets a new advance payment amount.

Overview Submission Deadlines in 2026 (for the year 2025)

What the Overview Contains

In the overview you report:

• Income from self-employment for the previous year
• Expenses incurred to generate income (flat-rate or actual)
• Tax base (income minus expenses)
• Assessment base for health insurance (50% of the tax base)
• Number of months during which you were self-employed
• Total advance payments made during the relevant year
• Calculation of any additional payment or overpayment

Additional Payments and Overpayments

After submitting the overview, you may have:

• An additional payment due — if the advance payments you made did not cover the full-year premium. The additional payment is due within 8 days of the date you submitted (or were required to submit) the overview.
• An overpayment — if you paid more in advance payments than required. You can request a refund in writing. The insurer will return the overpayment within 1 month.

Specific Situations

Starting Self-Employment

If you are just starting out as self-employed, you pay the minimum advance payments from the very first month (for primary activity). After the first year, you submit the overview and your advance payments are recalculated based on your actual income.

Suspending or Terminating Self-Employment

If you suspend your trade, you must notify your health insurer. After suspension, you stop paying advance payments as an OSVČ, but you must ensure that someone is paying your health insurance (your employer, the state, or you yourself as an individually insured person).

Changing Your Health Insurer

You can change your insurer on 1 January or 1 July, provided you submit your application at least 3 months in advance (i.e. by 30 September or 31 March respectively). For the year in which you changed insurer, you submit the overview to both insurers — each covering the relevant portion of the year.

Working Abroad (EU)

If you work in another EU member state, the rules on coordination of social security apply. Generally, you pay contributions in the country where you carry out your activity. When activities are conducted in multiple countries simultaneously, the competent authority determines your situation (in the Czech Republic, this is the ČSSZ).

Penalties for Non-Payment

Health insurers monitor payments and may impose:

• Interest on arrears: 0.0322% of the outstanding amount for each day of delay (previously 0.05%, reduced in 2022)
• Fine for failing to submit the overview: up to 50,000 CZK
• Fine for failing to report changes: up to 10,000 CZK

Practical Examples

Example 1: Programmer with income of 1,200,000 CZK

Example 2: Consultant with income of 2,000,000 CZK

Example 3: OSVČ on Secondary Activity (Employee + Self-Employment)

Frequently Asked Questions (FAQ)

Do I have to pay health insurance even if I'm in my first year of self-employment and haven't earned anything yet?

Yes, if your self-employment is your primary activity. You pay the minimum advance payment of 3,306 CZK per month regardless of your income level. If self-employment is your secondary activity (you are employed, a student, etc.), you do not pay advance payments.

What happens if I don't work for a month?

If you haven't suspended or terminated your trade licence, you are still considered self-employed and must continue paying advance payments. If you want to stop paying, you must officially suspend your trade at the trade licensing office and notify your health insurer.

Can I pay advance payments in advance for the whole year?

Yes, you can pay advance payments in advance. However, we recommend always clearly indicating which months you are paying for (include the period in the payment reference), to avoid any discrepancies in the insurer's records.

How do I find out how much to pay after submitting the overview?

After submitting the overview, you can easily calculate your new advance payment: divide the annual premium from the overview by 12. If the result is lower than the minimum (3,306 CZK), you pay the minimum. Your insurer will also confirm the new advance payment amount.

Do I pay health insurance on rental income?

If the property is included in your business assets and the rental income forms part of your self-employment income (Section 7), then yes. If you rent out property as a private individual outside of self-employment (Section 9), you do not pay health insurance on that rental income.

Can I reduce my advance payments if I expect lower income this year?

Health insurance does not allow you to request a reduction in advance payments based on anticipated lower income. You pay the advance amount set from the overview for the previous year (or the minimum). Any resulting overpayment will be refunded by your insurer after you submit the overview.

Official Sources

• VZP – information for OSVČ — complete health insurance information for the self-employed
• VZP – payments in 2026 — current minimum advance payments
• VZP – overview submission deadlines — deadlines for submitting the overview
• OZP – information for OSVČ — Occupational Health Insurance Company
• ZP MV ČR – changes for OSVČ 2026 — Ministry of the Interior Health Insurance Company
• VoZP – changes in 2026 — Military Health Insurance Company

---

This article is for informational purposes only and does not replace professional advice. Specific terms and procedures may vary between individual health insurers. Always verify the latest information directly with your insurer. Information is valid as of the date of publication (February 2026).