Zdravotní pojišťovna: Jak si finančně zajistit psychoterapii v ČR

When you need help with your mental health, the last thing you want to worry about is whether you can afford it. In the Czech Republic, zdravotní pojišťovna, státní systém, který hradí základní lékařskou péči, včetně některých forem psychoterapie. Also known as pojistka, it doesn’t cover every type of therapy automatically, but it does offer real support if you know how to navigate the system. Many people assume that if they have health insurance, therapy is free — but that’s not true. The reality is more complicated, and it’s not about luck. It’s about knowing which therapies are covered, what credentials your therapist needs, and how to get the paperwork right.

Not all psychologists or psychotherapists are equal in the eyes of the insurance system. Only those registered with the Ministry of Health as psycholog, osoba s vysokoškolským vzděláním v psychologii a registrací v registru zdravotnických pracovníků or psychoterapeut, osoba s dalším specializačním vzděláním v psychoterapii a povolením k výkonu tohoto povolání can be reimbursed. If your therapist isn’t on the official list, you’ll pay out of pocket — no exceptions. That’s why it’s crucial to check their registration before booking your first session. Some therapists list this information on their websites. If they don’t, just ask: "Jste registrovaný v registru zdravotnických pracovníků?" If they hesitate, walk away.

Even if your therapist is registered, not every type of therapy is covered. Most commonly, kognitivně behaviorální terapie (KBT), metoda s nejvíce důkazy o účinnosti pro úzkost, depresi a OCD, kterou zdravotní pojišťovny nejčastěji hradí is approved. Other methods like EMDR, somatic therapy, or ACT are rarely covered — even if they work well. The insurance system lags behind science. That’s why many people choose to pay privately for therapies that suit them best. But if you’re on a tight budget, KBT is your best bet. You can typically get up to 20 sessions per year covered, though the exact number depends on your insurer and diagnosis.

Getting approval isn’t automatic. You usually need a referral from your general practitioner, who must document your mental health condition using ICD-10 codes like F32 (deprese) or F41 (úzkostné poruchy). Without that, the insurance won’t pay. Some therapists help you with the paperwork, others don’t. Ask upfront. Also, don’t be surprised if your insurer requires you to try a few sessions with a public clinic first — they often push people toward cheaper, state-run options before approving private care.

What’s changing? Since 2023, some insurers like VZP and ČSPP have started piloting programs that allow direct access to therapists without a GP referral — but only for mild to moderate depression and anxiety. This is still experimental and not nationwide. If you’re lucky enough to live in one of those regions, you can skip the doctor’s visit and go straight to your therapist. But for most people, the old rules still apply.

Don’t let bureaucracy stop you. If you’re struggling, you have rights — and resources. Many people think therapy is only for those who can afford it, but that’s not true. With the right knowledge, you can get real help without draining your savings. Below, you’ll find practical guides on how to find a covered therapist, what to expect during your first appointment, and how to handle situations when your insurance says no — even when you know you need help.