Czech self-employed: how to pay for health and social insurance?

As self-employed persons, you must monitor the proper payment of contributions yourself. However, it is easy to get lost in the flood of regulations – that is why we have prepared an overview of the basic obligations and current amounts for 2026 for you.

Mandatory contributions at a glance

All self-employed persons are required to pay not only taxes, but also health insurance and often social security contributions. In addition, every entrepreneur (except those under the flat-rate tax regime) must submit annual income and expenditure statements to their health insurance company and the Czech Social Security Administration (ČSSZ).

The rules vary depending on whether you run your business as your main or secondary activity. How can you tell?

• If your business is your sole/predominant source of income, it is usually considered your main activity.
• If you are self-employed while studying, working, on parental leave, or retired, your activity is usually considered secondary.

Let's now take a look at how contributions work in practice.

Health insurance

Health insurance is paid by every entrepreneur (self-employed persons engaged in main and secondary activities). The type of activity determines how to pay health insurance and the principles for calculating the insurance premium. We will gradually look at the cost of health insurance and when health insurance is paid.

Main activity

When doing business as your main activity, you pay at least the minimum amount of advance payments each month (see overview table).

Secondary activity

For secondary activities, the minimum advance payments do not apply – insurance premiums are always calculated based on your actual income. If you earn extra income as a self-employed person while employed, you do not pay monthly advance payments at all and you always pay insurance premiums once a year after submitting an overview of your income and expenses.

If you are self-employed as a state-insured person (while studying, on maternity leave, or retired), you also do not pay monthly advance payments in the first year of business and pay insurance premiums for the entire year retroactively after submitting your overview. For the following period, the insurance company will set monthly advance payments, which it will calculate based on your statement. You can find details in the instructions for  self-employed persons engaged in secondary activities.

Calculation of insurance premiums

Self-employed persons are required to pay 13.5% of the assessment base to their health insurance company. The assessment base for health insurance premiums for self-employed persons is calculated as 50% of the tax base. The tax base, or more precisely the partial tax base from self-employment income, is the difference between your business income and related expenses.

The law also specifies the minimum assessment base (based on the average wage and changing every year). This determines the minimum amount of mandatory monthly advance payments. Entrepreneurs whose main activity is self-employment must pay at least this minimum, even if the formula results in a lower amount.

Health insurance premiums for self-employed persons

When to pay health insurance advance payments?

Advance payments are due from the 1st day of the month for which you are paying insurance to the 8th day of the following month.

Example: The deadline for paying the advance payment for January is from January 1 to February 8.

If you pay the minimum health insurance advance payments, you must always pay the new amount for the following year from the beginning of the new year (i.e., by February 8 for January) – don't forget to change your standing order in time. You should do the same if you are currently paying calculated advance payments lower than the minimum for 2026.

Social security

The rules for social insurance are a little more complicated. They are governed by several legal regulations, in particular the Social Security Insurance Act and the Pension and Sickness Insurance Acts. So how does social insurance for self-employed persons work?

While pension insurance and contributions to state employment policy are mandatory, self-employed persons pay sickness insurance voluntarily.

Other rules for social security payments depend on whether you are engaged in primary or secondary gainful activity, as well as on the amount of your income.

Main activity

If you are self-employed as your main gainful activity, you must pay social insurance regardless of how much you earn. You also pay a monthly advance payment to the Czech Social Security Administration (ČSSZ), at least in the minimum amount (see overview table).

Secondary activity

In the case of secondary activity, you are only subject to compulsory social insurance if your gross annual profit (the difference between income and expenses from business) exceeds a certain amount – for 2025, the limit was CZK 111,736, and in 2026 it will be CZK 117,521. If you earn less than this limit or have zero income from secondary activities, you do not have to pay social insurance (but you can register for it voluntarily).

If you pay insurance for your secondary activity, you are also subject to minimum monthly advance payments, but at a reduced rate compared to sole traders whose main activity is self-employment (see overview table).

Calculation of insurance premiums

Social security for self-employed persons is calculated in a similar way to health insurance, as a percentage of the assessment base. However, the assessment base for social security contributions is 55% of the tax base (i.e., the difference between annual business income and related expenses). Here, too, the law specifies the minimum assessment base according to the average wage and the maximum assessment base as 48 times the average wage.

The insurance premium is calculated as 29.2% of the assessment base, with 28% going to pension insurance and 1.2% to state employment policy.

If you also voluntarily pay self-employed sickness insurance, you will pay an additional 2.7% of the assessment base.

Social insurance contributions for self-employed persons

*Starting in 2025, new self-employed persons will pay reduced social security advance payments. This relief applies for the first three years of business (the year of commencement + the following two years) if you have never been self-employed in the previous 20 years.

Note: The government's consolidation package from 2024 changed the method of calculating the minimum assessment base, which is why the amount of minimum advance payments has recently increased significantly.

When to pay social security advance payments?

Advance payments for pension and health insurance must always be paid by the end of the month for which you are paying insurance.

Example: Social security for January is due from January 1 to January 31.

And what about advance payments in the following period? From January, you must always pay at least the minimum social security advance payment valid for the given year.

• So if you pay the minimum advance payments in 2025, adjust your standing order to the new minimum according to the overview table above from January 2026.
• You should do the same if you are currently paying calculated advance payments that are lower than the minimum for 2026.
• However, if you pay calculated advance payments higher than the minimum for 2026, continue with the payments and start paying the new calculated amount only from the month in which you submit your income and expenditure statement for the previous year (i.e., if you submit the statement in May, you will pay the new amount from May).

Income and expenditure report

Every entrepreneur who does not use the flat-rate tax regime must submit an income and expenditure statement at the end of the tax period. And they must do so twice – once for the health insurance company and once for the ČSSZ.

The income and expenditure overview is essentially an annual settlement with the insurance company and the CSSA, where you calculate how much you have paid in advance payments during the year and how much you may need to pay in addition based on your income. When calculating, you will also find out how much you will pay in advance payments in the following year – you must pay at least the minimum for the given year.

Example: An entrepreneur pays minimum monthly health insurance advance payments of CZK 3,143, so during 2025, he paid a total of CZK 37,716 to the insurance company. He uses a 60% flat-rate expense allowance and earned CZK 1.5 million in 2025. In the overview, he calculated that with this income, the annual insurance premium amounts to CZK 40,500. He therefore has an underpayment of CZK 2,784 on his health insurance.

He files his tax return electronically by May 2, 2026. He submits it on April 30, so he sends the overview to the insurance company by May 30 and pays the underpayment within 8 days of filing.

Flat-rate tax payments

Self-employed persons can also voluntarily enter the flat-rate tax regime. This combines mandatory contributions and income tax payments – entrepreneurs thus pay a uniform monthly amount according to their tax bracket. If you comply with the conditions of the flat-rate regime throughout the year, you do not have to file tax returns or reports.

Although the flat-rate tax means less administration, it is not always more advantageous than standard contributions. You can read more details in the article on flat-rate tax.

We will take care of the paperwork for you

Are all these rules, amounts, and percentages making your head spin? You are not alone. We will be happy to help you with your contributions and taxes and prepare your tax return, including the mandatory overviews. Leave us a message in the form below and we will discuss the details.

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