Spa care covered by health insurance — still a real option
The information in this guide applies to guests insured in the Czech Republic; visitors from other countries come to Mariánské Lázně (Marienbad) as self-paying guests, and the section on self-paying stays below applies to them.
The Czech Republic is one of the few European countries where spa treatment is still part of the public health insurance system. For thousands of patients a year, this means the chance to take a therapeutic stay of several weeks at a spa without digging deep into their pockets. Even so, many people never apply — often because they have no idea how the whole process works.
This guide takes you through the entire procedure, from the first visit to the doctor to arrival at the spa. Please note that the information is for guidance only — specific conditions may differ depending on your insurer and current legislation. Always consult your doctor and your insurer.
Comprehensive vs. contributory spa care
The basic distinction you need to know lies in the two types of spa care covered by public health insurance.
Comprehensive spa care (K)
Comprehensive spa care is fully covered by the health insurer. The insurer pays for accommodation, meals, therapeutic treatments and medical supervision. The patient pays only a regulatory fee for the stay (currently in the order of tens of crowns a day) and any above-standard services.
Comprehensive care is intended for patients with more serious diagnoses, for whom spa treatment is regarded as a necessary part of the treatment process. The length of stay is 21 or 28 days, depending on the item on the indication list.
Contributory spa care (P)
Under contributory care, the insurer covers the therapeutic treatments and medical supervision, but the patient pays for accommodation and meals. This is a form of care for patients whose condition requires spa treatment but is not serious enough to justify full coverage.
A stay under contributory care lasts 14 or 21 days, depending on the indication.
The practical effect on your budget
With comprehensive care, expect minimal outlay — regulatory fees and personal spending. With contributory care, the costs of accommodation and meals run to thousands of crowns a week, depending on the spa facility and room category chosen. Even so, it is a fraction of the price you would pay as a self-paying guest.
Who is entitled to spa care
Entitlement to spa care is governed by a decree of the Ministry of Health that lays down the Czech indication list (Decree No. 2/2015 Coll.) — an overview of the diagnoses and conditions for which spa treatment is indicated.
The most common indications for Mariánské Lázně
Thanks to the unique composition of its mineral springs, Mariánské Lázně specialises above all in:
- Diseases of the kidneys and urinary tract — chronic inflammations, conditions after surgery, urolithiasis
- Diseases of the airways — chronic bronchitis, asthma, conditions after pneumonia
- Disorders of the musculoskeletal system — osteoarthritis, vertebrogenic syndromes, conditions after orthopaedic surgery
- Metabolic diseases — obesity, diabetes mellitus, disorders of fat metabolism
- Oncological diseases — rehabilitation after cancer treatment
The decree is updated regularly. Your doctor has access to the current wording and can assess whether your diagnosis meets the conditions. A full overview of the items, with type of care and length of stay, can be found in the indication list for Mariánské Lázně.
The procedure step by step
1. A visit to your GP
The whole process begins with your registered general practitioner. They assess your state of health and decide whether spa treatment is appropriate in your case. If so, they may refer you to a specialist, whose assessment is essential for some diagnoses.
Tip: Prepare for the visit — bring all your medical records, test results and a list of the medications you take.
2. Specialist examination
The specialist (e.g. a urologist, orthopaedist or pulmonologist) carries out a targeted examination and issues a recommendation for spa treatment. This recommendation is the key basis for the proposal for spa care.
3. Completing the proposal for spa care
The proposal for spa rehabilitation care (the so-called "Návrh na LP/LRP") is completed by your GP on the basis of the specialist's recommendation. The form contains:
- The patient's personal details
- The diagnosis and its justification
- Test results
- The recommended spa resort
- The proposed type of care (comprehensive or contributory)
4. Submission to the insurer
The doctor sends the completed proposal to your health insurer for approval. The insurer has a statutory deadline for assessing the application.
5. The insurer's decision
The insurer assesses the proposal and decides on:
- Approval — including the type of care and the recommended spa facility
- Rejection — with reasons, against which you can appeal
- Return for completion — if any documents are missing
6. Choosing the spa facility and admission
After approval, you receive a decision with information on the type of care and, where applicable, the recommended spa resort. Within that resort you can usually choose the specific spa facility. You then contact the chosen spa and arrange an admission date.
What documents you will need
Have the following documents ready:
- Identity card or another proof of identity
- Insurance card of your health insurer
- The approved proposal for spa care — the original of the insurer's decision
- Medical report from your GP and specialist
- Test results — laboratory results, X-rays, ECG (depending on the diagnosis)
- A list of the medications you take, with dosages
Time frames
The whole process, from the first visit to the doctor to admission to the spa, usually takes 2 to 4 months. The individual phases:
- Specialist examinations: 2–4 weeks (depending on waiting times for specialists)
- Preparation of the proposal by the doctor: 1–2 weeks
- Assessment by the insurer: 30 days (statutory deadline), in practice often shorter
- Arranging a date with the spa: 2–6 weeks (depending on the season and occupancy)
For some diagnoses there are urgent indications with shorter deadlines — for example conditions after surgery, where early rehabilitation is crucial.
What is covered and what is not
Covered by the insurer (under comprehensive care)
- Accommodation in a standard room
- Full board
- Therapeutic treatments according to the individual treatment plan
- Initial and ongoing medical examinations
- A regulated treatment regime
Not covered by the insurer
- An above-standard room — single room, suite, room with a view
- Treatments beyond the treatment plan — cosmetic treatments, wellness services
- Transport to the spa — the exception being immobile patients for whom transport is indicated
- Personal expenses — telephone calls, laundry, minibar
Under contributory care you also pay for accommodation and meals.
Self-paying guests — an alternative without waiting
If you do not meet the conditions for spa care covered by insurance, or do not want to wait for approval, you can come to the spa as a self-paying guest. This option offers several advantages:
- No waiting — you choose a date to suit yourself
- Choice of treatments — the treatment plan is drawn up on the basis of the initial examination, but you have greater freedom of choice
- Flexible length of stay — from one week to several weeks
Price range
Prices for self-paying spa stays in Mariánské Lázně fall roughly within this range:
- One-week stay (7 nights, half board, approx. 15–18 treatments): from CZK 15,000 to 35,000 depending on the hotel category
- Two-week stay (14 nights): from CZK 28,000 to 65,000
- Three-week stay (21 nights): from CZK 40,000 to 90,000
Prices vary by season, accommodation category and the scope of the treatment programme. The amounts given are indicative — current price lists are available from the individual spa facilities.
Combining insurance and self-payment
An interesting option is a combination — you complete a stay covered by the insurer and then add extra days as a self-paying guest. This extends the stay and lets you treat yourself to above-standard services as well.
Why Mariánské Lázně
Mariánské Lázně is among the most important spa towns in Europe. The town has more than 40 mineral springs of unique composition — from carbonated waters through sulphate waters to ferruginous ones. These natural riches form the basis of the therapeutic treatments.
The town is surrounded by the beautiful countryside of the Slavkov Forest. The spa colonnade, extensive parks and walking routes create an ideal setting for convalescence.
The Ensana spa facilities
The Ensana hotels in Mariánské Lázně are state-recognised spa facilities with their own treatment operations. That means they meet the strict requirements for quality of care, professional staff and equipment laid down by the Ministry of Health.
The complex comprises several historic spa houses connected to modern treatment facilities. The treatment programmes are led by experienced balneologists and physiotherapists, who draw up an individual treatment plan on the basis of the initial examination.
The most commonly applied treatments include:
- CO₂ baths — using natural CO₂ from the Marienbad springs
- Mineral baths — in local mineral water warmed to bathing temperature
- Peat wraps — with peat from local deposits
- Gas injections — subcutaneous application of natural CO₂
- Inhalations — with mineral water from the Cross Spring
- Drinking cure — an individually selected spring according to the diagnosis
Practical advice to finish
Before you leave
- Check with your insurer for current conditions and any changes in legislation
- Make sure you have enough medication for the whole stay
- Inform the spa facility of any allergies or dietary restrictions
- Read the practical information about Mariánské Lázně
During your stay
- Follow the treatment regime set by the spa physician
- Make use of the drinking cure — visit the colonnade and taste the mineral springs as recommended by the physician
- Combine treatments with exercise in the fresh air
- Avoid alcohol and heavy meals unless the physician has advised otherwise
After you return
- Visit your GP and tell them how the treatment went
- Continue with the recommended regime — fluid intake, exercise, diet
- A number of items on the indication list also provide for a repeat stay — ask your doctor whether this applies to you
Frequently asked questions
Can I choose a specific spa? In the proposal for spa care, the doctor recommends a spa resort according to your diagnosis. Within that resort you can usually choose the specific facility. Details can be found in our frequently asked questions section.
How often can I go to the spa on insurance? The frequency depends on the diagnosis and the type of care. For some diagnoses repeat treatment is possible every two years, for others more often. The doctor and the insurer always decide.
Can the insurer refuse me? Yes, the insurer can reject the proposal if it concludes that the indication conditions are not met. You can appeal against the decision. In that case we recommend discussing how to proceed with your doctor.
Can I go to the spa with a companion? Yes, a companion can book accommodation and meals as a self-paying guest. Some facilities offer discounted packages for accompanying persons.
For up-to-date information on spa care and treatment programmes, visit the official website of Léčebné lázně.
