Health systems in developed countries have their universal and optional part. This paper demonstrates the importance and fiscal position of the universally available care and shows the possibilities where it can be extended by optional financing schemes such as prepaid health packages. We use comparative approach including international experience, SWOT analysis and synthesis of included concepts into single health system. A simple scheme of possible configurations is created and the consequences of utilizing the described concepts are discussed. Overall this paper brings a theoretically substantiated overview of health policy options for Czechia, that support principles of universally available care, solidarity, fiscal neutrality, adequate fiscal space for health and possibilities of optional private health expenditure.