Today, every person from the moment of birth must have a medical insurance policy. But have you ever wondered what guarantees he provides? And in general, what is a policy? Let's look at these issues.
Terminology
You should first deal with the term. Find out the meaning of the word "policy". From ancient Greek the term literally translates as "city". The word refers to a special form of political and socio-economic organization of society, which was characteristic of ancient Greece and Italy. Also, the policy (translated from French means "receipt, receipt") is a document attesting to the conclusion of a contract of both personal and material insurance. There is another term. General policy is an insurance document that provides systematic insurance services.
Compulsory medical insurance in Russia
Compulsory health insurance is part of the state structure of social services. It guarantees equal opportunities in obtaining medical and medical care. This type of service is allocated from the mandatory medical insurance funds in the required amount in accordance with state programs. Studying the question "what is a policy", you should talk a little about the territory of its action. In Russia , compulsory type of health insurance is carried out in accordance with the Federal Law approved on November 29, 2010. The legislation of the Russian Federation stipulates that every citizen who owns an MHI policy has privileges to receive medical care throughout the country absolutely free of charge in the amount of the basic state program. And if the policy is issued in the regions of the Russian Federation, then in accordance with the framework of the regulatory provisions of a particular area. The base amount is approved by order of the Government of the Russian Federation within the framework of the State Support Program to provide free medical care to citizens. In the regions, on its basis, the framework of the local self-government is created and approved. These programs cannot be less in terms of volume and types of the Basic Program. But the territorial volume may include special types of medical care, which are provided at the expense of the subject of the Russian Federation. From all that has been said, it can be concluded that any Russian citizen insured under compulsory medical insurance in his region has the right to receive medical care in an increased amount (if specified in the territorial program) and in the amount provided for in the Basic program, if he is in the territory of others regions of the country.
Voluntary health insurance
Now let's figure out what is a VHI policy? What is it for? This type of policy is a type of individual insurance that allows you to receive medical care in health care facilities that are not included in the compulsory medical insurance program. Voluntary insurance is divided into 2 categories: collective and individual. In the first case, the risk of various diseases in a group of people is taken into account. And individual insurance covers the complexity of a particular disease in a particular person. In this case, either individuals (under an individual program) or employers (under collective programs) act as entities providing services. The role of the insured are citizens.
Protection and enforcement of the rights of insured persons
Studying the question "what is a policy", special attention should be paid to protecting and ensuring the rights of insured citizens.
According to the legislation of the Russian Federation, this type of protection is carried out by:
- Employer.
- Executive or legislative bodies of the regions of the Russian Federation.
- Fund of territorial importance of the compulsory medical insurance.
- Medical insurance institutions and their communities.
- Health Supervisory Authorities.
- Medical facilities of a professional type.
- Hospitals, clinics.
- Antimonopoly committee and prosecutor's office.
- Roszdravnadzor.
- Subjects of judicial and pre-trial settlement of disputes.
So we studied what the MHI policy is, why is it needed and what are the main types of insurance for citizens.