You need to know and understand the basic principles that are implemented in practice by the basic program of compulsory health insurance :
路 Guaranteed free medical care
路 The amount of mandatory medical insurance contributions is determined by the state
路 Equality of all subjects and participants of CHI
路 Availability and quality of medical care for all insured persons
The insured persons may be citizens of the Russian Federation, refugees and foreign citizens. Policyholders are employers. Notaries, lawyers and private entrepreneurs pay fees for themselves. For unemployed citizens, the policyholder is the executive body of the subject of the federation. The health insurance insurer is the federal fund. And all together - these are the subjects of health insurance.
The insured persons have the right to choose an insurance medical organization and institution, change it once a year at will and be sure to move to a new place of residence, choose a doctor, receive information on the services provided, receive compensation for damage due to erroneous actions or inaction of doctors.
When applying to a medical institution for medical assistance, a person must present a compulsory medical insurance policy. Always report all changes to your insurance company, change of surname, place of residence, medical institution. For children, the insurance organization is chosen by parents.
The rights and obligations of policyholders are regulated by the basic program of compulsory health insurance, which provides information on registration and deregistration in connection with the termination of the policyholder, on the full payment or arrears of contributions of compulsory medical insurance.
The basic program of compulsory health insurance is unified and is valid throughout the country. First aid, preventive and ambulance are provided. Specialized medical care is provided for many surgical, therapeutic diseases, injuries and infectious diseases, children and women during pregnancy and childbirth. The exceptions are tuberculosis, HIV infection, genital infections, and mental illness.
The Ministry of Health is developing a basic compulsory health insurance program , which is approved by the government. The insurance premiums paid by the insured go to the accounts of territorial funds -2% and to the federal fund -1.1%, where they are accumulated and used in the process of providing medical services.
Medical insurance organizations monitor the volume, quality, terms of assistance to insured persons, protecting their interests. In addition, they receive insured citizens, provide them with information about the list of medical services provided under the compulsory medical insurance. Conclude contracts with clinics and hospitals and issue insurance policies to employers. When hiring employees at the enterprise, they take the policy from their employer and return it upon dismissal. If the policy is lost, the employee is given a duplicate for a fee, and the previous policy is canceled.
Since 2011, a single model policy has been introduced. The medical insurance system in the Russian Federation guarantees the necessary medical care free of charge to all citizens and non-citizens of the Russian Federation residing on its territory. But a few practical tips people need to remember, so that as little as possible there are conflict or controversial situations in their life:
1. There are many excellent competent specialists and medical institutions, know how to make the right choice.
2. If you have problems communicating with your doctor, always contact the department head or deputy. Chief Medical Officer to resolve all issues.
3. If you violate your rights to free medical care, contact the insurance company in writing to protect your interests.
4. If in doubt about the legitimacy of payment for medical services, check the list with your insurance company.
5. When paying for medical services, keep the contract, receipts, so that they can be presented at the proceedings with the insurance company in order to receive reimbursement.
6. Address all questions to the heads of hospitals, experts of insurance companies and specialists of the territorial compulsory health insurance fund.