One of the common problems today is the need to receive medical care outside the place of residence. Citizens who have moved to another region and need medical services often do not have temporary registration.

Is it possible to count on free medical care in these cases?

Let's turn to the law. In the Constitution of the Russian Federation, article 41, paragraph 1, we read: “Everyone has the right to health protection and medical care. Medical care in state and municipal health care institutions is provided to citizens free of charge at the expense of the appropriate budget, insurance premiums, and other revenues”

The Federal Law “On Compulsory Medical Insurance” No. 326-FZ of November 29, 2010, article 10 defines the concept of “insured persons”
Article 16 of the same Federal Law lists the categories of insured persons who, upon the occurrence insured event, are entitled to free medical care.
And it is also indicated here that when seeking medical help, with the exception of emergency cases, we are required to present a policy compulsory honey ice insurance.

Now let's look at regional laws. According toOrder of the Department of Health of Moscow and the Moscow City Fund for mandatory health insurance dated November 14, 2008 No. 931/131 “On approval of the Procedure and conditions for the provision of medical care under the Moscow city CHI program”, “in the absence compulsory medical insurance policy for patients (in case of emergency treatment), medical institutions take measures to identify the patient in order to identify the insurer or classify him (according to his passport) into the category nonresident citizens or unidentified patients »

Thus, all citizens of the Russian Federation have the right to high-quality, affordable, and most importantly, free medical care, regardless of their place of residence in Russia.

Let's move on to practice. Let me give you an example of a real the story of Irina M. from the city of K.
Irina is a citizen of Russia, in the city of K. she has an apartment, residence permit and registration. Recently, she moved to live and work in Moscow. While staying with friends.So, Ira just caught a common cold. Symptoms are standard: drowsiness, fatigue, ear / throat / nose, low (up to 38) temperature and slight chills. After lying down for a couple of days and self-medicating, she decided to see a doctor.
Typing inGoogle her address, Ira found a polyclinic not far from her house and started calling. Read full story.

Circle one - calls to clinics .
In polyclinics Irinaeither did not respond or demanded registration; in polyclinic No. 104, she was told that she had the right to visit 1 doctor once; offered to call an ambulance.

Circle two - Calls to authorities. On hotline Department of Health of the city of Moscow she was sent to the health department for the Western Autonomous Okrug.
In the Department of Health for the Western Autonomous Region - advisedgo to the head doctor of the polyclinic and negotiate with him, because "Medical care will be fully depend on his decision.

Before going to the clinic, Irina decides to call the Moscow and Federal CHI Fundsto get answers to two questions:
1. Is registration still required?
2. Is it necessary to choose medical organization where you actually live? Or are there other selection criteria?

Calls to authorities-2.
Mandatory medical insurance fund for Moscow.
Here it was recommended to write an appropriate letter addressed to the head physician. They advised to send it by registered mail, because. the secretary of the polyclinic, in view of her high employment, simply will not have time to receive him. Kindly reminded of the existence of an ambulance.

Federal Compulsory Medical Insurance Fund. From the hotline immediately redirected to Baklashova Marina Anatolyevna - Deputy Head of the Department of the organization of compulsory medical insurance. She explained that registration is not needed, a passport and a compulsory medical insurance policy are enough, and you can write your real place of registration and the address of your actual residence. She also did not rule out the possibility of refusal to attach if the hospital was staffed, but noted : if help is needed right now, then polyclinics do not have the right to refuse a visit to the doctor. And you can choose any clinic near your home.

Circle three.
Polyclinic No. 140.
Ira was quickly and easily attached to polyclinic No. 140 right at the reception desk, they did not require registration, they wrote a letter addressed to the head physician and issued a card.

Conclusions.

• It does not make sense to call the registries of polyclinics, since they can answer an obvious gag.


• The Citizens' Appeal Department of the Moscow Compulsory Medical Insurance Fund and the hotline of the Moscow Department of Health in this particular case did not work well, because they did not give explanations on the merits, and only more confused.


• But the Federal Compulsory Medical Insurance Fund pleasantly surprised us.

So, if you have health problems, you just need to go to the nearest clinic to the place of actual residence with a compulsory medical insurance policy and a passport. You must be attached to the clinic and provide the necessary medical care. They will require registration - confidently refer to the law.Refusal to attach to the clinic is possible if it is staffed. But if medical assistance is needed urgently, then no one has the right to refuse a visit to the doctor.

If you have the opposite experience, write to us, we will try to help.
Our address[email protected]

The policy is valid throughout Russia. The volume of free medical care is provided for by the basic CHI program.

If you are required to pay, contact the authorities listed under the heading "Important!"

What to do if in another region they refuse to provide medical care under the MHI policy?

The policy is valid throughout Russia.

Can I seek medical help in another city if you forgot your policy at home? How to find out the policy number?

For policy information, please contact territorial fund Compulsory medical insurance at the place of medical care, which has access to the federal fund. In this case, you must provide your data specified when applying for the policy.

Is it possible to count on assistance under the CHI policy in another region if a chronic disease has worsened?

In case of refusal, contact the authorities listed under the heading "Important!"

How to get help for acute toothache?

The MHI policy is valid throughout Russia. According to emergency indications, medical care should be provided immediately, without prior appointment, out of the general queue.

For medical assistance, contact a medical organization working in compulsory medical insurance. You must have a passport, compulsory health insurance policy with you.

In case of refusal, contact the authorities listed under the heading "Important!"

How to get help for acute poisoning, injuries?

According to emergency indications, medical care should be provided immediately, without prior appointment, out of the general queue. The absence of a policy and personal documents is not a reason for refusing an emergency admission.

In case of refusal, contact the authorities listed under the heading "Important!"

Is it possible to undergo a comprehensive examination or medical examination in another city?

The policy is valid throughout Russia. To undergo a medical examination, contact a medical organization working in the field of CHI. You must have a passport, compulsory health insurance policy with you.

In case of refusal, contact the authorities listed under the heading "Important!"

Do I need to be attached to a medical institution if you are temporarily in another region?

You don't need to attach anywhere. For assistance, you should contact a medical organization working in the field of CHI. You must have a passport, compulsory health insurance policy with you.

In case of refusal, contact the authorities listed under the heading "Important!"

How to register in another city for registration or observation of pregnancy in a antenatal clinic?

The policy is valid throughout Russia. As part of the basic program of compulsory medical insurance, citizens are provided with primary health care.

For assistance, you should contact a medical organization working in the field of CHI. You must have a passport, compulsory health insurance policy with you.

In case of refusal, contact the authorities listed under the heading "Important!"

How to vaccinate a child by age in another city?

Russian citizens are provided with vaccines at the expense of the relevant budgets on a territorial basis. Thus, by default, the population of this region has the right to free vaccination in medical organizations of a particular region.

Therefore, it would be logical to vaccinate the child in advance, without delaying it until the holidays.

Important!

If you are being denied what you are legally entitled to, contact:

to the head of the medical organization

to the territorial CHI fund at the place of medical care

to the health insurance organization where you are registered

Under the MHI policy, you can take tests for the diagnosis and treatment of most diseases for free. Forcing a patient to pay for tests in most cases is illegal, but in order to avoid unnecessary expenses or return funds for paying for procedures in public clinics, it is necessary to know the legal basis for the interaction between medical institutions, their patients and the insurance company.

What tests can be taken for free

The procedure for providing citizens with free medical care under compulsory medical insurance policies is regulated by the following regulations:

• Law No. 326;
• Decree No. 1403;
• the laws of the subjects of the Russian Federation.

All citizens of the Russian Federation who have received a compulsory medical insurance policy are guaranteed medical care, both under the basic and additional (regional) programs. The main program includes not only the treatment of pathologies established by the doctor, but also the timely detection of such pathologies, as well as preventive measures.

The list of diseases subject to free therapy throughout the Russian Federation is briefly presented in paragraph 6 of Art. 35 of Law No. 326, and in more detail is given in the List of Section 4 of Decree No. 1403.

Free analyzes are prescribed for the following purposes:

1. treatment of the pathology present in the List;
2. diagnosis of this pathology;
3. diagnosis of possible comorbidities;
4. prevention of suspected pathology and concomitant diseases.

For example, a doctor, based on the symptoms described by the patient, suspects a specific pathology, which is often accompanied by another pathology. If tests for the presence of the underlying disease are free, then tests for the presence of a concomitant disease must also be performed as part of the services paid by the insurance company.

The main medical standards for the treatment of diseases listed in the basic and additional programs can be viewed on the website of the Ministry of Health of the Russian Federation.

Among the main free types of analyzes are the following:

• blood test for syphilis - markers, HIV, and other infections;
  blood and plasma tests for the content of the main elements (red cells);
• biochemical studies of blood and lymph;
• analysis of the content of hormones;
• tissue biopsy;
• high-tech analytical studies of tissues and organs (MRI, CT);
• x-ray studies;
• ultrasound analyzes of tissues and organs;
• scrapings and smears of the skin, foreskin and saliva.

Only expensive tests for suspected rare autoimmune or genetic diseases, which occur less frequently than in 0.01% of cases, as well as aesthetic medicine tests, can be paid.

How to check if analysis is free

To determine the legality of sending a doctor to take paid tests, you need to find out if the necessary analysis is included in the list of services provided under the basic insurance program.

It's important to know that basic list medical services provided throughout the country can be supplemented by:

• regional medical programs;
• employer programs.

Regional programs are budget subventions for paying for services that are not on the All-Russian list, and which are provided free of charge only in a specific subject of the federation. Only patients who are registered in the region and have received an insurance policy from local insurers can receive these services.

In addition, large employers paying insurance premiums for their employees, may provide additional packages of services for free examinations.

To check the possibility to pass the analysis prescribed by the doctor for free, you need to perform the following steps:

1. View the presence of the pathology suspected by the doctor in the main list approved by Resolution No. 1403.
2. In the absence of a disease in this list, find out if it is in the list of services provided by the insurers of the given region or the patient's employer.
3. Find out the list of tests necessary for diagnosis and treatment this disease from the standards on the website of the Ministry of Health.

The list of additional regional services can be viewed on the website of the regional Ministry of Health, and the services provided under insurance from the employer are listed in the appendix to the employment agreement.

If the diagnosed disease is in one of the free programs, and the prescribed tests are included in the standard for the treatment of this disease determined by the Ministry of Health, then the patient has the right to take this analysis free of charge.

How to get a referral

At the initial appointment, the patient is often given a referral for tests to a paid clinic under the pretext that the necessary equipment or reagents are not available in this clinic. It is important to know that only the patient has the right to choose where medical services are provided. The doctor can only issue a referral for analysis, and the place of delivery and processing of the results is determined by the patient.

Getting a referral for free tests is as follows:

1. the patient goes to a specialist doctor to diagnose the disease;
2. the doctor determines which tests the patient needs to pass and issues a referral;
3. if it is not possible to conduct an analysis in this clinic, the doctor issues a referral to another medical institution;
4. if the clinic employee refuses to give a referral for a free analysis, it is necessary to write a complaint addressed to the head or chief physician.

If the appeal to the management of the clinic did not bring results, and the necessary analysis is included in the list of basic or regional services provided under the CHI policy, then the patient should contact the representative of his insurance company.

You can contact both with the help of the hotline, and in person, at the representative office of this insurer in the locality. Most insurance companies have special departments whose work is aimed at resolving conflicts between medical institutions and patients.

If, after the attempts made, a referral for a free analysis is not received, then you should contact the regional health insurance fund. Such funds monitor the activities of private insurers in the context of respecting the rights of insured patients.

In some cases financial resources, spent by the patient on the delivery of free tests can be returned. You can return funds in 2 ways:

• at the cash desk of the clinic;
• in an insurance company.

If the patient was referred for a paid analysis at the treatment clinic, then to return the funds, you need to do the following:

1. write an application to the head physician for a refund Money;
2. attach to the application a check for payment for tests and an agreement on the medical services provided;
3. receive an order-resolution on the payment of compensation;
4. apply with a copy of the order and a passport to the accounting department of a medical institution.

The application indicates the full name of the patient, his address at the registration and passport data, then you need to state the reasons for the return of funds, indicate the amount spent and the number of the insurance policy. The basis should indicate the presence of the passed analysis in the basic list of services that holders of compulsory medical insurance policies can apply for.

For a refund, you must keep a receipt for payment for services and an agreement on paid services.

If the patient was sent to a private clinic for testing, the money spent is refunded through the insurer that issued the policy. To do this, you must contact the representative office of the insurance company of the municipality and draw up an application for a refund based on the occurrence of an insured event - the need to pass an analysis from the basic or additional lists.

Transferring money through insurance company usually within 3-8 business days. If the employer pays the contributions for the CHI policy, then the compensation can be transferred through the cash desk of the enterprise or to a salary card.

Difficult situations

When applying for compensation or when requesting a referral to another medical facility, the patient may experience a refusal or a severe delay in responding to the appeal. In most cases, the situation is resolved by a call to the specialists of the insurance company that issued the policy, or a complaint to the regional MHI fund.

If the prescribed tests are included in the basic list and are an expensive procedure, then the patient has the right to demand the provision of this service free of charge through the judicial authorities. It is important to consider that referral for tests to another locality or a paid clinic can only be issued under the following circumstances:

• the inability to conduct these studies in public clinics of the municipality;
• the absence at the moment of the necessary specialists in the clinic;
• lack of assigned analysis in the basic and additional lists free services;
• application of a person from another region for a service provided within the framework of the program of the subject of the federation.

The doctor must inform the patient about the free equivalent of any medical service provided. Often, patients are deceived by giving a referral for paid tests with the promise of subsequent compensation, to which the patient will not be entitled due to a personal waiver of demons. paid service.

To avoid such deception, you need to carefully review the contract offered for signature when passing paid analyzes for the presence of a clause on the refusal of a free service. In the presence of this item, the money spent can be returned only by a court decision.

If the patient, when providing a paid service, is refused to issue a contract and a check, you need to refuse payment and file a complaint with the head doctor and the insurance company, since these actions of the staff are illegal.

Conclusion

Most of the tests in public clinics can be taken by holders of compulsory health insurance policies free of charge. In order to exercise your rights, you should look for the prescribed analysis in the list of free services and, if necessary, require referral to another medical institution, and in order to return the money spent, it is important to keep a copy of the contract and receipt. Most difficult situations are resolved by contacting representatives of the insurance company.

According to the legislation in force in the Russian Federation, a medical insurance policy (CMI) is valid throughout Russia, and not only in the city where it was issued. Therefore, refusal to serve a citizen due to the fact that his policy would be registered in another region is illegal and is a direct violation of the law. How is the service under the MHI policy in another city, what law regulates it, and what are the consequences for the medical institution in case of refusal to provide services? We will try to answer these questions in detail in this article.

The procedure for servicing non-resident citizens

In order to use medical assistance under compulsory medical insurance in another city, you can contact any public clinic or hospital. In this case, the guarantor of the citizen's right to free qualified service will be a document certifying the availability of insurance, namely the policy. It is enough just to present it when visiting a medical institution.

Note! According to the legislation, emergency and emergency assistance should be provided to all those in need in any case, regardless of whether they have insurance, passports, etc. In such a situation, the medical institution simply does not have the right to require any documents.

If a patient from another region is forced to pay for the service rendered, then all checks and receipts for treatment should be kept. Upon returning to the settlement of permanent residence, it will be necessary to contact the local territorial compulsory medical insurance fund and report the fact of an illegal demand for payment for medical services, after which, based on the receipts provided, the expenses will be reimbursed. If a citizen has forgotten the policy, then he will also be able to use free medical care in another city, but for this, either he personally or an employee of a healthcare institution will have to contact the territorial fund that issued the insurance document and find out information about the availability of the policy.

What law governs the CHI policy?

Principle of operation and procedure insurance document Compulsory medical insurance in the territory of the Russian Federation is regulated by Law No. 323-FZ “On the Fundamentals of Protecting the Health of Citizens” adopted in 2011. As mentioned above, according to this law, a citizen has the right to use medical care even if the policy was obtained in another city. At the same time, in such a situation, the patient may encounter a number of features of the insurance operation. First of all, we are talking about the fact that, being outside his home region, he can count on a slightly different scope of services, since such patients are served according to the basic health insurance program established by law.

The list of services included in this program is described in detail and regulated in Law No. 326-FZ of November 29, 2010. Summarizing this document, we can say that the basic program is somewhat smaller in terms of the volume of included services than the territorial one (this includes more expensive diagnostics, procedures and operations), however, in both cases, the patient can be sure that he will receive highly qualified medical care.

Denial of Service Liability

In a situation where a citizen does not want to be served in a healthcare facility on the basis that the policy was issued in another city, you should immediately write an application addressed to the head physician of this organization. In most cases, this is more than enough for the clinic staff to change their mind and provide the necessary assistance. If this scenario cannot be implemented, you can call the insurance company directly (by the phone number indicated on the policy) or the territorial CHI fund.

Note! Medical services the policy is provided only by those organizations that are part of the territorial CHI program. That is, if a person turned to some private clinic(not included in the CHI), without needing emergency medical care (for example, just caught a cold), then it is likely that no one will accept it for free.

Health care workers CHI systems according to the law, they do not have the right to refuse to provide assistance to the patient due to a discrepancy between the region. In case of denial of service, the patient has the full right to go to court and demand compensation not only for the costs of treatment, but also moral damage. And if, through the fault of a health worker who did not provide timely medical care to the patient, the patient's health was harmed, the doctor faces criminal liability.