State health insurance of citizens

State health insurance of citizens is a mandatory procedure. Due to this, free medical care is provided. Insurers are bodies of territorial or federal authorities.

Citizens are persons who have, and the insurer is a municipal or village budget. What is included in the free service with an MHI policy?

professional help medical workers can be obtained free of charge. Moreover, the planned examinations are carried out in the territory where the person is insured, that is, in order to receive the services of specialists, it is necessary to purchase a policy. The accrual of insurance is based on contractual obligations. The issuance of the policy is carried out directly in organizations, enterprises or funds located in different areas.

For each locality, a register of medical services is approved. Any hospital or clinic has this list, agreed with the municipal or regional authorities.

The current program includes the following areas of assistance:

• first medical;
• specialized;
• ambulance;
• used in the treatment of incurable pathologies.

These directions are determined by regulatory documents.

About types of assistance

Types of first aid, and which specialists provide it:

1. Nurses provide medical and sanitary support to the patient.
2. Paramedics or obstetrician-gynecologists provide first aid.
3. Medical assistance is provided by local doctors, including general practitioners and pediatricians.

First aid is provided by medical staff in the clinic, directly at the patient's home or in a day hospital.

Specialist responsibilities include:

• reception of a citizen;
• appointment of procedures to clarify the diagnosis;
• determination of the name of the disease;
• appointment of complex therapy;
• recovery control.

Moreover, the purchase of medicines is not included in the list demon paid services.

Specialized medical care is provided when the patient is under observation in a day hospital.

These include drips, injections, massage, physiotherapy, and surgery that does not require hospitalization.

Ambulance services are divided into:

1. Specialized and urgent. That is, the deterioration of the citizen's well-being does not threaten his life as a whole.
2. Emergency urgent or emergency. The condition of a citizen is dangerous for his life.

In the presence of acute diseases, hospitalization is prescribed, namely:

• vascular hemorrhages;
• heart attacks;
• in case of poisoning;
• injuries;
• infectious pathologies.

According to the order of the Ministry of Health, in the next two years, a full medical examination of all Russian citizens will take place. As a result of this survey, each person will be assigned a specific health group.

If any chronic disease is detected, it will be obligatory to undergo a medical examination as many times a year as necessary based on the diagnosis.

If a person misses this examination, he will receive a message about this in the form sms messages. According to the introduced rules, insurance companies will have to process appeals and complaints from citizens and provide assistance in case of disputes.

If the patient has doubts about the quality of the medical services, insurance workers will have to appoint an examination.

Amendments will be introduced to the Labor Code, which will legislate the annual additional day of vacation. This day will be provided to employees from 40 years of age to undergo a medical examination while maintaining their average earnings.

The policy can be issued in paper form, as before, or in the form of an electronic card, in the presence of which in medical institutions it will not be necessary to present a passport. The temporary policy will be valid for 45 days.

Modern Assistance Programs provide for:

1. Providing free medicines to patients with chronic pathologies.
2. Surveys of workers employed in hazardous or difficult conditions, as well as those whose activities are related to food.
3. Ensuring control over the condition of young children, including those under guardianship or orphans.
4. Examination of pregnant women in anticipation of childbirth.
5. Examinations of only born babies for hereditary pathologies.

Pregnancy care

The policy provides women with the right to free medical qualified assistance while waiting for the baby. The document provides for the possibility of choosing a clinic and a doctor expectant mother while waiting for the baby.

Upon presentation of the policy to the clinic, a woman has the right to a whole range of procedures and examinations, which include:

1. therapeutic or prophylactic procedures.
2. Home visiting nurse.
3. Research of biomaterial in specialized laboratories.
4. Hospitalization, if necessary.
5. Diagnosis of pathologies of the unborn child.
6. Preparing for .
7. Rules and recommendations for breastfeeding.
8. Consultations of specialists of a different profile.
9. The choice of a gynecologist with the consent of the specialist.
10. Preventive, therapeutic and diagnostic measures in special organizations that have the right to engage in this activity.
11. Pain relief if surgery is needed.
12. Ensuring the protection of health information.
13. The right to refuse assistance.
14. Presence at the birth of relatives or friends.

If a premature baby is born, then free program such children are cared for, and organ transplantation is performed.

Benefits in dentistry

Dentist services are quite expensive, so many people are puzzled about what kind of care they are entitled to receive without paying. To do this, you must have health insurance.

In each territory there is an individual Program, according to which dental services are provided, and throughout Russia only provision is made for the provision of emergency care.

Specialized dental care covers:

1. Treatment in district clinics.
2. Treatment of babies in children's clinics.

Moreover, in each institution, a list of services must be approved, and the patient must be informed:

1. About the varieties of services.
2. About the working time of specialists.
3. About the telephone numbers and the locations of the insurers.
4. About the privileges provided.

Many private medical institutions also provide services without payment, and you can learn about this from the operators.

For children, the following types of services are provided:

• restoration and tooth enamel, not affected by caries;
• silver treatment and remineralization of teeth;
• reception and services of an orthodontist.

Free service

Free adult service includes:

• doctor's appointment, specialist consultation and examination of the oral cavity;
• treatment of pathology of periodontal disease and gingivitis, caries and pulpitis;
• elimination of exacerbation;
• building up hard tissues of a tooth with a damaged root;
• surgical interventions;
• cleaning teeth from stones;
• straightening of the jawbone;
• removal of decayed teeth;
• radiography;
• treatment of salivary glands;
• physiotherapy;
• local and general anesthesia.

Medicines can be given free of charge if they are on the list of free medicines approved by regional level. Usually, these are the means of domestic production.

Complaints about specialists

If there are contentious issues and conflict situations are brewing, you can complain to the doctor.

Constitution Russian Federation guarantees all citizens free medical care under the policy of compulsory medical insurance (CHI). Kinds free help provided by compulsory medical insurance policy:

• primary health care(ambulatory polyclinic);
• emergency,
• specialized medical care(if the diagnosis is established, the specific disease is treated)
• high-tech medical care(treatment of diseases using high-tech, complex, costly methods of treatment).

The presence of a compulsory medical insurance policy confirms that the patient's treatment in public and some private clinics will be paid from the compulsory medical insurance fund, which is formed at the expense of assessed contributions citizens.

Briefly about the CHI system

Payment for treatment in CHI system occurs at specially formed rates for each disease, but does not depend on the method of treatment of this disease. Tariffs are the same for all medical institutions. IN compulsory medical insurance tariff it is prescribed how many and what procedures, analyzes and studies the clinic can and must perform in the treatment of a particular disease.

Tariffs are the same for all clinics, which means that the patient can choose a more high-tech and well-equipped clinic, regardless of the cost of treatment. Mutual settlements with the clinic will be carried out by the insurance company.

Some expensive procedures under the CHI system can only be performed if strictly necessary, which the clinic must prove, otherwise they simply will not be paid. CHI fund. Therefore, the treatment of patients in the CHI system, unfortunately, has its limitations.

Medical institutions are forced to work according to the rules established by the CHI fund for each disease. It is important to say that the provision of high-tech medical care (HTMC) to patients, the so-called “quota” treatment, is also paid from the CHI fund and, accordingly, is carried out according to the algorithms prescribed above.

But the tariffs of the VMP system are higher and are intended specifically for the provision of complex, high-tech treatment, which allows the clinic staff to use all their powers. modern ways treatment, advanced technology and high-quality consumables.

Not all hospitals in Russia have the right to provide high-tech medical care. Every year, the Ministry of Health of the Russian Federation compiles a list of clinics that can treat patients according to the VMP. Selected clinics receive a so-called task from the Ministry of Health, which determines the number of patients that the hospital can treat according to the HTMC.

In medical centers of federal significance, only high-tech and specialized medical care is provided under the compulsory medical insurance policy. The Clinic of Coloproctology and Minimally Invasive Surgery is part of the first Moscow State Medical University. Sechenov, respectively, the same requirements apply to her.

How to get medical assistance under the MHI policy?

Option 1. Referral from the clinic

You need the CHI policy itself. If it is not there, and you are a citizen of the Russian Federation, you need to contact insurance company which works with territorial fund CHI, write an application and receive immediately temporary policy, and about a month later, a permanent compulsory medical insurance policy. After receiving the compulsory medical insurance policy, you need to attach to a polyclinic, which you can choose yourself. After that, you can apply for high-tech medical care under the CHI policy.

Referral from the clinic to which the patient is assigned (at the place of residence or at his choice). Such a referral to a city hospital or a federal center is issued to a patient if the doctors of the polyclinic cannot independently diagnose the patient or provide treatment. The direction from the clinic allows the federal medical institution, which is the First Moscow State Medical University. Sechenov and our Clinic, to provide the patient with primary, specialized and high-tech care.

In the polyclinic, you can get both a referral for a free consultation at our Clinic, and a referral for free treatment.

Option 2. As directed by the doctors of our Clinic.

Doctors of the Clinic of Coloproctology and Minimally Invasive Surgery can also issue referrals for treatment in some cases. The number of referrals is limited and applies to certain types of diseases or complications.

You can find out about the possibility of free treatment under the CHI policy during an in-person consultation with a doctor. In this case, you will bypass the stage of approval and receiving a referral at the clinic. Please note that referrals for CHI treatment, which are issued directly at our Clinic, have a limited number.

To issue a referral under the CHI policy through the doctor of the KKMC Clinic, you will need:

1. compulsory medical insurance policy
2. self-treatment to the clinic only for treatment (not carrying out a complex of diagnostic measures) with an already established diagnosis

Who is eligible for dental treatment under the CHI policy and what does it include? The answer to these questions can be found in the current Russian legislation, because not all people know about their rights and can use them. According to regulatory legal acts, every person who owns a CHI policy has the right to use free dental care.

When contacting a medical institution, it is necessary to provide a policy that guarantees the reimbursement of the cost of all services provided by the insurance company. There are some restrictions, so you first need to familiarize yourself with the terms of the contract in order to know exactly what you can count on.

Basic Information

The state program of dental care includes several areas. These include:

1. Children's help.
2. Surgical care.
3. Therapeutic dentistry.

Applications contain important information:

In case of occurrence or other emergency situations, a person must call the insurance company, whose representative will coordinate his further actions. Provides information on the nearest outpatient clinics, which will provide specialized care.

In the future, the patient will be able to receive permanent care in this clinic under the terms of the health insurance program.

Who can get free dental care?

Based Russian legislation everyone can get free dental care.

He has the right:

• independently choose a medical institution (from the list of clinics participating in the program);
• choose a doctor (requires consent from both parties);
• get reliable data about the dental clinic, working doctors, their qualifications, work experience and other professional data.

In doing so, contact medical institution for receiving free services is possible only during the period of validity of the insurance policy. If the contract expires in the near future, it must be renewed in a timely manner. The necessary information is presented on one side of the policy.

Legal Framework

The state program for the provision of free dental treatment is based on regulatory legal acts.

No. p / p	Document's name	Summary
1.	Government Decree No. 103 of February 14, 2002	Includes a list of medicines that are necessary for the treatment of diseases of the teeth and gums. Medicines are provided free of charge.
2.	Government Decree No. 890 of July 30, 1994	On the development of medicine for citizens to receive quality medical care. Improvement state support the population of the country and medical institutions with medicines and medical products.
3.	Government Decree No. 1006 dated October 04, 2012	Displays the features of the provision of paid services by private medical centers.
4.	Order of the Ministry of Health No. 81a of October 2013	State control over dental institutions participating in the program and providing medical services to the population.

The implementation of the state dental program is also controlled by other legal documents.

How to get help?

When contacting a dental clinic, the patient must necessarily clarify the list of services and materials that will be used in the treatment. Some medicines and consumables may be included in the list of free dental care, others are provided exclusively on a fee basis.

Free materials and medicines:

No. p / p	Types of medicines and materials	Features of the insurance contract
1.	Materials for filling	If necessary, filling the roots of the teeth
2.	dental material	Silicate materials, phosphate cement, composite materials
3.	Consumables	Disposable syringes and needles for anesthesia, X-ray film, dressings, suture material, etc.
4.	Medicines	Painkillers - Novocaine, Trimecaine, Lidocaine. Fluorine varnish of domestic production.

The list of dental profile services, which can be obtained for a fee:

• regular preventive examination of the teeth and oral cavity;
• the use of filling materials, anesthetics and sealants of foreign origin;
• removal of dental complications with ultrasound and other hardware techniques;
• caries treatment requiring the use of foreign materials;
• consultation and installation of braces;
• teeth whitening;
• restoration of fallen or destroyed crowns;
• application of modern techniques.

Mandatory conditions

To receive the necessary treatment, the patient must study the compulsory health insurance contract. This will allow you to find out what is included in the list of services provided. To avoid rejection, you should follow some rules:

1.	When contacting a medical facility	Provide a valid insurance policy, as well as documents confirming the person's identity (passport, driver's license).
2.	Choosing a dental clinic	Each patient is assigned to a specific medical institution.
3.	The occurrence of acute conditions and complications	For acute toothache and other emergencies, a person can go to any clinic that participates in the free medical care program based on an insurance policy. You can find out the list of clinics in the memo, the possibility of visiting the institution should be agreed with the insurance company.

If a person moves or is in another city on a business trip, the insurance company is obliged to provide a list of medical institutions where he can apply if necessary.

It is necessary to immediately carefully review the contract, since in the event of a move, the policy is not always subject to replacement. Sometimes the company responsible for the provision of medical services issues a new leaflet with a list of clinics.

How to get a compulsory health insurance policy?

To obtain a policy, you must provide the following documents:

• internal passport (at the age of over 14 years);
• birth certificate (under the age of 14);
• internal passport of the guardian or legal representative of the child under the age of 14;
• insurance number of an individual personal account (SNILS);
• an application for attachment to a specific medical institution in order to receive free dental care in the future.

What kind of dental care can be obtained with the CHI policy?

Free dental treatment under the compulsory health insurance program is provided upon the occurrence of insured event. These include:

• primary medical examination and assessment of the condition of the teeth;
• elimination of congenital defects of teething;
• treatment of caries, pulpitis and other diseases;
• abscess;
• extraction of teeth;
• channel cleaning during the development of an infectious-inflammatory process and the accumulation of pus;
• removal of stones by hand;
• surgical intervention;
• therapy of pathologies provoked by improper salivation.

If necessary, local anesthesia, x-rays, physiotherapy are performed.

These medical procedures insurance policy will be completely free of charge when the patient contacts the attached clinic. When visiting another medical institution, a partial payment for the procedures by the insurance company may be made, or the cost may be reimbursed upon submission of the necessary documents.

If a person needs to undergo a paid course of treatment in order to receive a refund, certain rules must be followed.

Prosthetics and implantation of teeth are not included in the list of free services. All procedures are carried out only for a fee.

The only exceptions are certain categories of the population:

• pensioners (upon providing a pension certificate);
• people with 1 or 2 disability groups, mentally disabled;
• war veterans;
• combatants in Chechnya, Afghanistan, etc.;
• liquidators of the accident at the Chernobyl nuclear power plant and people living in the radiation zone.

However, there are some limitations. Implantation and prosthetics can be done only with domestic materials.

Video: what types of treatment are available under the MHI policy in dentistry?

Where can you get your teeth treated in Moscow?

You can treat your teeth for free under the compulsory health insurance policy in Moscow in public clinics. The best option– turn to novice doctors who have recently completed their studies and practice under the supervision of experienced professionals. This will allow you to get high-quality and at the same time free help.

Private clinics participate in the program partially, so you first need to clarify the possibility of treatment under the policy in this institution. It depends on the availability of free time at the doctor, while the list of services provided is very limited.

According to the adopted legislation, practically every person registered and residing in the territory of the Russian Federation has the right assigned to him to apply to any medical institution for appropriate treatment if such a need arises. However, there is one important nuance- services of this kind, as well as the right to receive medicines free of charge, that is, free of charge, are provided only if the citizen has such a document as a compulsory medical insurance policy.

Who can receive free medical services?

Any citizen who is the owner of:

• Employed citizens. That is, the category of persons who regularly pays taxes to the state budget. That is, in fact, he pays for his treatment in advance.
• unemployed citizens. In this case, the payment Money for the treatment of these persons also occurs at the expense of the federal budget.
• Children, teenagers, and who have not reached the age of eighteen and are not taxpayers.

In the event that a person is officially employed, he has the right to issue, as well as . If he is not employed, works unofficially, or has not reached the age of majority, you can apply for this document at any company that provides insurance services.

In the event that any citizen needs to contact a specialist who is receiving outside locality where the specified individual also requires a referral from the attending physician.

There is a certain list of medical services, the provision of which is free of charge. These include the following:

1. Help of an emergency nature, that is, the departure of an ambulance on a call from a patient. This service is provided free of charge not only to persons who have, but also do not have this document. In the recent past, there were unreliable rumors that if a person does not have a compulsory medical insurance policy, he will have to pay about one and a half to two thousand rubles for calling an emergency. This is wrong. This service is provided in any case absolutely free of charge.
2. Ambulatory treatment in the medical institution that is included in the insurance system and includes a number of many different manipulations: examining and diagnosing the patient's disease, performing the necessary procedures and prescribing adequate treatment. However, when the patient is on the terms of the so-called outpatient, day care or home treatment, all the necessary medicines must be purchased by him at his own expense, since there are no benefits in this case.
3. Work with the public to raise awareness of sanitary and hygienic issues. That is, holding various lectures, seminars and so on.
4. Diagnosis and treatment of the population using expensive innovative drugs and methods. For example, in some regions of the Russian Federation, in vitro fertilization is carried out free of charge.
5. Diagnosis of the disease with subsequent hospitalization.
6. in dental clinics and offices with state status.

Free services under the MHI policy

For example, while being treated in a state-type hospital, a citizen has the right to receive free services for the treatment of diseases of the following kind: pregnancy support in case of a complicated course, as well as in the presence of pathologies of any kind, medical abortion, the presence of chronic diseases, or in case of exacerbation of the disease, poisoning , bodily harm and so on. In this case, the provision of medicines necessary for adequate treatment is free of charge.

The diseases, the treatment of which, according to the list, is free of charge, include the following:

1. Diseases of an infectious nature, with the exception of those categories that are classified as sexually transmitted infections.
2. Various diseases of the blood, vascular system, heart.
3. Diseases of the stomach, as well as the gastrointestinal tract in general.
4. Any disease caused by a nervous breakdown.
5. Diseases of the joints, bones, muscles and so on.
6. All kinds of defects in vision, hearing, speech.
7. Tumors, both benign and malignant.
8. Diseases of tissues and skin.
9. Diseases of the urinary tract.
10. Diseases of the respiratory system.

What to do if you are denied treatment if you have a policy?

At present, not every citizen is fully aware of the rights that are granted to him in accordance with, which is often used by unscrupulous workers in this field of activity, demanding a certain fee for providing the necessary assistance.

What to do if your rights are violated

Every citizen of the Russian Federation who has insurance has the right to seek help from any medical institution located on the territory of the state. In the indicated institution, he is obliged to accept and carry out appropriate diagnostics, treatment, as well as other manipulations that are necessary. However, it often happens that doctors, as well as hospital staff, refuse to admit a patient in such cases. This is not legal and violates human rights. It's important to produce.

To restore the violated right, the person who was denied the provision of medical services must file a complaint with, whose employees will take appropriate measures. If such a case is detected, administrative penalties may be applied to employees of the medical services sector.

What can you expect with a CHI policy?

In order to know the right to use which services the compulsory medical insurance policy gives, you need to carefully familiarize yourself with the list of services provided to the population free of charge.

It should be remembered that, in essence, these services are not free at all, due to the fact that wages Each employed citizen is deducted a certain amount each month, intended specifically for this purpose. Therefore, in this way, each individual pays in advance for his treatment in a state-type institution. In our other articles you can read and .

The holder of a compulsory medical insurance policy (CHI) can count on passing all the necessary examinations within the framework of the current insurance program. According to Law No. 323-FZ of November 21, 2011 “On the Basics of Protecting the Health of Citizens in the Russian Federation”, each insured person has the right to receive medical care in a guaranteed amount free of charge in accordance with the terms of the insurance contract. Are all tests CHI free and what is included in this list?

Who pays for free tests

Medical care under the CHI policy is free only for its owner. As for hospitals and polyclinics providing outpatient and inpatient treatment to insured persons, each of these medical institutions is obliged to pay the following costs:

• maintenance of special equipment and troubleshooting;
• wages for medical workers;
• purchase of necessary reagents, tools and preparations.

All of the above insurance costs are covered by federal fund compulsory health insurance (FOMS).

Rules for obtaining free analyzes

The receipt of a particular medical service under the CHI policy must be justified. When it becomes necessary to conduct any surveys, you need to proceed as follows:

• visit the clinic along with the compulsory medical insurance policy;
• contact a specialist of the required profile;
• get a referral for free tests.

The patient cannot independently decide which studies need to be done - this is determined by the doctor. All activities that are assigned by a specialist are done free of charge in the same clinic. If the clinic does not have the opportunity to conduct some research, the patient is sent to another medical institution.

On a note! When undergoing a course of treatment in a hospital under the CHI program, the patient has the right to receive all medical services free of charge.

How to get tested in another region

The scope of medical services under the contract compulsory insurance has some territorial restrictions. Outside their region, the insured person receives medical assistance under the terms of the basic program, which operates throughout the country. Within the boundaries of his region, he is served according to a program approved by the territorial fund compulsory medical insurance(TFOMS), which covers a wider range of services.

Rules for obtaining medical assistance under compulsory medical insurance in another region:

• during departure, the policy should be with you - it is better to take a picture of it and save the photo on your phone so that you can present it to health workers at least in this form;
• when they refuse to conduct a particular study on a free basis, explaining that this is not provided for by the basic program, you need to look into Art. 35 FZ No. 326-FZ dated November 29, 2010 “On the mandatory health insurance in the Russian Federation" (hereinafter - Federal Law No. 326). If the basic program does not provide for this type of examination, then the refusal is legitimate;
• when a state institution refuses to serve, call the regional TFOMS. The phone number can be found on the website of the Federal Compulsory Health Insurance Fund. It is illegal;
• when health workers claim that they work only with specific insurers, this is also illegal, since the policy is valid throughout the country.

Good to know! Analyzes are a preventive measure, which means an insured event. This is regulated by Art. 3 of the Federal Law No. 326. In accordance with the law, free research to clarify the diagnosis should be carried out throughout the territory of the Russian Federation.

In the event of an incomprehensible situation, call your insurance company - they will tell you how to proceed. The phone number is on the back of the policy.

What tests can be taken for compulsory health insurance for free

The problem is that there is no complete and exhaustive list of free CHI studies. Specialists sometimes do not even know whether a particular study falls under the insurance program. This is due to the fact that the diagnosis of various diseases sometimes requires an individual approach. To make a specific diagnosis, there is no need to puzzle over this issue - just look at the standards of medical care.

Remark: the standards of medical care are the selection of minimum effective measures for the diagnosis and treatment of a particular disease.

In order to find out if some type of research is provided for by the CHI program, you must:

1. Look at Article 35 of Federal Law No. 326. For example, if it is necessary to diagnose or observe a disease of the eye and its adnexa (for example, astigmatism), this is included in the CHI program.
2. Next, we are looking for a standard of medical care for this disease on the website of the Ministry of Health of the Russian Federation. We select the subsection “Diseases of the eye and its adnexa” and look for the Order of the Ministry of Health “On approval of the standard for primary health care for astigmatism”. We open it and look for the desired position in the nomenclature list.

An indicative list of standard analyzes for CHI 2020:

You can see a complete list of analyzes for compulsory medical insurance in 2020.

By eco

Approximately one seventh of married couples in the Russian Federation cannot conceive a child through natural insemination. Often this is due to the peculiarities of the physiological structure of the reproductive organs or the banal incompatibility of partners. Fortunately, the state proposes to solve this problem by providing a quota for IVF, which includes both sexes with infertility.

In order to become parents through in vitro fertilization under the CHI program, it is necessary to undergo a medical examination.

List of required list of analyzes for IVF according to CHI 2020:

• general and biochemical analysis of blood and general analysis of urine;
• fluorographic examination;
• blood sampling to determine the Rh factor and group;
• hysteroscopy and pipel biopsy;
• taking smears for the composition of the microflora from the vagina and from the urethra;
• hemostasiogram;
• blood test for homocysteine;
• hormonal panel: study of the level of hormones: prolactin, TSH, T4, in case of menstrual dysfunction - FSH, cortisol (important to exclude the stress factor), estradiol, metanephrine and normetanephrine.
• blood sampling to detect TORCH infections (syphilis, HIV, hepatitis, herpes);
• PCR of vaginal discharge for herpes virus and cytomegalovirus;
• microbiological analysis for chlamydia, mycoplasma, ureaplasma is also included in the compulsory medical insurance policy for IVF;
• smear cytology from the cervix and cervical canal;
• detection of antibodies to the rubella virus;
• Ultrasound of the pelvic organs and the thyroid gland;
• Ultrasound of the mammary glands - up to 35 years, mammography - after 35 years;

Studies for men:

• blood test for TORCH infection;
• spermogram;
• PCR of discharge from the urethra for herpes virus and cytomegalovirus;
• the CHI policy also includes seeding or PCR for chlamydia, ureaplasmosis, mycoplasmosis;
• taking swabs for flora from the urethra;
• blood sampling for Rh factor and group.

The shelf life of the results of the above studies is from 3 months to one year. If there were unsuccessful IVF attempts or interrupted pregnancies before the procedure, partners are advised to undergo a blood test for a karyotype.

Details about and all sorted out in separate articles on our website.

During pregnancy

Expectant mothers also have the right to conduct tests under the compulsory medical insurance policy. To do this, you must be registered in the antenatal clinic and regularly visit your obstetrician-gynecologist.

The list of standard studies includes:

• clinical blood and urine tests;
• blood chemistry;
• allergen tests (in the presence of skin reactions and mucosal reactions)
• research for the detection of infectious diseases;
• detection of antibodies to viral infections - measles and rubella;
• blood sampling for Rh factor and group;
• blood sampling for TORCH infection;
• hormonal panel: hCG, estrogen, progesterone, prolactin.

If the doctor sees the need for any additional studies, they are carried out on a paid basis only when the clinics providing services under the CHI program do not have the appropriate equipment, tools or reagents.

Refund Policy

It happens that the insured person takes a series of tests on his own initiative, so as not to waste time visiting the clinic. Accordingly, payment for the research carried out is made from his own pocket. In such a situation, it is extremely difficult to justify the need to provide free medical services. There is still a chance to return the money spent, but for this you need to do the following:

• keep all receipts for payment for medical services provided on a paid basis;
• bring them to the insurance company and find out if the study falls under the compulsory medical insurance program;
• if the tests are included in the list of free tests, you need to write an application for a refund and indicate in it the details of your bank account for a refund.

The above algorithm will take effect only when the patient has a referral from a doctor for paid tests. Otherwise, it is almost impossible to return the spent funds, because the state cannot pay for all studies conducted without a referral, and only on the basis of the insured person's own initiative.

Important! In order to prove your case, first of all you need to know your rights. If a doctor or insurer insists that the required analysis is not included in the MHI program, this can be checked on the website of the territorial MHIF or contact regulations. Some unscrupulous health workers deliberately send patients for paid tests, and then get their share for it.

Conclusion

Summarizing the above, the following conclusion suggests itself: almost all tests prescribed by a doctor can be carried out free of charge, because there is simply no exhaustive list. The specialist acts in accordance with generally accepted norms and standards - if a certain study is necessary to confirm the diagnosis and this is supported by a legislative act, then this does not run counter to the terms of the mandatory insurance program.

The patient, in turn, must: know his rights as an insured person, be able to find information of interest in legislative framework and on websites, have a policy with you and resolve all disputes with the insurer.

You can learn more about the system and your rights in our next article.

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