Taken from the Internet... Hello, all citizens of the Russian Federation! Hello, because now, thanks to the changes that have occurred in our medicine, there are every opportunity for the improvement of ordinary, poor people! The main thing in this matter is persistence and the desire to properly study your rights; fortunately, there is all the information for this on the Internet.

Now, based on the mandatory policy health insurance, ANY CITIZEN OF THE RUSSIAN FEDERATION can receive almost all the high-tech care that modern medicine has. This assistance is provided both by regular clinics that have such technical capabilities, and by clinics belonging to the FMBA system, research medical institutions and paid clinics that also have the appropriate technical capabilities.
To do this you need:
FIRST - find information on your disease and find out whether federal quotas are allocated for its treatment (including surgical treatment).
SECOND: Find (again, this can be done remotely, via the Internet) medical institution, which deals specifically with your problems and cooperates with that fund federal insurance, from which you received an insurance policy (by the way, changing the health insurance fund and getting a policy from another company is not a problem at all). Contact this institution via the Internet, attaching ALL medical reports that you have received. Wait for a response (it is better to contact several organizations at once), and in correspondence obtain consent for hospitalization (face-to-face consultation, surgery, or whatever is required in each specific case).
THIRD: with this consent, go to your local clinic and receive a referral to the institution that has agreed to help you on the basis of the compulsory medical insurance policy.
YOU DO NOT HAVE THE RIGHT TO REFUSE A REFERRAL WITH THE CONSENT OF THE HEALTHCARE INSTITUTION! UNDER ANY PRECASE! I myself am a group 2 disabled person, unfortunately I cannot leave the house (for now), my right lung, mediastinum, and large intestine have been completely removed. In general, I have been fighting cancer since I was 14 years old, now I am 45... I have undergone seven operations, two of which are high-tech, both were done under a quota, financially we would not have been able to cope with them even if we had sold our only home. Each of these two operations lasted longer than eight hours.
Of course, I would hardly have managed it without the help of my husband, but he is golden, like all our relatives (I really hope that none of us is alone and there is at least one person who does what we, in due to their illnesses, they are simply unable). So don't lose hope and STUDY THE LAWS!!! They are written for us and they really work.
Of course, not everything is “rosy” for us either - my husband cannot work at all, because he is constantly “pulling me out of the grave,” plus all these experiences have greatly undermined his health. We are sorely short of money, and now we have accumulated a debt of 10,000 rubles for an apartment - we have no idea where to get it. It just so happens that besides my husband, I only have a 78-year-old father, who himself needs help... My disease is an orphan disease - unfortunately, there are no free medicines for it... And even vitamins and those - only chewable ones - are suitable for me. There is no large intestine... It’s kind of a shame to go to the funds, there people there collect a pretty penny for a living, but I’ll ask for diapers, vitamins, rent... I don’t know... I can’t. To be honest, I really believe in God and hope for a New Year’s miracle))))

Many people have a medical insurance policy (CHI). However, not everyone knows how to use it to its fullest. How to get a voucher for an examination or operation and how to achieve high-tech medical care?

What is High-Tech Medical Care (HTMC)?

High-tech medical care is treatment using high medical technologies or unique treatment methods. The list of types of assistance is approved every year by the Russian Ministry of Health. .

What diseases are treated with VMP?

The list of diseases for the current year is prescribed in the “Program state guarantees free provision of medical care to citizens for 2015 and for the planning period of 2016 and 2017.” This includes: abdominal surgery (treatment of the abdominal organs), obstetrics and gynecology, gastroenterology, hematology, combustiology (treatment of severe burn injuries), neurology, neurosurgery, oncology, otorhinolaryngology, ophthalmology, pediatrics, rheumatology, cardiovascular surgery, thoracic surgery ( surgery of the chest organs), traumatology and orthopedics, transplantation, urology, maxillofacial surgery, endocrinology, neonatology.

What documents are needed for treatment with high-tech methods?

To obtain a coupon for surgery and other types of medical treatment, you need to collect a package of documents: an application from the citizen in need of treatment; an extract from the minutes of the meeting of the doctors’ commission; an extract from the medical record justifying the need for treatment (no longer than one month); passport and its copy; compulsory medical insurance policy and its copy; pension insurance policy and copy; certificate of disability (if any).

How can I get help?

The referral for hospitalization is issued by the attending physician, who also handles the paperwork. The referral is sent to a medical institution or the Ministry of Health within three days to receive a treatment voucher. The department's commission decides whether to give the patient a referral within seven to ten days. Then, at the right time, hospitalization occurs.

There may be several reasons for refusal: if the patient can be cured without the use of VMT, the patient does not have indications for treatment with high-tech methods; This is what the commission in the Ministry of Health decided, the limit of benefits has been exhausted. In this case, you need to find out whether there are budget places in other institutions for the current year. If there are no places, you need to prepare all the documents to obtain a coupon, so that you can then get a quota in the first place. If treatment is urgent, it is better to get it in own funds, and then return the money through the Ministry of Health, providing the necessary papers.

Does the patient have the right to choose a clinic?

The patient can express his wishes, but the decision remains with the specialist issuing the coupons. The list of institutions includes institutions that have the latest equipment and specialists of the highest categories.

Do I need to pay extra for the provision of services?

In some situations, treatment under compulsory medical insurance will require partial payment. For example, searching for donors for surgery. The operation itself will be carried out from the state budget. It is better to find out in advance what exactly is included in the quota and what may be required at the stage of preparation for the operation.

Where to go if a medical institution does not provide medical care or provides it with violations?

The insured person has the right to contact the head of the medical institution. If he refuses to understand the situation, you can contact the insurance company that issued the policy (the address and telephone number must be indicated on the policy) or the judicial authorities.

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The doctors were shocked when I showed...

Over the weekend, I was at home with an impossible sore throat and a temperature of 39.6.

Taking another dose of paracetamol that day, I called an ambulance. I was told that it was a sore throat and that I should call the local police officer on Monday. The ambulance didn't arrive.

Zhenya Ivanova

was treated and recovered

I typed in the search bar: “What to do if the ambulance refuses to go.” I saw advice on the forum: “Say threateningly that you should call the insurance company now. They'll come right away." I did so. The ambulance has arrived. Afterwards, I threatened the doctors twice more with calling the insurance company, and once I actually called the number listed on the policy. It helped every time.

The insurance company protects my rights and actually guarantees free treatment. But if you don’t know the laws, then unscrupulous doctors will be able to deceive you, refuse treatment, and demand additional payment.

I recovered and decided to figure out what your compulsory health insurance guarantees you.

Get to know your compulsory medical insurance policy

Most likely, you already have a compulsory health insurance policy. Your parents made it for you immediately after birth. It is either in your passport or in the box with all your important documents.

If you don't have a policy, drop everything and go get one.

Without a policy, you will not get any free treatment. Fortunately, you can get or exchange a policy in any city without residence permit or registration. To do this, take your passport and SNILS with you and go to an insurance company that is convenient for you, which issues these policies.

This is a card If you don’t have SNILS, you first go to the insurance company with your passport, then wait 21 days and only then get the policy.

Citizens of the Russian Federation who permanently or temporarily reside in the territory of the Russian Federation can obtain the policy Foreign citizens, refugees and stateless persons. Citizens Russian Federation The policy is issued without limitation of validity period. According to the law, even if you have an old policy and it is expired, the insurance will still work. Only until you change your passport details: first name, last name, place of residence.

If you come to the clinic with an old expired policy and are denied treatment, this is illegal. You must be accepted. Clinics ask everyone to change their policies to new documents, but for now this is only a recommendation. Of course, it is better to heed this recommendation: when a law comes out that terminates the old-style policies, it will not take you by surprise.

Which insurance companies provide compulsory medical insurance policies?

Compulsory medical insurance is an insurance program, that is, everyone pays a little into a common pot, and then they pay from it to those who need it. The state collects the common pot from entrepreneurs and distributes it through an extensive system of funds, which, in turn, pay hospitals. A Insurance Company- This is an intermediary manager who connects you, the hospital and the state.

Insurance companies make money from compulsory medical insurance in the same way as from other services. They are also responsible for the quality of services and discipline in the system. Your first point of contact is the insurance company.

Each region has its own registries of companies that issue compulsory medical insurance policies. Just Google it.

Where can you get treatment with a compulsory medical insurance policy?

To get to a clinic in another city or region, you need:

1. Select a clinic. Any, not necessarily the one that is closer to home.
2. Find out at the reception which insurance companies work with this clinic. If you have a choice, look at the company description on the CMO website. Everyone has the same insurance, but some have more offices, while others have 24-hour support.
3. Come to the insurance office with your passport and SNILS and fill out an application for a replacement policy.
4. Get a temporary certificate. It works like a policy for a month.
5. Return to the clinic. Tell the receptionist the code phrase “I want to join your clinic.” Receive an application form, fill it out and return it to the registration office.

Now you can be treated for free at this clinic.

If your insurance company services the clinic to which you are going to attach, then you do not need to change your policy. But you need to inform the insurance company that you have moved and want to be treated in another place. Otherwise, money for your treatment new clinic won't receive it.

Why do you need to join a clinic?

You need to be attached to a clinic because our country has a per capita financing system. Money for your treatment is given only to the institution to which you are assigned. Therefore, you cannot be assigned to several clinics at once. You can also officially change clinics no more than once a year. Previously, this could only be done if you moved. In this case, the new clinic will ask you to write an application addressed to the chief physician.

You cannot attach to a research institute or hospital, only to a district clinic. And there your local therapist will write out referrals to specialized specialists: an eye surgeon, a cardiologist, a chiropractor. Without a referral from your attending physician or emergency specialist, specialized clinics can only admit you for a fee.

What is EMIAS

In Moscow, the data of all patients is entered into EMIAS - a unified medical information and analytical system. This simplifies the process of making appointments with specialists: you can get a doctor’s voucher, cancel or reschedule an appointment, and receive a written prescription electronically. EMIAS even has mobile app.

Please note: if you have moved and decided to join a new clinic, you cannot simply do it through the system. You need to write an application addressed to the chief physician and wait until the bureaucratic apparatus approves it. This may take 7-10 business days. If you are registered on the Moscow government services portal, you can submit an application electronically. They promise to review it within 3 business days.

When I faced such a problem, I needed help urgently. And by law they are obliged to help me without any multi-day delays. But the clinic is afraid that if they treat me before the clumsy machine enters new data into EMIAS, then they will not receive money for me from the insurance company.

Right in front of the hospital administrator on duty, I called the insurance company, after which I received the necessary consultations at the hospital for free. I was also examined by a whole commission of department heads, and to this day everyone treats me very carefully.

What is included in compulsory medical insurance treatment?

The law on compulsory health insurance gives us all the right to treatment for free. And even if your policy has expired, you can still use it.

If you don’t have the insurance policy with you, you can still make an appointment with a doctor; they don’t have the right to refuse you.

Although for nurses this is additional concern, so most likely they will try to convince you that this is impossible. If this happens, just call your insurance company.

In any unclear situation, call your insurance company.

The minimum amount of assistance is described in the basic compulsory health insurance program. Each region decides independently whether to add anything else to this list. The exact list of insurance claims can be found in any clinic or found on the website of the Ministry of Health in your region.

In any case, you can apply the following rule: if something threatens your life and health, it is treated for free. If you are generally healthy, but want to feel even better, then most likely you can only do it for money. If the state can help you, but the level of this assistance seems too low to you, you will have to accept it or pay extra.

Examples of what can and cannot be done under the compulsory medical insurance policy

It is forbidden	Can
Teeth whitening is an aesthetic procedure	Brushing your teeth because it prevents caries
Get imported Japanese adult diapers by choosing your own brand	Get diapers for an elderly person
Remove a couple of extra pounds. Your figure is not insured by the state	Remove boil
Wait for exercises from hatha yoga or a modern gym during physical therapy	Go to physical therapy
Contact a dermatologist if you are simply concerned about increased oiliness of your facial skin.	See a dermatologist if you have a serious skin rash
Make a denture	Remove the tooth

Teeth whitening is an aesthetic procedure

Brushing your teeth because it prevents caries

Get imported Japanese adult diapers by choosing your own brand

Get diapers for an elderly person

Remove a couple of extra pounds. Your figure is not insured by the state

Remove boil

Wait for exercises from hatha yoga or a modern gym during physical therapy

Go to physical therapy

Contact a dermatologist if you are simply concerned about increased oiliness of your facial skin.

See a dermatologist if you have a serious skin rash

Make a denture

Remove the tooth

When something hurts, you can see a therapist for free, who will write a referral to a specialist. If indicated, the therapist must write out referrals to any doctors who work in public clinics.

Without a referral, you can make an appointment with a surgeon, gynecologist, dentist and dermatologist at the dermatovenerology clinic. Or register your child with a child psychiatrist, surgeon, urologist-andrologist or dentist. Compulsory medical insurance does not guarantee free tests and examinations without a referral from the attending physician.

Once every three years you can undergo a free medical examination and find out whether everything is in order with your health. A medical examination is carried out for everyone every three years - that is, if this year you turn 21, 24, 27 years old, and so on.

IN compulsory medical insurance program also includes free pain relief and rehabilitation after illnesses and injuries. But it won’t be possible to write down once or twice in which cases you are entitled to free insurance assistance, and in which cases you will have to pay on your own. There are a lot of nuances in this matter. If you have a rare disease or a difficult situation, contact the Federal Compulsory Medical Insurance Fund.

What exactly is not included in the compulsory medical insurance program

The state will not pay for:

1. Any treatment without a doctor's prescription.
2. Conducting surveys and examinations.
3. Treatment at home is optional, not for special indications.
4. Vaccinations outside government programs.
5. Sanatorium-resort treatment, if you are not a sick child or a pensioner.
6. Cosmetology services.
7. Homeopathy and traditional medicine.
8. Dentures.
9. Superior rooms - with special meals, individual care, TV and other amenities.
10. Medicines and medical devices, if you are not in a hospital.

If the hospital asks for money for services that are not on this list, just in case, call your insurance company and find out if it is legal.

Privileges

People with disabilities, orphans, large families, participants in military operations and other citizens who are entitled to social benefits, the state is ready to pay for more medical services. Each category has its own lists of benefits, you can find them in the department social protection or find it on the Internet.

Sometimes you are legally entitled to free treatment, but doctors just shrug their shoulders. There may be a waiting list of up to several months for free rehabilitation, and your local hospital may simply not have painkillers. It's illegal, but it's a fact of life.

Extortion

Doctors are people too, and nothing human is alien to them. Like any person, some doctors are more interested in getting a lot of money from you right now than getting a little less money from the insurance company and much later. Therefore, a whole illegal practice of extorting money for treatment under compulsory medical insurance has grown in Russia.

This extortion is based on legal illiteracy. All a doctor needs to do is pretend to be smart and take a stern tone so that frightened patients will start throwing money at him. But the slightest sign that the doctor is facing a legally savvy patient, and the tone changes. Therefore, it is very useful to know what medical services are required to be provided to you free of charge.

Remember that treatment is free only for you. The hospital and doctor will receive money for this treatment from the health insurance fund. This money was paid into the fund by entrepreneurs, including your employer.

You do not have to pay out of pocket a second time for what the state guarantees to you. Moreover, the doctor will most likely receive payment from the fund, even if you are forced to pay.

You do not pay for treatment, but the hospital will receive money for it

If you know for sure that you should and can be treated for free, but the doctor offers to pay, call the insurance company. The insurance number is written on your policy, the hotline specialists will help you.

If you cannot do this, ask your doctor to write a written refusal to provide free medical care. If the doctor behaves defiantly, you can turn on the recorder, this is legal. If even this does not help, call the Civil Rights Department in compulsory medical insurance system.

7 499 973-31-86 - telephone number of the department for the protection of citizens' rights in the compulsory medical insurance system

Emergency assistance is always free

If something really bad happens - you lose consciousness, break your leg or feel acute pain - you should be helped in any public clinic, even if you don’t have any documents with you and you’ve never received a policy.

The hospital does not have the right to refuse assistance to newborns and children under one year of age, even if the child’s parents do not have an insurance policy or registration. They cannot refuse pregnant women either - they can go to any antenatal clinic and any maternity hospital, even without documents.

All participants in the healthcare system are just people: someone’s acquaintances, friends, brothers, matchmakers and godfathers. They have parents and children. They are all Russians and they work just like any of us.

• If a surgeon demands a bribe for pain relief, then it’s not the healthcare system, it’s this particular surgeon, his parents and teachers. This means that somewhere in his childhood his father set an example for him that a bribe is normal. How do you feel about bribes?
• If a hospital says that it doesn’t have money for medicine, it’s not Putin’s fault, but some officials who don’t know how to draw up budgets. Or the head physician who doesn’t know how to manage money. You have plenty of friends who do the same thing at their jobs.
• After all, when you receive your salary in an envelope, it is your employers who underpay into the health insurance fund. Where will the money for your medications come from if you have given permission not to pay for them?

It turns out to be mild schizophrenia: the same person supports gray salary and complains about insufficient funding for hospitals.

Putin, Navalny, Medvedev, Tinkov or Trump will not solve our healthcare problems. We will solve this problem ourselves if we set an example for our children of a conscientious attitude towards work and the law. To skip classes at the institute was not a feat, but a shame. It was a shame to take tests for money. It was against our principles to give bribes. Knowing and standing up for your rights was a responsibility, not a superpower.

In short: no one will fly in and do it for us. free medicine as in paid Israeli clinics. All the hell that we see in hospitals is not hospitals, it is ourselves. And me too.

Let's start with paying taxes and fees. I have everything, thank you. Sorry for the moralizing tone, but I'm just tired of this whining.

Remember

1. If you don’t have a policy, drop everything and go get one.
2. With a compulsory medical insurance policy, you should be treated for free in any state clinic throughout Russia.
3. The treatment is free only for you. The hospital and doctor will receive money for this treatment from the health insurance fund.
4. The policy works even if it has expired. If you come to the clinic with an old policy and are denied treatment, this is illegal.
5. In any unclear situation, call your insurance company medical company. The number is on the policy. Put it in your phone right now.
6. If your insurance doesn't help you, call Federal Fund compulsory health insurance: +7 499 973-31-86.
7. If you spent money on treatment, which should be free by law, write a statement to the insurance company - you should get your money back.
8. Emergency assistance is always free, even if you do not have documents.

Laser vision correction (LVC) is becoming increasingly common in the treatment of a wide variety of diseases.

In 96% of cases the operation is completed successfully, the patient gets rid of the need to wear glasses and contact lenses.

Technologies for treating eye pathologies with laser have advanced significantly in recent years.

During the procedure it is used excimer laser, under its influence the shape of the cornea is adjusted, resulting in improved image clarity. LKZ - effective method cure farsightedness, myopia, astigmatism and other visual impairments.

Is it possible to do laser vision correction under the compulsory medical insurance policy?

It is possible to undergo vision correction under compulsory medical insurance; changes are constantly being made to the list of operations performed, thanks to which the number of potential recipients of assistance is expanding.

Photo 1. New sample compulsory health insurance policy. It is made in the form plastic card.

Compulsory medical insurance - what is it, do commercial clinics accept it?

Every citizen must have compulsory medical insurance; the document applies to all regions of the Russian Federation. Holder of a compulsory health insurance policy receives the right to preferential treatment anywhere in the country, while the address and region of registration do not matter. LKZ is carried out in all public and some private clinics. The state annually allocates funds for the provision of services, the LKZ operation is carried out at the expense of this money.

Free services under the policy, is LKZ included?

The list of services is subject to change and is approved annually by the regional health care program. Find out the full list of services in different regions You can contact the insurance company with which the contract is concluded. Laser correction is one of the methods for treating various eye pathologies, so the policy covers operations of this type.

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• emergency care for a patient;

• diagnosis and therapy using expensive technologies and drugs (in vitro fertilization);
• dental treatment;
• infectious diseases;
• cardiovascular pathologies, blood diseases;
• gastrointestinal diseases;
• diseases that have developed due to nervous disorders;
• sensory organ defects, joint diseases, muscle and bone diseases;
• neoplasms;
• skin diseases;
• pathologies of the respiratory and genitourinary systems.

When honey institutions refuse free surgery

Sometimes you can get a refusal to provide an operation, even if it is included in the list of mandatory services.

Reasons for refusal:

• possibility of curing the disease without intervention;
• no indications for treatment high-tech methods;
• exhausted limit for the provision of services for compulsory medical insurance policy as of the current year.

Reference. After receiving a refusal at one clinic it is recommended to contact another, there is a possibility of maintaining preferential places. In their absence, it is advisable to start issuing coupons and quotas. Urgent surgery is carried out for a fee, but after it you can apply for compensation.

Distribution of quotas for LKZ

Quotas are considered a forced measure, since the funds allocated by the state are not enough to finance the treatment of all those in need.

Quota places apply to certain types of surgical operations. After the disease is diagnosed, the patient gets on the waiting list There is no final deadline for the quota; the operation will be carried out in any case.

After completing the service you need to be patient, since for some categories of citizens, receiving medical services on a preferential basis is the only possible way out of the situation.

Who is entitled to it and in what cases?

The compulsory medical insurance policy covers the treatment of the following pathologies:

• cataract, lens replacement;
• glaucoma;
• traumatic retinal deformation;
• strabismus, including strabismus in children;
• congenital anomalies.

Add to list free services LKZ is not included for diagnosed refractive errors. They have the right to receive a quota all citizens who have entered into an insurance contract.

Attention! The waiting period for receiving preferential medical services is sometimes delayed due to the large number of applicants; the wait may take a year or more.

Vision correction services are provided to the following categories of citizens without a queue:

• labor veterans, pensioners;
• disabled people of all groups;
• participants of the Second World War and persons equivalent to them.

Receipt procedure

There are two ways obtaining a quota: through a health department organization or through a clinic where treatment is carried out. First of all, you need to contact your local doctor, who will write a referral to an ophthalmologist.

At the next stage, an examination is carried out, based on the results of which a decision is made on the need for treatment and hospitalization. Required documents:

• referral from honey institutions, in which the observation was made;
• extract from medical card, which describes the medical history, as well as the treatment performed;
• test results;
• written request;
• copy of health insurance policy;
• copy of the passport.

Stages of registration:

1. Going to the hospital at your place of residence.
2. Review of documents by specialists of the commission of the health authority, makes a conclusion Chief Specialist subject of the Russian Federation according to the patient’s disease.
3. Commission meeting, consideration of the provided conclusions, making a decision on sending the patient to a specific medical institution.
4. Transferring papers to the clinic, where the treatment will be carried out, setting the date of the operation.

The patient must come to the hospital at exactly the specified time with the originals of your documents.