When you are treated as an inpatient (that is, you are in the hospital), you are required to provide medicines free of charge. When on an outpatient basis, you will have to purchase medicines on your own, if you are not related to privileged categories of citizens.

A citizen can only have one current policy(paper form or electronic policy). If he moved for a long period of residence to another region, he needs to contact the point of issue of policies of VTB MS LLC in the territory of this region to notify the insurance medical organization about a change of residence. Otherwise, he will not be able to use the medical services that are guaranteed by the territorial program of compulsory medical insurance in the region of residence.

If a citizen wants to change insurance company, then after the move, he can immediately contact the selected organization. In this case, the number and the policy itself do not change. You can change the insurance company once a year until November 1st.

A new policy form is issued if the existing one has been lost or has become unsuitable for further use, in the event of a change in personal data (last name, first name, patronymic), upon receipt of a new passport, as well as to all newborns.

Citizens with a CHI policy can use free medical care throughout the Russian Federation. Medical assistance is provided in the amount provided for by the basic CHI program. If her health condition worsens, your daughter can seek emergency medical care (emergency or emergency) at a medical facility or call a doctor at home. In this case, there is no need to attach to the clinic. If she plans to live in Vologda for a long time, we recommend that you join a local clinic.

If there is evidence, it is possible to get a referral. When issuing such a referral, the attending physician is obliged to inform you about medical organizations that provide the necessary medical care free of charge, as well as about the waiting time for hospitalization. Based on the information received from the doctor, you can choose a medical organization for planned hospitalization.

According to the basic program state guarantees free provision of medical care to citizens for 2018, planned hospitalization (provision of specialized medical care) of the patient is carried out no later than 30* calendar days from the date the attending physician issues a referral for hospitalization. For patients with oncological diseases, the waiting period should not exceed 14 calendar days from the moment of histological verification of the tumor or from the moment the diagnosis of the disease (condition) is established.

If the doctor refuses to discuss your options for hospitalization with you and to give you a referral based on your choice, contact your healthcare provider or your insurance company.

* - Decree of the Government of the Russian Federation of 08.12.2017 N 1492"On the Program of State Guarantees of Free Provision of Medical Care to Citizens for 2018 and for the Planning Period of 2019 and 2020"

To date, the basic CHI program does not include teeth whitening, implantation, prosthetics. But there are preferential categories of citizens who can use free prosthetics: these are veterans of the Second World War and military operations, Chernobyl victims and other categories, the full list of which is indicated in the Decree of the Government of the Russian Federation of July 30, 1994 No. 890. In addition, individual regions may introduce additional prosthetics programs.

If you have any doubts about the need to pay for a particular medical service, we recommend that you contact your insurance company for clarification, which, according to the law, advises patients on all CHI issues free of charge and helps protect the rights to high-quality free medical care.

Before starting treatment, the doctor is obliged to inform the patient about the list of services that can be provided to him free of charge, discuss the plan for the upcoming treatment and possible risks. An examination, appointment, consultation with a dentist, as well as the treatment of caries, pulpitis, periodontitis, periodontal disease and other diseases, tooth extraction, X-ray examination and physiotherapy procedures as part of treatment with the use of certain types of medicines are free of charge.

The full list of services provided under compulsory medical insurance can be found on the official website of the dental clinic

In order to get an appointment with a doctor, you must first contact the reception of the clinic. You need to have an OMS policy with you. The specialist will issue an outpatient card of the patient, which must be taken to the appointment.

Dentistry is included in the list of free medical care under the CHI policy. Free services By insurance policy can be obtained both in public dental clinics and in private ones participating in the implementation territorial program OMS. You can make an appointment with a doctor through the portal public services, as well as by calling the receptionist of the polyclinic.

You have the right to apply to your insurance company with a written request about the services provided to you under compulsory medical insurance. You will receive an answer within 30 days. You can also clarify all the information about the previous medical examination in the clinic where the previous examination took place. If you have not previously undergone medical examination, but want to do it, then you should contact the clinic at the place of attachment.

Medical examination can be carried out by working and non-working citizens, as well as students studying in educational organizations in face form. You can get a medical examination while in maternity leave if your age is a multiple of three in the current year (starting at 21). You can also undergo a preventive medical examination, which is carried out for citizens aged 18 years and older once every two years at the clinic to which you are attached. In the year of the medical examination, preventive examinations are not carried out.

With a temporary certificate, you can get a medical examination free of charge.

You undergo a periodic medical examination, which is carried out at the expense of the employer, in order to determine medical contraindications to work. Despite the passage of such a medical examination, you retain the right to undergo a medical examination free of charge under the compulsory medical insurance policy at the clinic at the place of attachment.

If you doubt the scope of the medical services provided, or you are not satisfied with their quality, you should contact your insurance company.

As part of the medical examination, every woman over 39 years old can undergo a study such as mammography of both mammary glands. In addition, since January 2018, women aged 39-48 years old have the right to undergo a study once every three years, and those aged 50-70 years old once every two years. If there are medical indications based on the results of mammography, a mammologist will consult you.

Another mandatory examination as part of the medical examination - for women aged 30 to 60 years - is an examination by a gynecologist.

Clinical examination is a complex of diagnostic measures, the passage of which allows to identify chronic non-communicable diseases (cardiovascular, bronchopulmonary, oncological, diabetes mellitus).

We recommend that you do not miss the opportunity to timely diagnose hidden health problems and existing risk factors for their occurrence. If signs of such disorders are detected, a second, more extended, individual diagnostic complex is carried out, and if necessary, treatment. All stages of medical examination are completely free for insured persons under CHI.

Leonid K., Zvenigorod

The CHI policy must be presented when applying for medical care to medical organizations operating in the system of compulsory health insurance. This obligation of a citizen insured under compulsory medical insurance is spelled out in article 16 of chapter 4 federal law dated November 29, 2010 No. 326-FZ “On compulsory medical insurance in Russian Federation».

Vladimir Petrovich, Domodedovo

The temporary certificate confirms the execution of the policy and certifies your right to receive free medical care. The temporary certificate is valid until the receipt of the CHI policy, but not more than 30 working days from the date of its issuance. In the event of the expiration of the temporary certificate until the insured person receives a policy of a single sample, the territorial compulsory medical insurance fund and the insurance medical organization take measures to organize the unimpeded provision of medical care to the insured persons under the temporary certificate upon the occurrence of insured event until the moment when the insured persons are provided with a policy of compulsory medical insurance of a single sample.

Maria I-na, Yegoryevsk

In accordance with clause 9 of the Rules for Compulsory Medical Insurance, for children who are citizens of the Russian Federation, after state registration birth and up to fourteen years of age, the following documents are attached to the application for the choice (replacement) of an insurance medical organization:

• birth certificate;
• identity document of the legal representative of the child;
• insurance certificate of state pension insurance - SNILS (for children under 14 years old - if available).

Yuri M., Zelenograd

Yes, valid. In accordance with Part 2 of Article 51 of Federal Law 326-FZ dated November 29, 2010, policies issued to persons insured under compulsory health insurance prior to the date of entry into force of the Federal Law are valid until they are replaced by policies of a single sample.

Inna, Balashikha

Compulsory medical insurance of children from the date of birth until the day of state registration of birth is carried out by an insurance medical organization in which their mothers or other legal representatives are insured.

Thus, the child receives free medical care under the policy of the mother or other legal representative.

(Compulsory health insurance rules, approved by the Order of the Ministry of Health and Social Development of the Russian Federation of February 28, 2011 No. 158n, clause 5).

You can apply for a CHI policy for a baby if you have the following documents:

• Temporary residence permit (TRP) for a child;
• birth certificate;
• passport of a foreign citizen or other document established by the Federal Law or recognized in accordance with international treaty the Russian Federation as an identity document of a foreign citizen, with a mark on a temporary residence permit in the Russian Federation;
• insurance certificate of state pension insurance - SNILS (if any).

Farkhad, Moscow

In accordance with the Federal Law "On Compulsory Medical Insurance of Citizens in the Russian Federation" dated November 29, 2010 No. 326-FZ, your child can be provided with a CHI policy if there is a mark on the temporary residence permit (TRP) of the child in the Russian Federation in his certificate on birth, or if there is the same mark in the RVP of his mother. For foreign citizens temporarily residing on the territory of the Russian Federation, the policy is issued for the duration of the temporary residence permit.

Decree of the Government of the Russian Federation dated March 6, 2013 No. 186 provides for the provision of emergency medical care to foreign citizens free of charge and without delay, and the provision of planned medical care after leaving conditions that pose an immediate threat to life or require urgent medical intervention, on a paid basis, provided that there is no compulsory medical insurance policy .

Irina P., Ryazan region

You can get a CHI policy at any health insurance organization (HIO) that provides compulsory health insurance in Moscow, regardless of registration at the place of residence (propiska). This right is enshrined in the Federal Law "On Compulsory Medical Insurance in the Russian Federation" dated November 29, 2010 No. No. 326-FZ.

It is necessary to submit an application of the established form on the choice (replacement) of the insurance company to the selected HMO and present the documents required for registration as an insured person.

You can find detailed information about insurance medical organizations providing compulsory medical insurance in the territory of Moscow on the website of the Moscow City Compulsory Medical Insurance Fund www.mgfoms.ru in the sections: Databank - Register of insurance medical organizations operating in the field of compulsory medical insurance in the city of Moscow - Register of points of issue of policies.

Guzal M., Moscow

In accordance with the Federal Law "On Compulsory Medical Insurance of Citizens in the Russian Federation" dated November 29, 2010 No. 326-FZ, foreign citizens permanently or temporarily residing in Russia, when applying to a medical insurance organization to apply for a CHI policy, must present the following documentation:

• passport of a foreign citizen or other document established by the Federal Law or recognized in accordance with an international treaty of the Russian Federation as a document proving the identity of a foreign citizen;
• residence permit or temporary residence permit (TRP);
• insurance certificate of compulsory pension insurance - SNILS (if any).

Elizabeth, Moscow

Citizens who have changed their last name, lost the policy, parents of newborns to apply for a policy for a child, as well as those who have decided to choose VTB MS as their insurance company, need to apply to VTB MS offices to obtain a single-form CHI policy.

Nikolay, Reutov

Yes, you can. If your family members do not have the opportunity to apply to VTB MC on their own, then you, if you have a properly executed power of attorney, will be able to apply for a compulsory medical insurance policy for them. The form of the power of attorney, as well as the list of necessary documents for obtaining a policy of a single sample, are posted on the company's website.

Maxim Eduardovich, retired. Zvenigorod

Indeed, according to Article 16 of the law, citizens insured under MHI have the right to choose a medical organization and a doctor. The choice of a medical organization is carried out from among those participating in the implementation of the territorial CHI program in accordance with the legislation of the Russian Federation. When choosing a polyclinic, you need to make sure that it is included in the register of medical organizations operating in compulsory medical insurance. Such a register is maintained by the territorial CHI fund.

The implementation of the right of citizens insured under compulsory medical insurance to choose a medical organization is carried out on the basis of a written application addressed to the head physician, in accordance with the resource capabilities of the institution: capacity, staffing of medical personnel, and the Regulations on the organization of primary health care for the adult population, approved by order Ministry of Health and Social Development of the Russian Federation dated May 15, 2012 N 543n.

When choosing a doctor or a polyclinic, you need to think carefully: how can a citizen attached to the polyclinic of his choice, but living in another district of the Moscow region or in another city, get help at home? Will a person with poor health be able to get to the doctor if the journey takes a long time?

Tatiana, Odintsovsky district

In accordance with the current legislation, the CHI policy is valid throughout the Russian Federation. Your mother has the right to receive free medical care at the clinic in Odintsovo, if the clinic participates in the implementation of the CHI program. The register of medical organizations participating in the implementation of the CHI program is posted on the website of the Territorial Fund for CHI of the Moscow Region www.mofoms.ru

If your mother permanently lives with you, we recommend that she be attached to the clinic at the place of actual residence by writing a written application for attachment addressed to the head physician.

Katerina, microdistrict Zarya, Balashikha

Indeed, you have the right to choose a medical organization once a year. Any citizen of the Russian Federation has the right to be attached to a medical organization participating in the implementation of the CHI program. The register of such medical organizations is maintained by the territorial funds of the constituent entities of the Russian Federation. A citizen has the right to be attached to a polyclinic not only at the place of actual residence, but also at the place of work or study. We advise you to apply with a written application for attachment addressed to the head physician to the medical organization of your choice in Moscow participating in the CHI program.

Julia A., Klinsky district

Dispensary observation of the child will be carried out by the children's polyclinic at the place of actual residence in Moscow. To attach a child to a children's clinic, it is necessary to issue a written application addressed to the head physician.

V.N., Noginsky district

If necessary, temporary medical assistance is provided to temporarily staying foreign citizens free of charge and without delay. After leaving a state that threatens the life of a citizen, he can be provided with planned medical care in medical institutions, regardless of their organizational and legal form, but on a paid basis.

(Rules for the provision of medical care to foreign citizens on the territory of the Russian Federation, approved by Decree of the Government of the Russian Federation of March 6, 2013 No. 186).

Svetlana Leonidovna, Moscow

In order to exercise your right to choose a medical organization in the system of compulsory health insurance, you need to apply with a written application for attachment to the head of this antenatal clinic. It is the manager who decides on this issue. However, there are norms for the number of attached patients - both for an individual specialist and for the entire medical institution. (clause 18 of the Regulations on the organization of the provision of primary health care to the adult population, approved by Order of the Ministry of Health and Social Development of the Russian Federation dated May 15, 2012 No. 543n). If your application is denied, it must also be in writing, indicating the reasons for the refusal. You can appeal the refusal by contacting your health insurance organization, the department for protecting the rights of the insured of the Moscow City Compulsory Medical Insurance Fund, or the Moscow City Health Department.

Irina K., Moscow

Pregnancy, childbirth and the postpartum period are included in the list of conditions for which medical care is provided free of charge under the CHI program.

You should contact the head of the antenatal clinic to decide on the organization of a free examination. If denied, contact your insurance company.

Maria P., Moscow

IVF is included in the Territorial Program of State Guarantees of Free Medical Care for Citizens in Moscow.

According to the Order of the Ministry of Health of the Russian Federation dated December 10, 2013 No. 916n “On the list of types of high-tech medical care”, IVF treatment according to MHI can be carried out for patients with various forms of infertility.

Contact the antenatal clinic where you are being observed under the CHI policy. If you are not observed in the antenatal clinic, attach yourself to it, since a free IVF procedure can be performed only with a diagnosis of infertility. This diagnosis is established based on the results of the examination, which takes several months.

If your diagnosis is consistent with medical indications for IVF, your attending physician will prepare an extract from the medical history, on the basis of which the medical commission of the antenatal clinic will issue a conclusion on the need for an IVF procedure at the expense of compulsory medical insurance. The conclusion, together with the minutes of the meeting at which it was considered and signed, is sent to the regional Commission for the selection of patients for IVF.

Based on the submitted documents, the Commission decides to issue a referral for the IVF procedure under compulsory medical insurance. In case of a positive response, the patient is given a list of medical organizations to choose from for a free IVF procedure.

Marina Sergeevna R., Moscow

Treatment of diseases of the endocrine system is included in the territorial CHI program. The study of blood hormones for persons who have indications for examination is carried out in medical organizations free of charge in the direction of the attending physician.

Ultrasound is also carried out free of charge if there are medical indications, a referral from the attending physician, in accordance with accepted examination standards for a specific disease. In order to promptly resolve issues related to the organization and provision of medical care, we recommend that you contact the medical insurance company where you are insured under compulsory medical insurance.

Maxim I., Moscow

Wrongful. If it is impossible to provide the insured citizen medical services by program CHI medical the institution is obliged to issue a referral, in your case - for consultations of an otolaryngologist and a urologist to another medical institution operating in CHI system.

To get a referral for a consultation, contact your attending physician or deputy chief physician, if refused, contact your insurance company.

Julia Dmitrievna, Odintsovo

You have such a right. To obtain an outpatient card, make a written application addressed to the head physician, indicating the reason why you need this document.

(Federal Law of the Russian Federation of November 21, 2011 No. 323-FZ “On the Basics of Protecting the Health of Citizens in the Russian Federation, Art. 22).

Zhanna Ya., Moscow

These studies can be done free of charge under the CHI policy. A referral for magnetic resonance imaging (MRI) or computed tomography (CT) is issued to patients on a routine basis in municipal outpatient clinics based on the recommendations of specialist doctors and indications for these studies.

K. Yurievich, Krasnodar

In order to receive free medical care under compulsory medical insurance in Moscow, nonresident citizens are required, first of all, to apply with a compulsory medical insurance policy to an insurance medical organization - their own or another, in the absence of a branch of their company in the region - to re-register the compulsory medical insurance policy at the place of stay . Moreover, if a citizen has an old-style policy, he will first need to issue new policy OMS of a single sample. This procedure applies in all cases when a person lives in one region, and plans to seek medical help in another subject of the Russian Federation.

After re-registration of the compulsory medical insurance policy, you need to attach yourself to the clinic at the place of actual residence. Further, based on the recommendations of the medical specialists of this medical institution, if there are indications for the study, you will be given a referral for magnetic resonance imaging (MRI).

If you have any questions regarding your examination or treatment, we recommend that you contact your health insurance company. Contact Information usually posted on the official website of the insurance medical organization and on your compulsory medical insurance policy.

Oleg T., Moscow

According to the Territorial Program of State Guarantees of Free Medical Care for Citizens in the City of Moscow, in case of diseases of the genitourinary system, medical care is provided free of charge.

The provision of medicines and medical devices for outpatient treatment is carried out at the expense of personal funds of citizens, for inpatient treatment - free of charge, at the expense of compulsory medical insurance, if drugs and physiotherapy procedures are prescribed by the attending physician.

Lyubov O., Moscow

In accordance with the Territorial Program of the CHI in Moscow, operations for defects in the anterior abdominal wall, including inguinal hernia, are performed free of charge. If you have any questions regarding your examination or treatment, we recommend that you contact your health insurance company. Contact information is available on the official website of the medical insurance organization and on your CHI policy.

Margarita Vladimirovna, Moscow

The diagnostic studies indicated by you are included in the Compulsory Medical Insurance Program and must be provided free of charge as prescribed by the attending physician and in a properly executed referral. To resolve the issue, we recommend that you contact the head physician of the clinic in writing, and in case of refusal, we suggest that you issue a written appeal to your insurance company.

Mikhail R., Moscow

Payment for specialized medical care provided in stationary conditions under the compulsory medical insurance program, is carried out in all insurance cases and includes payment for medicines and consumables.

Apply with a claim to the head of the medical organization in which this proposal was made.

In case of refusal to resolve the issue, call the insurance company.

Alexey Romanovich, Moscow

As part of the program of state guarantees for the provision of medical care to citizens in a hospital, including day care, free provision of medicines included in the List of vital and essential medicines is carried out (in accordance with Federal Law of April 12, 2010 N 61-FZ " On the circulation of medicines") and medical devices, which are provided for by the standards of medical care.

Medicines that are not included in the above List are provided free of charge for medical reasons only by decision of the medical commission.

Leonid Semenovich, Iksha

The MHI policy is valid throughout the territory of the Russian Federation. If you are attached to a medical organization in the Moscow region and your attending physician has ordered tests and issued a correctly issued referral, then the tests should be performed free of charge.

Gennady L-ch., Moscow.

In your case, free crutches for children are not provided for under the CHI program. We recommend that you contact the authorities social protection population at the place of residence. Information can be found on the website of the Department of Social Protection of the Population of the City of Moscow www.dszn.ru.

Vladimir Gennadievich, Dmitrov, Moscow region

Within the framework of the Moscow Regional Program of State Guarantees of Free Medical Assistance to Citizens, medical rehabilitation is carried out in sanatorium-resort complexes in the direction of a medical institution of the Moscow Region.

Rehabilitation is carried out by referring patients, if there are medical indications, to free Spa treatment immediately after the hospital in a sanatorium located on the territory of the Moscow Region, which have concluded agreements with the Territorial Fund for Compulsory Medical Insurance of the Moscow Region and have the appropriate specialized licenses. The patient is given a referral, a certificate of incapacity for work (for working citizens), an extract from the medical history with detailed data on the examination and treatment carried out in the hospital, recommendations for further treatment.

Therapeutic and prophylactic institutions of the Moscow Region carry out the selection and referral for medical rehabilitation of patients who have undergone acute myocardial infarction, operations on the heart and main vessels, acute cerebrovascular accident, operations for pancreatitis (pancreonecrosis), gastric ulcer, duodenal ulcer, removal of the gallbladder , orthopedic, traumatological operations; with defects and malformations of the spine, plastic joints, arthroplasty and re-endoprosthetics, replantation of limbs; after treated diseases: unstable angina, diabetes mellitus, as well as pregnant women at risk.

Alexey D., Moscow, SVAO

The law does not provide for compensation of citizens' expenses for receiving paid medical services from compulsory medical insurance funds. The funds received by the insurance medical organization have a designated purpose - they are intended to pay for medical care provided to citizens under the territorial CHI program.

According to the Federal Law "On the Basics of Protecting the Health of Citizens in the Russian Federation", citizens have the right to receive paid medical services at their request at their own expense. By deciding to receive medical services for a fee, you have exercised your right under this law.

Lidia Konstantinovna, Moscow, Maryino

You may be asked to receive certain medical services for a fee at the same clinic or hospital where you are being treated, or you may be offered (referral) to receive such medical services for a fee at another medical facility. This will be legal if the medical organization complies with all of the following requirements:

• You must be familiarized without fail with information about the possibilities and procedure for receiving free medical services in medical organizations participating in the implementation of CHI programs;
• medical services offered to you for a fee are not included in the territorial CHI program; paid medical care is provided in self-supporting offices and subdivisions by specialists in their free time from their main work;
• Information about paid services placed in a medical organization in places accessible to patients;
• the medical service is received out of the existing sequence at your request and subject to the registration in the medical card of the refusal to receive free medical care within the specified proposed time frame;
• during treatment you stay in conditions of increased comfort;
• the offer to provide paid medical services is consistent with your desire to receive them on a paid basis;
• a contract for the provision of paid medical services is concluded with you.

If you have any questions or doubts when you receive an offer to pay for medical services, contact your insurance company immediately for advice and support in resolving the situation. The phone number of the insurance company is indicated in your CHI policy.

Elena I., Moscow

Patients are referred to federal healthcare institutions based on the decision of the Commission of the Moscow Department of Health.

You should apply there in writing, having extracts from the patient's medical records and the results of clinical diagnostic studies.

Valentina I.

To check the quality of medical care provided by a medical institution, you need to contact the medical insurance organization with a written request, on the basis of which medical documentation is requested, issued in the name of the insured, and an examination of the quality of medical care is carried out. The examination is carried out by an independent expert of the required medical profile, included in the register of the territorial CHI fund. Based on the results of the examination, an act and a protocol of the expert opinion are drawn up, one copy of which can be issued to you upon application in writing and upon presentation of your passport.

Vladimir N., Podolsky district

In accordance with the contract for the provision and payment of medical care under compulsory medical insurance, concluded by a medical organization

with an insurance medical organization, the medical institution is obliged to:

• ensure that the insured persons exercise the right to choose a medical organization and a doctor in accordance with the legislation of the Russian Federation;
• to provide free of charge to insured persons upon the occurrence of an insured event, medical assistance included in the territorial CHI program;
• provide insured persons with information about the mode of operation, types of medical care provided, indicators of accessibility and quality of medical care;

Konstantin Semenovich, Moscow Region

If it is impossible to provide the insured citizen with medical services properly, the medical institution is obliged to send the insured citizen to receive the necessary medical care under the territorial CHI Program to another institution operating in the CHI system.

Mikhail Albertovich, Noginsky district, St. Kupavna

You can apply in writing to the head of the department, the deputy chief physician for medical work, the deputy chief physician for clinical and expert work, the chief physician.

If it is not possible to resolve the issue at the level of the medical institution, you must contact your insurance company with a written complaint against the medical organization.

When you are on vacation, there is no need to attach. Attachment to the clinic is carried out in order to receive planned medical care at the place of residence, place of work or study. If your health condition worsens, you can seek emergency medical care (emergency or emergency), including outpatient care. You must take all necessary measures to stabilize or improve your health.

Be sure to take the original CHI policy with you on your trip. In accordance with the current legislation, a citizen, when applying for medical assistance (with the exception of emergency medical care), is obliged to present a CHI policy.

If a medical organization at a place of rest requires payment for treatment or refuses medical care, you must contact the head of the medical organization for clarification, and in case of refusal, contact your insurance company by phone hotline, the number of which is indicated on your CHI policy.

If you are planning to travel to another locality for several months and assume that during this period you may need planned medical care, then you need to apply for attachment to the clinic at the place of temporary stay.

Alexey Mikhailovich, Moscow

Education of patients with diabetes mellitus is carried out in medical institutions operating in the system of compulsory health insurance (CHI) and providing primary health care and specialized medical care to the adult population in the field of endocrinology, for example, in district clinics or endocrinology departments of outpatient centers. An endocrinologist is responsible for organizing the education of patients with diabetes mellitus. The main areas of study are the correct measurement and assessment of blood glucose levels, the organization of the daily routine, the patient's dietary habits, compiling a food diary to record carbohydrates consumed, and optimizing daily physical activity. In addition, the office of an endocrinologist may provide for the work of a “School for patients with diabetes mellitus”. You can get more detailed information about the training from the local therapist or from the endocrinologist you are seeing.

Vladimir Petrovich, Domodedovo

The temporary certificate confirms the execution of the policy and certifies your right to receive free medical care. The temporary certificate is valid until the receipt of the CHI policy, but not more than 30 working days from the date of its issuance. In the event of the expiration of the temporary certificate until the insured person receives a policy of a single sample, the territorial fund of compulsory medical insurance and the insurance medical organization take measures to organize the unhindered provision of medical care to insured persons under a temporary certificate in the event of an insured event until the insured person is provided with a compulsory medical insurance policy single sample.

Pyotr Osipov, Ruza

Early signs of diabetes can appear at any age. It is possible to recognize and begin treatment in time only by knowing the initial manifestations of the disease. Symptoms of diabetes mellitus: chronic fatigue, frequent urination, unexplained weight loss, wounds that do not heal for a long time, constant hunger, blurry vision, numbness and tingling in the legs or arms, constant thirst, sexual problems, vaginal infections in women. If these symptoms appear, you should contact a local therapist (family doctor) with a compulsory health insurance policy at the clinic, who, if there are medical indications, will refer you to an endocrinologist to clarify the diagnosis, treatment and further monitoring. In case of acute development of the disease, emergency hospitalization in a specialized department is indicated. Treatment of diseases of the endocrine system, which include diabetes mellitus, is carried out free of charge under the Program of State Guarantees of Free Provision of Medical Care to Citizens for 2016, approved by Decree of the Government of the Russian Federation of December 19, 2015 No. 1382 and Territorial Programs of State Guarantees of Free Provision of Medical Care to Citizens.

How to apply for a compulsory medical insurance policy of a single sample?

Policies issued before 05/01/2011, regardless of their validity period, even expired ones, are valid until they are replaced with CHI policies of a single sample. If you decide to issue a policy of a single sample, then:
Step 1. On your own or through a trusted person, choose an insurance medical organization (hereinafter referred to as the HIO) operating in the CHI system in the territory of your residence. All information on HMOs providing compulsory medical insurance in the Stavropol Territory is posted on the website of the SKFOMS www.skfoms.ru in the section “participants of compulsory medical insurance”.
The employer is excluded from the procedure for issuing CHI policies. Upon dismissal, it is not necessary to hand over the compulsory medical insurance policy, and the personnel department cannot require reissuing the compulsory medical insurance policy.
Step 2. On the first visit to the CMO, you or an authorized representative submit an application, providing an identity document and SNILS (if available). You will immediately receive a temporary certificate confirming the execution of the CHI policy. The certificate is valid for 30 working days and in case of applying for medical assistance, you present it instead of the CHI policy.
The compulsory medical insurance policy is manufactured at the Goznak factory in Moscow by order of the Federal Compulsory Medical Insurance Fund. On the front side of the paper policy, a barcode containing information about the insured person is applied. The compulsory medical insurance policy does not contain information about the place of residence or registration, however, this information is entered into the unified electronic register of insured citizens when issuing the policy. Then the policy is sent to the CMO.
Step 3. After receiving the CHI policy of a single sample, the CMO will notify you of this. You can track the readiness of the policy yourself on-line on the website of the TFOMS SK in the "Checking the policy" section. You (or a trusted person) will need to make a second visit to the HMO to obtain a CHI policy.
Please note that the reverse side of the paper policy provides the opportunity to place information about the replacement of the CMO by the insured person. To ensure the possibility of entering new information about the CMO, the CHI policy of a single sample cannot be laminated. From 08/01/2012, an improved form of the compulsory medical insurance policy of a single sample has been put into circulation. The front side of the form has changed; the fields for filling in the personal data of the insured persons on the form have been shifted upwards (previously they were in the middle of the policy and were erased when the form was folded). There was a possibility of compact addition of the document.

Who is eligible for a CHI policy?

All citizens of the Russian Federation, foreign citizens and stateless persons permanently or temporarily residing on the territory of the Stavropol Territory, as well as persons without a fixed place of residence, have the right to receive a CHI policy. All categories of citizens are provided with compulsory medical insurance policy free of charge.

How to get a CHI policy for a foreign citizen?

In accordance with Articles 9 and 10 of Federal Law No. 326-FZ of November 29, 2010 “On Compulsory Medical Insurance in the Russian Federation”, foreign citizens permanently or temporarily residing in the Russian Federation may be insured under CHI.
To register as an insured person, foreign citizens must attach the following documents or their certified copies to the application for choosing an insurance company:
1) permanently residing in the Russian Federation:
passport of a foreign citizen or other document proving the identity of a foreign citizen;
resident card;
SNILS (if available).
2) temporarily residing in the Russian Federation:
passport of a foreign citizen or other document proving the identity of a foreign citizen, with a mark on a temporary residence permit in the Russian Federation;
SNILS (if available).
The current legislation of the Russian Federation does not provide for compulsory medical insurance for foreign citizens who do not have a residence permit or a mark in an identity document on a temporary residence permit in the Russian Federation.

Where and how to get a CHI policy if the place of registration and actual residence do not match?

Regardless of the place of registration, in order to obtain a CHI policy, you need to choose one of the CMOs that carry out CHI in the territory of your actual residence and apply to the CMO with an identity document and SNILS (if available). All information on HMOs providing compulsory medical insurance in the Stavropol Territory is posted on the website of the TFOMS SK www.skfoms.ru. in the "Participants" section.
If your life activity is connected with constant or frequent movement, then it is advisable to draw up a CHI policy where you actually live most of the time. This is due to the fact that in the region where the compulsory medical insurance policy is issued, a citizen enjoys the right to medical care in the scope of the territorial compulsory medical insurance program, and in all other cases in the scope of the basic compulsory medical insurance program. The territorial CHI program cannot be less than the basic one, but there are regions where it is much larger.

How to restore a lost CHI policy?

In case of loss of the compulsory medical insurance policy, a duplicate of the compulsory medical insurance policy is issued on the basis of an application for issuing a duplicate of the policy or reissuing the policy.
In the event that you remember the name of the CMO that issued the CHI policy, you need to contact it with the above application. In addition, if in the current year you have not exercised the right to choose an HIO as an insured person, you can choose one of the HMOs operating in the field of compulsory medical insurance in the Stavropol Territory and apply to it with an application for the choice (replacement) of an insurance medical organization in person or through your representative.
Together with the application, an identity document and SNILS (if any) must be presented.

Is it necessary to change the CHI policy when changing the place of residence and surname?

In the event of a change of residence, you must notify the CMO of such a change within 1 month, and if the new place of residence does not have the insurance company where the CHI policy was issued, then you must select an insurance company and apply to it for compulsory medical insurance.
In the event of a change of surname, name, patronymic, you are obliged to notify the CMO of the changes that have taken place within one month from the day these changes took place. In these cases, according to your application, the policy is reissued.

Can military personnel and persons equated to them receive a compulsory medical insurance policy?

In accordance with the current legislation, military personnel and persons equated to them in the organization of medical care are not provided with a CHI policy (Article 10 of the Federal Law of November 29, 2010 No. 326 - FZ "On Compulsory Medical Insurance in the Russian Federation").
In accordance with Article 25 of the Federal Law of November 21, 2011 No. 323-FZ “On the Basics of Protecting the Health of Citizens in the Russian Federation”, military personnel and persons equivalent to them have the right to receive medical care in departmental medical organizations, and in their absence or in the absence of departmental medical organizations of departments of the relevant profile, specialists or special medical equipment - to receive medical care in the manner established by the Government of the Russian Federation.

How to choose the right SMO?

Familiarize yourself with the list of SMOs on the TFOMS website www.skfoms.ru in the section " CHI participants» (there are CMO phone numbers, a list and addresses of points for issuing policies).
Familiarize yourself with the indicators for assessing the performance of HIOs on the website of the MHIF www.ffoms.ru in the section “Rating of insurance medical organizations”.
Familiarize yourself with the information on work in the CHI system posted on the official websites of the branch of LLC IC Ingosstrakh-M in Stavropol - EMESK www.emesk.ru and the branch of CJSC MSK Solidarity for Life in the Stavropol Territory www.sovita .ru.
After comparing all the indicators, making sure that this CMO satisfies all your requests, apply to it personally or through your representative.

What are OMS programs?

In Russia, there are basic and territorial CHI programs.
The basic CHI program is approved by the Government of the Russian Federation and is an integral part of the federal Program of State Guarantees of Free Medical Care for Citizens. The basic CHI program establishes a guaranteed amount of medical care that insured persons can receive under the CHI system. Guarantees under the basic CHI program are the same for all insured persons throughout the Russian Federation. This condition makes it possible to ensure the realization of the right of citizens to free medical care, enshrined in Part 1 of Art. 41 of the Constitution of the Russian Federation, and follows the principle of the unity of all before the law, established by Art. 19 of the Constitution (including regardless of place of residence).
The basic CHI program first of all establishes a list of insured events, in the event of which the insured person has the right to receive medical assistance under CHI, as well as the types and volume of such assistance.
Territorial CHI programs are developed in each subject of the Russian Federation independently and are an integral part of the territorial programs of state guarantees of free medical care for citizens (hereinafter referred to as the Territorial Program of State Guarantees). Such programs are designed to provide maximum protection to insured persons, taking into account the specific conditions of the region of residence of such persons, such as population structure, climatic and geographical conditions, economic conditions, state of ecology, etc. The territorial CHI program provides a level of guarantees no lower than the basic CHI program.
In the Stavropol Territory, the Territorial Program of State Guarantees is approved by a decree of the Government of the Stavropol Territory. The territorial CHI program determines the list of types, conditions and forms of medical care provided free of charge, the list of diseases and conditions in which medical care is provided free of charge, standards for the volume of medical care, standards financial costs per unit volume of medical care, per capita financing standards, methods of payment for medical care, the procedure for the formation and structure of tariffs for paying for medical care, and also determines the procedure and conditions for the provision of medical care, criteria for the availability and quality of medical care.
The annexes to the Territorial Program of State Guarantees are the conditions for exercising the right to choose a doctor, the conditions of stay in medical organizations, the waiting time for medical care, the list of medical organizations of the Stavropol Territory participating in the implementation of the Territorial Program of State Guarantees, including the territorial CHI program, the List of medicinal medicines that are dispensed free of charge on doctor's prescriptions, the target values ​​of the criteria for the availability and quality of medical care provided under the Territorial Program of State Guarantees, etc.
As part of the implementation of the territorial CHI program, in addition to the types of medical care established by the basic CHI program, in the Stavropol Territory in 2013, medical care is provided in medical and physical education dispensaries and in family planning and reproduction centers, including medical genetic consultations.

How long to wait for planned medical care?

Planned medical care is provided during preventive measures, in diseases and conditions that are not accompanied by a threat to the patient's life, and the delay in the provision of which for a certain time will not entail a deterioration in the patient's condition, a threat to his life and health.
The territorial program of state guarantees establishes a waiting period for primary (pre-medical, medical) health care - 7 days, as well as a waiting period for a planned outpatient appointment with a specialist doctor and scheduled diagnostic and therapeutic measures, which is no more than 14 days.
Planned hospitalization is carried out in order of priority no later than 14 days from the date of receipt of the referral for hospitalization. Hospitalization of citizens in a planned manner is carried out in the direction of an outpatient doctor, if there is an extract from the outpatient medical record with the results of a pre-hospital examination.
The waiting period for high-tech medical care in medical organizations in the Stavropol Territory is 2 months.
Emergency or urgent medical care is provided around the clock on the referral of a doctor, an ambulance team, as well as upon self-appeal. Emergency medical care is provided immediately and free of charge, regardless of whether a citizen has a compulsory medical insurance policy or identity documents. Refusal to provide it is not allowed.

What to do if a new medical organization refuses to attach?

Many people want to change clinics. The main reasons for this desire are the rudeness and incompetence of the doctor, in addition, the patient's move to a new place of residence. You can change one district police officer for another in the same clinic or the clinic as a whole only once a year. The exception is when a person moves to a new place of residence. When choosing a polyclinic, a citizen must write an application addressed to the head physician. The administration of the polyclinic is obliged to provide an answer (consent or refusal). They can refuse if the polyclinic cannot provide home call service, that is, the place of your residence does not belong to the service area of ​​the selected polyclinic.

Where can I complain if I am eligible for reduced drug coverage, but I am denied?

Preferential drug provision is provided at the expense of budgets of various levels, so a citizen needs to contact the Ministry of Health of the Stavropol Territory or the Ministry of Health of the Russian Federation.

Can an insurance medical organization solve any problem?

If, for example, you are dissatisfied with the medical care provided in psychiatric, drug treatment or tuberculosis dispensary, the insurance company will not be able to resolve this issue, since these types of medical care are not included in the territorial compulsory medical insurance program. It's not in her jurisdiction.
Everything related to the diseases included in the territorial CHI program is the field of activity of the HMO. The insurance company pays bills for the medical care provided, monitors the quality of medical care, and ensures the protection of your rights to receive free medical care.

If I believe that I am being treated incorrectly, can I apply to the CMO for a medical examination?

Of course, at the request of the insured person or his representative, an examination of the quality of medical care is carried out. Moreover, it is better to contact the CMO at the time of treatment. After all, this is very important. When the treatment process is still underway, it, and therefore the result, can be influenced. To do this, the patient must call his insurance company and ask for a "face-to-face examination of the quality of medical care." The insurance company is obliged to send its experts, who, together with the attending physician, make a decision on adjusting the treatment, the need to transfer to another doctor or to another medical institution, if, as a result of the examination, it is concluded that the patient needs help at a different level. But, of course, it happens differently: the experts of the insurance company fully agree with the attending physician. In this case, you will also be provided with a reasoned opinion.

If I have already paid for a medical service that should have been provided free of charge under the policy, is there a chance to get the money back? What is the algorithm of actions for this?

If you have paid for treatment or examination, you must keep all receipts and documents confirming payment from personal funds. To return the funds spent, you can apply to a medical organization with an application addressed to the head doctor, to the health insurance organization or to the TFOMS SK, attaching copies of payment documents. When establishing facts of unreasonable collection Money, provides for both pre-trial resolution of this issue, and the possibility of its resolution in court. insurance organization can assist in filing a claim and a lawsuit against a medical institution or a private practitioner for referral to the court.

How to apply for a compulsory medical insurance policy of a single sample?

Policies issued before 05/01/2011, regardless of their validity period, even expired ones, are valid until they are replaced with CHI policies of a single sample. If you decide to issue a policy of a single sample, then:
Step 1. On your own or through a trusted person, choose an insurance medical organization (hereinafter referred to as the HIO) operating in the CHI system in the territory of your residence. All information on HMOs providing compulsory medical insurance in the Stavropol Territory is posted on the website of the SKFOMS www.skfoms.ru in the section “participants of compulsory medical insurance”.
The employer is excluded from the procedure for issuing CHI policies. Upon dismissal, it is not necessary to hand over the compulsory medical insurance policy, and the personnel department cannot require reissuing the compulsory medical insurance policy.
Step 2. On the first visit to the CMO, you or an authorized representative submit an application, providing an identity document and SNILS (if available). You will immediately receive a temporary certificate confirming the execution of the CHI policy. The certificate is valid for 30 working days and in case of applying for medical assistance, you present it instead of the CHI policy.
The compulsory medical insurance policy is manufactured at the Goznak factory in Moscow by order of the Federal Compulsory Medical Insurance Fund. On the front side of the paper policy, a barcode containing information about the insured person is applied. The compulsory medical insurance policy does not contain information about the place of residence or registration, however, this information is entered into the unified electronic register of insured citizens when issuing the policy. Then the policy is sent to the CMO.
Step 3. After receiving the CHI policy of a single sample, the CMO will notify you of this. You can track the readiness of the policy yourself on-line on the website of the TFOMS SK in the "Checking the policy" section. You (or a trusted person) will need to make a second visit to the HMO to obtain a CHI policy.
Please note that the reverse side of the paper policy provides the opportunity to place information about the replacement of the CMO by the insured person. To ensure the possibility of entering new information about the CMO, the CHI policy of a single sample cannot be laminated. From 08/01/2012, an improved form of the compulsory medical insurance policy of a single sample has been put into circulation. The front side of the form has changed; the fields for filling in the personal data of the insured persons on the form have been shifted upwards (previously they were in the middle of the policy and were erased when the form was folded). There was a possibility of compact addition of the document.

Who is eligible for a CHI policy?

All citizens of the Russian Federation, foreign citizens and stateless persons permanently or temporarily residing on the territory of the Stavropol Territory, as well as persons without a fixed place of residence, have the right to receive a CHI policy. All categories of citizens are provided with compulsory medical insurance policy free of charge.

How to get a CHI policy for a foreign citizen?

In accordance with Articles 9 and 10 of Federal Law No. 326-FZ of November 29, 2010 “On Compulsory Medical Insurance in the Russian Federation”, foreign citizens permanently or temporarily residing in the Russian Federation may be insured under CHI.
To register as an insured person, foreign citizens must attach the following documents or their certified copies to the application for choosing an insurance company:
1) permanently residing in the Russian Federation:
passport of a foreign citizen or other document proving the identity of a foreign citizen;
resident card;
SNILS (if available).
2) temporarily residing in the Russian Federation:
passport of a foreign citizen or other document proving the identity of a foreign citizen, with a mark on a temporary residence permit in the Russian Federation;
SNILS (if available).
The current legislation of the Russian Federation does not provide for compulsory medical insurance for foreign citizens who do not have a residence permit or a mark in an identity document on a temporary residence permit in the Russian Federation.

Where and how to get a CHI policy if the place of registration and actual residence do not match?

Regardless of the place of registration, in order to obtain a CHI policy, you need to choose one of the CMOs that carry out CHI in the territory of your actual residence and apply to the CMO with an identity document and SNILS (if available). All information on HMOs providing CHI in the Stavropol Territory is posted on the SKFOMS website www.skfoms.ru. in the "Participants" section.
If your life activity is connected with constant or frequent movement, then it is advisable to draw up a CHI policy where you actually live most of the time. This is due to the fact that in the region where the compulsory medical insurance policy is issued, a citizen enjoys the right to medical care in the scope of the territorial compulsory medical insurance program, and in all other cases in the scope of the basic compulsory medical insurance program. The territorial CHI program cannot be less than the basic one, but there are regions where it is much larger.

How to get a policy Compulsory medical insurance for a newborn to kid?

The first days after birth, medical care for the baby will be provided free of charge, under the policy of the mother or other legal representative. But as soon as the child's birth certificate is issued, immediately think about the CHI policy for your son or daughter.
Parents must choose the insurance medical organization themselves. On the territory of the Stavropol Territory, 2 insurance medical organizations operate in the field of compulsory medical insurance. Their list, including addresses, phone numbers and working hours of policy issuing points, is posted on the website of the SKFOMS www.skfoms.ru in the section “members of compulsory medical insurance”.
To obtain a CHI policy, a legal representative must write an application and submit their identity document, birth certificate of the child and SNILS of the child (if any).

How to restore a lost CHI policy?

In case of loss of the compulsory medical insurance policy, a duplicate of the compulsory medical insurance policy is issued on the basis of an application for issuing a duplicate of the policy or reissuing the policy.
In the event that you remember the name of the CMO that issued the CHI policy, you need to contact it with the above application. In addition, if in the current year you have not exercised the right to choose an HIO as an insured person, you can choose one of the HMOs operating in the field of compulsory medical insurance in the Stavropol Territory and apply to it with an application for the choice (replacement) of an insurance medical organization in person or through your representative.
Together with the application, an identity document and SNILS (if any) must be presented.

Is it necessary to change the CHI policy when changing the place of residence and surname?

In the event of a change of residence, you must notify the CMO of such a change within 1 month, and if the new place of residence does not have the insurance company where the CHI policy was issued, then you must select an insurance company and apply to it for compulsory medical insurance.
In the event of a change of surname, name, patronymic, you are obliged to notify the CMO of the changes that have taken place within one month from the day these changes took place. In these cases, according to your application, the policy is reissued.

Can military personnel and persons equated to them receive a compulsory medical insurance policy?

In accordance with the current legislation, military personnel and persons equated to them in the organization of medical care are not provided with a CHI policy (Article 10 of the Federal Law of November 29, 2010 No. 326 - FZ "On Compulsory Medical Insurance in the Russian Federation").
In accordance with Article 25 of the Federal Law of November 21, 2011 No. 323-FZ “On the Basics of Protecting the Health of Citizens in the Russian Federation”, military personnel and persons equivalent to them have the right to receive medical care in departmental medical organizations, and in their absence or in the absence of departmental medical organizations of departments of the relevant profile, specialists or special medical equipment - to receive medical care in the manner established by the Government of the Russian Federation.

How to choose the right SMO?

Familiarize yourself with the list of CMOs on the TFOMS website www.skfoms.ru in the section “CMI Participants” (there are CMO telephone numbers, a list and addresses of policy issuance points here).
Familiarize yourself with the indicators for assessing the performance of HIOs on the website of the MHIF www.ffoms.ru in the section “Rating of insurance medical organizations”.
Familiarize yourself with the information on work in the CHI system posted on the official websites of the branch of LLC IC Ingosstrakh-M in Stavropol - EMESK www.emesk.ru and the branch of CJSC MSK Solidarity for Life in the Stavropol Territory www.sovita .ru.
After comparing all the indicators, making sure that this CMO satisfies all your requests, apply to it personally or through your representative.

What are OMS programs?

In Russia, there are basic and territorial CHI programs.
The basic CHI program is approved by the Government of the Russian Federation and is an integral part of the federal Program of State Guarantees of Free Medical Care for Citizens. The basic CHI program establishes a guaranteed amount of medical care that insured persons can receive under the CHI system. Guarantees under the basic CHI program are the same for all insured persons throughout the Russian Federation. This condition makes it possible to ensure the realization of the right of citizens to free medical care, enshrined in Part 1 of Art. 41 of the Constitution of the Russian Federation, and follows the principle of the unity of all before the law, established by Art. 19 of the Constitution (including regardless of place of residence).
The basic CHI program first of all establishes a list of insured events, in the event of which the insured person has the right to receive medical assistance under CHI, as well as the types and volume of such assistance.
Territorial CHI programs are developed in each subject of the Russian Federation independently and are an integral part of the territorial programs of state guarantees of free medical care for citizens (hereinafter referred to as the Territorial Program of State Guarantees). Such programs are designed to provide maximum protection to insured persons, taking into account the specific conditions of the region where such persons live, such as population structure, climatic and geographical conditions, economic conditions, environmental conditions, etc. The territorial CHI program provides a level of guarantees no lower than the basic CHI program.
In the Stavropol Territory, the Territorial Program of State Guarantees is approved by a decree of the Government of the Stavropol Territory. The territorial CHI program defines a list of types, conditions and forms of medical care provided free of charge, a list of diseases and conditions in which medical care is provided free of charge, standards for the volume of medical care, standards for financial costs per unit of medical care, per capita financing standards, methods of payment for medical assistance, the procedure for the formation and structure of tariffs for payment for medical care, and also determines the procedure and conditions for the provision of medical care, criteria for the availability and quality of medical care.
The annexes to the Territorial Program of State Guarantees are the conditions for exercising the right to choose a doctor, the conditions of stay in medical organizations, the waiting time for medical care, the list of medical organizations of the Stavropol Territory participating in the implementation of the Territorial Program of State Guarantees, including the territorial CHI program, the List of medicinal medicines that are dispensed free of charge on doctor's prescriptions, the target values ​​of the criteria for the availability and quality of medical care provided under the Territorial Program of State Guarantees, etc.
As part of the implementation of the territorial CHI program, in addition to the types of medical care established by the basic CHI program, in the Stavropol Territory in 2013, medical care is provided in medical and physical education dispensaries and in family planning and reproduction centers, including medical genetic consultations.

How long to wait for planned medical care?

Planned medical care is provided during preventive measures, in diseases and conditions that are not accompanied by a threat to the patient's life, and the delay in the provision of which for a certain time will not entail a deterioration in the patient's condition, a threat to his life and health.
The territorial program of state guarantees establishes a waiting period for primary (pre-medical, medical) health care - 7 days, as well as a waiting period for a planned outpatient appointment with a specialist doctor and scheduled diagnostic and therapeutic measures, which is no more than 14 days.
Planned hospitalization is carried out in order of priority no later than 14 days from the date of receipt of the referral for hospitalization. Hospitalization of citizens in a planned manner is carried out in the direction of an outpatient doctor, if there is an extract from the outpatient medical record with the results of a pre-hospital examination.
The waiting period for high-tech medical care in medical organizations in the Stavropol Territory is 2 months.
Emergency or urgent medical care is provided around the clock on the referral of a doctor, an ambulance team, as well as upon self-appeal. Emergency medical care is provided immediately and free of charge, regardless of whether a citizen has a compulsory medical insurance policy or identity documents. Refusal to provide it is not allowed.

What to do if a new medical organization refuses to attach?

Many people want to change clinics. The main reasons for this desire are the rudeness and incompetence of the doctor, in addition, the patient's move to a new place of residence. You can change one district police officer for another in the same clinic or the clinic as a whole only once a year. The exception is when a person moves to a new place of residence. When choosing a polyclinic, a citizen must write an application addressed to the head physician. The administration of the polyclinic is obliged to provide an answer (consent or refusal). They can refuse if the polyclinic cannot provide home call service, that is, the place of your residence does not belong to the service area of ​​the selected polyclinic.

Where can I complain if I am eligible for reduced drug coverage, but I am denied?

Preferential drug provision is provided at the expense of budgets of various levels, so a citizen needs to contact the Ministry of Health of the Stavropol Territory or the Ministry of Health of the Russian Federation.

Can an insurance medical organization solve any problem?

If, for example, you are dissatisfied with the medical care provided in psychiatric, drug treatment or tuberculosis dispensary, the insurance company will not be able to resolve this issue, since these types of medical care are not included in the territorial compulsory medical insurance program. It's not in her jurisdiction.
Everything related to the diseases included in the territorial CHI program is the field of activity of the HMO. The insurance company pays bills for the medical care provided, monitors the quality of medical care, and ensures the protection of your rights to receive free medical care.

If I believe that I am being treated incorrectly, can I apply to the CMO for a medical examination?

Of course, at the request of the insured person or his representative, an examination of the quality of medical care is carried out. Moreover, it is better to contact the CMO at the time of treatment. After all, this is very important. When the treatment process is still underway, it, and therefore the result, can be influenced. To do this, the patient must call his insurance company and ask for a "face-to-face examination of the quality of medical care." The insurance company is obliged to send its experts, who, together with the attending physician, make a decision on adjusting the treatment, the need to transfer to another doctor or to another medical institution, if, as a result of the examination, it is concluded that the patient needs help at a different level. But, of course, it happens differently: the experts of the insurance company fully agree with the attending physician. In this case, you will also be provided with a reasoned opinion.

If I have already paid for a medical service that should have been provided free of charge under the policy, is there a chance to get the money back? What is the algorithm of actions for this?

Transfer of policies to other policy issuing points (POIs)

In the event that you received a Temporary Certificate in one PVP, and you want to receive a ready-made MHI policy of a single sample in another PVP, you need to discuss the provision of this service with an insurance company specialist: upon the fact that the policy is ready and received by the insurance company, you can call by a specialist of the insurance company at the phone number indicated in the temporary certificate and inform at which point of issue of policies it will be more convenient for you to receive the policy.

I'm in the military and I'm going on vacation. If necessary, will I be provided with emergency medical assistance?

Military personnel are paid for medical care not from the funds of compulsory medical insurance, but from the funds federal budget. But, according to Art. 11, medical organizations do not have the right to refuse to provide a citizen with free emergency (if there is a threat to life) and urgent (if there is a threat to health) medical care. Medical assistance must be provided in full.

I am a former military man and now retired. Do I need to get an OMS policy? Where will I be served, in which hospitals?

Yes, you can get a CHI policy. You will be served general conditions, like all other citizens, i.e. in medical organizations working in the CHI system.

I work in the power structure (FSB, FSO, etc.). Do I need to get a CHI policy?

If in your particular organization employees are not equated to military personnel, then you can get a compulsory medical insurance policy on general terms. Military personnel and persons equated to them in the organization of medical care are not subject to insurance in the compulsory medical insurance system.

I serve in the army, where can I get a CHI policy?

Soldiers are not subject to compulsory health insurance, in accordance with subparagraph g) of paragraph 5 of Article 10 of the Federal Law of the Russian Federation dated November 29, 2010. At the end of your service in the army, in order to obtain a compulsory medical insurance policy, you need to contact the branch office of the company at your place of residence.

My medical card was taken away for verification by insurers, but I need it! What should I do?

I was told at the hospital that my policy was invalid! What should I do?

First of all, you need to contact the company's office in your region, whose contacts can be indicated on the policy. In the absence of this information in the policy, you can contact the Territorial Compulsory Medical Insurance Fund, whose specialists can also confirm the status of your policy: valid / invalid. In the event that your policy is invalid for some reason, you need to contact the insurance company to resolve this issue.

I have complaints about the quality of medical care provided to me at polyclinic No. ___, working in the CHI system. There are doubts about the diagnosis, they were not sent for examination, treatment does not help, they refused to issue a preferential prescription. Tell me how should I proceed?

For clarification, please contact the Insured Rights Protection Department of the branch of the company where you live.

Is my CHI policy valid in other Russian regions, or do I need to get another one there?

Of course, the CHI policy is valid throughout Russia. Insured persons are entitled to free medical care in a medical institution in the event of an insured event:

— throughout the territory of the Russian Federation in the amount established by the basic program of compulsory medical insurance;

When traveling outside your city, be sure to take the CHI policy with you. Emergency medical care will be provided to you without a policy. In case of refusal to provide medical assistance, you must contact the Territorial CHI Fund of the region to which you left.

What to do if there is no policy (expired, document lost, etc.), but you need urgent medical care?

According to Art. 11, medical organizations do not have the right to refuse to provide a citizen with free emergency (if there is a threat to life) and urgent (if there is a threat to health) medical care. To provide planned medical care, you must obtain a new compulsory medical insurance policy.

The clinic/hospital told me that this service/medicine is provided on a paid basis. Is it so?

For a complete answer, you need to consult with a specialist in the department for protecting the rights of insured citizens. Please contact your insurance company office by phone or in person.

What medical services are provided free of charge under the compulsory medical insurance policy, and which are paid only?

All services included in the territorial program of state guarantees are provided at the expense of compulsory medical insurance free of charge for a citizen. You can get acquainted with the territorial program on the company's website. For a more complete answer, you need to contact the department for the protection of the rights of the insured in the branch located in your city.

What if I was denied my right to choose a healthcare facility/doctor?

The selection procedure provides for a written application of the patient to a medical organization (a copy of the application with a registration number must be in the hands of a citizen). If 30 days have passed since the application was submitted, but no response has been received, or an official refusal has been received, it is necessary to contact the medical insurance organization with an appropriate application, attaching a copy of the application and an official refusal.

How to exercise your right to choose a medical institution / doctor under the new law?

Federal Law of the Russian Federation of November 21, 2011 . Apply to the chief physician of the selected medical institution with a request to enroll you for services in this medical institution / with this doctor.

Can I get a temporary registration policy?

Can. To do this, you need to contact one of the points of issue of policies of our company and fill out an application. You must have a passport and SNILS with you (if available).

Who to contact if there are errors in the issued policy?

If errors are found in the policy, it is replaced on the basis of an application for issuing a duplicate (renewal) of the policy, upon presentation of the old policy and an identity document. To do this, you need to contact any point of issue of policies of our company.

How long are policies issued for?

The policy is issued for the period:

Citizens of the Russian Federation are issued a compulsory medical insurance policy without limitation of validity

For foreign citizens and stateless persons permanently residing in the Russian Federation, the policy is issued in paper format with a validity period until the end of the calendar year

Persons entitled to medical care in accordance with the Federal Law "On Refugees" are issued paper policy valid until the end of the calendar year, but not more than the period of stay specified in the documents specified in subparagraph, paragraph 9 of the Rules.

Foreign citizens and stateless persons temporarily residing on the territory of the Russian Federation are issued a paper policy valid until the end of the calendar year, but not more than the validity period of the temporary residence permit.

Workers of the EAEU member states temporarily staying in the Russian Federation are issued a paper policy valid until the end of the calendar year, but not more than the term of the employment contract concluded with the worker of the EAEU member state.

Foreign citizens temporarily staying in the Russian Federation, belonging to the category of members of the Board of the Commission, officials and employees of the EAEU bodies, are issued a paper policy valid until the end of the calendar year, but not more than the term they exercise their respective powers.

Production of policies in paper form and in the form plastic card:

According to the law on CHI, the policy can be paper, electronic or as part of a universal electronic card(UEC). An electronic policy is a policy in the form of a plastic card with electronic media.

The Territorial Fund makes a decision on the issuance of electronic policies to insured persons of the constituent entity of the Russian Federation, taking into account the technical capability of the constituent entity of the Russian Federation to ensure their circulation. If this decision is made, the electronic policy is issued to the insured persons at their request.

All presented types of policies provide equal opportunities to receive medical care in the field of compulsory health insurance.

Where to send Private Entrepreneurs (PE, PBOYuL) to replace the policy?

On January 1, 2011, the Federal Law of November 29, 2010 “On Compulsory Medical Insurance in the Russian Federation” came into force, according to which, the status of a citizen (working / not working), address and place of his work when choosing an insurance medical company and obtaining a compulsory medical insurance policy do not matter.

Where do full-time students who are 18 years of age go to? What package of documents is required.

A full-time student can apply to any point of issue of policies of our company. You must have a passport and SNILS with you.

Can I exchange my policy at home? Will social workers come to people with disabilities to change the policy at home?

Can. A policy for you can be obtained by proxy, in addition to a social worker, a relative or friend, you can also invite an employee of our company to your home. For this matter, please contact our offices.

Where can I get a policy for a child?

A policy for a child can be obtained at any point of issue of policies of our company. To do this, you must submit a birth certificate (passport - for a child over 14 years old), a passport of a legal representative, SNILS (if any).

How long does it take to change the policy?

Terms of replacement of policies are not established by law. If you have a policy of a single sample, then it is not subject to replacement.

Which companies' policies can be exchanged for AC policies?

You can exchange the policy of any operating insurance company by applying for the choice of CMO to the offices of our company. At the same time, it must be remembered that if you have already chosen an insurance company in the current year, then in November and December of each year, replacement is not made, except for cases of change of residence, provided that the company you previously selected is not available at the new place of residence or the previously selected insurance company ceases to operate. company.

I work informally, can I get a policy?

On January 1, 2011, the Federal Law of November 29, 2010 “On Compulsory Medical Insurance in the Russian Federation” came into force, according to which the status (working / non-working) of a citizen, address and place of work do not matter when a citizen chooses an insurance medical companies and obtaining a compulsory medical insurance policy.

Where can I see all the points of issue of policies?

I was denied a policy.

You need to call the telephone number of the advisory center indicated on the official website of our company in the section Branches at your place of residence.

Refused to provide medical care with the old policy.

No medical institution has the right to refuse to provide you with free medical care due to the presence of an old-style policy. Contact the head physician of the medical institution to solve your problem. If the head physician cannot help, call the advisory center listed on the official website of our company in the section

09.08.2013

How to get a compulsory health insurance policy?

A compulsory health insurance policy is issued by medical insurance organizations (insurance companies) operating in the field of compulsory health insurance.

Federal Law No. 326-FZ of November 29, 2010 “On Compulsory Medical Insurance” grants the right to choose a medical insurance organization in which a citizen wishes to be insured, to the citizen himself, and not to the employer (for working citizens) or the local government (for non-working citizens) , as it was before the entry into force of this law (before January 1, 2011).

Therefore, the first step to obtaining a compulsory health insurance policy is to choose an insurance medical organization. A citizen can choose an insurance medical organization at the place of actual residence, regardless of where he is registered at the place of residence or at the place of stay. The register of insurance medical organizations operating in the field of compulsory health insurance in the constituent entity of the Russian Federation (republic, territory, region, autonomous district) in which the citizen actually resides is posted on the official website of the territorial compulsory medical insurance fund of this constituent entity of the Russian Federation on the Internet and may be additionally published in other ways.

When the choice of an insurance medical organization is made, you need to go to its website or call by phone to find out the addresses of points for issuing policies and choose the point where it is most convenient to come.

At the point of issuing policies of an insurance medical organization, a citizen personally or through his representative submits an application for choosing an insurance medical organization.

The application for the choice (replacement) of an insurance medical organization shall be accompanied by the following documents or their certified copies required for registration as an insured person:

• for citizens of the Russian Federation aged eighteen years and older - an identity document (passport of a citizen of the Russian Federation, a temporary identity card of a citizen of the Russian Federation, issued for the period of issuing a passport); insurance certificate of state pension insurance, also called SNILS (if any);
• for the representative of the insured person - an identity document; power of attorney for registration as an insured person in the selected insurance medical organization, drawn up in accordance with article 185 of part one Civil Code Russian Federation.

On the day of receipt of the application for the choice of an insurance medical organization, the insurance medical organization issues to the insured person a temporary certificate confirming the execution of the policy and certifying the right to free provision of medical care to the insured person by medical organizations in the event of an insured event, or (if the citizen has a policy of compulsory medical insurance of a single sample ) puts the seal of the insurance medical organization on the back of the policy.

Insured persons who submitted to the point of issue of policies Required documents, are informed about the terms of registration and issuance of policies in person or by phone and / or e-mail indicated in the documents. After receiving notification of the readiness of the policy, the insured person must come to the point of issue of policies, where the application was submitted, to exchange a temporary certificate for a permanent policy of a single sample.

The policy is issued to citizens of the Russian Federation without limitation of validity period.

Insurance medical organizations are obliged to familiarize the insured persons receiving the policy with the Rules of compulsory medical insurance, the basic program of compulsory medical insurance, the territorial program of compulsory medical insurance, the list of medical organizations participating in the field of compulsory medical insurance in the constituent entity of the Russian Federation. Simultaneously with the policy, the insurance medical organization provides the insured person with information on the rights of the insured persons in the field of compulsory medical insurance and contact numbers of the territorial compulsory medical insurance fund and the medical insurance organization that issued the policy, which can be communicated to the insured persons in the form of a memo.

How to get a compulsory health insurance policy for a child?

Compulsory medical insurance of children from the date of birth until the day of state registration of birth is carried out by an insurance medical organization in which their mothers or other legal representatives are insured. After the day of state registration of the birth of a child and until he reaches the age of majority, compulsory medical insurance is carried out by an insurance medical organization chosen by one of his parents or another legal representative.

The choice of a medical insurance organization for a child and the procedure for obtaining a policy are similar to those for an adult citizen (see the answer to the question "How to get a compulsory medical insurance policy?"). Only one of the parents or other legal representative of the child submits an application for choosing an insurance medical organization.

The application for choosing an insurance medical organization shall be accompanied by the following documents or their certified copies required for registration as an insured person:

• for children after state registration of birth and up to fourteen years of age who are citizens of the Russian Federation - a birth certificate; a document proving the identity of the legal representative of the child, and (or) a document confirming the authority of the legal representative; SNILS (if available);
• for children from fourteen to eighteen years old who are citizens of the Russian Federation - an identity document (passport of a citizen of the Russian Federation, a temporary identity card of a citizen of the Russian Federation, issued for the period of issuing a passport); a document proving the identity of the legal representative of the child, and (or) a document confirming the authority of the legal representative; SNILS (if available).

Which categories of foreign citizens and stateless persons are issued a compulsory health insurance policy?

In accordance with Article 10 of the Federal Law of November 29, 2010 No. 326-FZ “On Compulsory Medical Insurance in the Russian Federation” (hereinafter referred to as the Federal Law), in addition to citizens of the Russian Federation, insured persons are foreign citizens permanently or temporarily residing in the Russian Federation, stateless persons .

According to the Federal Law of July 25, 2002 No. 115-FZ “On the Legal Status of Foreign Citizens in the Russian Federation”, a foreign citizen permanently residing in the Russian Federation is a person who has received a residence permit, and a foreign citizen temporarily residing in the Russian Federation is a person who has received a permit for temporary residence. For the purposes of this Federal Law, the concept of "foreign citizen" includes the concept of "stateless person".

A foreign citizen who arrived in the Russian Federation on the basis of a visa or in a manner that does not require a visa, but does not have a residence permit or a temporary residence permit, is considered to be temporarily staying in the Russian Federation.

Foreign citizens permanently or temporarily residing in the Russian Federation, stateless persons can obtain a compulsory medical insurance policy, which is a document certifying the right of the insured person to free medical care throughout the Russian Federation in the amount provided for by the basic program of compulsory medical insurance.

The choice of an insurance medical organization for foreign citizens and stateless persons permanently or temporarily residing in the Russian Federation and the procedure for obtaining a policy are similar to those for citizens of the Russian Federation (see the answer to the question "How to get a compulsory medical insurance policy?").

• for foreign citizens permanently residing in the Russian Federation - a passport of a foreign citizen or another document established by federal law or recognized in accordance with an international treaty of the Russian Federation as a document proving the identity of a foreign citizen; resident card; SNILS (if available);
• for stateless persons permanently residing in the Russian Federation - a document recognized in accordance with an international treaty of the Russian Federation as a document proving the identity of a stateless person; resident card; SNILS (if available);
• for foreign citizens temporarily residing in the Russian Federation - a passport of a foreign citizen or another document established by federal law or recognized in accordance with an international treaty of the Russian Federation as a document proving the identity of a foreign citizen, with a mark on permission for temporary residence in the Russian Federation; SNILS (if available);
• for stateless persons temporarily residing in the Russian Federation - a document recognized in accordance with an international treaty of the Russian Federation as a document proving the identity of a stateless person, with a mark on a temporary residence permit in the Russian Federation; or a document of the established form, issued in the Russian Federation to a stateless person who does not have a document proving his identity; SNILS (if available).

For foreign citizens and stateless persons permanently residing in the Russian Federation, the policy is issued without limitation of validity.

Foreign citizens and stateless persons temporarily residing on the territory of the Russian Federation shall be issued a policy for the duration of the temporary residence permit.

Foreign citizens temporarily staying in the Russian Federation, according to the Federal Law, are not insured persons and they are not issued compulsory medical insurance policies. The provision of medical care to this category of foreign citizens is carried out in accordance with the Rules for the provision of medical care to foreign citizens on the territory of the Russian Federation, approved by Decree of the Government of the Russian Federation dated 01.09.2005 No. 546.

Emergency medical assistance to foreign citizens is provided free of charge and without delay in the event of conditions that pose an immediate threat to their lives or require urgent medical intervention (consequences of accidents, injuries, poisoning). After exiting from these states, foreign citizens can be provided with planned medical care.

Scheduled medical assistance to foreign citizens is provided in case of a health disorder that does not pose an immediate threat to their life, on a paid basis in accordance with an agreement on the provision of paid medical services or a voluntary medical insurance agreement.

How to get a compulsory medical insurance policy for citizens who are entitled to medical care in accordance with the Federal Law "On Refugees"?

Persons entitled to medical care in accordance with Federal Law No. 4528-1 of February 19, 1993 "On Refugees", in accordance with Article 10 of Federal Law No. 326-FZ of November 29, 2010 "On Compulsory Medical Insurance in the Russian Federation" ( hereinafter referred to as the Federal Law) are insured persons.

The choice of an insurance medical organization for persons entitled to medical care in accordance with the Federal Law "On Refugees" and the procedure for obtaining a policy are similar to those for citizens of the Russian Federation (see the answer to the question "How to get a compulsory medical insurance policy?").

The application for the choice (replacement) of an insurance medical organization shall be accompanied by the following documents or their certified copies required for registration as an insured person:

for persons entitled to medical care in accordance with the Federal Law "On Refugees" - a refugee certificate, or a certificate of consideration of an application for recognition as a refugee on the merits, or a copy of the complaint against the decision to deprive the refugee status to the Federal Migration Service with a note about its acceptance for consideration, or a certificate of temporary asylum on the territory of the Russian Federation.

Persons entitled to receive medical assistance in accordance with the Federal Law "On Refugees" are issued a policy for the period of stay specified in the documents attached to the application.

What categories of citizens of the Republic of Belarus are issued a compulsory medical insurance policy?

The procedure for providing medical care to citizens of the Republic of Belarus in state and municipal healthcare institutions of the Russian Federation in accordance with the Federal Law of November 29, 2010 No. 326-FZ "On Compulsory Medical Insurance in the Russian Federation" and the Agreement between the Government of the Russian Federation and the Government of the Republic of Belarus on the procedure for providing medical care for citizens of the Russian Federation in healthcare institutions of the Republic of Belarus and citizens of the Republic of Belarus in healthcare institutions of the Russian Federation, concluded in St. Petersburg on January 24, 2006 (hereinafter referred to as the Agreement), clarified by the information letter of the Ministry of Health and Social Development of Russia dated July 21, 2011 No. 20-1 / 10/2-7112.

Citizens of the Republic of Belarus permanently residing in the Russian Federation (having a residence permit) and citizens of the Republic of Belarus temporarily residing in the Russian Federation (having a temporary residence permit) are subject to compulsory medical insurance and compulsory medical insurance policies are issued to them in accordance with the Federal Law .

The choice of an insurance medical organization for citizens of the Republic of Belarus subject to compulsory medical insurance, and the procedure for obtaining a policy are similar to those for citizens of the Russian Federation (see the answer to the question "How to get a compulsory medical insurance policy?").

The application for the choice (replacement) of an insurance medical organization shall be accompanied by the following documents or their certified copies required for registration as an insured person:

• for citizens of the Republic of Belarus permanently residing in the Russian Federation - a passport of a foreign citizen or another document established by federal law or recognized in accordance with an international treaty of the Russian Federation as a document proving the identity of a foreign citizen; resident card; SNILS (if available);
• for citizens of the Republic of Belarus temporarily residing in the Russian Federation - a passport of a foreign citizen or another document established by federal law or recognized in accordance with an international treaty of the Russian Federation as a document proving the identity of a foreign citizen, with a mark on permission for temporary residence in the Russian Federation; SNILS (if available).

Citizens of the Republic of Belarus permanently residing on the territory of the Russian Federation are issued a policy without limitation of validity period. Citizens of the Republic of Belarus temporarily residing on the territory of the Russian Federation are issued a policy for the duration of the temporary residence permit.

Citizens of the Republic of Belarus temporarily residing in the Russian Federation (who do not have a residence permit or a temporary residence permit) are not subject to compulsory medical insurance, they are not issued compulsory medical insurance policies, and the amounts of payments and other remuneration according to employment contracts in their favor by insurance premiums established by Federal Law No. 212-FZ of July 24, 2009

"On insurance premiums in Pension Fund Russian Federation, Social Insurance Fund of the Russian Federation, federal fund compulsory medical insurance and territorial funds of compulsory medical insurance”, are not taxed.

Citizens of the Republic of Belarus temporarily staying in the Russian Federation and working in institutions (organizations) of the Russian Federation under employment contracts, regardless of whether they belong to the system of compulsory medical insurance, medical care in state and municipal health care institutions of the Russian Federation is provided on an equal basis with citizens of the Russian Federation at the expense of budget appropriations provided by the budget of the subject of the Russian Federation.

Medical assistance to other categories of citizens of the Republic of Belarus is provided in accordance with the Rules for the provision of medical assistance to foreign citizens on the territory of the Russian Federation, approved by Decree of the Government of the Russian Federation dated September 1, 2005 No. 546. Emergency medical care is provided to all foreign citizens free of charge and without delay in the event of conditions imminent threat to their lives or requiring urgent medical attention. Planned medical care is provided on a paid basis in accordance with an agreement for the provision of paid medical services or a voluntary medical insurance agreement.

When do you need to renew your compulsory health insurance policy?

Renewal of the policy is carried out in the following cases:

· changes in the last name, first name, patronymic, place of residence of the insured person;

· changes in the date of birth, place of birth of the insured person;

Establishing inaccuracies or erroneous information contained in the policy.

Reissuance of the policy is carried out upon the application of the insured person to the medical insurance organization for reissuance (a sample application for issuing a duplicate policy or reissuing the policy is given below). Re-issuance of the policy is carried out upon presentation of documents confirming the changes.

When do I need to get a duplicate of the compulsory health insurance policy?

Issuance of a duplicate of the policy is carried out at the request of the insured person to the insurance medical organization for the issuance of a duplicate of the policy, in the following cases:

· dilapidation and unsuitability of the policy for further use (loss of parts of the document, breaks, partial or complete fading of the text, mechanical damage to the plastic card with electronic media, and others);

loss of the policy.

How to replace the insurance medical organization?

Insured persons who have received a single standard compulsory medical insurance policy have the right to replace the medical insurance organization in which the citizen was previously insured, once during the calendar year no later than November 1, or more often in the event of a change of residence or termination of the financial security agreement compulsory health insurance by submitting an application for selection (replacement) to a newly selected medical insurance organization.

The insurance medical organization chosen by the insured person when replacing the insurance medical organization on the basis of the application for the choice (replacement) of the insurance medical organization, on the day the insured person submits the application, enters its details into new line on the reverse side of the compulsory medical insurance policy and sends information about the replacement of the insured person by the insurance medical organization to the territorial compulsory medical insurance fund.

What rights do insured persons have in the field of compulsory health insurance?

The insured persons are entitled to:

• free provision of medical care to them by medical organizations throughout the Russian Federation in the amount established by the basic program of compulsory medical insurance, in the territory of the subject of the Russian Federation in which the compulsory medical insurance policy was issued - in the amount established by the territorial program of compulsory medical insurance;
• choice of medical insurance organization. The register of insurance medical organizations operating in the field of compulsory medical insurance on the territory of the Russian Federation is posted on the official website of the Federal Compulsory Medical Insurance Fund;
• replacement of the insurance medical organization once during the calendar year no later than November 1, or more often in the event of a change of residence or termination of the agreement on financial support for compulsory medical insurance by submitting an application to the newly selected insurance medical organization;
• selection of a medical organization from medical organizations participating in the implementation of the territorial program of compulsory medical insurance. The register of medical organizations operating in the field of compulsory medical insurance on the territory of a constituent entity of the Russian Federation is posted on the official website of the territorial compulsory medical insurance fund on the Internet and may be additionally published in other ways;
• obtaining from the territorial fund, insurance medical organization and medical organizations reliable information about the types, quality and conditions for the provision of medical care;
• protection of personal data necessary for maintaining personalized records in the field of compulsory health insurance;
• compensation by an insurance medical organization for damage caused due to non-fulfillment or improper execution its responsibilities for organizing the provision of medical care;
• compensation by a medical organization for damage caused in connection with its failure to perform or improper performance of its obligations to organize and provide medical care;
• protection of rights and legitimate interests in the field of compulsory health insurance.

Do insured persons have obligations in the field of compulsory health insurance?

The insured persons are obliged:

• present a compulsory medical insurance policy when applying for medical care, except in cases of emergency medical care;
• submit to the insurance medical organization personally or through his representative an application for the choice of the insurance medical organization;
• notify the health insurance organization of a change in last name, first name, patronymic, place of residence within one month from the day these changes occurred;
• to select an insurance medical organization at a new place of residence within one month in the event of a change in the place of residence and the absence of an insurance medical organization in which the citizen was previously insured.

Is it possible, when calculating a differentiated per capita standard, to use not only the age and sex composition of insured persons, but also differences in the costs of medical care?

According to paragraph 153 of the Rules of Compulsory Medical Insurance, approved by the order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n (as amended by the order of the Ministry of Health and Social Development of Russia dated September 09, 2011 No. 1036n), when calculating the differentiated per capita standard, it is permissible to use the distribution of the number into age and sex subgroups, taking into account differentiation in the provision of medical care in a subject of the Russian Federation.

The differentiated per capita standard is determined by the categories of insured persons in a particular insurance medical organization that has concluded an agreement for the provision and payment of medical care under compulsory medical insurance with medical organizations included in the register of medical organizations operating in the field of compulsory medical insurance within the framework of the territorial program of compulsory medical insurance . Differentiation in the provision of medical care reflects the level and structure of the incidence of the population of the subject of the Russian Federation, the climatic and geographical conditions of the region, and the transport accessibility of medical organizations on the territory of the subject of the Russian Federation.

When calculating the differentiated per capita standard, it is necessary to take into account the indicators of medical care consumption, which allow determining the amount financial resources required by the insurance medical organization to pay for medical care.

Is it possible to choose a medical insurance organization in a constituent entity of the Russian Federation if a citizen does not have registration in this constituent entity?

In connection with the adoption of the Federal Law of November 29, 2010 No. 326-FZ “In accordance with the Law of the Russian Federation of June 25, 1993 No. 5242-1 “On the right of citizens of the Russian Federation to freedom of movement, choice of place of stay and residence within of the Russian Federation” registration of a citizen of the Russian Federation at the place of stay is carried out without deregistration at the place of residence. Registration or lack thereof cannot serve as a basis for restriction or a condition for the exercise of the rights and freedoms of citizens provided for by the Constitution of the Russian Federation, the laws of the Russian Federation, the Constitutions and laws of the republics within the Russian Federation.

Federal Law No. 326-FZ of November 29, 2010 “On Compulsory Medical Insurance in the Russian Federation” grants insured persons the right to choose an insurance medical organization and receive a compulsory medical insurance policy at the place of registration or at the place of residence of the insured person.

In addition, the Rules of Compulsory Medical Insurance approved by the order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n, registered with the Ministry of Justice of Russia on March 3, 2011 No. 19998, and Guidelines on the provision of information in the field of compulsory health insurance, approved by the MHIF on April 4, 2011, it is provided that citizens without a fixed place of residence (that is, with the absence of any registration on the territory of the Russian Federation) have the right to choose an insurance medical organization.

Where can I find information about insurance medical organizations and medical organizations operating in the field of compulsory medical insurance?

The Federal Compulsory Medical Insurance Fund places on its official website on the Internet single register insurance medical organizations and medical organizations operating in the field of compulsory medical insurance on the territory of the Russian Federation.

The register of medical organizations and insurance medical organizations operating in the field of compulsory medical insurance on the territory of a constituent entity of the Russian Federation is posted on the official website of the territorial compulsory medical insurance fund on the Internet and may be additionally published in other ways.

The register of medical organizations contains the names, addresses of medical organizations and a list of services provided by these medical organizations within the framework of the territorial program of compulsory medical insurance.

The register of insurance medical organizations contains the registry number, name, address of the insurance medical organization and information about the license.

Insurance medical organizations post on their official websites on the Internet, publish in the media or bring to the attention of insured persons in other ways information:

on their activities, the number of insured persons, medical organizations operating in the field of compulsory medical insurance in the territory of a constituent entity of the Russian Federation,

types, quality and conditions for the provision of medical care, violations identified in the provision of medical care, the rights and obligations of insured persons in the field of compulsory medical insurance.

Medical organizations are required to post on their official website on the Internet information about the mode of operation, types of medical care provided.

What documents must be submitted for registration as an insured person when choosing an insurance medical organization?

The application for the choice (replacement) of an insurance medical organization shall be accompanied by the following documents or their certified copies required for registration as an insured person:

• 1) for children after state registration of birth and up to fourteen years of age who are citizens of the Russian Federation:
  • birth certificate;
  • identity document of the legal representative of the child;
  • SNILS (if available);
• 2) for citizens of the Russian Federation aged fourteen years and older:
  • identity document (passport of a citizen of the Russian Federation, temporary identity card of a citizen of the Russian Federation, issued for the period of issuing a passport);
  • SNILS (if available);
• 3) for persons entitled to medical care in accordance with the Federal Law "On Refugees" - a certificate of a refugee or a certificate of consideration of an application for recognition as a refugee on the merits, or a copy of the complaint against the decision to deprive the status of a refugee to the Federal Migration Service with a note on its acceptance for consideration;
• 4) for foreign citizens permanently residing in the Russian Federation:
  • passport of a foreign citizen or other document established by federal law or recognized in accordance with an international treaty of the Russian Federation as a document proving the identity of a foreign citizen;
  • resident card;
  • SNILS (if available);
• 5) for stateless persons permanently residing in the Russian Federation:
  • a document recognized in accordance with an international treaty of the Russian Federation as a document proving the identity of a stateless person;
  • resident card;
  • SNILS (if available);
• 6) for foreign citizens temporarily residing in the Russian Federation:
  • passport of a foreign citizen or other document established by federal law or recognized in accordance with an international treaty of the Russian Federation as a document proving the identity of a foreign citizen, with a mark on a temporary residence permit in the Russian Federation;
  • SNILS (if available);
• 7) for stateless persons temporarily residing in the Russian Federation:
  • a document recognized in accordance with an international treaty of the Russian Federation as a document certifying the identity of a stateless person, with a mark on a temporary residence permit in the Russian Federation;
  • or a document of the established form, issued in the Russian Federation to a stateless person who does not have a document proving his identity;
  • SNILS (if available);
• 8) for the representative of the insured person:
  • identity document;
  • a power of attorney for registration as an insured person in the selected insurance medical organization, issued in accordance with Article 185 of the first part of the Civil Code of the Russian Federation;
• 9) for the legal representative of the insured person: an identity document and (or) a document confirming the authority of the legal representative.

When is a temporary certificate issued?

Temporary certificate - a document confirming the execution of the policy and certifying the right to free provision of medical care to the insured by medical organizations in the event of an insured event. In accordance with Article 46 of the Federal Law of November 29, 2011 No. 326-FZ “On Compulsory Medical Insurance in the Russian Federation”, on the day of receipt of an application for choosing an insurance medical organization, the insurance medical organization or, in its absence, the territorial fund of compulsory medical insurance issues to the insured person or his representative a temporary certificate.

The provisional certificate is valid until the date of receipt of the policy, but not more than thirty working days from the date of its issue.

How to choose a medical organization and a local doctor (therapist, pediatrician, general practitioner)?

In accordance with Article 16 of the Federal Law of November 29, 2011 No. 326-FZ "On Compulsory Medical Insurance of Citizens in the Russian Federation", the insured person has the right to choose a medical organization from among medical organizations participating in the implementation of the territorial program of compulsory medical insurance, and the choice doctor by submitting an application personally or through his representative addressed to the head of the medical organization in accordance with the legislation of the Russian Federation.

Under the terms of the contract for the provision and payment of medical care under compulsory medical insurance, the standard form of which was approved by the order of the Ministry of Health and Social Development of Russia dated December 24, 2010 No. 1184n, registered with the Ministry of Justice of Russia on February 4, 2011 No. 19714, a medical organization that entered into an agreement with an insurance medical organization undertakes to provide insured persons with the right to choose a medical organization and a doctor in accordance with the legislation of the Russian Federation.

Currently, according to the Procedure for organizing medical care for the population on the basis of the district principle, approved by order of the Ministry of Health and Social Development of Russia dated August 4, 2006 No. 584, registered with the Ministry of Justice of Russia on September 4, 2006 No. 8200, by the health authorities of municipalities in order to comply with the principle of providing primary health -health care, service areas are established and the population is assigned to outpatient and inpatient polyclinic institutions at the place of residence. In order to ensure the right of citizens to choose a doctor and a medical institution, the heads of outpatient polyclinic or inpatient polyclinic institutions attach citizens living outside the service area of ​​an outpatient clinic or inpatient polyclinic institution to district general practitioners, district pediatricians, doctors general practice(family doctors) for medical supervision and treatment, not exceeding the population per position of a district doctor by more than 15 percent of the standard number.

According to Article 58 of the Fundamentals of the Legislation of the Russian Federation on the protection of the health of citizens of July 22, 1993 No. 5487-1 (as amended by the Federal Law of September 28, 2010 No. 243-FZ), the attending physician is appointed at the choice of the patient or the head of the medical institution ( its divisions). If the patient requests a replacement of the attending physician, the latter shall facilitate the selection of another physician.

On the validity of the compulsory medical insurance policy on the territory of the Russian Federation.

In connection with the adoption of the Federal Law of November 29, 2011 No. 326-FZ “On Compulsory Medical Insurance of Citizens in the Russian Federation”, from January 1, 2011, compulsory medical insurance in the Russian Federation is subject to:

• citizens of the Russian Federation, with the exception of military personnel and persons equated to them in terms of organizing the provision of medical care;
• foreign citizens permanently and temporarily residing in the Russian Federation, with the exception of highly qualified specialists receiving wages(remuneration) in the amount of two or more million rubles per year, and members of their families;
• stateless persons permanently and temporarily residing in the Russian Federation, with the exception of highly qualified specialists, with the exception of highly qualified specialists receiving a salary (remuneration) in the amount of two or more million rubles per year, and members of their families;
• refugees, asylum seekers and family members accompanying them.

From January 1, 2011, a citizen can choose a medical insurance organization where he actually lives, regardless of registration at the place of residence. To obtain a compulsory medical insurance policy, a citizen or his representative submits an application to the insurance medical organization for choosing an insurance medical organization. The list of insurance medical organizations participating in the field of compulsory medical insurance of a constituent entity of the Russian Federation is posted on the websites of the Federal and territorial funds compulsory health insurance, as well as in the regional media.

Compulsory medical insurance policies received by citizens before January 1, 2011 are valid until they are replaced with compulsory medical insurance policies of a single sample or a citizen receives a universal electronic card.

The medical organization offers to pay for the examination or treatment prescribed by the attending physician. Is it legal?

If the health facility offers you to pay for services, you need to contact the insurance company that issued the CHI policy (the phone number is indicated on the CHI policy) and make sure that this service can really be provided only on a paid basis. If you have already paid for medical services, you must keep receipts (or other payment documents confirming payment) in order to later contact the insurance company with an application for review of the legality of collecting money. In each case, when it is offered to pay for medical services, it is necessary first of all to get advice on this issue from the medical insurance organization that issued the CHI insurance policy.

Who can be contacted for assistance if the attending physician of the district polyclinic refuses to refer a patient insured under compulsory medical insurance for a consultation and diagnostic examination to a specialized medical institution in the city.

You can contact the head physician of the polyclinic, the deputy head physician for medical work, the head of the department, the Health Department (contact details are available at the polyclinic) or the Health Department, or a medical insurance organization.

Can the HMO reimburse the costs of medicines recommended by a doctor in a commercial clinic?

No, he can not. In accordance with the Law of the Russian Federation “On health insurance of citizens of the Russian Federation”, compulsory medical insurance funds have an exclusively designated purpose: to pay for medical care provided under the compulsory medical insurance program to insured persons under CHI for citizens in medical institutions operating in the CHI system and are sent to medical institutions in which this assistance was provided.