According to the adopted legislation, almost every person registered and living in the territory Russian Federation, has the right assigned to him to apply to any medical institution to receive appropriate treatment if such a need arises.
However, there is one important nuance - services under the compulsory medical insurance policy, as well as the right to receive medicines on a gratuitous basis, that is, free of charge, are provided only if the citizen has such a document as a compulsory health insurance policy.
Who can receive free medical services?
Any citizen who is the holder of a compulsory health insurance policy has the right to use the services of medical institutions:
Employed citizens. That is, the category of persons who regularly pay taxes to the state budget. That is, in essence, he pays for his treatment in advance. Unemployed citizens. IN in this case pay Money Treatment of these persons is also paid for from the federal budget.
Children, as well as teenagers who have not reached the age of eighteen and are not taxpayers.
Compulsory medical insurance system in the Russian Federation
If a person is officially employed, he has the right to apply for and receive health insurance at his place of work. If he is not employed, works unofficially, or has not reached the age of majority, you can apply for the specified document to any company that provides insurance services.
If there is no compulsory medical insurance policy, workers in the sphere medical services there remains the right to refuse to provide medical care to the applying individual. In this case, the refusal to provide medical services is lawful, that is, it does not entail negative consequences for the person who carried it out.
Where can I get treatment for free?
There is a certain list of medical institutions that any citizen with a compulsory health insurance policy can apply to. These include the following clinics operating under compulsory medical insurance:
Children's medical centers and clinics;
antenatal clinics, as well as government maternity;
medical centers, clinics, dispensaries and other specialized institutions, also classified as public.
Specialized institutions classified as territorial administrative ones are burdened with the obligation to provide medical services to the population free of charge. That is, those clinics and hospitals whose funding comes from the state budget.
You can download clinic addresses here
Rights of citizens in the field of compulsory medical insurance
Every citizen has the right to be assigned to a medical institution that is located in close proximity to his place of registration or residence. This is necessary in order to make it easier for individuals to receive government health services.
In order to confirm the fact that a citizen lives at a certain address, you can provide the medical institution with absolutely any document that can confirm this fact. For example, a residential lease agreement.
In this case, healthcare workers do not have the right to refuse to register an individual.
Where can I find out the list of compulsory medical insurance services?
The list of services provided under the compulsory health insurance policy free of charge is slightly modified and approved every year special program health care, which has regional status. To find out which services are included in the list above in a particular region, you should contact the insurance company directly where the procedure for registering and receiving the relevant document took place.
List of services under the health insurance policy
In a number of cases, state medical institutions have the right to require a citizen to contribute a certain sum of money for the provision of a particular service. To obtain information about whether these actions are legal, you should contact the appropriate territorial insurance fund operating in the same region where the institution mentioned above is located.
To receive medical care free of charge, you should contact an institution that is state-owned, that is, financed from the budget of the region or region. Private clinics do not provide free services under compulsory medical insurance.
Next, you must provide a policy entitling you to receive free services and complete the registration procedure with one or another specialist. After this, the person who applied to the medical institution will be issued an appropriate coupon indicating the date and time of the specialist’s appointment.
In the event that any citizen needs to contact a specialist who receives outside settlement where the said person lives individual, a referral from the attending physician is also required.
Free medical services under compulsory medical insurance
There is a certain list of compulsory medical insurance services, the provision of which is free of charge if the citizen has a compulsory health insurance policy. These include the following:
Emergency assistance, that is, ambulance dispatch when a patient is called. This service is provided free of charge not only to persons who have health insurance, but also to those who do not have this document. In the recent past, there were false rumors that if a person does not have a compulsory health insurance policy, calling emergency care he will have to pay about one and a half to two thousand rubles. This is wrong. This service is provided absolutely free of charge in any case.
Outpatient treatment in a medical institution that is included in the insurance system and includes a number of different manipulations: examination and diagnosis of the patient’s disease, necessary procedures and purpose adequate treatment. However, when the patient is on a so-called outpatient, day or home treatment, all necessary medications must be purchased by him at his own expense, since there are no benefits in this case.
Working with the public to raise awareness of sanitary and hygienic issues. That is, holding various lectures, seminars and so on.
Diagnosis and treatment of the population using expensive innovative drugs and methods. For example, in some regions of the Russian Federation, in vitro fertilization is carried out free of charge. Diagnosis of the disease followed by hospitalization.
Treatment, extraction, as well as prosthetics of teeth in dental clinics and offices with state status.
Free services under compulsory medical insurance policy
For example, while undergoing treatment in a state hospital, a citizen has the right to receive free services under the compulsory medical insurance policy in the treatment of the following types of diseases:
1. Accompaniment of pregnancy during its complicated course, as well as in the presence of pathologies of any kind, medical abortion, availability chronic diseases, or during an exacerbation of the disease, poisoning, bodily harm, and so on. In this case, the provision of medications necessary for adequate treatment is free of charge.
2. List of compulsory medical insurance services provided free of charge:
Diseases infectious nature, with the exception of those categories classified as sexually transmitted infections.
Various diseases of the blood, vascular system, heart.
Stomach diseases, as well as gastrointestinal tract generally.
Any disease caused by a nervous disorder.
Diseases of joints, bones, muscles and so on. All kinds of defects in vision, hearing, speech.
Tumors of both benign and malignant nature.
Diseases of tissues and skin.
Diseases of the genitourinary area.
Diseases of the respiratory system.
What to do if treatment is denied if you have a policy?
Currently, not every citizen is fully aware of the rights that are granted to him in accordance with the presence of a compulsory health insurance policy, which is often used by unscrupulous workers in this field of activity, demanding payment of a certain fee for the provision of necessary assistance.
What to do if your rights are violated? Every citizen of the Russian Federation who has insurance has the right to seek help from any medical institution located on the territory of the state. In the compulsory medical insurance clinic, they are required to admit him and carry out appropriate diagnosis, treatment, as well as other manipulations that are necessary.
However, it often happens that doctors, as well as hospital staff, refuse to admit the patient in such cases. This is not legal and violates human rights. To restore the violated right, a person who has been denied medical services must file a complaint with the Federal Compulsory Health Insurance Fund, whose employees will take appropriate measures. If such a case is detected, administrative penalties may be applied to medical service workers.
The exception is private clinics, which do not provide free services under compulsory medical insurance.
What can you expect with a compulsory medical insurance policy?
In order to know which services the compulsory health insurance policy gives you, you need to carefully read the list of services provided to the population free of charge.
It should be remembered that, in essence, these services are not free at all due to the fact that wages Each employed citizen is deducted a certain amount every month, intended specifically for this purpose. Thus, each individual pays in advance for his treatment in a public institution.
The times when the state provided every citizen with free medicine and education are gone.
Modern Russia has left us one loophole that gives us the opportunity to receive treatment “for thanks.” But the current generation, confident that free cheese is only in a mousetrap, does not often use your legal right.
What is a compulsory medical insurance policy?
Compulsory medical insurance policy (compulsory medical insurance) - a document confirming the right of the insured person for free medical care throughout the Russian Federation.
The policy only works upon the occurrence of an insured event(Articles 16 and 35 Federal Law dated November 25, 2013 N 317-FZ). That is, there is a basic level of medical services (examinations, tests, etc.) - the patient does not pay for them.
But no one forbids the doctor from offering or prescribing tests or examinations that are not included in the program basic medical compulsory insurance. To clarify the situation, do not hesitate to call insurance company.
Free dentistry step by step
If you decide to have your teeth treated for free, take our recommendations into account, as well as useful information from video:
Choosing a clinic
Not all clinics work with insurance policies. And, without waiting for an unpleasant surprise after visiting the doctor, We clarify the situation with the insurance company, which is obliged to provide you with a list of dentists operating under the compulsory medical insurance policy upon your first request.
Be sure to call your insurance company and find out if you can according to your policy treat your teeth for free and where you can do it.
Few people know that you can be treated under the policy both in the state and in private clinic (Article 15 of the Federal Law of November 25, 2013 N 317-FZ). Another thing is that “private owners” do not really like those who are not able to pay right away.
Everything is according to the law
The most important thing is self-confidence. Set yourself up that you are not a victim, but a buyer. And the buyer, as they say, is always right. Even if you don't pay money now, you pay taxes every month and insurance premiums. Behind unemployed citizens this is done by the state (Articles 23, 24 and 25 of the Federal Law of December 1, 2012 N 213-FZ).
When going to any clinic, you should take with you policy, passport and SNILS. Then there should be no problems at the reception, you will be given a coupon and you will be taken to the doctor.
Since 2011, every citizen, regardless of registration, has the right to choose not only a clinic, but also attending physician at your request(Article No. 326-FZ). At the same time, you are not obliged to explain to anyone the reasons for this decision.
List of free dental services
The dentist is obliged to provide the following services free of charge:
- education proper hygiene mouth and teeth brushing;
- anesthesia;
- soft tissue operations;
- removal of diseased teeth;
- simple orthodontics;
- physiotherapy;
- radiography;
- treatment of pulpitis and caries;
- treatment of gum diseases;
- treatment of abscesses;
- correction of irregular teething defects.
Paid procedures
It should be said here that to receive these services you will have to be patient. Because you'll have to wait in line in every new office. Which is not very pleasant when you have a toothache. Paid help on these problems it turns out to be out of turn.
And yet, the doctor may sometimes suggest paid examination or analysis. Let's say that a painkiller that is included in the list of free medical supplies is not suitable for you. Or in fact demands to pay for treatment.
To ensure the legality of his actions, you need seek clarification to the chief physician and/or insurance company.
The telephone number can be found on the back of the policy. And be sure to keep all payment receipts. Only on their basis can you prove that you are right.
Emergency situation
No one is immune from unforeseen situations. And if suddenly sharp pain (whether it’s a bad tooth or a broken jaw) - in nature or at work, but you don’t have a policy at hand, you any clinic must accept, regardless of the coverage area of the compulsory medical insurance policy.
Doctors must provide necessary medical care. Only then, within 3 days, the policy still needs to be brought to the registry.
If a conflict situation arises
Let's consider a situation where the doctor did not work professionally. And, let’s say, the free seal fell out almost immediately. According to the policy, you do not have a receipt for the provision of medical services, nor do you have a guarantee. So it is almost impossible to prove anything. Although, going to the head doctor should solve the problem.
Most often this has a positive effect, because no the clinic is not interested in scandals and, moreover, he will do everything to prevent you from going higher, for example, to the Ministry of Health or, even worse, to the prosecutor’s office.
Claims can also be made to the health department, your county health department, or your insurance company. You must be given a sample application at the place of application.
Typically this is followed by quality examination medical services (Federal Law dated December 1, 2012 N 213-FZ). And then only the court will figure out who is right and wrong.
IN paid clinic There is a concept of “guarantee”. It is issued for all types of services. For example, for a filling it takes 1-2 years. If something unexpected happens during this time, then feel free to make an appointment with the same doctor with the receipt saved. And they will fix the problem and give you a filling for free.
To pay or not?
Treat for free or pay – everyone's personal business. It all depends on your personal attitude, financial capabilities and the time you are willing to spend on your health. For some it is more convenient to pay and do everything in as soon as possible and don't think about the pain. Some people don't have the funds for extra services. But this does not mean that he is not human and does not feel pain.
good doctor doesn't see the difference in patients. Find out more, ask friends and acquaintances. Find your doctor. Still, most people know how to treat their teeth for free under their compulsory health insurance policy.
Free dentistry under your policy - why not? Each doctor is responsible for his work. This is supported not only by the Hippocratic oath, but also by his employment contract.
Treatment under a policy is not a reason to believe that the doctor can deliberately harm, just because we came to him for free. But it’s still better to have a minimum amount in your pocket for unforeseen needs, and also eliminate all problems in a timely manner oral cavity, such as or .
Doctor Smile is a private medical company that has been providing dental services for more than 17 years. In our clinics, patients can receive the most modern assistance in full. Technological equipment, highly qualified doctors and innovative materials allow us to offer high level service and quality guarantee for all types of work.
Permission to provide free medical services for Federal program The network of Doctor Smile clinics received compulsory medical insurance in 2015. All necessary steps state registration were passed. Our clinics have confirmed their right to provide quality services to the population.
Dental services of the highest level
Possibility to contact private dentistry significantly expands the options for patients whose choice was previously limited to municipal institutions close to home. Now any resident of Moscow and the region can make an appointment without an absentee ballot and receive qualified service for free. You can also contact us if necessary urgent help dentist. This assistance will be provided immediately and in full upon presentation of the policy.
Here is a list of services that are covered by the compulsory medical insurance policy:
- initial appointment with a dentist, drawing up a treatment plan;
- diagnostic measures, including dental radiography;
- anesthesia (pain relief);
- caries treatment, acute pulpitis and periodontitis, installation of fillings;
- tooth extraction;
- removal of dental plaque;
- emergency dental care;
- modern dental materials;
- formation of one carious cavity;
- application of a therapeutic dressing for dentin caries ( deep caries), biological method pulp treatment;
- opening of the tooth cavity with medicinal treatment;
- pulp amputation;
- extirpation, removal of decay from 1 channel;
- impregnation or medicinal treatment of 1 channel;
- filling one canal with paste;
- filling one canal with a gutta-percha pin;
- application of arsenic paste;
- applying a temporary filling;
- removal of temporary filling;
- treatment of teeth with fluoride varnish for hypersensitivity;
- mechanical and medication stop bleeding;
- polishing the filling;
- selective grinding of 2-4 teeth;
- reading a radiograph;
- cement filling;
- filling made of chemically cured composite material;
- deletion permanent tooth(simple);
- removal of a permanent tooth (complicated) using a drill and/or detachment of a mucoperiosteal flap;
- dressing after difficult surgical intervention;
- opening of a soft tissue abscess in the oral cavity;
- opening of the subperiosteal abscess (washing, drainage);
- treatment of alveolitis with socket curettage;
- enucleation of the cyst;
- excision of the hood;
- release incision;
- primary dentist appointment, amb.;
- appointment with a dentist, repeated, amb.;
- primary appointment with a dentist-surgeon, amb.;
- appointment with a dentist-surgeon, repeated, amb.;
- dispensary appointment with a dentist;
- preventive appointment with a dentist;
- diathermocoagulation in dentistry;
- removal of fillings, crown trephination;
- definition hygienic index;
- removal of dental plaque in the area of 1 tooth (manual/mechanical);
- medicinal treatment of pathological periodontal pockets;
- opening of periodontal abscess.
The following types of services are provided for an additional fee:
Any types of prosthetics, implantology, aesthetic dentistry and operations aimed at preserving the tooth.
You need to take this with you!
When visiting the clinic, the patient must have in hand: a passport, SNILS and a compulsory medical insurance policy issued in any region of the Russian Federation. No other documents required!
3 reasons to go to private dentistry under the compulsory medical insurance policy
- High level of service. Exhaustive waits and long lines remained at municipal clinics. At the Doctor Smile clinic, appointments are made by appointment at a time convenient for the patient. All patient data is stored in individual card. From it, the dentist receives information about previous treatment, individual intolerance, etc. This allows him to offer a personalized approach to each patient.
- Qualified dentists and the latest equipment. Our clinics employ specialists with extensive experience, including doctors with a narrow specialization. Each specialist regularly undergoes advanced training courses, which allows our doctors to be one of the first to use innovative treatment methods and carry out any dental procedures without pain, quickly and with a guarantee.
- Convenient location and work schedule. Doctor Smile clinics are located in different areas Moscow near metro stations. Our patients can easily reach the nearest clinic using any type of transport. For the convenience of patients, clinic opening hours have been increased from 9 a.m. to 9 p.m. We also work on weekends!
The services of the Doctor Smile blade are available to everyone under the compulsory medical insurance program!
Contact one of the Doctor Smile clinics closest to you and make sure that pain-free dental treatment in a comfortable atmosphere with a guarantee of results can be free!
legal information
(On approval of the list of vital and essential medicines and products medical purposes for free acquisition by citizens permanently residing (working) in the territory of the zone of residence with the right to resettlement, in accordance with paragraph 19 of part one of article 18 of the law of the Russian Federation “on social protection citizens exposed to radiation as a result of the Chernobyl disaster").
(On state support for the development of the medical industry and improving the provision of the population and healthcare institutions medicines and medical products).
(List of vital and essential drugs for medical use. list of medications for medical use, including medications for medical use prescribed by decision of medical commissions of medical organizations).
(List of medications intended to provide persons with hemophilia, cystic fibrosis, pituitary dwarfism, Gaucher disease, malignant neoplasms lymphoid, hematopoietic and related tissues, multiple sclerosis, persons after organ and (or) tissue transplantation).
(On approval of the Rules for the provision medical organizations paid medical services).
(On approval of the Regulations on the Federal Service for Surveillance in Healthcare).
(On approval of SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities”).
(On the organization of work on the formation of an independent system for assessing the quality of work of state (municipal) institutions providing services in the field of healthcare).
(“On the Territorial Program of State Guarantees of Free Provision to Citizens medical care in Moscow for 2016”)
The Constitution of the Russian Federation guarantees all citizens free medical care under the compulsory health insurance policy (CHI). Kinds free help provided under the compulsory medical insurance policy:
- primary health care(outpatient clinic);
- emergency,
- specialized medical care(if a diagnosis is established, treatment of a specific disease is carried out)
- high-tech medical care(treatment of diseases using high-tech, complex, costly treatment methods).
The presence of a compulsory medical insurance policy confirms that the patient’s treatment in public and some private clinics will be paid for from the compulsory health insurance fund, which is formed from mandatory contributions from citizens.
Briefly about the compulsory medical insurance system
Payment for treatment in the compulsory medical insurance system occurs at specially formed tariffs for each disease, but does not depend on the method of treating this disease. Tariffs are the same for all medical institutions. The compulsory medical insurance tariff specifies how many and what procedures, tests and studies the clinic can and should perform in the treatment of a particular disease.
Tariffs are the same for all clinics, which means that the patient can choose a more high-tech and well-equipped clinic, regardless of the cost of treatment. The insurance company will handle settlements with the clinic.
Some expensive procedures within the compulsory medical insurance system can only be performed if strictly necessary, which the clinic must prove, otherwise they simply will not be paid for by the compulsory medical insurance fund. Therefore, treatment of patients in the compulsory medical insurance system, unfortunately, has its limitations.
Medical institutions are forced to work according to the rules established by the compulsory medical insurance fund for each disease. It is important to say that the provision of high-tech medical care (HTMC) to patients, the so-called “quota” treatment, is also paid for from the compulsory medical insurance fund and, accordingly, is carried out according to the algorithms prescribed above.
But the tariffs of the VMP system are higher and are intended specifically for providing complex, high-tech treatment, which allows the clinic staff to use all their powers modern methods treatments, advanced technologies and high-quality consumables.
Not all hospitals in Russia have the right to provide high-tech medical care. Every year, the Ministry of Health of the Russian Federation creates a list of clinics that can treat patients with VMP. Selected clinics receive a so-called assignment from the Ministry of Health, which determines the number of patients that the hospital can treat under VMP.
IN medical centers Federal significance under the compulsory medical insurance policy provides only high-tech and specialized medical care. The Clinic of Coloproctology and Minimally Invasive Surgery is part of first MSMU them. Sechenov, accordingly, the same requirements apply to her.
How to get medical care under the compulsory medical insurance policy?
Option 1. By referral from the clinic
The compulsory medical insurance policy itself is required. If it is not there, and you are a citizen of the Russian Federation, you need to contact an insurance company that works with the territorial compulsory medical insurance fund, write an application and immediately receive a temporary policy, and after about a month, a permanent compulsory medical insurance policy. After receiving the compulsory medical insurance policy, you need to be assigned to a clinic, which you can choose yourself. After this, you can qualify for high-tech medical care under the compulsory medical insurance policy.
Referral from the clinic to which the patient is attached (at his place of residence or at his choice). This direction in city hospital or federal center issued to the patient if the clinic doctors cannot independently diagnose the patient or carry out treatment. A referral from the clinic allows the federal medical institution, which is the First Moscow State Medical University named after. Sechenov and our Clinic, provide the patient with primary, specialized and high-tech care.
At the clinic you can get a referral for free consultation in our Clinic, and a referral for free treatment.
Option 2. Referred by doctors from our Clinic.
In some cases, doctors at the Clinic of Coloproctology and Minimally Invasive Surgery can also issue referrals for treatment. The number of referrals is limited and applies to certain types of diseases or complications.
You can find out about the possibility of free treatment under the compulsory medical insurance policy during a face-to-face consultation with a doctor. In this case, you will bypass the stage of agreeing and receiving a referral at the clinic. Please note that referrals for compulsory medical insurance treatment, which are issued directly at our Clinic, have a limited number.
To make a referral under the compulsory medical insurance policy through a doctor at the KKMH Clinic, you will need:
- compulsory medical insurance policy
- independent visit to the clinic only for treatment (not carrying out a complex diagnostic measures) with an already established diagnosis
