Replacement operation knee joint- an expensive surgical intervention that not all of our fellow citizens can afford. However, there is Government program quotas under which patients will be able to receive medical care free of charge. In order for a knee joint replacement to be carried out according to the quota, you need to collect the required documents, take tests and wait for your turn.
How to get a quota for joint replacement?
Knee replacement is an expensive service. Medical care of this kind costs about 60 thousand rubles, not counting the cost of hospital stay, purchase of medications, examination, purchase of a prosthesis and rehabilitation. After the operation, the damaged parts of the knee are restored and the person can move as before the illness.
Agree that saving the required amount is an impossible task for most. Queuing up to receive a quota in such cases is the only way to recover.
But even here one cannot do without bureaucratic issues. Those wishing to receive a quota will need to collect a package of documents, undergo an examination and wait for the decision of a special commission. The following papers are needed:
- a conclusion from the attending physician indicating the need for knee replacement;
- test results, x-rays, etc.;
- general civil passport of the Russian Federation;
- compulsory medical insurance policy;
- application for a quota;
- signed consent to the processing of personal data;
- a document confirming the status of a disabled person, if any;
- SNILS.
The algorithm of actions will be as follows:
- Contacting your doctor and obtaining a medical opinion on the need for surgical intervention.
- Providing documents to the commission of the medical institution where the patient is being observed. The review period is three days.
- Transfer of papers to the health department of the constituent entity of the Russian Federation. Here the decision on granting a quota is made. The review period is 10 days.
- Redirection of documents to the clinic where the knee joint replacement will be performed.
At the medical institution where endoprosthetics is performed under a quota, they study the documents received and decide on the length of wait for the operation. Typically, joint replacements are performed on a first-come, first-served basis.
After a decision is made, the applicant is notified about the date of hospitalization. In some cases, additional preparation steps are required (undergo examination, etc.). The waiting period is at least three months. Sometimes citizens are forced to wait a year or more for their turn.
Who is entitled to the quota?
Only citizens of the Russian Federation can count on receiving a quota. In addition, you must be an insured person under the compulsory medical insurance program.
Now the state budget fully pays for knee replacements, primarily for children and adults who suffer oncological diseases with complications on the musculoskeletal system. If a prosthesis is required due to another diagnosis, you still need to submit documents for a quota. However, the wait for your hospitalization date may be lengthy.
In some cases, knee replacement surgery cannot be performed. Contraindications include:
- diseases of the cardiovascular system;
- pathology nervous system;
- diabetes.
Contraindications may be temporary. The commission considers each case individually.
Cost of treatment
Usually the quota covers only the immediate replacement, hospital stay and necessary medications. Most often you have to purchase a prosthesis at your own expense.
The cost of the prosthesis depends on the country of origin and the material used. Imported prostheses are more expensive than those produced in Russia. By type of material, the average prices were distributed as follows:
- cement - from 120,000 rubles;
- made of metal and polyethylene - from 130,000 rubles;
- made of metal and ceramics - from 170,000 rubles.
Prostheses made of metal and ceramics last the longest. However, their price is the highest. To choose the optimal prosthesis, it is recommended to consult a doctor. The specialist will study the characteristics of the patient’s body and select the best option.
The cost of treatment may increase due to the need for special types of examination, if prescribed by the attending physician. Their feasibility is also determined on an individual basis.
A limited number of citizens can receive medical care on a preferential basis. The number of quotas is limited and set annually. Often people have to wait until next year to participate in the quota program, since the current year's quotas have already been allocated.
There is a possibility that someone in the queue for hospitalization will refuse the operation, then the waiting period will be reduced. However, this rarely happens.
Features of quota knee replacement
Citizens awaiting surgical intervention under a quota face two problems:
- Long terms of receipt medical care.
- Quality of prosthetics according to quota.
If a person requires a knee replacement, and the wait for hospitalization under the quota threatens to drag on for several years, there is a possibility that by that time the ability to move will be completely lost. In this case, practically the only way out is to pay for prosthetics at your own expense. Timely medical care significantly increases the chances of full recovery the patient's previous lifestyle.
In this case, you will be able to save money by going to a public clinic. There you will not have to pay for hospital stay and surgery - this is included in the list of services covered by standard insurance. You will have to pay the cost of the prosthesis, medications and additional measures to examine the patient.
If a citizen does not have that kind of money, you can try turning to a charitable foundation. There are several organizations in our country that provide all possible assistance in raising funds for surgical intervention.
In the future, it is recommended to submit documents to receive compensation for funds spent on treatment from the state budget. To do this, all receipts and other documents related to the knee replacement performed are provided to the health department. Compensation is possible either in full or in part.
The second problem is related to the quality of the prosthesis, which is installed according to a quota. As a rule, the patient does not have to choose - they install the prosthesis available in the clinic. If a citizen is not satisfied with the quality of the prosthesis according to the quota, he has the right to purchase his own, but at his own expense. However, all other treatment will continue to be provided at the expense of the state budget.
Now exists great amount types of prostheses. This allows you to choose the option that suits your needs. individual characteristics person.
Author NN asked a question in the section Doctors, Clinics, Insurance
Is it difficult to “knock out” a quota for an operation and how long on average do you have to wait for your turn? and got the best answer
Answer from Piramidonovna[guru]
To obtain a quota, testimony is required. If they are, then it is enough to contact a specialized doctor at your clinic. He will complete the documents and send them to the VMP center. If there are no indications for VMP, then there is no point in “knocking out”, since there is a certain list of indications and types of treatment for these diseases. The quota will be given as soon as it is your turn at the medical institution where you need it.
Source: surgeon
Answer from 2 answers[guru]
Hello! Here is a selection of topics with answers to your question: Is it difficult to “get” a quota for an operation and how long on average do you have to wait for your turn?
Answer from Yotyana Pimenova[newbie]
It turns out that the Coupon is hanging, not being updated no matter how you look at it, it’s still under review! Call Putin - everything will be decided immediately! It's a mess everywhere!
Answer from Oksana Hetman[newbie]
And if there is no time to wait. Die?
Answer from STOM.RU[guru]
According to the order on the provision of high-tech medical care in 2011, the following procedure was established for receiving high-tech medical care by citizens of the Russian Federation:
The attending physician has identified a disease in the patient, for the treatment of which, as he believes, the patient needs high-tech care. Most often, a complete examination cannot be carried out in a clinic.
The doctor refers the patient to an institution where he will undergo in-depth studies to clarify the diagnosis and correctly navigate the scope of the operation.
When the final diagnosis is established, the doctor prepares documents - an extract from the medical history, results of tests and studies. This package, signed by the chief physician of the medical institution, is submitted for consideration to a special commission under the regional health authority - in some regions these are ministries, in others committees, health departments.
Next, the documents are reviewed by the commission of the constituent entity of the Russian Federation for the provision of high-tech medical care with the participation of the chief specialist in this area. He is best versed in a particular area, he knows the medical institutions where the necessary type of assistance is provided. As a rule, the commission meeting takes place without the participation of the patient, although, if necessary, the chief specialist can invite him to an in-person consultation. As a result of the commission's consideration of the patient's package of documents, a decision is made on the presence or absence of indications for providing him with VMP. If a positive decision is made, then the head of the body executive power the subject of the Russian Federation in the field of healthcare issues a special accounting form for the patient “Coupon for the provision of medical care”. Currently, the “Coupon for the provision of VMP” is electronic, which means that all stages of receiving VMP by the patient, copies of extracts and examination results are recorded in the electronic account, and the stages of obtaining VMP can be tracked on the Internet, knowing the number of the “Voucher for the provision of VMP”.
After making a positive decision and issuing a “Coupon for the provision of VMP”, the commission of the regional health care authority sends medical documents patient to a specialized clinic that has the right to provide high-tech medical care in this profile. These documents are then reviewed by a special Commission for the selection of patients for the provision of high-tech medical care for this medical institution, for example Russian scientific center surgery named after acad. B.V. Petrovsky RAMS (hereinafter referred to as the Medical Institution Commission). The commission of a medical institution makes a decision on whether or not the patient has medical indications for hospitalization and provision of medical treatment based on the provision of a “Voucher for the provision of medical treatment” and an extract from medical documentation patient. The period for making a decision by the Commission of a medical institution should not exceed 10 days from the date of registration of the Voucher for the provision of medical treatment, and in case of face-to-face consultation of the patient - no more than three days.
If the commission makes a positive decision, then it sets a date for the patient’s hospitalization and informs the health authority of the region where the patient lives.
The patient is notified of the commission's decision, usually through the institution that referred him to further treatment, and issue a referral to a specific clinic indicating the date of hospitalization. If the patient belongs to preferential category, and did not refuse the package social services, he also has the right to free travel to the clinic and back at the expense of the Foundation social insurance. The patient is given a coupon for receiving VMP with the signature of an official.
On average, between the diagnosis by the attending physician and the hospitalization of the patient for surgery, it can take from several days to several months, depending on the need for urgent high-tech medical care, the queue on the waiting list, and the availability of available places in the medical institution where the region issues the referral.
There are married couples who cannot have children for certain reasons. In addition, a young family does not have the financial ability to pay for artificial insemination. Therefore, they are waiting for the quota for IVF.
Receipt
The IVF program is included in the state guarantee program, so it can be done for free. The federal quota involves a free procedure. Despite the fact that the state allocates money for thousands of operations every year, it is still not enough to meet the needs of people.
Along with the federal one, there is also a regional quota for free IVF. It is worth noting that not every region can afford such costs, since the procedure is expensive.
Approximate steps:
- in order to receive a quota for IVF, a couple must be diagnosed with infertility for unclear reasons, ineffective standard methods of conception, male factor;
- find out the queue for IVF according to quota. This is done in a antenatal clinic with a gynecologist;
- collect everything Required documents;
- pass all tests according to the list. The patient does this at her own expense. In addition, it is recommended to focus on tests that are taken in a certain order. There are really a lot of them, and the shelf life is quite short;
- submit documents to the medical commission for an IVF quota, an application from the expectant mother.
As soon as received positive result from the commission, the documents are transferred to another commission, where a decision is made that the right to assistance is granted. The patient is then placed on a waiting list for a quota.
With a voucher for the queue, the patient is sent to the appropriate clinic.
In the future, a clinic is selected where the procedure will be performed. Therefore, the next question will be how long to wait for the IVF quota.
Expectation
Quite often the procedure turns out to be more complicated. Many women claim that they are treated poorly, they have to wait a long time, and bureaucracy reigns everywhere. But such a test must be completed, because it is an expensive procedure. The state provides quotas to those people who really need it.
How long to wait for IVF quota? There is no definite answer, but certain dates are still foreseen. Tests are completed within two months. The first commission issues the result on the third day, and the next one makes a decision within ten days. Then the patient either gets in line or is turned away. Then it is impossible to guess how much you have to wait. Some wait several months, and some wait several years. This is influenced by the workload of the clinic.
As soon as a patient is added to the quota waiting list, she can monitor her queue via the Internet. The Ministry of Health provides such information on its website. When applying for a regional quota, auxiliary tests may be required, there are age restrictions, and you cannot choose a clinic yourself.
List of documents for IVF quota:
- decision of the medical commission;
- written statement from the patient;
- passport;
- referral for IVF according to the collected documentation;
- tests that confirm the diagnosis;
- the patient’s consent to the processing of personal data.
How many times is the IVF quota given? The law does not limit the number of times people can try. The attending physician decides how appropriate it is to make further attempts. But about five opportunities are allowed per year. It should be remembered that each time you need to take tests again and collect a list of documents.
Thus, free quota IVF is the inseparable right of any woman to motherhood. If the state gives guarantees for this, then it would be stupid not to use them. If a woman is denied such a right, the commission issues an extract indicating the reasons for the refusal. Naturally, not everything works out right away; you have to wait in line.
It’s downright difficult to get in line at a hospital for knee replacement for free. The surgical intervention itself costs a lot of money - at least fifty thousand rubles (plus a prosthesis!), and it’s a rare family in our country that can afford it. The state program makes it possible for some people in need to receive services without financial compensation, but to do this they will have to collect the necessary documents confirming the need for surgery, take tests and wait their turn. There are restrictions on the number of people accepted into the government program each year. How to be among the lucky ones?
General overview
The cost of knee replacement surgery is currently quite high - from 50,000 rubles only for the intervention itself, and, in addition, you will have to pay for the hospital stay used medications, all the studies that will be carried out, as well as the prosthesis. Many believe that the intervention is worth the money, because we are talking about an operation in which the damaged parts of the knee are successfully restored, and the person is able to move normally. The question is extremely relevant; many of our compatriots suffer from knee problems. For others, the cause is injury, for others it is age-related changes that have destroyed the joint tissue.
By waiting your turn under the quota for knee surgery, you can count on full compensation for the costs spent on surgery Money or partial refund. As can be seen from the responses of people who managed to get into the program, such an intervention restores the quality of life, and the state program gives hope to those whose financial capabilities would never allow them to accumulate such a significant amount on their own.
What to do?
Perhaps the most actual question- how to apply for a quota for knee replacement. Bureaucracy in our country is one of the important enemies, and we have to fight it almost every day, especially in a situation when it comes to medical services. The legislation establishes a list of sequential actions that allow you to gain access to the desired program. It all starts with a full medical examination at the place of residence. The doctor’s task is to correctly complete the documentation and write a conclusion indicating the need for knee replacement. Based on such paper, you can already count on being included in the queue.
The documentation on the basis of which knee arthroplasty is performed involves providing the medical institution with not only a medical opinion, but also a statement written personally by the patient, as well as transferring a copy of the passport, insurance policy, identification number. It will be necessary to conclude an agreement with the institution. If a person has disabled status, a document confirming this fact must be provided.
Appearances and passwords
The described documents must first be submitted to a commission assembled by local government agencies responsible for healthcare and social protection population. The participants' task is to determine to what extent a person needs urgent knee replacement and whether he should be given access to the program under a quota. The duration of consideration of the case is 10 days. If the outcome is positive, the documentation is automatically forwarded to the clinic responsible for providing the relevant medical services. 
The next stage of paperwork is the responsibility of the medical institution. Clinic managers study the received documentation and then decide how long to wait for the knee replacement quota. The facility usually already has a waiting list of patients who need such intervention. Data on a new person is analyzed to understand which date will be optimal for him. As the decision is made, information about it is officially transferred to the medical commission, which notifies the citizen who requested help about when and where endoprosthetics will be performed, and what additional measures need to be taken to prepare for the intervention.
So, where are knee replacements done on a quota basis? Medical institutions in Moscow are listed below:
- Urban clinical Hospital №67.
- KB MSMU im. Sechenov.
- Hospital named after N. Semashko.
- Medical and Surgical Center named after. N. Pirogova
About the timing. Who should
The laws establish that the waiting time in line is about a quarter of a year. In reality, the period increases significantly due to the high demand for participation in this program.
Currently, knee joint replacement is a quota for adults, children, and patients with cancer that negatively affects the capabilities of the musculoskeletal system. A person who is suffering from severe pain syndrome, and conservative treatment methods do not show effectiveness. Those who have already received a prosthesis, but it has worn out or collapsed completely or partially, have certain opportunities. You should also try to get in line if a prosthesis was previously placed, but this area is inflamed.
There are certain opportunities for knee replacement under a quota for those who have suffered a fracture or experienced unsuccessful surgery. If the situation is complicated by rheumatism, arthrosis and other similar pathologies, the limbs are susceptible to destructive changes, you need to try to submit documents to be included in the queue.
Is it possible or not?
In some cases, knee replacement is not carried out under a quota (or without it, on a general basis). This applies to situations where doctors identify contraindications to intervention. In particular, a ban on surgery is established for patients suffering from cardiac disorders or vascular diseases, problems in the functioning of the nervous system. Surgery should not be performed on a person with diabetes. 
In some cases, the indications are absolute, sometimes temporary. In each individual option, doctors tell you exactly why knee replacement is currently not possible under the quota, and also tell you whether the condition will change over time. There is a possibility that the operation will be allowed once the person’s position has stabilized, when the risk of negative outcomes is reduced. Good example: when stabilizing blood glucose levels with diabetes mellitus surgery can be performed.
What about the money?
According to reviews, knee replacement is an operation for which it is not easy to calculate how large the costs will be. This largely depends on the hospital chosen by the medical commission. If this government agency, then in most cases payment is due only for the prosthesis installed on the patient. If the choice fell on a private owner, then you need to pay for the intervention, and for the drugs and prosthesis used, and for being in the ward. Often the amount depends on the qualifications of the doctor performing the intervention.
Another important point related to financial aspects mentioned in reviews of knee replacement: the price of the prostheses used by doctors varies quite a lot. If this product is made in our country, it will cost relatively cheap, but imported models are many times more expensive. Additionally, the increase in price may be explained by special types of examination, if any are prescribed to the patient.
Will I be on the list?
Currently, the quota program involves providing the opportunity to receive relatively inexpensive medical care only to a strictly limited number of patients. From year to year, everyone turns to medical institutions more people in need of urgent surgery, but only a small percentage receive access to the government program. 
Usually quotas are distributed at the beginning of the year. If the request, for example, to replace the meniscus of the knee joint was later, you will have to wait. As a rule, this lasts for long time. There is a possibility that someone who has already been allocated a quota will refuse the operation. This doesn't happen often, but it is possible. Such an event somewhat shortens the waiting period for those who are in line after the refusenik.
What to do?
Two aspects are quite relevant for many: deadlines and which knee joints are placed according to the quota. The first one is clear: not everyone has the opportunity to wait their turn. If the approximate waiting period is years, during this time organic tissues can be destroyed very much, and the person himself will completely lose the ability to move. In such a situation, many try to find an alternative option, looking for funds to pay for the operation themselves. Timely medical care significantly increases the chances of restoring quality of life.
The second aspect is related to the prostheses that will be installed. It is usually assumed that those who go to the clinic at their own expense have a choice. People who get an appointment under a quota can only rely on those prostheses that are currently available in the institution. Of course, this is in any case better than nothing, especially for patients who objectively do not have the opportunity to pay for an operation that allows them to choose what and how to perform it. At the same time, no one can guarantee that at the right time, the doctors of the institution will actually have the best and most modern prostheses.
To find out the current legal standards regarding the issue under consideration, you should study the order issued in 2013 by the Ministry of Health, issued under number 565n. It indicates all the features of the provision of quotas, as well as a list of persons eligible to participate in the program. Additional official information is also contained in the government decree issued a year later. This document was published under number 1273. It also discusses the features of inclusion in the waiting list, possible diagnoses, with which you can get to the clinic for free (or partially free).
How to save money?
If you cannot find out for yourself how knee replacement surgery works under a quota, and you need to carry out the event entirely at your own expense, you can take advantage of several opportunities to reduce the cost of the event. The cheapest way available to our compatriots is to contact the government surgical clinic. In this case, you will not have to pay for hospital and surgical services - these amounts are covered by the insurance policy, which mandatory should be available to all citizens of the country. But the cost of the prosthesis will have to be reimbursed. 
Sometimes the situation develops in such a way that the operation is required very urgently, while the person simply does not have the opportunity to collect all the documentation required by the rules. State clinic does not always have the right to accept such a patient, so the risk of refusal is high free help. If the circumstances are this way, the only option is to use the services of a private organization, where you will have to pay both the price of the prosthesis and the costs of the operation.
Disability and some features
The rehabilitation program after knee replacement, in accordance with current legislation, is intended for patients who have become disabled precisely due to the disease for which they were referred for prosthetics. IPR allows you to slightly reduce the financial costs associated with surgical intervention. The federal budget undertakes to reimburse the cost of prostheses if they were secured by rights that came into force before the beginning of 2015. It does not matter in what year the intervention itself will be carried out - in 2018 or later. True, there is also a subtle point: the budget is ready to provide only 160,000 rubles; if the price of the prosthesis is higher, you will have to pay extra on your own.
If the patient entered the rehabilitation program after knee replacement after the end of 2014, then the prostheses are installed in accordance with the Compulsory Medical Insurance, and are guided by the decree issued under number 1776, signed by the government of the country. It contains full list funds that the budget can provide to disabled people, and endoprostheses are not included in it. Through the IPR, you can gain access to other rehabilitation devices - crutches, personal hygiene products, etc. At the same time, lawyers point out that many aspects are still not clearly regulated by laws, so it is likely that at the stage of reimbursement of expenses you will have to make a lot of effort to defend your interests.
Help is needed!
As experts note, in order to learn from your own experience how a knee replacement operation goes, without going broke and not waiting for several years, it is best to try to take advantage of the assistance of a charitable foundation. Currently there are several operating public organizations ready to help raise funds for surgery.
Price of dentures: what to expect
The most inexpensive option is cement. This design will cost from 120,000 rubles. Systems without cement will cost 45,000 more. 
From 130,000 rub. the price for prostheses created on the basis of metal and polyethylene begins. From 170,000 rub. and completely metal products and those where metal is in contact with ceramics are more expensive.
What's in the future?
The prices are, of course, terrifying, but there is one aspect that scares many even more: the service life of the prosthesis. Modern systems- this is not eternal help. As the years pass, they gradually deteriorate. The service life is determined by several parameters. One of the most important is the method of attaching the artificial system to bone tissue. In some cases, the components of the prosthesis are literally driven into the bone, and gradually the objects grow together. In medicine this is called osseointegration. When using this technique, the joint elements are firmly fixed, so the system will last quite a long time.
This technique is not always feasible. Often, the quality of the bone simply does not allow for such prosthetics, but there may be other reasons. An alternative option is the use of bone cement, that is, a hardening mass that allows you to quickly fix the prosthesis.
Friction pair
This parameter of the prosthesis directly determines the length of its service life and the effect on the patient’s organic tissues. In fact, a joint is a joint whose components rub against each other. If in technology the process is smoothed out by the presence of lubricant, then in the human body there is none, so the components wear out significantly over time. The degree of wear is directly related to the survival of the joint. It is determined by the materials used and the number of movements made by a person.
In order for the joint to live longer, it is necessary to install systems with the most effective friction parameters, as well as reduce the number of motion cycles. The longest wear periods are typical for systems that use ceramics, but the price for such prostheses is the highest.
What to choose?
Not every material is suitable for a particular patient. In some cases, polyethylene is the most profitable option; for others, ceramics will be the optimal solution. Sometimes doctors may recommend using metal prostheses. To choose best option, you should seek advice from an experienced doctor. Only a qualified specialist can evaluate all the positive and negative aspects of different types of prosthesis in relation to a person’s specific situation, on the basis of which a reasonable decision will be made - both in terms of quality and financial investment. 
This is interesting
Just a few years ago, there were only five types of prostheses. Currently, about seven dozen species are used in European clinics. This allows you to choose the best option, taking into account age, gender, and body type. Having access to the latest technologies, you can truly regain your quality of life with surgical intervention performed in a timely and professional manner.
On March 31, we had a consultation with a doctor at the Sechenov Coloproctology Clinic, where they took a package of documents from us to obtain a quota for surgery (VMP)..
Today, April 10, we decided to call to clarify what and how, or rather when, but our documents did not arrive in Arkhangelsk, and the clinic replied that the documents were transferred to their quota department and wait for them to call you back, the phone number is neither the doctor nor this they don't give department...
Please tell me who has encountered the problem of receiving a quota and how long they waited for it.
- Like
- I do not like
We were told that if Moscow agrees to treatment, then a quota in Krasnodar will be issued to us within a week.
Be sure to call them, if you don’t keep track of the documents, then this will all drag on.
How to get a quota for surgery and treatment in 2018
The treatment of some diseases is so complex and expensive that citizens are not able to pay for it and organize it themselves. But every citizen Russian Federation has guarantees from the state written in the Basic Law. They are ensured by quotas for specialized medical services.
You just need to know how to get a quota for treatment in 2018. This is a complex process regulated by law.
What is a quota and who is eligible for it?
It is necessary to proceed from the fact that certain types of treatment (surgical intervention) are provided only by health care institutions that are provided with:
- specialized equipment;
- highly professional personnel.
This means that such clinics receive additional funding for development. It is allocated from the state budget so that doctors can save citizens in especially difficult situations. There are not many such hospitals yet.
If you understand this, then it will not be difficult to understand how to get a quota for an operation. All quota issues are dealt with only by government bodies. Each stage is embedded in regulatory framework. Deviation from compliance with the law in this case is unacceptable.
Thus, a quota is the allocation of state support to people in need special treatment, within the framework of the Generally Mandatory health insurance(OMS).
The Ministry of Health of the Russian Federation determines the lists:
- medical institutions treating illnesses;
- diseases for which quotas are provided.
The legislative framework
A number of government documents fully describe the process of allocating and using quotas. These include:
- regulations guaranteeing free medical care to citizens of the country;
- Federal Law No. 323. Its Article 34 precisely describes the process of issuing quotas, the conditions for the implementation of this state guarantee;
- orders of the Ministry of Health of the Russian Federation specifying the quota process.
Issues of financing medical care are the responsibility of this ministry. Only this government agency has the right to decide how many quotas will be provided to citizens this year and in which health care institutions they can be implemented. They issue relevant decrees regularly. Download to view and print
Do you need expert advice on this issue? Describe your problem and our lawyers will contact you as soon as possible.
Diseases subject to quotas
The state does not issue money to relieve a citizen of any illness. To obtain a quota, compelling reasons are required.
The Ministry of Health issues a document containing a list of diseases that can be treated at public expense. The list is extensive, it contains up to 140 ailments.
Here are some of them:
- Heart diseases for which surgical intervention (including repeated surgery) is indicated.
- Internal organ transplantation.
- Joint replacement, if endoprosthesis replacement is necessary.
- Neurosurgical intervention.
- In vitro fertilization (IVF).
- Treatment of severe hereditary diseases, including leukemia.
- Surgical intervention requiring specialized equipment, that is, high-tech medical care (HTMC):
- before our eyes;
- on the spine and so on.
The Ministry of Health of the Russian Federation determines the number of quotas for each institution that has the appropriate license. This means that the relevant clinic can only accept a certain number of patients for treatment at the expense of the budget.
The procedure for obtaining a preferential place in the clinic
The path to a medical facility that can cure is not easy. The patient will have to wait for a positive decision from three commissions. This procedure for obtaining a quota was established by the Ministry of Health of the Russian Federation.
There is a workaround. We'll describe it a little later. Any application for a quota should begin with the attending physician.
To receive preferential treatment, you must confirm the diagnosis. This may require paid tests and examinations. The patient will have to do them at his own expense.
The first commission is at the patient’s place of observation
The sequence for initiating receiving a quota is as follows:
- Contact your doctor and describe your intention.
- Get a referral from him if you need to undergo additional testing. Failure to do so will result in non-receipt of the quota.
- The doctor draws up a certificate indicating the following information:
- about the diagnosis;
- about treatment;
- about diagnostic measures;
- about general condition sick.
- The certificate is reviewed by a commission responsible for resolving quota issues created at the given medical institution.
- This body has three days to make a decision.
The attending doctor is responsible for the “candidate” for the quota. He cannot recommend to the commission a citizen who can do without VMP.
Decision of the first commission
If the patient needs specialized services, the hospital commission decides to forward the documents to the next authority - the regional health department. At this stage, a package of documents is formed, which includes:
- An extract from the minutes of the meeting with the rationale for the positive decision;
- A photocopy of the passport (or birth certificate if we are talking about a child under 14 years old);
- A statement that must include:
- registration address;
- passport details;
- citizenship;
- contact information;
- A copy of the OM C policy;
- Pension insurance policy;
- Insurance account information (in some cases);
- Data on examinations and analyzes (originals);
- An extract from the medical record with a detailed diagnosis (prepared by the doctor).
Consent required medical organization for the processing of personal data. For this purpose, another statement is being written.
Second stage of decision making
The regional-level commission includes five specialists. Its activities are supervised by the head of the relevant department. This body is given ten days to make a decision.
If a positive decision is made, this commission:
- determines the medical institution in which treatment will be carried out;
- sends a package of documents there;
- informs the applicant.
It is customary to choose a clinic located near the patient’s place of residence. However, not all hospitals are licensed to perform specialized operations. Consequently, a citizen may well be given a referral to another region or to a metropolitan institution.
The work of this body is recorded. The paper reflects the following data:
- basis for creating a commission of a constituent entity of the Russian Federation;
- specific composition of the sitting persons;
- information about the patient whose application has been reviewed;
- conclusion, which deciphers:
- complete data on the indications for the provision of a quota;
- diagnosis, including its code;
- reasons for referral to the clinic;
- the need for additional examination;
- grounds for refusal upon receipt of VMP.
The following are sent to the medical institution where the patient will receive VMP:
- voucher for the provision of medical treatment;
- copy of the protocol;
- medical information about human health.
The third stage is the final one
The medical institution chosen for treatment also has a quota commission. Having received the documents, she holds her own meeting, in which at least three people must take part.
- Examines the information provided to determine the possibility of providing the treatment necessary for the patient.
- Makes a decision on its provision.
- Defines specific deadlines.
- On this work he is given ten days.
The coupon, if used, is stored in this clinic. It is the basis for budgetary financing of treatment.
Thus, the decision to include a person in the quota program takes at least 23 days (the time for sending documentation should also be taken into account).
Features of quota services
Behind public funds only those are provided medical services, which cannot be obtained at your local hospital.
- surgical intervention;
- treatment.
Each type of assistance requires specialized equipment and appropriate training of specialists. That is, ordinary diseases are not subject to quotas.
Operation
This type of support is provided to people whose diagnosis matches the list of the Ministry of Health. They are sent to a clinic capable of performing the necessary manipulation. All treatment is provided to them free of charge.
Some citizens are also paid for travel to the place of assistance.
This type of service involves the use of high technology to get rid of the disease. This is an expensive procedure. All necessary expenses are covered by the budget.
However, to provide VMP, compelling medical reasons are necessary.
Treatment
This type of government support involves the purchase of expensive drugs that the patient himself is not able to pay for. Its order is determined Federal law No. 323 (Article 34). Concretizes the implementation into practice of the provisions of the specified normative act The Government of the Russian Federation with its regulations.
Women diagnosed with infertility are referred for this operation. In vitro fertilization is a high-cost and lengthy procedure.
Many women are unable to experience the joy of motherhood without such an operation. But referrals for IVF are given only to patients who have gone through a difficult preliminary period of examination and treatment.
Not all types of assistance in restoring health and preserving the life of a citizen of the Russian Federation are described. There are many ailments, almost all of them fall into one of the areas described medical technologies. But there are also exceptions.
How to reduce the time it takes to receive support
Often people do not have the opportunity to wait. Help is needed urgently.
It is not easy to speed up the decision-making process of three commissions.
In the first case, you can put “pressure” on the people responsible for allocating quotas:
- call them to find out about the progress of resolving the issue;
- go to meetings with managers;
- write letters and so on.
Efficiency this method doubtful. Only experienced specialists take part in the work of the commissions. These people themselves understand that delay is unacceptable.
The second option is to contact the clinic directly that provides the necessary services. To do this you need:
- collect a package of documents (described above);
- bring it to the hospital and write a statement on the spot.
Documents from the local hospital where the patient was initially diagnosed must be certified by:
Unfortunately, without complying with formalities, a clinic operating under quotas will not be able to provide assistance. This medical institution has yet to account for the use of budget funds.
We describe typical ways to resolve legal issues, but each case is unique and requires individual legal assistance.
To quickly resolve your problem, we recommend contacting qualified lawyers on our website.
Changes in 2018
Our experts monitor all changes in legislation to provide you with reliable information.
Quota for cancer treatment
Financing of the treatment of diseases that are considered deadly diseases is provided by the state. This “service” is called a quota for cancer treatment. It is provided to certain segments of the population for legally. But you should know that financial support from the state is not very large, and also requires some waiting for registration.
Quota for cancer treatment - what is it?
The funds allocated by the state are minimal. This factor is the most controversial; it causes a lot of conflicts when seeking help from a medical institution. Not many patients can afford expensive treatment, which forces them to apply for a special quota.
High-tech medical care is provided using complex and unique technologies. Qualified specialists undertake surgical interventions.
People who urgently need organ transplantation and patients suffering from cancer can get help. Many types of diseases cannot be eliminated in the CIS countries, which forces patients to go abroad for help.
Services included in the federal list are provided through direct funding. This happens using regional quotas, by calculating the required service taking into account its provision in a certain territory of the country. A fixed number of “shares” are allocated each year, which are often in short supply.
Quotas for oncological operations
The list of types of high-tech assistance includes:
- cardiac surgical interventions open type;
- organ transplantation;
- joint prosthetics;
- in vitro fertilization;
- neurosurgical profile of operations;
- elimination of oncology;
- surgical interventions of high complexity.
These are common types of interventions that have been complemented by 137 services to date. In total, there are about 22 profiles in the list. The list is revised annually and supplemented with new services. Medical intervention various types complexity is carried out by trained personnel using the latest equipment.
The number of “shares” is strictly limited. Moreover, they are distributed among all medical institutions. Information about their number is available from the Department of Health. Each medical institution has a special department that has the necessary information.
There are often situations when the “shares” run out and a person cannot receive help this year. In this case, you need to apply for information not to the clinic at your place of residence, but to other medical institutions. Perhaps there are still quotas left, if not, it is not recommended to despair.
A person must register and receive a coupon according to which he will be given a “share” after an indefinite period. As soon as quotas are available again, the patient will be able to use it on a first-come, first-served basis. If treatment is required urgently, it is provided for a fee. The funds spent will be returned by the health department after submitting certain documents.
How to get a quota for cancer treatment?
After diagnosis, the patient must take a referral from the doctor. Oncology treatment in many CIS countries is free. Having a quota is necessary if a complex operation is to be performed using high-tech equipment. Receiving a “share” is an opportunity to go through all stages of treatment for free without financial costs on the part of the cancer patient.
The decision to provide this type of care is made by the attending physician after examining the patient. To receive help, a specialist must draw up an extract from the medical history, support it with examination results, diagnosis and information about the course of treatment. Additionally, the current condition of the patient is described. You can get all the information from your local physician. For an initial examination, it is recommended to contact an oncologist. In this case, you will need a passport, insurance policy and the results of the previous examination (if available). Detailed extract from outpatient card is a mandatory document.
After receiving all the information, you need to prepare documentation. Mandatory documents include:
- patient's application for assistance;
- photocopy of passport;
- birth certificate (for children);
- photocopy of pension insurance (for pensioners);
- extract from the card.
If for some reason the information is insufficient, the patient is referred for further examination. Some specialized cancer centers can provide assistance in obtaining a quota. If there are no free “shares”, the person is given a coupon. It is important to monitor its status at all times. The decision on the possibility of receiving free medical care is made by a special body within 10 days. In some cases, help is not provided immediately. The patient is placed on a waiting list for hospitalization. Each coupon has its own number, and each person receives medical care in turn.
A quota for cancer treatment is a necessary “service”, without which it is difficult to independently eliminate severe tumor diseases and more.
comments 3
Good day. I’m from Pskov. They took documents from my father, who had lung cancer, threw them on the table and, looking as if they had to take money out of their pocket, said: “Go and wait. We’ll call.” That’s it. No explanation. How with a dying animal. A month has passed. What to do.
Write a complaint to the Russian Ministry of Health
On June 7, the patient was admitted to the emergency room with suspected acute pancreatitis, and on June 19 she was operated on to remove stage 3-4 pancreatic head cancer. The sick Muscovite was accordingly taken from her home to a Moscow hospital. They charged 90 thousand for the operation and they also say that if he survives, then 3 weeks of chemotherapy at 50 thousand a week. this is right?? Or are cancer patients still treated for free?
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The information on the site is presented for informational purposes only! It is not recommended to use the described methods and recipes for treating cancer on your own and without consulting a doctor!
- To receive a quota:
- - statement of treatment performed;
- - results of clinical diagnostic tests;
- - written appeal;
- - a copy of a passport or birth certificate, for children a copy of the passport of one of the parents or legal representative;
- - a copy of the compulsory medical insurance policy;
- - a copy of the pension insurance policy;
- - a copy of the insurance number of the individual personal account.
- To receive a coupon for free travel to the place of treatment:
- - compulsory health insurance policy;
- - copies of the first page and the registration page of your passport;
- - a document confirming the right to the benefit;
- - a referral from a medical institution signed by the city’s chief specialist in this profile.
- - visit a gynecologist;
- - passport;
- - compulsory medical insurance policy;
- - pension insurance certificate;
- - visit the committee for selecting patients for IVF;
- what documents are required to apply for a quota?
Since 2013, the IVF procedure has been included in the free medical care program through the allocation of funds from the Federal and Regional budgets.
Women diagnosed with:
- female infertility due to tubo-peritoneal factor;
- female infertility due to gynecological history;
- female infertility due to disruption of the body's endocrine system;
- female infertility due to partner infertility.
To obtain a quota, you must pass a special medical commission, which considers the feasibility of obtaining a quota. To do this you need to antenatal clinic at your place of registration, submit the following documents:
- personal, written application to receive IVF services;
- Identification documents: passport, birth certificate (copy);
- an extract from the medical history indicating the diagnosis;
- compulsory medical insurance policy (copy);
- insurance pension certificate (copy);
- email address, contact phone number.
If the members of the commission make a positive decision, then the documents are transferred to the Regional Ministry of Health within three days.
The Ministry of Health is reconsidering your application for a quota. If a positive decision is made, a “Voucher for VMP” is issued and submitted to the nearest medical Center, at the place of registration, who will carry out the IVF procedure.
Thus, the processing time for your documents will not exceed 2 weeks.
How long will I have to wait for a quota for joint replacement surgery?
The head of the Moscow Department of Health Alexey Khripun answers.
The number of endoprosthetics operations in Moscow is constantly increasing, because in general the amount of funding for high-tech medical care doubled last year. Therefore, the waiting time is reduced. It can last from 2-3 weeks to 2-3 months. This depends not only on the number of people in need of this operation, but also on the condition of the patient himself. In particular, the replacement operation hip joint often required by older people who likely have other chronic diseases. This means that they need additional examinations before surgery. Therefore, those who reproach us that patients wait a long time for help (allegedly there are not enough joints or doctors) simply do not understand the situation.
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