In today's world, more and more people realize the value of compulsory he alth insurance and prefer not to save money by waiving it. What is OMS? They call it a system of social guarantees that allow citizens to receive medical care in a timely manner. More information will be provided in this article.
What is CHI?
Why was the compulsory he alth insurance system created? Its main goal is to provide citizens with timely assistance at the expense of accumulated funds. In addition to the occurrence of an insured event in the form of a particular disease, the MHI is obliged to finance preventive measures.
What is CHI? This is an integral part of state insurance, which should provide citizens of the country with equal opportunities in obtaining medical care. The conditions for its provision are specified in special programs.
Who should have a CHI policy?
According to Russian law, the following persons must have a policy:
- all citizenscountry;
- foreigners who temporarily or permanently reside in Russia;
- stateless;
- those who qualify for he alth care under the Refugee Law.
Exempted from this obligation are highly qualified stateless specialists and members of their families. This is regulated by the Law "On the Legal Status of Foreigners in the Russian Federation".
Document validity period
Citizens of the Russian Federation, as well as foreign stateless persons permanently residing in the country, the insurance company issues CHI without time limits. For those who are en titled to receive medical care in accordance with the law "On Refugees", the document is issued for the period of stay. Time limits are specified in the respective applications. Persons who temporarily reside in the country can receive CHI for the duration of their registration.
Services provided to MHI policy holders
What does the (new) CHI policy give? The list of services is described below:
- choose a medical organization;
- free drug and medical care in a guaranteed amount in the event of an insured event;
- possibility to obtain full information about the types and volumes of services;
- protection of interests and rights;
- possibility of compensation for damage that was caused to he alth during the provision of assistance;
- choose an insurance medical organization;
- providing assistance out of turn (certain categories of citizens);
- doctor's choice(family and attending).
Free medical care
The program of state guarantees fully tells what CHI is. The following assistance is provided free of charge at the expense of the accumulated funds:
- Ambulance (except for air ambulance evacuation).
- Specialized.
- Preventive and primary he alth care.
- Help in the treatment of diseases included in the basic program.
In addition to the accumulated funds, the system of social guarantees operates at the expense of the budget allocations of the constituent entities of Russia. Assistance is provided free of charge:
- Palliative.
- For all diseases according to the CHI program.
- High-tech.
- Insured and uninsured.
- Specialized ambulance.
- For conditions and diseases outside the list, for example - tuberculosis, psychiatry, narcology, etc.
What diseases are included in the list of free medical care?
Special editions contain a list of diseases for which medicinal and medical care is provided. Here are the main ones:
- birth, pregnancy, abortion;
- diseases of the endocrine system;
- infections, including parasitic ones;
- diseases of the nervous system;
- metabolic disorders;
- diseases of the digestive system;
- chromosomal abnormalities;
- diseases of the subcutaneous tissue, skin;
- impaired immune mechanism;
- poisoning;
- injuries;
- diseases of the ears, eyes, etc.
Mental disorders, tuberculosis, sexually transmitted diseases, in particular AIDS and HIV, are treated free of charge at the expense of budget allocations. In addition to the above, the presence of a policy (what is compulsory medical insurance, was discussed above) guarantees the provision of assistance for behavioral disorders during the use of psychoactive drugs. In order to identify signs of early addiction in minors, preventive medical examinations are carried out.
Where can I get a CHI policy?
In all regions of our country, you can get a compulsory medical insurance policy. A sample document is provided in this article. Today there are 58 different insurance companies. There are both large organizations, whose branches are scattered throughout the country, and small ones that specialize in one subject. Typically, such companies have the same set of services, so there is no difference where to receive compulsory medical insurance. Despite this, organizations compete with each other and poach customers. To do this, they create various ratings, promotions and offer their policyholders lucrative bonuses. But to obtain a compulsory medical insurance policy, it does not matter what the company will be. The conditions for obtaining a document are the same everywhere. When choosing an organization, people usually adhere to a geographical and territorial feature, that is, they go where they are closer. Some prefer to work with trusted offices, paying attention to advertising. Most listen to the advice of friends and acquaintances. Often employees of clinics and hospitalssend clients to a specific office, but this is not prohibited by law, so you can safely choose any point of obtaining a compulsory medical insurance policy.
What does the mandatory he alth insurance policy form look like, you need to know for sure. Take a close look at the sample posted in the article above. OMS is an area in which fraudulent schemes very often pop up today. Armed with knowledge, you will not fall for the bait of intruders.
Documents for obtaining a CHI policy
To obtain a policy, persons under 14 must provide:
- SNILS (if available).
- Birth certificate.
- Identification documents of the child's legal representative.
After the age of 14, a passport is issued. Therefore, when receiving a compulsory medical insurance policy, instead of a birth certificate, you must provide an identity document of the applicant.
Foreign citizens who permanently live in the Russian Federation also receive a certain CHI policy number. To do this, they provide to the appropriate insurance organization:
- residence permit;
- SNILS, if any;
- identification document of a foreigner (passport, etc.).
The same list of papers applies to persons who permanently reside in Russia, but do not have citizenship. Legal representatives of the insured person must have a passport and a power of attorney. The last document confirms their authority.
It is advisable to choose an organization to replace or issue a policy from the list establishedTerritorial CHI fund (Sberbank, Rossgostrakh, etc.). This information can be found on the official website or other trusted sources. Persons recognized as capable, that is, those who are already 18 years old, can submit documents on their own. Citizens who have not reached this age can apply to the offices of companies only with legal representatives, that is, parents, relatives, etc. For example, if a mother wants to insure a child, then a power of attorney is not needed. Guardians and direct relatives are the direct legal representatives.
Before submitting documents for obtaining or replacing a policy, make certified copies of your passport, SNILS, etc. As a rule, employees require the provision of such a package of papers.
Very often you can find a temporary CHI policy. It is issued when changing the surname, etc. This document is valid for no more than a month from the date of its receipt. The CHI policy number is changing. The document immediately enters into force, that is, you can receive medical care on it without fear. The document is prepared in about 30 days, after which the company's employees contact the insured by phone or e-mail. Clients leave details in their applications.
Modern companies provide such a service as issuing compulsory medical insurance policies at home. Only people with disabilities can take advantage of this offer. All detailed information about the work schedules of distribution points and their addresses can be found on the companies' websites. An application for the production and replacement of documents, as a rule, is left byphone.
If customers are not satisfied with the work of the company's employees, you can leave a written claim or an oral complaint to the leadership of the regional or federal office. The rules for compiling these documents are written in special annexes.
What you need to know about the CHI policy?
- There are many offices where you can get a CHI policy. Sberbank, for example, issues a universal electronic card that can be used not only as a passport and compulsory medical insurance policy, but also as a payment bank card, etc.
- In 2011, a single sample document was created.
- An insured person can have only one CHI policy.
- The document must contain contact information about the CMO. It also contains the address and phone number of the insurance company.
- The company in which the client plans to change the policy must familiarize him with all the rules and conditions of social protection. The employee is obliged to tell in detail what rights and obligations the insured person has.
Thus, the compulsory medical insurance policy will allow you to receive medical care in a timely manner, so it is better to take care of its registration in advance.
