In accordance with Article 41 of the Constitution of the Russian Federation, every citizen has the right to health care and free medical care, оказываемую в гарантированном объеме без взимания платы в соответствии с Программой государственных гарантий бесплатного оказания гражданам медицинской помощи (hereinafter - Program), annually approved by the Government of the Russian Federation.
The main state sources of financing of the Program are the funds of the compulsory medical insurance system and budgetary funds.
On the basis of the Program, the constituent entities of the Russian Federation annually approve territorial programs of state guarantees of free medical care (further - territorial programs).
What You Shouldn't Pay For
In accordance with the legislation of the Russian Federation in the field of protecting the health of citizens, when providing medical care under the Program and territorial programs, they are not subject to payment at the expense of personal funds of citizens:
— оказание медицинских услуг;
— назначение и применение в стационарных условиях, in a day hospital, in the provision of medical care in emergency and urgent form of drugs for medical reasons:
a) included in the list of vital and essential medicines;
b) not included in the list of vital and essential drugs, in cases of their replacement due to individual intolerance, according to vital indications;
— назначение и применение медицинских изделий, blood components, medical nutrition, including specialized medical nutrition products for medical reasons;
— размещение в маломестных палатах (boxes) patients for medical and (or) epidemiological indications;
— для детей в возрасте до четырех лет создание условий пребывания в стационарных условиях, including provision of bed and meals, when one of the parents is together, other family member or other legal representative in a medical organization, а для ребенка старше указанного возраста — при наличии медицинских показаний;
— транспортные услуги при сопровождении медицинским работником пациента, being treated in a hospital, if it is necessary to conduct diagnostic studies for him in the absence of the possibility of their conduct by a medical organization, providing medical care.
Where to contact with questions and in case of violation of your rights to free medical care
On issues of free medical care and in case of violation of the rights of citizens to its provision, conflict resolution, including denial of medical care, collection of money for its provision, should contact:
— администрацию медицинской организации — к заведующему отделением, head of a medical organization;
— в офис страховой медицинской организации, including insurance representative, — очно или по телефону, the number of which is indicated in the insurance policy;
— территориальный орган управления здравоохранением и территориальный орган Росздравнадзора, territorial fund of obligatory medical insurance;
— общественные советы (organizations) for the protection of patients' rights under the state authority of the constituent entity of the Russian Federation in the field of health protection and under the territorial body of Roszdravnadzor;
— профессиональные некоммерческие медицинские и пациентские организации;
— федеральные органы власти и организации, including Ministry of Health of the Russian Federation, Federal Compulsory Medical Insurance Fund, Roszdravnadzor, etc.
What you should know about insurance representatives of medical insurance organizations
An insurance representative is an employee of an insurance medical organization, trained, representing your interests and providing your individual support in the provision of medical care, provided by law.
insurance representative:
— предоставляет Вам справочно-консультативную информацию, including the right to choose (substitutions) and order of choice (substitutions) insurance medical organization, medical organization and doctor, as well as the procedure for obtaining a compulsory medical insurance policy;
— информирует Вас о необходимости прохождения диспансеризации и опрашивает по результатам ее прохождения;
— консультирует Вас по вопросам оказания медицинской помощи;
— сообщает об условиях оказания медицинской помощи и наличии свободных мест для госпитализации в плановом порядке;
— помогает Вам подобрать медицинскую организацию, including specialized medical care;
— контролирует прохождение Вами диспансеризации;
— организует рассмотрение жалоб застрахованных граждан на качество и доступность оказания медицинской помощи.
Besides, You can contact the office of the insurance medical organization to the insurance representative when:
— отказе в записи на приём к врачу специалисту при наличии направления лечащего врача;
— нарушении предельных сроков ожидания медицинской помощи в плановой, urgent and emergency forms;
— отказе в бесплатном предоставлении лекарственных препаратов, medical devices, medical nutrition - all that, what is provided by the Program;
— ситуации, when you are asked to pay for those medical services, prescribed by your doctor for medical reasons. If you have already paid for medical services, Be sure to keep your receipt, sales receipts and contact the insurance medical organization, where you will be helped to establish the legitimacy of the collection of funds, and in case of illegality - to organize their compensation;
— иных случаях, when you think, that your rights are being violated.
be healthy!