In accordance with Article 41 of the Constitution of the Russian Federation, every citizen has the right to health care and free medical care, provided in a guaranteed amount without charging a fee in accordance with the Program of State Guarantees of Free Provision of Medical Care to Citizens (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:
– provision of medical services;
– appointment and use in stationary conditions, 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;
– purpose and use of medical devices, blood components, medical nutrition, including specialized medical nutrition products for medical reasons;
- accommodation in small rooms (boxes) patients for medical and (or) epidemiological indications;
– for children under the age of four years, the creation of conditions for staying in stationary conditions, including provision of bed and meals, when one of the parents is together, other family member or other legal representative in a medical organization, and for a child older than the specified age - if there are medical indications;
– transport services when accompanied by a medical worker of the patient, 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:
— the administration of the medical organization — to the head of the department, head of a medical organization;
- to the office of the insurance medical organization, including insurance representative, - in person or by phone, the number of which is indicated in the insurance policy;
— territorial body of health management and territorial body of Roszdravnadzor, territorial fund of obligatory medical insurance;
- public councils (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;
— professional non-profit medical and patient organizations;
— federal authorities and organizations, 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.
- provides you with reference and advisory information, 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;
– informs you about the need to undergo a medical examination and asks you based on the results of its passage;
- Advise you on medical issues;
– informs about the conditions for the provision of medical care and the availability of vacant places for hospitalization in a planned manner;
- helps you choose a medical organization, including specialized medical care;
- supervises your medical examination;
– organizes consideration of complaints of insured citizens about the quality and availability of medical care.
Besides, You can contact the office of the insurance medical organization to the insurance representative when:
– refusal to make an appointment with a specialist doctor if there is a referral from the attending physician;
- Violation of the deadlines for waiting for medical care in the planned, urgent and emergency forms;
- refusal to provide free medicines, medical devices, medical nutrition - all that, what is provided by the Program;
- situations, 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;
- other cases, when you think, that your rights are being violated.
Decree of the Government of the Russian Federation dated 29.12.2022 № 2497 “On the Program of State Guarantees of Free Provision of Medical Care to Citizens in 2023 year and for the planned period 2024 and 2025 years”