Polis Oms rating of insurance companies. Choosing an insurance company by OMS, list and ratings. Differences between medical insurance organizations

Compulsory medical insurance is compulsory health insurance. With its help, absolutely every citizen of the Russian Federation has the right to restore their health completely free of charge. It is noteworthy that the main advantage of the program is to ensure equal conditions for receiving medical care for residents of different regions of the country.

In other words, the services that should be provided to citizens free of charge under the CHI do not depend on the place of registration of the population. But the quality of these services directly depends on the choice of the insurer. Consider how not to make a mistake with the choice and conclude a profitable contract.

It should be noted right away that the program involves the provision of the same services to citizens of the Russian Federation. But when choosing a suitable insurance company, you need to pay attention to the extent to which it can guarantee the coverage of the territory. This is the most important point, on which exactly where a person can receive the necessary medical care will directly depend. The differences are as follows:

• regional medical insurance organizations will be able to guarantee the provision of medical care only within the framework of the location of their own offices. For example, if there are no company offices in Krasnodar, then the person will not be able to receive medical care;
• in terms of cooperation, federal companies are more profitable, since they can provide qualified medical care throughout the entire Russian Federation. In other words, they do not and cannot have any obstacles, which is very convenient. Especially for people who have to travel often or are on business trips;
• it is easier for large companies to protect the rights of clients that have been violated. The same applies to issues related to the settlement of disputes that have arisen.

To make it easier for Russians to make the final choice, a special official website of the FFMS was created. This site contains a rating of insurance companies and all the necessary information about them. But the most important thing is that the page also has a section with reviews of real people who collaborated with such firms. After reviewing this information, it becomes much easier to choose the most suitable insurer.

How to avoid becoming a victim of scammers?

Insurance fraud is not uncommon. And therefore, Russians need to exercise maximum caution when signing a contract with an insurer, so that in the end they do not become another victim of deception. Remember that:

• every insurance company has a license. Before signing the contract, be sure to ask for a document proving that such a license has been obtained. This information can also be found on the MHIF page;
• companies never ask a customer to pay for a contract or a policy. This is a completely free service;
• the company always attaches a list of those medical serviceswhich will be carried out free of charge. If a representative requests payment for a printout of this list, he is a common scammer;
• a temporary policy is issued immediately after the conclusion of the contract with the company. Since the permanent is issued within 60 days. Therefore, no one can issue a permanent one right away. An exception is scammers;
• the list of documents required for obtaining insurance is clearly indicated in the regulatory documents. Only scammers can demand to present them with some additional papers.

TOP-10 insurance companies

Representatives of the official department insist that Russians should choose a company with which they will cooperate in the future, focusing on a special rating. It is he who will help protect against fraudsters and choose a bona fide insurer. This rating was formed based on data on the number of insured clients.

1. LLC "Rosgosstrakh-Medicine"
2. JSC "MASK MASK-M"
3. OJSC SK SOGAZ-Med
4. LLC "VTB MS"
5. LLC "Alfa Insurance MS"
6. OOO "VTB-Medicine"
7. LLC "RESO-MED"
8. LLC "Ingosstrakh-M"
9. JSC SMK "ASTRAMED-MS"
10. CJSC "Spasskie Vorota-M"

Moscow insurance companies

Residents of the capital can choose a suitable company using the list below:

1. "Health insurance"
2. Insurance company "UralSib"
3. "MAKS-M"
4. LLC "MEDSTRAKH"
5. "Spassky Gate - M"
6. "RESO-MED"
7. SOGAZ-Med
8. Ingosstrakh-M
9. Rosgosstrakh-Medicine

Change of insurance company

The state provides every citizen with the opportunity to renegotiate an insurance contract with another company in the future. This guarantees that if a person nevertheless made a mistake and entered into a contract that is unfavorable for him, he will be able to terminate it. Indeed, it sometimes happens that, having studied other market offers, a citizen finds something more attractive. And then it becomes necessary to renegotiate the contract. According to the current legislation, replacement of the insurance is possible only once per calendar year, not more often. But in some cases, exceptions can still be:

• moving - if a citizen has changed his place of registration, then he may think about concluding an agreement with another insurance company. This is especially true if cooperation was provided for with a regional organization;
• change of personal data - according to the law, a citizen of the Russian Federation can change his last name, first name and even, in some cases, patronymic. If this happens, then it is possible to renew the insurance contract;
• the closure of the insurer is an extremely undesirable event, but it does not threaten any losses for citizens, since they can immediately terminate the contract and conclude a new one.

In all of the above cases, a citizen can contact the company and conclude a new contract.

List of documents

For the company to be able to issue an insurance policy, the client must provide a certain package of documents. As mentioned above in the article, the law establishes a list of those documents that Russians must provide to the insurer. And it includes:

• application - it should be written according to the template provided by the company representative;
• passport (including national), residence permit, documents that confirm temporary registration;
• SNILS (if available).

Please note that individuals who have not yet determined their citizenship are required to present an identity document. Refugees, however, must submit a document confirming their status. Since minor children can be registered in this program, additional paperwork may be required. In this case, their birth certificate and parent's passport must be attached to the application.

Refusal to issue a policy: what to do?

By law, a company cannot refuse a citizen to issue a policy if all required documents... But if this happened, you should receive a written refusal from the company and then inform the MHIF about the incident. If no further measures are taken on this issue, then the only way out is to draw up a statement of claim.

Sometimes citizens receive a partial refusal. That is, the company refuses to include in the policy those medical services that are required by law. In this case, you must first file a claim. In it, of course, you should indicate the exact data of the company to which the citizen has claims. You can find them out in two ways:

• by the policy number on the FFOMS website;
• request for information in the CMO.

Once the data is received, you can submit a claim.

The quality of medical care in Russia depends on the efficiency of the medical insurance organization, which is the link between the territorial funds health insurance, medical institutions and consumers of insurance services. Every citizen of Russia has the right to choose and replace an insurance medical organization in the CHI system, which is enshrined in law. These companies have a lot in common, but there are also nuances that affect the ultimate attractiveness for a potential client.

General characteristics of medical insurance organizations

The employer acts as the insurer for working citizens, and the local administration for the unemployed. Self-employed persons, which include individual entrepreneurs, lawyers, farmers, etc., should independently decide the issue of concluding an insurance contract. If a citizen is not satisfied with the services provided by an insurance medical organization, then he has the right to conclude an agreement with another company. Each medical insurance organization:

• Works under a license for the provision of compulsory medical insurance services, carrying out measures to control the quality of medical care;
• Concludes model contracts with Territorial funds of compulsory medical insurance, medical institutions;
• Pays for medical services provided to insured persons by medical organizations at a single rate. It is approved for each subject of the Russian Federation;
• Works only in the field of compulsory or compulsory and supplementary medical insurance;
• Receives the same amount of funds from the Territorial Fund for one insured person;
• Has an authorized capital of 10 million rubles. (with additional provision of medicines - from 30 million rubles).

An insurance medical organization is obliged to protect the interests of insured citizens, including in court, filing claims against medical institutions for material compensation for physical or moral damage caused to the insured person through their fault. Medical insurance organizations advise and inform insured citizens about regulatory legal acts on compulsory health insurance.

Differences between medical insurance organizations

Equal conditions for the start of work of medical insurance organizations does not mean that they will function in the same way. Differences can be traced in the organization of work with a specific client. Companies that conclude contracts with large enterprises and institutions work more efficiently. Negative feedback from employees and constant complaints can lead to the termination of the insurance contract, which means - to the simultaneous loss of a large number of insured persons and funds. In the process of interaction between the insured citizen and the insurance medical organization, it is important how quickly it is possible to resolve controversial issues and conflicts: is there a possibility of round-the-clock communication with consultants, the territorial availability of the branch, the competence and ability of employees to adequately respond to complaints.

The difference can also be observed in the list of insurance services. When the company also carries out additional medical insurance, it is beneficial for it that the insured was satisfied with the service. In this case, there is a chance that the client will want to conclude an agreement on additional medical insurance, which will have a beneficial effect on the organization's budget. The number of clients also significantly affects the funds provided by the Territorial Fund, which are also spent on conducting medical examinations in response to complaints from insured persons. If the insurance company has more than 100 thousand clients, then the chance for a full expert judgment the quality of medical care is higher.

The level of customer awareness in each organization is different. An informal approach to the consulting work of employees of insurance companies allows the client to better navigate the list of free medical services, the rights and capabilities of the insured person. The client's complaint must be considered within a month (with a written application). When an insured person is denied the provision of services with a policy, the insurance company is obliged to respond within 3 days: take measures to eliminate the problem, and if they are not taken, then explain the reasons to the client in writing.

The largest insurance medical companies in Russia for 2017

In 2017 at insurance market there was a continuation of positive dynamics, although the growth rates decreased compared to 2016. According to the official statistics of the Central Bank of the Russian Federation, in the first quarter of 2017, 316 billion rubles of insurance premiums were collected for all types of insurance, which is 5.3% or 16 billion rubles more than in the same period of 2016. TOP-3 largest insurance medical companies according to RIA Rating, SOGAZ, Rosgosstrakh and MAKS-M are included.

Limited Liability Company "Rosgosstrakh-Medicine"

From 2011 to 2017, this company included several insurance medical organizations (Ikar, Ekofond, Lipetsk-Zdorovye), including the Closed Joint Stock Company Capital Medical Insurance. "Rosgosstrakh-medicine" was officially registered in 2002, today the authorized capital is 210 million rubles, it works only with policies compulsory medical insurance... The main office is located in Moscow, there are 42 regional branches, the total number of insured persons is more than 22 million. The company's employees provide consultations by telephone around the clock.

Closed Joint Stock Company "MAKS-M"

It has been operating since 1994, has representative offices in 24 constituent entities of the Russian Federation, authorized capital of 220 million rubles. About 18.5 million clients are insured, the company operates only in the field of compulsory medical insurance. The main office is located in the capital, there are 80 regional offices. There is a hot line and contact center... In 2017, the company acquired a full block of shares in the insurance company Astro-Volga-Med, which was one of the largest in the Volga region.

Joint Stock Company "IC" SOGAZ-Med "

It has been operating since 1998, serving 40 constituent entities of the Russian Federation, regional branches - 640. Authorized capital - 123 million rubles. The company's clients are about 18.8 million Russians, work is carried out in two directions: compulsory and voluntary health insurance. The consulting center is open 24/7. In 2003, Gazprommedstrakh became part of IC SOGAZ-Med JSC.

Conclusion

All insurance medical organizations in the Russian Federation operate under state licenses and receive funds from territorial funds, which take on the obligations of policyholders in the event of bankruptcy. The insured person has the right to change the insurance company if the quality of its services is unsatisfactory. The choice of the optimal company depends on a number of factors: the organization of work, the availability of information, the number of clients, etc.

How is the authenticity of the OMS policy carried out? Where can I get or renew my compulsory health insurance policy? Is it possible to issue an electronic compulsory medical insurance policy new sample online?

Good day, dear readers! Welcome to the HeatherBober website and insurance expert Denis Kuderin.

The topic of our article is the Compulsory Medical Insurance Policy (MHI). Such insurance is necessary for everyone who is not indifferent to their own health, so the material will be of interest to every reader.

And now - in detail on each item!

1. What is a compulsory medical insurance policy?

The system of unified health insurance was created by the state to support the health of citizens and their treatment in case of illness.

Compulsory medical insurance allows any resident of the Russian Federation, regardless of his status, income and age, to receive medical assistance in a regulated volume.

System compulsory insurance there is a form of social protection of the population that guarantees free services upon occurrence of insurance situations. The compulsory medical insurance policy is an official document confirming the right to receive qualified medical care by citizens.

The basic CHI program includes the following activities:

• diagnostic procedures;
• ambulatory treatment;
• hospital treatment;
• preventive care;
• vaccination;
• purchase of medicines at discounted prices;
• dispensary supervision of minors.

In addition to the above, the policy gives the right to compensate for damage caused to patients by medical institutions during therapy or diagnosis.

If a person does not have medical insurance, the clinic has the right to refuse assistance. Exceptions are emergencies (injuries, situations that directly threaten life).

Example

A patient who does not have a compulsory medical insurance policy was taken to the hospital in a state of acute renal failure. Physicians must stabilize the patient's status, but are not required to carry out further treatment of the underlying disease.

For children under one year old and pregnant women, doctors are obliged to provide free help without any policy. However, with insurance, patients will feel safer anyway.

Introduced in circulation since 2011 medical policy uniform sample... If earlier such a document was issued at the place of work, now it is necessary to obtain it yourself by contacting insurance organization.

The owner of the policy of a single sample has the right to choose the clinic to provide assistance himself. Now he is not tied to a residence permit, as before, and can carry the document with him when traveling across Russia. The OMS policy is valid in any region and point.

If a citizen was denied assistance in any clinic or provided services in an incomplete volume, he has the right to file a complaint with cHI fund or to the insurance company where the document was issued.

The activities of doctors and medical personnel are paid for by federal funds and deductions from municipal budgets. In some regions, the list of health services included in the core program may be expanded with additional allocations.

3. How to get a compulsory medical insurance policy - step by step instructions for beginners

It doesn't take long to get the policy. However, one should take a responsible approach to the choice of an insurance organization and to the very process of document registration.

People who are familiar with modern information technologies can obtain a policy online.

On the websites of many insurance companies, you can take out insurance without leaving your home. True, it is better to receive a ready-made document offline - it's more reliable this way.

Another good news for advanced policyholders: every citizen has the right to receive an electronic (plastic) insurance policy. It looks like bank card, and contains a microchip on which all information about the owner is recorded.

It is, of course, more convenient to have such a policy: you can always carry it with you in your wallet - it does not tear and does not take up much space.

Policies are issued in any region of the Russian Federation where there are branches of insurance organizations from the official list of the CHI fund. True, electronic cards are not issued everywhere yet, but I think the situation will change for the better in the next few years.

And now - a step-by-step guide to getting the document.

Step 1. Determine if you are an insured person

So, all citizens of the Russian Federation have the right to receive an insurance document, regardless of their age, employment and registration.

Persons with official refugee status, as well as foreigners living in Russia, can also be insured.

Step 2. Choose an insurance medical company

Often, citizens do not really think about which company to insure with, and choose an insurer on a territorial basis. Whose branch is closer to their place of residence, they go there.

This approach is logical, but not entirely correct. Insurance conditions in all companies are approximately the same, but the approach to issues of social and legal protection of clients may differ.

Experts advise to choose the most famous and reliable insurers from the list of organizations included in the official register of the CHI Fund. A complete list of health insurance companies is available on the fund's website.

Step 3. Collect the required package of documents

For citizens of the Russian Federation, two documents are enough to obtain insurance.

• passport;
• SNILS - pension certificate.

An application for insurance is attached to the documents.

Children under 14 years old will need a birth certificate. The law allows one parent to receive policies for the entire family. However, in this case, a written power of attorney from adult family members is required.

Foreigners, in addition to an identity card, must present a certificate of registration on the territory of Russia. Refugees will need documentary evidence of their status or a certificate from the migration center.

Step 4. Obtain an interim certificate

On the day of submission of the application, the insurer is obliged to issue a temporary certificate to the client. Such a document confirms that the policy is in the process of being issued.

The certificate allows you to receive the same amount of medical services that are provided for holders of full insurance. But remember that the temporary document is only valid for 30 days from the date of receipt.

The insurance of a single sample is done in just 30 days or a little less. Employees of the company must notify you of his readiness (unless, of course, you forgot to leave your phone number or e-mail in the application).

Step 5. Get a compulsory medical insurance policy of a single sample

The finished document is issued at the same office where you applied. The client is only required to sign the registration log.

After that, he receives a full-fledged document in his hands, giving the right to free treatment and prophylactic services in any state institution.

Citizens of the Russian Federation are issued a document once and for all. The policy has no limited validity period. Refugees, foreign nationals, stateless persons receive MHI insurance for the duration of their stay in the country or for the duration of the residence permit.

For more information, see the article "".

4. How and why is the compulsory medical insurance policy checked?

It happens that citizens who do not follow the news regarding health insurance fall for the tricks of scammers and buy a fake or written off policy for money.

There is another situation: the policy itself is genuine, but the insurance organization no longer exists (or its license has been revoked).

Such documents are not valid - of course, it is impossible to get free medical care using them.

How do you know which document you are holding - fake or real? There are several ways to do this.

1) Visual inspection

Genuine compulsory medical insurance policies, regardless of the organizations in which they were issued, have a single appearance.

• Full name of the owner;
• unique personal number;
• the name of the insurance company and its seal;
• special barcode.

The texture of the paper is special and has several degrees of protection. That is, if you have on hand a form printed on a printer, it is definitely a fake.

2) Check by number

The personal number is entered into a unified database: its authenticity can be verified online.

To do this, type the number into the appropriate column on the MHIF website and click on the "check" button. Checking by passport number and series is also available.

What to do if the policy is invalid? First of all - don't panic, enter the number again. Perhaps you are simply wrong.

If the document really turned out to be a fake, you will have to get the policy again. But this time, do not purchase the document from dubious insurers, but contact the companies included in the official register of the health insurance fund.

For clarity, watch the video on the topic of policy authentication.

The detailed material is also available to our readers in the corresponding publication.

5. Where to get a compulsory medical insurance policy - TOP-5 companies with the best insurance conditions

And now - a list of five Russian insurers with the best insurance conditions.

1) RESO-MED

A company operating in the health insurance industry since 1992. Member of the Presidium of the Interregional Union of Medical Insurers. In the regions it is represented by a network of branches. At the moment, more than 6 million citizens are under the protection of the organization. Included in the RESO insurance group.

2) Rosgosstrakh-Medicine

Subsidiary of Rosgosstrakh, the oldest Russian insurer. The company's motto: "we make insurance coverage even more reliable and affordable!"

According to statistics, every seventh owner of compulsory medical insurance in Russia received it at the branches of the Rosgosstrakh-Medicine company. The total number of clients insured under compulsory medical insurance is 21 million.

3) SOGAZ-Med

An insurance company with a high rating and branches in all cities of the Russian Federation. He is engaged in the design of both ordinary compulsory medical insurance policies and the issuance of electronic insurance documents. Here you can insure online and order delivery of the policy to your workplace.

The company pays great attention to protecting the rights of the insured. Representatives of the insurer are ready to assist clients in resolving disputes with medical organizations.

4) VTB Medical insurance

The company has been operating in the health insurance market for over 20 years. The number of insured clients is approaching 6 million. It is part of the VTB insurance group. It has a wide network of representative offices in many regions of Russia.

Provides legal support to insured citizens. Delivers policies free of charge to people with disabilities, large families or people who have issued at least 3 policies to one delivery address.

5) Ingosstrakh-M

Subdivision of the insurance group "Ingosstrakh". It has branches in 19 regions of the Russian Federation. It is included in the TOP-10 compulsory medical insurance insurers. Engaged in the prompt settlement of any conflict situations between insured and medical organizations.

Provides legal support in litigation. All clients are available around the clock free consultations regarding the company's services.

For the convenience of readers, the above companies are listed in the table:

№	Insurer	Reliability level	Benefits
1	"RESO-MED"	Tall	Almost a quarter of a century in the medical insurance market
2	Rosgosstrakh-Medicine	Highest	The most popular medical insurer in the Russian Federation
3	SOGAZ-Med	Tall	Help in protecting clients' rights
4	« VTB Medical insurance"	Tall	Free delivery of policies to privileged categories of citizens
5	Ingosstrakh-M	Highest	Legal support for policyholders

About and there are separate articles on the site.

6. How to restore the compulsory medical insurance policy in case of loss or damage to the document?

There are all sorts of situations in life - the policy can get lost, get wet, torn, become unusable.

To restore the document, you need to contact the same company where you received the insurance. You must have a passport (for children - a birth certificate) and SNILS. You write a statement and the staff will give you a temporary certificate.

If the document is lost, its number will be blocked so that unauthorized persons cannot exercise your right to medical assistance.

All citizens of the Russian Federation are insured in the CHI system, without exception. Foreigners permanently residing in Russia are eligible for an insurance policy.

The policyholders in the system of this type are:

• institutions;
• enterprises;
• directly the state.

Enterprises transfer 5.1% of the total amount of wages to the territorial or federal funds of the compulsory medical insurance. Health insurance for unemployed citizens is paid directly by the state.

The most important link in the CHI is special funds. They are non-profit organizations that accumulate all the money transfers to the health insurance system.

They ensure financial stability and, if necessary, carry out material support insurance companies.

Immediate oMS participants are commercial insurance companies. They are required to have an appropriate state license to carry out insurance activities.

They conclude contracts with medical institutions for the provision of services to their clients, issue medical policies, control the quality and timing of medical care.

Medical institutions are the final segment of compulsory medical insurance. Citizens of the Russian Federation apply to them to receive appropriate assistance. The presence of the policy of the described sample gives the full right to receive medical services free of charge.

CHI Law

Today, the basis for oMS actions is the Federal Law “On Compulsory Health Insurance in the Russian Federation”.

The main function of this law is to regulate the relationship of all participants in the compulsory health insurance system (insurers, policyholders, funds, government agencies).

It also determines the legal status of subjects and objects in the CHI. The basis for the adoption and operation of the law in question is the Constitution of the Russian Federation.

Complement the action of the Federal Law No. 326:

• the law of 21.11.11 "On the basics of health protection of citizens of the Russian Federation";
• the law of 16.07.99 "On the basics of compulsory medical insurance".

The relationship between the subjects of the CHI system is also regulated by various other provisions and acts of the regions of the Russian Federation. Each insured event is considered separately, on an individual basis.

Compliance with the law under consideration is primarily monitored by the federal and regional CHI fund.

Each organization has a special legal and legal department that performs the function of supervision in the field of compliance with the legislation in force in the territory of the Russian Federation.

What does the policy give

The compulsory medical insurance policy confirms that a citizen has the right to receive free medical care.

If available, the insured person has the right to contact the following institutions:

• the clinic to which the insured is assigned;
• traumatology;
• dentistry;
• oncology departments, dispensaries;
• hospitals participating in compulsory medical insurance.

Having a compulsory health insurance policy allows you to get almost any medical care without any financial costs.

This document is currently mandatory for submission to medical institution when contacting. If a compulsory medical insurance policy is missing for some reason, then an individual can receive medical care on a paid basis.

What does he look like

Today, the compulsory health insurance policy has a standard form. Moreover, its format does not depend on the services of which insurance company the citizen uses. The appearance depends only on the type of medical policy.

Reforms of the health insurance system have been carried out recently. It was in this connection that a new type of insurance policy was issued. It has the form plastic card, on the face of which there is an individual card number.

Invalid Displayed Gallery

On the back there is the following information:

• the signature of the policyholder;
• photo of the policyholder;
• validity;
• gender and date of birth.

A copy of the image is simply applied to the policy, it is not an EDS. Even a picture with a not very high quality can be used as a photo. The duration of the document is determined by many factors.

There is also another type of policy - temporary. It is issued for a period of 30 days in case of a situation when plastic policy withdrawn.

This happens if a person previously had no policy of the type in question, or it is being replaced. Upon the expiration of a thirty-day period from the date of receipt, the temporary policy ceases to be valid.

It itself is A5 paper and contains the following information:

• date of issue;
• the signature of the policyholder;
• name of the representative of the medical insurance organization.

Previously, old-style policies were in effect. They were in A3 format and contained information similar to that presented on temporary policy OMS.

Terms of an agreement

The terms of the compulsory medical insurance contract were approved by the Director of the Federal MHI Fund A.M. Taranov 03.10.03.

All documents of this type should be formed only taking into account this provision, not contradict it. Otherwise, this agreement may be considered partially invalid.

The document in question in mandatory contains points to avoid the occurrence of various kinds of conflicts, the boundaries of responsibility are indicated.

The section “Subject of the contract” stipulates the conditions under which the insurer provides its services to the policyholder. A certain amount is paid to the insurance company (insurance premium).

Based on this, when the insured event the company pays for its client to visit a medical institution.

This section denotes the object of insurance - the property interest of the client. That is, in fact, the OMS medical policy protects its owner, first of all, from financial damage. Also in this section the concept of an insured event is indicated.

Section " Sum insured, the order of its introduction ”explains in detail these two terms. The size of the insurance premium, the limit of liability, the procedure for paying the insurance premium and the moment of this operation are also indicated.

When issuing a standard policy OMS given there is no section - it is displayed in the agreement between the UK and the regional (federal) CHI fund. The section "Terms of the agreement" defines the duration of the agreement of the type in question.

The clause "rights and obligations of the parties" discloses the obligations arising between the policyholder and the insurer in the event of its conclusion.

The rights of the parties are also considered in maximum detail. The occurrence of serious violations of at least one clause is a serious reason for terminating the contract.

The insurance company must ensure the confidentiality of information regarding the policyholder. An exception is possible only in cases provided for by the current legislation of the Russian Federation.

The following information is confidential:

• the content of the contract, its form;
• the health status of the insured, all available cases of seeking medical care;
• personal data of the policyholder (place of residence, home phone number, etc.).

The section "Modification and termination of the agreement" lists situations when it is possible to make any amendments to the text of the document.

All cases when the contract can be terminated and the procedure for carrying out this process are listed. At the end of the contract, the details of the parties are indicated: actual and legal address, phone numbers.

Validity

Several years ago, different compulsory insurance policies were issued in different regions. That is why their validity period varies significantly. In 2011, a gradual transition to single policy compulsory health insurance.

Today policies of this typethat represent a plastic card, usually do not have an expiration date. The only exception is the issuance of a policy to a foreign citizen.

If an individual uses the old policy (today this is quite acceptable), then you can find out the expiration date of its validity directly on him.

This information is most often found at the back of the document. Previously, contracts for compulsory medical insurance policies were concluded most often for 12 months.

After that it was necessary to carry out their extension. The expiration of the policy is the basis for its replacement.

Required documents for registration

The list of documents required for issuing an OMI policy differs depending on the age, as well as the legal status of the person applying to the insurance company.

Children over 14 years old (citizens of the Russian Federation) must submit the following documents to the UK to obtain a policy:

• identity card (birth certificate or other document);
• (if available).

If the papers for registration of a policy of the corresponding sample are provided by a parent, guardian, then a passport or other identity document is required.

If the policy is issued by relatives, then they are required to present:

• identification;
• a document allowing registration as an insured person (power of attorney).

Citizens of the Russian Federation under the age of 18, but overcame the age threshold of 14:

• temporary identity card or passport;
• SNILS (if already available);
• identity card of the representative of the insured person;
• a power of attorney allowing registration (if the representative is a grandmother or grandfather);
• representative's identity card.

Persons who have reached the age of 18:

• identity document or passport;
• SNILS.

Refugees who can legally become members of the health insurance system (the Law on Refugees) are required to provide:

• petition;
• certificate of the corresponding sample;
• an appeal against a court decision to revoke refugee status with the FMS;
• document confirming the receipt of a temporary asylum.

For individualswho do not have permanent citizenship, but possess real estate, a residence permit:

• passport of a foreign citizen;
• SNILS (if available);
• residence.

Individuals who do not have citizenship (refugees or otherwise) require the following documents to participate in the CHI:

• identity card and document confirming the absence of citizenship;
• SNILS (if available);
• residence.

In the absence of any document, obtaining an insurance policy becomes simply impossible.

Insurance premiums

Insurance premiums for compulsory medical insurance are payments transferred to the Federal Compulsory Medical Insurance Fund of the Russian Federation.

To date, payers of compulsory medical insurance contributions, according to Federal law "On compulsory health insurance" are:

• organizations;
• individual entrepreneurs;
• individuals who are not individual entrepreneurs (leading private practice).

The amount of insurance premiums itself is calculated and then paid depending on the type of organization, the tax system used, and other factors.

Contribution to federal fund OMS is 5.1% of the total fund wageswhich is paid to employees.

The duration of the settlement period for contributions of the type under consideration is one calendar year. The reporting periods are:

• quarter;
• half a year;
• nine month;
• twelve months.

Service register

The basic list of compulsory health insurance includes the following types of assistance:

• emergency medical;
• preventive;
• primary health care.

There is also a list of specialized services that are provided completely free of charge or on a preferential basis.

Under the compulsory health insurance policy, you can have an abortion, childbirth or the postpartum period free of charge.

The CHI system provides the following types of medical care:

• dental, oncological (the list is approved by the Healthcare Committee of the Russian Federation);
• implementation of preventive fluorographic studies in order to detect tuberculosis in the early stages;
• prevention of various diseases using special types of vaccines;
• preferential prosthetics, provision of medicines;
• inpatient, provided in special outpatient departments.

Dental treatment according to the policy

To date, the list of services provided under the compulsory medical insurance policy includes dental treatment.

Free of charge, if available, is carried out:

• initial examination and consultation (including for patients who are not able to move independently);
• preparation of a preventive disease map;
• treatment:
  • carious formations;
  • pulpitis;
  • periodontitis;
  • periodontic diseases;
  • diseases of the oral cavity, mucous membranes;

• treatment of injuries by surgical intervention, removal of foreign bodies from the canals of the teeth;
• removal of teeth and malignant tumors;
• operations on the soft tissues of the oral cavity;
• reduction of dislocations of various types.

For children under the age of 14, many polyclinics provide treatment:

• non-carious lesions of dental hard tissues;
• demineralization;
• orthodontics using special removable equipment.

What are the types

Today there are three types of compulsory medical insurance policy:

• a sheet of A5 paper with a special barcode on it;
• plastic card, which is a spiked electronic carrier;
• an electronic application with a number printed on the UEC (universal electronic card).

Earlier, until 2011, compulsory medical insurance policies of various formats were issued. Today this area of \u200b\u200binsurance is more streamlined.

Amendments were made to the legislation, allowing any citizen to choose the policy format independently.

Policies in in electronic format have one important advantage over paper media - there is no need to renew them.

A standard A5 policy can be obtained at any point of issue. To obtain a universal electronic card or a plastic card, you must visit a specialized issue point.

The legislation in force on the territory of the Russian Federation allows all citizens to receive medical care in full free of charge. Only in some cases will it be necessary to pay, but this applies only to very rare cases.

Most often, when visiting a clinic, you just need to provide the compulsory medical insurance policy to the registry - this will be enough.

Video: Protecting the rights of patients in the CHI system

The care and love of parents is the most important thing that a new baby needs in the first place. In an emergency, a child may need urgent medical care, so the best manifestation of parental care will be to issue a compulsory medical ...

Now basic health insurance in Russia has become compulsory. Every citizen must have a compulsory medical insurance policy in order to receive basic medical care. This product is offered by many companies, including VTB Insurance. Features of the policy in the company ...

The compulsory medical insurance is not just an innovation designed to fill the budgets of polyclinics and hospitals with contributions from organizations and citizens. This is one of the state's social programs, designed to provide guaranteed and free medical care to all citizens, albeit in the minimum amount established by the state. Insurance ...

The compulsory medical insurance policy is a mandatory document for every citizen. An insurance policy is required when contacting a medical institution. In the article we will answer the question "what to do if the insurance policy is lost?" Why you need insurance The name of the certificate - "compulsory health insurance policy" speaks for itself. For...

What is hidden by the abbreviation MHI, what are the features and conditions of health insurance, in which cases a citizen has the right to use an insurance policy - you should find the answer to such questions. This will allow you to take full advantage of your insurer rights and receive reimbursement from medical insurance ...

Insurance company MAKS was founded in March 1992. Over the years of its activity over a 20-year period, it has gained popularity for its impeccable work in the insurance market. The company is developing, improving its programs, increasing the volume of services rendered to the population. It consists of two Joint Stock Companies ...

In the insurance market Medical Insurance Company URALSIB was founded in 1994. She provides her services to Russian citizens, attracting clients to conclude a compulsory health insurance contract. Over the years, the company has become one of the leading companies, gaining popularity among the population. Developed ...

The compulsory medical insurance policy is absolutely free for all citizens of the Russian Federation. At the same time, its presence is mandatory when receiving medical care in state institutions. A person can have only one policy. Advantages of obtaining a policy in a company In 2013, OJSC AlfaStrakhovanie took the sixth place in the collection of insurance premiums ....

In many countries, they are gradually coming to the understanding that insurance medicine is a one hundred percent guarantee of receiving reliable, timely, high-quality and highly qualified medical care. Moreover, examinations and treatment will take place with the use of modern apparatus and equipment. System...

All Russian citizens must have compulsory health insurance policies in their hands. More than 60 insurance companies and 200 of their branches, including 13 leaders, compete in this market in the Russian Federation. These include the RESO group of companies. Features of the policy in the company When seeking medical help, it is important to be sure of ...