MOSCOW, April 13 - PRIME, Natalia Karnova. The state will gradually reduce participation in the health insurance system, so it is likely that unemployed Russians who do not have benefits will still have to pay for compulsory health insurance policies (CHI) on their own. True, they will not be alone in this - to one degree or another, all over the world, both poor and rich, have to pay for medicine. Even in countries where health care is fully paid from the budget, citizens have to go abroad for treatment due to long waiting periods.

The mechanism of paid compulsory medical insurance will be implemented, only ambulance services will remain free

Opinions of experts and society on the idea of ​​obliging the unemployed to fully or partially pay for policies (CHI) differ diametrically. Some believe that the state and working citizens really should not bear the cost of treating the unemployed, others are sure that the innovation is "crude" and looks anti-social in its declared form, violating the rights of Russian citizens to medical care.

At present, 146.5 million Russians are insured in the CHI system, of which, according to various estimates, about 8-12 million people do not pay contributions to social funds (including the MHIF). There are also self-employed, the situation with which is ambiguous. Lawyers in private practice, notaries, arbitration managers and entrepreneurs often pay fees themselves. Categories such as nannies, nurses and tutors do not always do this.

WHAT IS INCLUDED IN CHI

To understand why this topic causes such a stormy response, you need to know how the CHI system works. Now almost every citizen of the Russian Federation has the right to medical care, but not "free", as many people think, but only under the CHI policy. The policy is issued free of charge, and the money for the maintenance of the medical infrastructure and payment for the medical care provided goes through medical insurance organizations from the Compulsory Medical Insurance Fund, where employers' contributions for their employees are transferred. Means for the treatment of the unemployed are directed from the regional budgets.

CHI provides almost the entire average statistically necessary volume of medical care, said Dmitry Kuznetsov, vice president of the All-Russian Union of Insurers (ARI), president of the Interregional Union of Medical Insurers. “Recently, many types of high-tech assistance have been loaded into the system, including ambulance, treatment of oncological diseases, which were previously paid from budget funds. Thanks to this person, who was brought in an ambulance, they will undergo an emergency operation, the necessary equipment is always availability. The waiting time for medical assistance has also been significantly reduced," he said.

Undoubtedly, the system needs to be improved. This also applies to concretization of the program and changes in the role of participants in the system.

VOLUNTARY INSURANCE

In parallel, there is a system of voluntary medical insurance (VHI), when a person who wishes to buy a policy from an insurance company that is valid in selected medical institutions. Almost all major insurers work under VHI programs. The scope of services depends on the price of the policy and the amount of insurance coverage - some include dentistry using the most modern materials and technologies, prosthetics, long-term treatment of severe diseases, rehabilitation (including outside the Russian Federation). There are policies for certain types of diseases. Policy prices start from one and a half thousand rubles a year, but this is a minimum program. Also, a VHI policy can be obtained "free of charge" if your company purchases insurance as part of corporate medical insurance.

"VHI is less regulated compared to CHI, built on the basis of classical insurance market mechanisms and has fully proved its worth. It offers more services, freedom of choice, faster access to specialists. In terms of income, VHI is already comparable to OSAGO and at the same time leads in the smallest number complaints from clients of insurance companies," Kuznetsov said. This suggests that the insurer is interested in providing fast and high-quality medical care, otherwise he risks losing a client. Medical service providers are also interested in being chosen for insurance medicine, so they are forced to improve the quality, he added.

According to the expert, in the future Russia should move even more towards an insurance model with a system management similar to VMI. But emergency assistance should be free. It is also necessary to preserve the network of state institutions. To date, the share of private providers of medical services is about 30% and this is quite a sufficient figure.

FOREIGN EXPERIENCE

The Russian medical insurance system can be safely called unique, just like any other insurance system is unique. Each country takes one of the schemes as a basis and, on its basis, develops its own model, taking into account the mentality, the level of economic development, the income of citizens and many other parameters.

At present, two main fundamentally different health care systems can be distinguished - state and insurance. Predominantly public insurance system in the UK. In many ways, it is built on the example of the model that was in the USSR. The main part of the funds comes from the state budget and is distributed from top to bottom along the management vertical. Centralized funding helps ensure quality and keep costs down. However, the choice of doctor or medical institution is limited, and the waiting time for the study can be endless.

“In England, they are justifiably proud of their “medicine of equal opportunity” created after the war. However, the long waiting times for many diagnostic and therapeutic procedures do not allow us to consider it ideal. As you know, citizens different countries choose Germany, the USA or Israel - countries with insurance models for financing healthcare," Kuznetsov said.

The insurance system with a different share of state regulation operates in such European countries as Germany, France, Holland, Austria, Belgium, Switzerland, some countries of Latin America and Japan. Funding comes through three channels: insurance premiums from the employer or payments from the income of entrepreneurs, earnings of workers - deductions from wages and state budget funds.

Each country has its own nuances. "France is satisfied with its CHI system, but at the same time, 90% of the country has a VHI policy, since their CHI system contains severe restrictions on the set of included services (specialists such as, for example, an oculist, are removed from the CHI) and is somewhat less perfect than ours - the insurers are several funds, divided according to professional criteria," the expert said.

A special subspecies of the insurance system - private - in the United States. There, medical insurance is a voluntary matter of citizens, often paid in full or in part by the employer. There is no state regulation in this area, and more than 80% of the population is covered by private medical insurance. State programs work for the poor, but it is difficult to get them, and they do not cover all the costs. The system was tried to improve by former US President Barack Obama. His Obamacare program made insurance mandatory. However, the new president - Donald Trump - canceled Obamacare, although there is no approved plan to replace it yet.

"It's all about the mentality: if our citizens need someone to take care of them, because "they are entitled to everything," then the Americans have the opposite. They opposed Obama's idea of ​​​​mandatory insurance - they say, when needed, then we will buy " Kuznetsov explained.

WHERE IS BETTER FOR THE POOR

The insurance system allows 80-90% of the population to receive qualified medical care. The pluses of experts include control over the quality of services provided by insurers, the minuses are the fact that low-income citizens do not always have equal opportunities for treatment.

Of course, it all depends on the specifics of each particular country. The largest volume of medical care at public expense is in the developed countries of Europe, as well as in Japan. So, in Italy, for any operation in a private or public clinic, a person does not need to pay a single euro. However, there is practically no completely free medicine anywhere. In the same China, where alternative medicine is also included in the CHI system, there are mandatory payments. For example, a patient or his relatives pay 10% of hospital services.

In Israel, each insured person in the system participates in co-financing (working people deduct a percentage of their salary, pensioners - a percentage of old-age benefits, disabled people - a percentage of disability benefits), but at the same time, their MHI policy even involves the provision of foreign assistance if necessary, Kuznetsov said. . In Switzerland, insurance medicine implies significant payments from the population, but if we compare it with our shadow payments, the amounts are comparable. In the US, even a "golden policy" purchased by a citizen covers only 90% of medical services. So, with some degree of probability, even the most wealthy will have to pay extra.

WHAT EXPECTS THE UNEMPLOYED

In this situation, sooner or later, Russians, for whom the employer does not pay contributions, will have to fully or partially pay for the CHI policy themselves, experts are sure. “I think that sooner or later, truly free medicine, like everywhere else abroad, will remain only at the level of emergency medical care. The state will pay for policies for privileged categories of the population, and the employer will pay for the rest, or the employee will have to buy the policy himself,” - says the director of the National Institute of Medical Law Yulia Pavlova.

David Melik-Guseinov, director of the Research Institute for Health Organization and Medical Management of the Moscow City Health Department, believes that discussion of the topic will raise acute questions that society may not be ready for. "Won't this lead to the fact that the unemployed and self-employed will be formally registered at 0.25 of the rate and will be registered as employed? The effect for collecting taxes in favor of the MHIF will be minimal," he wrote on his Facebook page.

The flat rate of taxation will also raise questions - everyone pays the same percentage, but in absolute terms, those who receive a higher salary may require special service conditions, the expert notes. Thus, the reform of the system of insurance medicine itself will continue, and the share of state participation in it will most likely decrease.

In this article, we will discuss getting a compulsory health insurance policy for a person who either does not work at all or works informally. In addition, we will consider how realistic the introduction of a bill that will deprive the unemployed of the OMS policy. But first, we will explain what a CHI policy is.

The OMS policy is a kind of paper, a certificate that guarantees you the receipt of absolutely free medical services in organizations that are accredited by the Russian Federation. In general, every citizen of the Russian Federation must have a compulsory medical insurance policy. As a rule, this document is issued through the company in which this citizen works. University students, pensioners and those who are not officially employed receive the OMS policy themselves. Let's now consider an algorithm of actions that will allow the unemployed to receive an OMS policy.

How to get a CHI policy for an unemployed person?

In order to obtain a compulsory medical insurance policy for an unemployed person, you must take a passport, SPS (pension insurance certificate) and a birth certificate. As you know, the legislation of the Russian Federation allows you to independently choose the insurance company that suits you best. Do not be lazy, read the information on the Internet and study the compulsory health insurance market. This will help you choose the right insurance company. It's easy to do: you go to the official website of the compulsory medical insurance fund, go to the menu "Territorial CHI funds" and click on the contour of the Russian Federation. Then you find your area on the map and click on it. If you did everything correctly, then all the addresses and phone numbers of the organizations necessary to obtain the OMS policy should be displayed on your screen. We dial the indicated phone number of the insurance company and ask the operator when we can come to draw up an OMS policy. Come at the appointed time, taking with you an identity document and SPS. If you are taking out a policy for a child who has not yet turned fourteen, then also bring a birth certificate. You fill out the official paper, which is provided to you by an employee of the insurance company. After you fill out the required document, an employee of the organization must issue you a so-called temporary certificate of compulsory health insurance. This certificate will be valid until you are issued an OMS policy. That is, according to this certificate, you will be able to receive qualified medical care, if necessary. By the way, you have a choice of two options for the OMS policy - classic paper or plastic. The carrier depends on your desire. Somewhere in three weeks or four weeks, you can call the insurance company - your policy will most likely have already been made. In theory, the insurance company should notify you that you need to collect the policy by e-mail or by phone, but this does not always happen. Here, in fact, is the algorithm of actions for those who are unemployed and want to get an OMS policy.

Will the unemployed be deprived of OMS policies?

Now let's move from the present to the future and try to answer the question, will the unemployed be deprived of mandatory health insurance policies? Indeed, it is not the first year that State Duma deputies have been proposing such a bill that would take away the possibility of free medicine from those who do not work or work, but not officially. Such an innovation is proposed by the party of United Russia, namely by Ildar Gilmutdinov, who submitted these changes to the MLA for general discussion. But the Ministry of Health Russian Federation answered that if such a bill is adopted, it will strictly contradict the Constitutional article number 41, which states that every citizen of the Russian Federation can count on free medical care from the state. Yes, almost every citizen of the Russian Federation now has an OMS medical policy, but not many can clearly answer for what purpose the insurance companies that issue these policies to the population work. And we will answer that insurance organizations that have the right to issue OMS policies also have the option of protecting the rights of customers, as well as assistance in choosing the necessary medical organization and specialists. If you read the laws on compulsory health insurance, you will find that the sphere of influence of insurance organizations is quite large. This includes the transfer of a client from one medical organization to another, and defending the interests of the patient in case of violation of his rights by medical institutions, and supporting the holding of medical consultations, and much more. All these functions are undoubtedly important for those who have an OMS policy. But not everyone will be able to give their hard-earned money for these seemingly mandatory options.

How to classify the unemployed?

But you must admit that in order to deprive the unemployed of the right to free healthcare, you must first determine who exactly fits this definition. After all, students and pensioners are also unemployed, but it would be wrong, to put it mildly, to withdraw OMS policies from them. Supporters of the aforementioned innovation want to remove from the Federal Law “on compulsory health insurance” the clause stating that the insured person may be officially unemployed. The exception is the employees of the Russian army. Now we will consider who, in the opinion of the deputies, should remain insured unemployed.

For Russian citizens, insurance under the compulsory medical insurance program provides protection in the event of insured events. The chances of getting help from medical professionals are the same for all citizens.

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Moreover, protection is carried out regardless of gender, reaching a certain age, permanent place of residence, actual social legal status.

Payments are made from financial resources that are collected from the insurer under the CHI system. It is regulated by the law "On Compulsory Medical Insurance", namely.

What does the policy give

The policy of compulsory health insurance gives the right to medical care without payment in medical institutions owned by the state.

It implements the constitutional right of a citizen of the country, concluded in obtaining it under the ongoing basic program of compulsory medical insurance, which is provided by medical institutions operating in the system and located throughout Russia.

The basic CHI program is specially designed for citizens who need medical support, regardless of the region.

It consists of mandatory types of medical services, the scope of which is established by the norms of the legislative acts in force in the country.

Medical services are provided by the permanent residence of citizens:

• city, district polyclinics general purpose, including dental;
• inpatient departments of district, city hospitals;
• trauma centers;
• oncological, dermatovenerological dispensaries;
• medical and diagnostic centers.

When citizens apply for help to medical workers, they must present the policy together with documents proving his identity.

The term of the policy ends at the time that falls on the termination of the contract or the end of the duration of its validity.

If the policy is lost, then its duplicate is issued, for which the insured person must submit an application to the appropriate authority. It indicates the circumstances under which the policy was lost.

Upon dismissal from work, the medical insurance policy must be handed over to the personnel department of the enterprise so that it can be returned to the insurer.

When changing permanent residence, the policy is transferred to the fund of the former place of residence, at the new address the insured person receives a new policy.

A medical insurance policy allows you to receive the following types of services:

• emergency medical assistance;
• pre-medical, primary medical, primary specialized care;
• outpatient care, consisting of a diagnostic examination, the appointment of procedures that contribute to the treatment of diseases directly in the clinic, in the hospital at the day hospital;
• inpatient care, which is carried out with the use of intensive care with round-the-clock medical supervision. It is necessary for the treatment of acute types of diseases, poisoning of the body with great intoxication, bodily injuries, in the event of an exacerbation of chronic diseases, when it is necessary to isolate a patient infected with epidemiological diseases;
• cure of the pathology of intrauterine gestation, resolution of the burden, complications due to abortion;
• production of hospitalization of patients registered according to the plan of polyclinics in order to carry out the next treatment, rehabilitation in inpatient departments of hospitals, at a day hospital.

Territorial programs operating in certain regions are also determined by the government. There may be a little more of them, but they should not exceed the number of basic federal programs.

Where can I get

The compulsory medical insurance policy is purchased at the medical insurance organization at the place of residence free of charge. The only condition is the requirement that the organization must be listed in the registry of the system and have a license.

If it is not available in the area where the applicant lives, he needs to contact the territorial CHI fund.

Citizens of foreign countries residing in the country are allowed to take out health insurance and receive free medical care.

In order to use the granted right, they need to apply to the CHI fund, but they must necessarily have a residence permit in the country temporarily for some time, registration at their actual place of residence or a passport with a residence permit.

For a stateless person, in order to insure under the compulsory medical insurance program, it is enough to present an identity card, where a note is made of temporary residence in the country, registration at the place of temporary residence is affixed.

If there is a need to obtain a medical insurance policy for a minor child, then you need to provide the indicated fund with a birth certificate, a passport of one of the parents or guardian, which will verify their identity.

How to get a CHI policy for a non-working person

Unemployed citizens can be insured, including children and pensioners, by concluding an agreement at the office of an insurance medical organization that serves their area of ​​\u200b\u200btheir permanent residence.

To obtain a policy for a non-working citizen, he needs to contact the territorial CHI fund, where he needs to fill out an application form of a unified form for obtaining a medical insurance policy.

For the first time, a citizen is issued a temporary certificate, which confirms the fact of registration of the policy. It provides the owner with all free medical services provided by the compulsory health insurance program.

A photo. Temporary certificate of compulsory medical insurance policy.

It is issued for a whole month during which the application is considered, the documents submitted for obtaining an insurance medical policy are studied, and a policy is made.

Usually, fund employees notify the readiness of the policy and tell you at what time it can be picked up. However, only citizens of the Federation have the right to be insured in this way.

A medical policy under the CHI insurance program is issued upon presentation of a passport or temporary identity card confirming the identity of the applicant. Pensioners must provide a pension certificate.

What documents are required

In order to obtain or reissue a compulsory medical insurance policy, you must first select a medical insurance organization suitable for the applicant, to which he must submit the required documents.

The order of the Ministry of Health and Social Development of the Russian Federation established the documents required for registration, depending on the age of the citizen.

These include:

• an application for a compulsory medical insurance policy, drawn up on a form with a unified form;
• passport of a citizen of the Russian Federation, proving the identity of the applicant;
• , denoted by SNILS.

Citizens in order to obtain a compulsory medical insurance policy who have not reached the age of majority, whose age is 14-18 years old, must add to the above documents the passport of one of the parents or guardian, if he is an orphan.

If the need arises for a minor child who is under 14 years old, a birth certificate is submitted in addition to the passport of the parent or guardian. Foreign citizens provide a passport, residence permit.

Legal advice:

1. Is the CHI policy valid after dismissal? Can an unemployed person be served in a polyclinic on it?

1.1. The CHI policy is now in no way tied to the place of work and continues to operate.

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1.2. There is no connection between work and the CHI policy. You can continue to heal.

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2. My uncle has a suspicion of oncology, he pees with blood. Doctors all in a row prescribe paid tests, the so-called. tumor markers. Now he is officially unemployed, part-time work is scanty. How legal is it? Why do we need a CHI policy at all?

2.1. It all depends on what tests are prescribed by doctors, as a general rule, medicine is free in accordance with the law of the Russian Federation, most of the tests can be data on the CHI policy. You can apply to the Health Department with a written application to clarify which services can be provided on a paid or free basis, for one request to check the legality of the actions of the medical institution in prescribing paid tests for you.

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3. I am a citizen of Russia. Permanently residing in Ukraine. Registration at the place of stay for 3 years in St. Petersburg? 59 years. Unemployed. Grave and how to get a compulsory medical insurance policy and do I have the right, the opportunity to be served at the clinic at the place of registration, district? Will the clinic refuse to register .. without an internal passport - only a foreign one and a certificate of registration at the place of stay (do I have the right to receive an internal passport)? Thanks in advance?

3.1. Since you are a citizen of the Russian Federation and have temporary registration, you need to apply to the Migration Department with an application for a passport. You also have the right to receive a compulsory medical insurance policy and be serviced at the district clinic at the place of residence.

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3.2. You not only have the right to obtain an internal passport, but you are also obliged to do so, because. you are a citizen of the Russian Federation And for living without a passport there will be a fine of 3 to 5,000 rubles. Liability under Art. 19.15 Administrative Code of the Russian Federation.

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4. Question on honey. services under the CHI policy for the unemployed. Does an unemployed person who is not officially registered with the Employment Center (the period of 1 year of stay at the labor exchange has ended) have the right to receive free honey. services under the CHI policy!?

4.1. Regardless of whether you are unemployed or employed, if you have a compulsory medical insurance policy, medical services should be provided free of charge in polyclinics. However, each region has its own list free services who are under the CHI policy.

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4.2. Alexey.
Yes, a non-working citizen has the right to receive free services under the CHI policy.

Federal Law "On the fundamentals of protecting the health of citizens in the Russian Federation" dated November 21, 2011 N 323-FZ.

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5. Can an unemployed person get insurance payment in case of an accident under the MHI policy? (broke the leg). Thanks!

5.1. Alas, if you are unemployed, you will not be able to receive any payments under the MHI policy. You had to stand at least at the labor exchange.

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6. I do not have a CHI policy. I work in the military. I slipped and broke my leg, not at the time of my service, I had a day off, I came to the clinic at my place of residence, the surgeon refused to apply a cast, referring to the fact that I am a military man and they do not pay for these services. I went to another city and only after I said that the unemployed man was put in plaster and put in the hospital. How to punish doctors and prove the illegality of the actions of the local clinic?

6.1. According to Article 11 of the Federal Law “On the Basics of Protecting the Health of Citizens in the Russian Federation”, emergency medical care is provided by a medical organization and a medical worker to a citizen without delay and free of charge. Refusal to provide it is not allowed. For violation of these requirements, medical organizations and medical workers are liable in accordance with the legislation of the Russian Federation.

If you are still faced with arbitrariness, file a complaint with the head doctor of the clinic at which the emergency room operates, or with the prosecutor's office. Or contact the Compulsory Medical Insurance Fund - federal, or territorial, or the territorial department of health.

I believe that a fracture is an emergency.

Regards, Mikhail.

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7. I do not have a CHI policy. I work in the military. He slipped and broke his leg, not at the time of service, it was a day off. I came to the clinic at the place of residence, the surgeon refused to apply plaster, referring to the fact that I am a military man and they do not pay for these services. I went to another city and only after I said that the unemployed man was put in plaster and put in the hospital. How to punish doctors and prove the illegality of the actions of the local clinic?

7.1. Contact the prosecutor's office and the health department of the municipal clinic with a complaint, since in your emergency you are required to provide medical assistance in any case, regardless of the availability of compulsory medical insurance.

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8. I do not have a CHI policy. I work in the military. I slipped and broke my leg, came to the clinic at the place of residence, the surgeon refused to apply a cast, referring to the fact that I am a military man and they do not pay for these services. I went to another city and only after I said that the unemployed man was put in plaster and put in the hospital. How to punish doctors and prove the illegality of the actions of the local clinic?

8.1. Indeed, the military is not insured under the CHI. All services provided in regular hospitals must be substantiated by referral in part. With the permission of the head of the department. The doctor's actions are legal.
You now need to write a report for an internal audit and receive monetary compensation. The life and health of a serviceman are insured. You were injured while on duty.

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8.2. How to punish doctors and prove the illegality of the actions of the local clinic?

You don't need to prove anything. File a complaint with the prosecutor's office and the regional health department.

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9. Is there any liability if you receive medical assistance under the MHI policy, being unemployed, and said that you were working?

9.1. There is no such responsibility in the law.

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10. At the moment I am unemployed, the contract was terminated on May 1, 2016. After 15 days on May 15, 2016 I got into an accident, I have injuries, I am in the hospital. Can I receive payments under the MHI policy due to temporary incapacity?

10.1. No you can not
GOOD LUCK TO YOU

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10.2. MHI provides only treatment, not payments

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11. At the moment I am unemployed, I have a compulsory health insurance policy, am I entitled to a lump sum payment at the birth of a child.

11.1. Put. Contact the social committee. residence protection.

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11.2. Marina Sergeevna! Yes, you can receive payment from the authorities social protection population. With the certificate that will be given to you at the maternity hospital, you will need to contact the social protection authority to apply for benefits and attach all required documents that you are required to.
Regards, Anna.

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11.3. This payment is due to everyone who gave birth to a child!
Whether you work or not doesn't matter.
You need to apply to the social protection authorities at the place of residence, taking with you your passport and the original birth certificate of the child.
You can also apply for child care allowance up to 1.5 years.

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12. When applying for a compulsory health insurance policy, I indicated that I was unemployed, but in fact I was a military man. What are the possible consequences.

12.1. There will be serious trouble in the service.

GOOD LUCK TO YOU

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13. I work under an employment contract, without social. package, the employer does not make any deductions for me. My salary is below the subsistence level, and I am simply not able to make any deductions for myself, I have a young child as a dependent. Now I need a CHI policy. Can I register it as unemployed or do I need to pay for it and how much?

13.1. Irina Vladimirovna!
In your case, it is better to conclude a formal employment contract. Or in court to recognize the fact of labor relations on the basis of testimonies.

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Consultation on your question

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14. I recently opened an individual entrepreneur. Do I need to change the Compulsory Medical Insurance Policy (I received it last year as an unemployed person and in another region)

14.1. You do not need to change your compulsory health insurance policy.

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15. The husband works in the police and wants to get a compulsory medical insurance policy in order to go to the hospital near the house! They say he has no right to the policy, only if he says that he is unemployed! If you draw up a policy in this way, then will he face any punishment if he says at the time of registration that he is unemployed and he will be given a policy?
Thanks.

15.1. yes you can do. I wish you good luck and all the best.

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16. I need to get a CHI policy, but I don't have a Moscow registration.
Where can I get such a policy in Moscow, being a citizen of the Russian Federation? Address and phone?
Temporarily unemployed.

16.1. In any health insurance organization at the place of your registration.

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17. How long can I use the CHI policy after dismissal? At the moment I am unemployed. Thanks.

17.1. The CHI policy is now not tied to the place of work. You can use it until its expiration date.

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18. I work as a seller - cashier, now I fell ill, and gave the policy for replacement, I was given a temporary certificate confirming the registration of the compulsory medical insurance policy, is sick leave paid to me according to this certificate or not? (before that, the policy was unemployed, studying) Please help!

18.1. Yes, they are required to pay, because the validity of the temporary certificate has not expired

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19. I work unofficially, and therefore my employer cannot issue a CHI policy for me. I need to see a doctor and get tested. Do I have the right to obtain a compulsory medical insurance policy from an insurance company at my place of residence? I called there, they told me that they could not issue a policy, since I receive income, and if I apply as unemployed, they will be prosecuted for fraud. Thanks in advance for your reply.

19.1. No one will be attracted for anything. Present your work book, in which there is no record of your work at the present time. And receive a policy at the place of residence

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20. My mother (she is 54 years old, unemployed) broke her arm and was admitted to the hospital. They demand money for an operation to insert a plate into the arm.
How can the compulsory medical insurance policy help her and can they do the operation for free?

20.1. Hope! The easiest way for you is to contact the insurance company that issued the policy and decide there whether the operation is paid or free. That's the only way. Good luck

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21. My husband at work (official registration) was denied a compulsory medical insurance policy, as well as the rest of the employees. They offered to go to the district clinic and get a policy at the place of registration as unemployed. Is it legal? How to proceed in such a case? What document can I refer to? Thank you in advance.

21.1. This is illegal.
Law of the Russian Federation No. 1499-1 of 06/28/1991 "On medical insurance of citizens in the Russian Federation"
Article 2 "The insured under compulsory health insurance are:
for the working population - enterprises, institutions, organizations..."
Article 9 The policyholder is obliged:
-conclude an MHI agreement with an insurance medical organization
- pay insurance premiums
etc."

Decree of the Government of St. Petersburg of December 30, 2004 N 2088
"On the Rules of Compulsory Medical Insurance of Citizens in St. Petersburg"

2.5. "Insurers for working citizens are legal
persons regardless of the form of ownership and legal form, and
also individuals recognized as payers of the unified social
tax (contribution) or other tax in the part calculated and paid in
compulsory health insurance funds in accordance with
legislation of the Russian Federation on taxes and fees".
Sincerely!

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22. A person came to work with us with a previously issued compulsory medical insurance policy as for the unemployed. The policy has not yet expired. What if he will be treated under the old policy, although we transfer the UST to the MHI for him or we need to issue him a new one from us?

22.1. As soon as the organization hires an employee within five days, they are required to issue a health insurance policy for him.

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23. Please advise how to resolve the current situation. The wife is not issued a policy of mandatory honey. insurance, because she is not registered as unemployed with the employment service. Since we live far from her place of registration (registration), she cannot register with the employment service, where she has to come to check in every day, and because of the long distance, this is simply impossible. Does the law protect a person who finds himself in such a situation, because every person has the right to compulsory health insurance, and therefore to free medical care? Is there a way out of this situation? Best regards, Sergei.

23.1. If the wife is a citizen of the Russian Federation, then she has the right to receive a policy at the place of her permanent registration, and receive assistance anywhere in the Russian Federation. Refusal to issue a policy may be appealed to the court in the form of a complaint against the actions of officials who violate the rights of citizens.

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23.2. it is not clear from your question who exactly refused to issue you a policy of compulsory medical insurance. In accordance with the Law "On Compulsory Medical Insurance", the insurers for compulsory medical insurance for the non-working population are the Councils of Ministers of the republics within the Russian Federation, government bodies of the autonomous region , autonomous districts, territories, regions, cities of Moscow and St. Petersburg, local administration. In connection with the above, I recommend that you apply for a policy at the District Administration at your place of residence. Law firm "GM Trust"

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24. I work in Moscow (4 months), but I am registered and live in the Moscow region. I know that while working in Moscow, the employer must issue me a compulsory medical insurance policy in exchange for my compulsory medical insurance policy near Moscow (which was issued to me when I was unemployed). The policy at the place of work has not yet been issued to me (the management explains this by the lack of an insurance contract with the insurance company). However, there was a situation when I fell ill and spent 4 days in the hospital. From work they demanded a certificate confirming my illness, I brought it. But they didn’t pay me for it, because. according to the law, only sick leave is paid, they have issued, as it were, "vacation at my expense." I am pregnant at the 6th month, the LCD requires me to have a compulsory medical insurance policy from work so that I can then receive benefits as an employee, and not as an unemployed person. I addressed this issue to the labor inspectorate, but they answered that this is a problem of our health care, and not the employer. Please help me, what do I need to do to correct the situation, where to turn, because soon I will be on maternity leave ... Yes, and there are no guarantees that there will be no problems with health, and I don’t know how to protect myself. Thank you in advance for your response.

24.1. Marina, apparently in the labor inspectorate, a complete idiot answered you like that! To insure the employee is the OBLIGATION of the employer! Try to contact the inspectorate again and present them with the following argument:

Basic rights and obligations of the employer

The employer is obliged:
comply with labor legislation and other regulatory legal acts containing labor law norms, local regulations, terms of the collective agreement, agreements and employment contracts;
provide employees with work stipulated by the employment contract;
ensure safety and working conditions in accordance with state regulatory requirements labor protection;
provide employees with equipment, tools, technical documentation and other means necessary for the performance of their labor duties;
provide workers with equal pay for work of equal value;
pay in full the wages due to employees within the time limits established in accordance with this Code, the collective agreement, internal labor regulations, labor contracts;
conduct collective negotiations, as well as conclude a collective agreement in the manner prescribed by this Code;
provide representatives of employees with complete and reliable information necessary for the conclusion of a collective agreement, agreement and control over their implementation;
to acquaint employees against signature with the adopted local regulations directly related to their work activities;
timely comply with the instructions of the federal executive body authorized to conduct state supervision and control over compliance with labor laws and other regulatory legal acts containing labor law norms, other federal executive bodies exercising the functions of control and supervision in the established field of activity, pay fines, imposed for violations of labor legislation and other regulatory legal acts containing labor law norms;
consider the submissions of the relevant trade union bodies, other representatives elected by the employees about the revealed violations of labor legislation and other acts containing labor law norms, take measures to eliminate the identified violations and report the measures taken to these bodies and representatives;
create conditions that ensure the participation of employees in the management of the organization in the forms provided for by this Code, other federal laws and the collective agreement;
provide for the everyday needs of employees related to the performance of their labor duties;
carry out MANDATORY social INSURANCE of employees in the manner prescribed by federal laws;
compensate for harm caused to employees in connection with the performance of their labor duties, as well as compensate for moral damage in the manner and on the terms established by this Code, other federal laws and other regulatory legal acts of the Russian Federation;
perform other duties stipulated by labor legislation and other regulatory legal acts containing labor law norms, a collective agreement, agreements, local regulations and labor contracts.
(Part two as amended by Federal Law No. 90-FZ of June 30, 2006)

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25. The question is: should a compulsory medical insurance policy be issued in Moscow if there is a temporary registration for 5 years (citizenship of the Russian Federation, permanent residence permit in Omsk), but in the absence of an old policy? There is no old policy, because they took it away when I quit in 2005. I didn’t work for a long time.
At the clinic they said that they needed an old policy, which had to be received after being fired at the place of permanent registration, having registered as unemployed, and without the old policy they couldn’t issue me a new one.
It is not possible to travel to draw up such a policy, since it will take a lot of time, and I work and it is financially difficult to travel.

25.1. The policy can be issued to you at work.

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What documents does an unemployed person need to obtain a policy? When contacting an insurance company or the Compulsory Medical Insurance Fund, an unemployed person must bring the following documents with him:

1. Identification.
2. SNILS (pension insurance).
3. Statement.

Previously, proof of residence in a particular city or region was required. At the moment, all these restrictions have been canceled, since the compulsory medical insurance policy extends co-operation throughout the entire territory of the Russian Federation. How long does it take to get a policy? Since it takes some time to issue a policy, immediately at the time of applying to the unemployed, a temporary certificate is issued, which is a replacement for the policy for the entire period while it is being prepared. Such a certificate contains information about who it belongs to and the date when it loses its validity.

How to get an OMS policy for a non-working person

However, although the policy entitles you to free treatment, there are a number of items that it does not cover and for which the client will have to pay out of pocket, such as outpatient medicines. The full list of such items is quite extensive.

• Consultations of specialists, medical examinations and other requests carried out not for medical necessity or in accordance with the requirements of the law, but on the private initiative of citizens.
• Medical service for private events.
• Therapeutic, preventive and diagnostic measures carried out anonymously, with the exception of AIDS testing.
• all diagnostic examinations and procedures, as well as manipulations, consultations and other examinations performed at home.

Obtaining a medical insurance policy for the unemployed

In addition, if you are nevertheless illegally forced to pay for services (say, there was no time to argue because of a crisis situation), it is possible to appeal this decision and return the money, but only if you have kept a check or receipt for payment. When do you need to change the CHI policy and how to do it? The compulsory medical insurance policy does not need to be changed when temporarily leaving for another city or even for a long business trip, however, if you change your permanent place of residence or want to switch to another insurance company, you will need to get a new policy.

To do this, simply contact the desired insurance company, having an identity document and SSOPS with you, if you have one. Please note that changing insurance companies is only allowed once per year. calendar year and takes place on the first of November, so the application must be submitted before this date.

Change of health insurance policy

For a stateless person, in order to insure under the compulsory medical insurance program, it is enough to present an identity card, where a note is made of temporary residence in the country, registration at the place of temporary residence is affixed. If there is a need to obtain a medical insurance policy for a minor child, then you need to provide the indicated fund with a birth certificate, a passport of one of the parents or guardian, which will verify their identity.

How to get a compulsory medical insurance policy for a non-working citizen Non-working citizens can be insured, including children and pensioners, by concluding an agreement at the office of an insurance medical organization that serves their area of ​​\u200b\u200btheir permanent residence.

Can I use the OMS policy if I do not work at all?

According to paragraph 5 of article 10 of the law on compulsory medical insurance, the following categories of non-working citizens belong to the insured persons: - children under 18 years of age; - pensioners, regardless of the basis for the appointment of a pension; — students of universities and colleges of full-time education; - officially unemployed, registered with the employment service; - a parent or guardian caring for a child under three years of age; - able-bodied citizens engaged in caring for disabled children, disabled people of group I, elderly people over 80 years old; - other citizens who do not work under an employment contract, with the exception of military personnel and persons equated to them. The deputies propose deleting the last line from this list.

The unemployed will be deprived of the OMS policy

Info

Important In general, every citizen of the Russian Federation must have a compulsory medical insurance policy. How to get an OMS policy for a non-working person The choice of an insurance company falls on the shoulders of the citizen himself and the choice of a particular company is not the responsibility of the insured person.

At the same time, it must be remembered that the policy received before 2011 is valid and it can be used until this document is changed. Attention In order to make a replacement or obtain a medical policy, you should visit the desired insurance company.

Employees who process policies will offer the citizen to fill out a standard application or draw it up themselves according to the documents provided. The application will indicate the desire of the client to receive the service in this particular insurance fund.

How to get a health insurance policy for the unemployed and without a residence permit

Where can I get the CHI policy? It is purchased at the medical insurance organization at the place of residence for free. The only condition is the requirement that the organization must be listed in the registry of the system and have a license.

If it is not available in the area where the applicant lives, he needs to contact the territorial CHI fund. Citizens of foreign countries residing in the country are allowed to take out health insurance and receive free medical care.
In order to use the granted right, they need to apply to the CHI fund, but they must necessarily have a residence permit in the country temporarily for some time, registration at their actual place of residence or a passport with a residence permit.
The term of the policy ends at the time that falls on the termination of the contract or the end of the duration of its validity. If the policy is lost, then its duplicate is issued, for which the insured person must submit an application to the appropriate authority.

Attention

It indicates the circumstances under which the policy was lost. Upon dismissal from work, the medical insurance policy must be handed over to the personnel department of the enterprise so that it can be returned to the insurer.

When changing permanent residence, the policy is transferred to the fund of the former place of residence, at the new address the insured person receives a new policy.
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Both sides of the card are copied. - A certificate issued by the employment center at the place of your permanent residence. Please note that this certificate is valid only for ten days from the date of issue. - In the absence of a work book, you must provide permission from the district administration at your place of permanent residence to issue a medical insurance policy.
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Attach copies of documents to your application. You can get a medical policy for the unemployed on the day of applying for thirty minutes. Related video Please note When you change your place of residence, the policy must be replaced.

From May 01, 2011, policies of a new type are put into circulation. They should be obtained by citizens whose policies have become unusable and require replacement.

And also to citizens who, for various reasons, did not previously have a policy. From 2014, the policy will be included in a single universal electronic card.
Also, the policy needs to be changed when changing the name or surname, and for this you will need to contact the insurance company personally, again taking your passport, a document confirming your status of unemployed and SSOPS with you. Replacing a compulsory medical insurance policy in accordance with the legislation of the Russian Federation should be free.

Would you like to learn more about the validity period of the CHI policy? Or read THIS article about applying for a VHI policy for a newborn. What is a new policy? The phrase “new policy” became synonymous with a grandiose state confusion when, in 2011, new form filling out CHI policies, and in 2014 – electronic policies.

Both are called new-type policies, but paper policies were valid until 2014 and are no longer valid at the moment.
How to get a health insurance policy for an unemployed person? Our customers ask us this every day. The legislation of the Russian Federation establishes a list of persons entitled to receive free medical care from the state within the framework of compulsory insurance.

Unemployed citizens, as well as those who work under an employment contract, are included in this list. Where can you get a policy without having a job? The company's insurance premiums are paid by the employer or local authorities, depending on whether the person is employed or not.

If you work, then your employer will be the insured, he also makes contributions to the Compulsory Medical Insurance Fund. For the unemployed, these deductions are made from the local budget.