In the modern world, more and more people are aware of the value of compulsory health insurance and prefer not to save money by refusing it. What is OMS?They call the system of social guarantees, which allow citizens to receive timely medical assistance. More details will be provided in this article.
What is OMS?
Why was the system of compulsory health insurance established? Its main goal is to provide citizens with timely assistance at the expense of accumulated funds. In addition to the occurrence of an insured event in the form of a disease, the CHI is also obliged to fund preventive measures.
What is OMS?This is an integral part of state insurance, which should provide citizens of the country with equal opportunities in obtaining medical care. The conditions for its provision are prescribed in special programs.
Who should have the MHI policy?
Under the laws of Russia, the policy must have the following persons:
- all citizens of the country;
- foreigners who temporarily or permanent
- stateless persons;
- those who have the right to receive medical assistance under the law "On Refugees".
Highly skilled stateless persons and members of their families are exempt from this obligation. This is regulated by the law "On the Legal Status of Foreigners in the Russian Federation."
Duration of the document
Citizens of the Russian Federation, as well as foreign stateless persons who reside permanently in the country, the insurance compulsory medical insurance company issues unlimited time. Those who are entitled to receive medical assistance under the Refugee Law are issued a document for the duration of their stay. Limitations on time are prescribed in the corresponding applications. Persons who are temporarily resident in the country can receive MHI for the period of validity of their registration.
Services that are provided to policyholders of compulsory health insurance
What does the new( OMS) policy give? The list of services is described below:
- choice of medical organization;
- free medicinal and medical care in a guaranteed volume in the event of an insured event;
- possibility of obtaining complete information on the types and volumes of services;
- protection of interests and rights;
- possibility of reimbursement of damage, which was caused to health in the provision of assistance;
- the choice of an insurance company;
- rendering assistance outside the queue( separate categories of citizens);
- choice of doctor( family and treating).
Free medical care
The state guarantees program fully tells about what is the MHI.Due to accumulated funds, the following assistance is rendered free of charge:
- Ambulance( exception - air ambulance evacuation).
- Preventive and primary health care.
- Assistance in the treatment of diseases included in the basic program.
In addition to the accumulated funds, the system of social guarantees functions at the expense of appropriations of the budgets of the subjects of Russia. Free assistance is provided:
- For all diseases according to the OMS program.
- to the Insured and uninsured persons.
- Specialized ambulance.
- For conditions and diseases outside the list, for example - tuberculosis, psychiatry, narcology, etc.
What diseases are included in the list of free medical care?
There is a list of diseases in which medicinal and medical care is provided. Here are the main of them:
- birth, pregnancy, abortion;
- of the endocrine system;
- infections, including parasitic;
- of the nervous system;
- metabolic disorders;
- diseases of the digestive system;
- chromosomal abnormalities;
- subcutaneous tissue, skin;
- disorders of the immune mechanism;
- diseases of the ears, eyes, etc.
Due to the allocation of budgets, free mental disorders, tuberculosis, sexually transmitted diseases, in particular AIDS and HIV, are treated free of charge. In addition to the above, the availability of the policy( which is OMS, discussed above) guarantees assistance in behavioral disorders during the use of psychoactive drugs. In order to identify signs of early dependence in minors, conduct preventive medical examinations.
Where to get the MHI policy?
In all regions of our country it is possible to obtain a MHI policy. A sample document is presented in this article. To date, there are 58 different insurance companies. There are both large organizations, whose branches are scattered throughout the country, and small ones that specialize in one subject. Typically, these companies have the same set of services, so there is no difference where OMC receive. Despite this, organizations compete with each other and lure customers. To do this, they create different ratings, promotions and offer their policyholders profitable bonuses. But in order to obtain the MHI policy it does not matter what the company will be. Conditions for obtaining the document are the same everywhere. When choosing an organization, people usually adhere to a geographical and territorial feature, that is, they go where they are closer. Some prefer to work with trusted offices, paying attention to advertising. The majority listens to the advice of friends and acquaintances. Often, employees of polyclinics and hospitals send clients to a certain office, but this is not prohibited by law, so you can safely choose any point of obtaining the MHI policy.
As the form of the policy of compulsory medical insurance looks, you need to know for sure. Carefully look at the sample placed in the article above. OMC is a sphere in which fraudulent schemes very often emerge today. Being armed with knowledge, you will not fall for the bait of intruders.
Documents for Obtaining the MHI Policy
To obtain a policy for persons under 14 years of age, you must provide:
- SCHILS( if any).
- Birth certificate.
- Documents certifying the identity of the legal representative of the child.
After the execution of 14 years, a passport is issued. Therefore, when obtaining a MHI policy, instead of a birth certificate, you must provide a document proving the identity of the applicant.
Foreign citizens who permanently live in the Russian Federation also receive a certain number of the MHI policy. To this end, they provide the following to the relevant insurance organization:
- residence permit;
- SUNS, if any;
- the document proving the identity of the foreigner( passport, etc.).
The same list of securities applies to people who permanently reside in Russia, but do not have citizenship. Legal representatives of the insured person must carry a passport and a power of attorney. The last document confirms their authority.
It is advisable to choose an organization for replacement or issuance of a policy from the list established by the regional CHI fund( Sberbank, Rossgostrakh, etc.).This information can be viewed on the official website or in other trusted sources. Individuals who are recognized as legally capable, that is, those who are already 18 years old, can submit their documents independently. Citizens who have not reached this age can apply to company offices only with legal representatives, that is, parents, relatives, etc. For example, if the mother wants to insure the child, the power of attorney is not needed. Guardians and direct relatives are direct legal representatives.
Before submitting documents for obtaining or replacing the policy, make a certified copy of the passport, SNILSa, etc. As a rule, employees require the provision of such a package of securities.
Very often you can find a temporary MHI policy. It is issued when the name is changed, etc. This document is valid for no more than a month from the moment it was received. The number of the MHI policy varies. The document immediately comes into legal force, that is, you can receive medical help on it without fear. The document is produced for about 30 days, after which the company's employees contact the insured by phone or e-mail. Requisites customers leave in their applications.
Modern companies provide such services as registration of MHI policies at home. Only people with disabilities can take advantage of this offer. All the detailed information about the schedules of the issuing offices and their addresses can be found on the websites of companies. An application for the production and replacement of documents is usually left on the phone.
If clients are not satisfied with the work of the company's employees, you can leave a written claim or an oral complaint against the management of the regional or federal office. The rules for compiling these documents are spelled out in special applications.
What do you need to know about the MHI policy?
- There are many offices in which it is possible to obtain a MHI policy. Sberbank, for example, issues a universal electronic card that can be used not only as a passport and a policy of CHI, but also a payment bank card, etc.
- In 2011, a single document document was created.
- An insured person can have only one MHI policy.
- The document necessarily contains contact information about the QMS.It also indicates the address and telephone number of the insurance organization.
- The company, in which the client plans to change the policy, should familiarize him with all the rules and conditions of social protection. The employee is obliged to tell in detail about what rights and duties the insured person has.
Thus, the MHI policy will allow you to receive timely medical assistance, so it is better to take care of its registration in advance.