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Medical insurance policy (CHI) is a document according to which the person in whose name it is issued has the opportunity to use medical services free of charge in most healthcare institutions. Medical assistance implies the implementation of a set of measures for the prevention and elimination of threats to life and health in relation to the CHI owner.
Who is eligible for the compulsory health insurance policy?
You must have a policy. There is no health insurance in many post-Soviet countries. The following categories of citizens can be owners of CHI:
- all persons who are citizens Russian Federation;
- foreign persons temporarily or permanently residing on the territory of the Russian Federation;
- persons without any citizenship;
- persons officially granted refugee status.
The issuance of an MHI policy and the provision of all the necessary services under it are not at all affected by such a circumstance as the presence or absence of a permanent job.
During what period can I use the CHI policy?
All persons, including foreigners permanently residing on the territory of the Russian Federation, receive a medical policy that has no time limits. Persons staying in the country temporarily have policies valid for the period of stay. This period is determined in accordance with the documents allowing to stay in the Russian Federation.
Where to get a medical policy?
By law, no fee is charged for the purchase of this policy. Where to get a medical policy? Their issuance is handled by the CMO (medical insurance organization). To obtain a policy in your name, you need to fill out an application, according to which a particular company is selected. The application is submitted to the organization personally or through representatives. If the latter are not close relatives, then a power of attorney issued by a notary will be required.
How to make a choice in favor of one or another SMO?
Everyone who has reached the age of majority, as well as persons over the age of 14 who are recognized as capable, on the basis of a list published by officials and available on the Internet, has the right to choose a certain insurance company.
For children and adolescents, this choice is made by their parents. For newborns, a temporary policy is issued in the HMOs in which the mothers are members. Such a document extends to the time before the issuance of a birth certificate by the registry office. After that, parents can change the organization, i.e. the child and his legal representatives are not required to be in the same CMO.
What documents need to be attached to the application?
Citizens of the Russian Federation who are not yet 14 years old, in order to receive a policy (mandatory medical insurance), must provide:
- passport or other document that confirms the identity of the parent;
- birth certificate of the child;
- pension insurance certificate - SNILS (if already issued).
Citizens of the Russian Federation who are 14 years of age or older, in order to obtain a medical policy, must:
- passport or temporary identification document;
- SNILS, if available.
Persons covered by the Refugee Law:
- a document confirming the status of a refugee;
- or evidence that a request for recognition of such status is pending;
- or a copy of the complaint to the FMS, where there is a mark on its acceptance by these bodies;
- or a document confirming the fact of granting temporary asylum within the Russian Federation.
Persons who are foreign citizens and permanently residing on the territory of Russia, in order to receive an insurance medical policy, must provide:
- a passport of a citizen of another country or another document that, according to international agreements, can be presented to establish identity;
- resident card;
- SNILS.
Persons who are foreign citizens and temporarily staying on the territory of the Russian Federation, in order to obtain an insurance medical policy, must:
- a passport issued by the country of which the person is a citizen, or another document capable of confirming the identity (it must contain a mark on temporary residence);
- SNILS.
Citizens who do not have any citizenship and permanently reside within the Russian Federation:
- identity document (in accordance with international agreements);
- resident card;
- SNILS.
Persons who do not have any citizenship and temporarily reside within Russia:
- a document capable, in accordance with international agreements, to confirm the identity, with an existing mark of temporary residence, or a document of the appropriate form, which is issued to a person who does not have citizenship and a document to confirm his identity;
- SNILS (if any).
An exceptional case of obtaining compulsory medical insurance by an uninsured person
There are cases when a person is admitted to a medical institution, who cannot be identified. Then this institution sends an application to the territorial fund to establish the identity of the insured person. The document states:
- estimated information about the person whose identification needs to be carried out: full name, date and place of birth and stay, gender, citizenship;
- information about the institution submitting the application;
- the full official name of the territorial fund.
The application is considered by the relevant authority within 5 days from the date of its receipt, and within three days the results of the verification must be sent back to the institution that made the request.
In what cases should the MHI policy be reissued?
The document should be reissued only when changes have been made to the information about the person in whose name the policy was issued. To do this, you need to notify the CMO, in which the citizen is a member. But this must be done no later than one month from the date of making changes to the relevant documents:
- birth certificate;
- the passport.
To carry out the procedure for reissuing an MHI policy, it is necessary to submit a special application for issuing a duplicate, providing the above documents in accordance with the situation. It is also possible to issue a duplicate in case of damage or loss of the policy.
It usually takes 30 days to issue each policy, and it does not matter if it is issued for the first time or repeatedly. And in return, the insured person is provided with a temporary policy, which retains the right to receive medical care in full.
additional information
The health insurance policy provides an opportunity to receive assistance both throughout Russia and in your region. At the same time, the volume of compulsory medical insurance programs in all regions is different, only the basic program is the same.
Each citizen must have only one mandatory medical policy. It must be kept only by the owner and not transferred to third parties.
Since May 2011, a single sample document has been introduced. Policies issued earlier than this period do not lose their validity and should not be reissued.
The policy issuing organization must full information about the rules and the CHI program.
Compulsory health insurance protects the interests of citizens of the Russian Federation in the field of health. In every person's life, there are situations when medical assistance may be required, whether it is a sudden illness or an annual preventive examination. The policy guarantees that a citizen will be provided with medical assistance in any city, throughout the country. What is the principle of its action and how to get
Before 2011, there were rules in Russia according to which working citizens received a CHI policy from their employer. 2011 brought some changes, now you can get a policy not only at your place of work, but also on your own, in an insurance company.
In order to find out how to get a compulsory medical insurance policy, you can go to the website of the territorial administration for health insurance, there is all detailed information. A citizen has every right to choose an insurance organization himself. Old policies received before 2011 are also valid, they can be used until they are replaced with new document.
In order to get a medical policy, you need to perform a few simple steps. First, an application is submitted, which will contain information about which company you want to insure with. After that, after a certain time, a policy or a temporary certificate will be handed to you in the territorial fund.
In addition to the application to the insurance company, you will need to provide some more documents:
For children under the age of 14, it is mandatory to have SNILS, a passport of one of the parents;
For citizens of Russia over 14 years old, a passport (or a document replacing it) and SNILS are required.
For persons who fit the definition of “refugees”, the question often arises of how to obtain a policy in the Russian Federation. To do this, they must present a certificate of refugee status or a certificate that the assignment of this status is in the process of being considered by the authorities;
Citizens of other states permanently residing in Russia provide a residence permit, passport, SNILS to obtain a policy.
How to get a CHI policy for stateless persons? To do this, a representative of this category of the population must also write an application to the territorial office and provide a document proving that this person really does not have Russian citizenship.
Since 2011, the medical policy has been issued untimely and is subject to replacement only in some cases:
If a citizen changes his last name, first name or patronymic;
When changing the place of residence;
If the policy was not previously issued to a citizen or was lost by him;
If the insured has expressed a desire to change the insurance company.
Sometimes citizens wonder how to get a compulsory medical insurance policy if non-standard situations occur, for example, a change of gender or date of birth. In such cases, you just need to submit an application to the insurance organization to reissue the policy and, upon presentation of the required documents, receive a medical policy.
The health insurance policy is in full force on the territory of the entire state, regardless of in which subject of the Russian Federation it was issued. If you go on vacation or a business trip, be sure to take this document with you, if necessary, you will be provided with assistance in any medical institution, and all clinics and hospitals are required to do this completely free of charge.
In order to find out the phone numbers and addresses of insurance organizations that provide services for the preparation of a policy, you can simply contact the nearest clinic or call the territorial health insurance fund.
Entered into force on January 1, 2011, says that every citizen has the right to choose an insurance company. This means that by studying all such companies in your area, you can get medical insurance policy right by her. Before the new law, this prerogative was used by the employer or the state (for the unemployed).
For the legal representative of the insured person
- an identity document and (or) a document confirming the authority of the legal representative.
The policy is made within 30 working days. Some insurance companies make it possible to monitor the readiness of your document via the Internet in on-line mode.
Those who do not have a residence permit, provide the insurance company with the same set of documents as people with permanent residence registration. The fact is that you can apply for a CHI policy at the address of your actual residence. This document does not indicate your place of residence, but this data is still needed to be entered in a single electronic register for insured citizens.
If a person changes his place of residence, then he is obliged to inform his insurance company of his new address. If this new place of residence does not have his insurance, then the person is obliged to choose another company for compulsory medical insurance.
For those who are constantly on the road, it is more convenient to issue a policy in the place where they live most of the time. The fact is that there are territorial and basic CHI programs. First, you are served where you live. On the second - where you temporarily left. The territorial program cannot be less than the base one. But it can be much more if the region is "rich".
Compulsory health insurance should be exchanged if:
- last name, first name, patronymic, place of residence have been changed;
- the date of birth, place of birth of the insured person has been changed;
- established inaccuracy or erroneous information contained in the policy.
If your former employer is indicated in your policy, and now, say, you are not working or have changed your job for a long time, then change the policy NO NEED. Now the employer in the policy does not matter. Feel free to use this document!
Reissuance of the medical insurance policy lasts for a month from the date of the changes, and upon presentation of documents confirming these changes.
A duplicate of the policy is also issued after the application of the insured person and in the following cases:
- dilapidation and unsuitability of the policy for further use (loss of parts of the document, ruptures, partial or complete fading of the text, mechanical damage to a plastic card with electronic media, and others);
- loss of the policy.
A compulsory health insurance policy is an official document, without which it is impossible to provide a number of medical services free of charge. Previously, employers dealt with issues of issuing a policy, but from January 1, 2011, employed and unemployed citizens are obliged to take care of obtaining such a document themselves.
Citizens who have always received a policy from an employer may encounter some difficulties, as they are simply not aware of what documents are needed for this and where to get a CHI policy.
This is quite simple to do if you follow a certain sequence of actions. In each city of the Russian Federation there are points for issuing such documents.
These can be both territorial CHI funds and representative offices of various insurer organizations. You can find out information about obtaining a document in a particular city (for example, in Moscow or St. Petersburg) by reading the information on the websites of such organizations.
At each such point, the reception of citizens for issuing policies can take place at different time, and this point needs to be clarified in advance. As a rule, reception takes place on a first-come, first-served basis, but sometimes it is necessary to make an appointment for a certain time by phone or during a personal visit. Some organizations provide for the possibility of sending required documents for registration by e-mail or by filling out a special form on the Internet.
In most cases, you will personally have to be present at the point of issue of the policy to provide the following documents:
- A completed application, the form of which can be downloaded or taken directly from the branch of the insured organization.
- Passport of a citizen of the Russian Federation (in his absence - a temporary identity card).
- Pension card (SNILS).
- When applying for a policy for a minor child, you will also need his birth certificate.
It is worth noting that at present even children under the age of 14 can receive SNILS, and if such a document is available, it must also be provided to the insured. Such a document allows you to participate in some special health insurance programs, but it is not mandatory for issuing a CHI policy.
From foreign citizens in addition to a passport and SNILS, a residence permit will also be required. If a person has refugee status or has just applied for it, he must provide a refugee certificate or an application for such status.
In any case, after completing the documents, the citizen will immediately receive a temporary policy, which a person can use for thirty days. During this time, a new medical policy will be ready, and employees of the insurance company notify citizens about this by phone via a call or SMS.
Please note that not always you will need to fill out the above documents. An employee of the insurance company can fill out the application himself, according to the documents presented - a passport and SNILS. Therefore, you do not need to understand how to fill out an application, the main thing is to contact a suitable company.
Why do you need a policy
It would seem that the procedure for obtaining is quite simple, and in practice you do not have to collect any special documents for a long time and sit in queues for a long time. But some citizens still cannot find the time and desire to draw up this important document. Meanwhile, oms policy, free services in the presence of which medical institutions are obliged to provide, allows you to receive medical care throughout Russia.
In addition, the document guarantees:
- no need to pay for an ambulance call and delivery to a medical facility;
- treatment using all vital drugs that are available in any hospital;
- receiving resuscitation assistance;
- free admission in a polyclinic and examination by doctors of a narrow specialization in a hospital at the place of residence;
- the opportunity to take common tests for free, including x-rays and fluorography.
Nuances
Any citizen of the Russian Federation can obtain a medical policy, but is not required to do it personally. This can be done by a trusted person, from whom the employees of the insurance organization will require before issuing such a document:
- passport of the person for whom the policy is issued;
- SNILS of the insured person;
- Passport or ID confidant:
- A written power of attorney, which can be handwritten and does not require a notarization.
The validity period of the new CHI policy is not limited by anything, but only for citizens of the Russian Federation. For other persons, a restriction is introduced, according to which such a period will be equal to the period of stay of a person on the territory of Russia. The document loses its validity and becomes invalid only in cases where its owner changes the passport data (gender, surname), and also if errors are found in the issued policy.
If the document has become unusable (for example, during washing or has been torn as a result of any incidents), at the request of its owner, the document must be replaced.
The document itself may seem unusual at first, and some citizens face certain problems at first. For example, they cannot understand where the MHI policy number is. On this document, you can see two numbers at once, each of which may be needed with equal probability.
The trouble is that sometimes the doctors themselves get confused in such a situation, and when registering a patient, they indicate incorrect data. It must be remembered that the policy number is indicated on the front side of the document. On the reverse side, there is only a serial number. It is easier to remember such information in a different way: the "necessary" number is longer than the "useless" serial number, and it consists of 16 digits.
To receive free medical services in Russia, you must have an insurance policy. If you do not have this document, you will have to pay for any medical services. The process of obtaining insurance is quite simple, but includes some nuances for different categories of people.
There are two types of medical policy - on a mandatory and voluntary basis. The first option is regulated by the state and provides guarantees for the most basic services. In a voluntary policy, you can pick up and include individual services. To apply for any of the options, you must contact the insurance company and write an application.
You can get health insurance through an insurance broker who works with many companies and will help you choose the best option for you. If you lose your policy, you can apply for a duplicate, but you will have to pay for it. If your policy has expired, renew it.
