Ministry of health of the Russian Federation
about guarantees of free medical care
In accordance with article 41 of the Constitution of the Russian Federation, every citizen has the right to health protection and free medical care provided in a guaranteed amount without charge in accordance with the Program of state guarantees of free medical care for citizens (hereinafter – the Program), approved annually by the Government of the Russian Federation.
The main state sources of funding for the Program are the funds of the compulsory medical insurance system and budget funds.
On the basis of the Program, the subjects of the Russian Federation annually approve territorial programs of state guarantees of free medical care (hereinafter-territorial programs).
1. What types of medical care are provided to you for free
The Program provides free:
1. Primary health care, including:
- primary pre-medical care, which is provided by paramedics, midwives and other medical workers with secondary medical education in outpatient settings, in a day hospital;
- primary medical care, which is provided by physicians, district physicians, pediatricians, pediatricians district and General practitioners (family doctors);
- primary specialized medical care, which is provided by specialist doctors.
2. Specialized medical care, which is provided in inpatient and day care by medical specialists, and includes the prevention, diagnosis and treatment of diseases and conditions, including during pregnancy, childbirth and postpartum period, requiring the use of special methods and complex medical technologies.
3. High-tech medical care with the use of new complex and (or) unique methods of treatment, as well as resource-intensive methods of treatment with scientifically proven effectiveness, including cellular technologies, robotic technology.
The list of types of high-tech medical care, including treatment methods and sources of financial support, Can be found in the Appendix to the Program.
4. Emergency medical care, which is provided by state and municipal medical organizations for diseases, accidents, injuries, poisoning and other conditions that require urgent medical intervention. If necessary, medical evacuation is carried out.
To get rid of pain and relieve other severe manifestations of the disease, in order to improve the quality of life of terminally ill patients, citizens are provided with palliative medical care in outpatient and inpatient settings.
The above types of medical care include free of charge:
– medical rehabilitation;
- in vitro fertilization (IVF);
– various types of dialysis;
- chemotherapy for malignant diseases;
- preventive measures, including:
- preventive medical examinations, including children, working and non-working citizens who are studying in educational organizations on a full-time basis, in connection with physical culture and sports;
- medical examination, including staying in stationary institutions of children-orphans and children who are in a difficult life situation, and also children-orphans and children left without parental care, including adopted (adopted), accepted under guardianship (guardianship) in a foster or foster family. Citizens undergo medical examination free of charge in a medical organization where they receive primary health care. Most of the activities in the framework of medical examination are carried out 1 time in 3 years with the exception of mammography for women aged 51 to 69 years and fecal occult blood tests for citizens from 49 to 73 years, which are carried out 1 time in 2 years;
- dispensary observation of citizens suffering from socially significant diseases and diseases that pose a danger to others, as well as persons suffering from chronic diseases, functional disorders, and other conditions.
In addition the Program guarantees that:
- prenatal (prenatal) diagnosis of child development disorders in pregnant women;
- neonatal screening for 5 hereditary and congenital diseases in newborns;
- audiological screening in newborns and children of the first year of life.
Citizens are provided with medicines in accordance with the Program.
2. What are your waiting times for medical care
Medical care is provided to citizens in three forms-planned, urgent and emergency.
The emergency form provides medical care for sudden acute diseases, conditions, exacerbation of chronic diseases that pose a threat to the life of the patient. At the same time, medical assistance in an emergency form is provided by a medical organization and a medical worker to a citizen immediately and free of charge. Refusal in its rendering is not allowed.
The emergency form provides medical care for sudden acute diseases, conditions, exacerbation of chronic diseases without obvious signs of threat to the patient's life.
The scheduled form provides for the provision of medical aid at carrying out of preventive measures for diseases and conditions not accompanied by the threat to the life of the patient does not require emergency medical care, and delaying the provision of which at a certain time does not entail a deterioration of the patient, endangering his life and health.
Depending on these forms, the Government of the Russian Federation sets deadlines for waiting for medical care.
Thus, the waiting time for primary health care in the emergency form should not exceed 2 hours from the moment of the patient's appeal to the medical organization.
Waiting times for medical care in the planned form for:
- reception by district physicians, General practitioners (family doctors), pediatricians district should not exceed 24 hours from the moment of treatment of the patient in the medical organization;
- consultations of medical specialists should not exceed 14 calendar days from the date of the patient's appeal to the medical organization;
- carrying out diagnostic instrumental (radiographic studies, including mammography, functional diagnostics, ultrasound) and laboratory studies in the provision of primary health care should not exceed 14 calendar days from the date of appointment;
- conducting computed tomography (including single-photon emission computed tomography), magnetic resonance imaging and angiography in primary health care should not exceed 30 calendar days, and for patients with cancer - 14 calendar days from the date of appointment;
- specialized (with the exception of high-tech) medical care should not exceed 30 calendar days from the date of issuance by the attending physician referral for hospitalization, and for patients with cancer - 14 calendar days from the date of diagnosis of the disease.
The time of arrival to the patient of emergency medical teams when providing emergency medical care in an emergency form should not exceed 20 minutes from the moment of its call. At the same time, in territorial programs, the time of arrival of emergency medical teams can be reasonably adjusted taking into account transport accessibility, population density, as well as climatic and geographical features of the regions.
3. What You don't have to pay for
In accordance with the legislation of the Russian Federation in the sphere of protection of health of citizens when rendering medical aid under the Program and territorial programs do not have to be paid for by personal funds of citizens:
- provision of medical services;
- appointment and application in stationary conditions, in conditions of a day hospital, at rendering of medical care in the emergency and urgent form of medicines on medical indications:
a) included in the list of essential and essential medicines;
b) not included in the list of vital and essential medicines, in cases of their replacement due to individual intolerance, for life reasons;
- purpose and application of medical devices, blood components, medical nutrition, including specialized medical nutrition products for medical reasons;
- placement of patients in small wards (boxes) for medical and (or) epidemiological reasons;
- for children under the age of four years, the creation of conditions of stay in a hospital, including the provision of bed and food, with the joint presence of one of the parents, another family member or other legal representative in a medical organization, and for a child older than this age-if there are medical indications;
- transport services when accompanied by a medical professional of a patient who is being treated in a hospital, in case of need for him to conduct diagnostic tests in the absence of the possibility of their conduct by a medical organization that provides medical care.
4. About paid medical services
In accordance with the legislation of the Russian Federation, citizens have the right to receive paid medical services provided at their request in the provision of medical care, and paid non-medical services (household, service, transport and other services), provided additionally in the provision of medical care.
In this case, paid medical services can be provided in full medical care, or at Your request in the form of individual consultations or medical interventions.
Medical organizations participating in the implementation of the Program and territorial programs have the right to provide you with paid medical services:
– on other conditions than provided by the Program, territorial programs and (or) target programs. You should familiarize yourself with the important section of the Program and the territorial program - "Procedure and conditions for free medical care for citizens".
- when providing medical services anonymously, except for cases stipulated by the legislation of the Russian Federation;
- citizens of foreign States, stateless persons, with the exception of persons insured under compulsory medical insurance, and citizens of the Russian Federation who do not live permanently on its territory and are not insured under compulsory medical insurance, unless otherwise provided by international treaties of the Russian Federation;
– when applying for medical services independently, with the exception of:
a) an independent appeal of a citizen to a medical organization chosen by him no more than once a year (except for changing the place of residence or place of stay);
b) providing medical care in an emergency and urgent form when a citizen independently applies to a medical organization;
C) referrals for the provision of medical services by a district physician, a district pediatrician, a General practitioner (family doctor), a specialist doctor, a paramedic, as well as the provision of primary specialized medical care, specialized medical care in the direction of the attending physician;
d) other cases stipulated by the legislation in the sphere of health protection.
The refusal of a patient from the offer of paid medical services cannot be a reason for reducing the types and volume of care provided to the patient free of charge under the Program and territorial programs.
5. Where to contact if you have any questions or if your rights to free medical care are violated
For free medical care and in case of violation of the rights of citizens to provide it, conflict resolution, including refusal to provide medical care, charging money for its provision, you should contact the:
- administration of the medical organization-to the head of Department, the head of the medical organization;
- office of the insurance medical organization, including the insurance representative, - in person or by phone, the number of which is specified in the insurance policy;
- territorial body of health management and territorial body of Roszdravnadzor, territorial Fund of compulsory medical insurance;
- public councils (organizations) for the protection of patients ' rights under the state authority of the subject of the Russian Federation in the field of health protection and under the territorial body of Roszdravnadzor;
- professional non-profit medical and patient organizations;
- Federal authorities and organizations, including the Ministry of health of the Russian Federation, the Federal compulsory medical insurance Fund, Roszdravnadzor, etc.
6. What you should know about insurance representatives of insurance medical organizations
An insurance representative is an employee of an insurance medical organization who has received special training, represents Your interests and provides your individual support in providing medical care provided by law.
- provides you with reference and Advisory information, including the right to choose (replace) and the procedure for choosing (replacing) an insurance medical organization, medical organization and doctor, as well as the procedure for obtaining a compulsory medical insurance policy;
- informs You about the need for medical examination and interviews the results of its passage;
- advises You on the provision of medical care;
- reports on the conditions of medical care and availability of available places for hospitalization in a planned manner;
- helps you choose a medical organization, including providing specialized medical care;
- controls the passage of your medical examination;
- organizes consideration of complaints of insured citizens on the quality and availability of medical care.
In addition, you can contact the office of the insurance medical organization to the insurance representative when:
- refusal to make an appointment with a specialist doctor in the presence of a referral from the attending physician;
- violation of deadlines for waiting for medical care in planned, urgent and emergency forms;
- refusal to provide free of charge medicines, medical devices, medical nutrition – all that is provided by the Program;
- situations where you are asked to pay for those medical services that are medically prescribed by Your doctor. If you have already paid for medical services, be sure to save the cash receipt, sales receipts and contact the medical insurance organization, where you will be able to establish the legality of charging money, and if it is illegal – to organize their compensation;
– other cases where You believe that Your rights are violated.