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2019/03/29 14:47:09

How to choose or change a clinic for compulsory medical insurance

The All-Russian Union of Insurers recalls that any resident of the Russian Federation, insured under compulsory medical insurance, has the right to change once a year the medical organization in which he is provided with medical care on an outpatient basis, including a dental clinic, as well as women's consultation, etc. At the same time, a citizen can choose any medical organization from among the medical organizations included in the register participating in the implementation of the territorial program of state guarantees for the free provision of medical care to citizens. The principle of attachment to the clinic at the place of registration is canceled. No explanation is required for changing the clinic.

Content

In order to receive medical care on an outpatient basis within the framework of the compulsory medical insurance programme, the patient has the right not more than once a year to select a medical organization from among the medical organizations included in the register participating in the implementation of the territorial program [1]." Registers are posted on the websites of insurance medical organizations and Territorial funds of compulsory medical insurance. In the event of a change in the place of residence or place of stay of a citizen, he can attach himself to the new clinic more often than 1 times a year.

At the request of a citizen, the clinic is obliged to attach it and does not have the right to refuse or demand to attach at the place of residence without objective reasons. Attachment to a medical organization participating in the implementation of the territorial program is free of charge.

Note that in the event of a change of residence, the insured citizen is obliged to choose an insurance medical organization at the new place of residence within one month, if in the new region of residence there is no insurance medical organization in which the citizen was previously insured.

To attach, you must contact the selected medical organization providing medical care on an outpatient basis and have the following documents with you:

  • OMS policy or temporary OMS policy;
  • Passport, temporary identity or birth certificate (for children under 14 years of age);

  • A document certifying the identity of the legal representative of the minor if the child is to be attached;
  • SNILS (if any);
  • A document confirming a change of place of residence in the case of a change of clinic more often than 1 times a year due to a change of place of residence.

The medical organization is assigned four working days to check the information indicated by the citizen and attach. Disconnection from the previous clinic occurs automatically.

If in the structure of the city polyclinic, to which the citizen plans to attach, there is no department of dentistry and women's consultation (applies to the female sex), it is necessary to separately attach to the dental clinic and women's consultation.

In case of short stay in another constituent entity of the Russian Federation

Residents of Russia have the right to receive medical care under the basic compulsory medical insurance program throughout the Russian Federation. The existence of a compulsory medical insurance policy confirms these rights. To receive emergency and emergency medical care, a non-resident citizen must contact a medical organization providing medical care on an outpatient basis, at the place of temporary stay with a compulsory medical insurance policy and an identity document. Refusal to provide medical care to non-resident residents in the presence of these documents is unlawful.


With a long stay in another constituent entity of the Russian Federation

If a citizen works or lives for a long time outside the place of permanent registration, he has the right to attach himself to the clinic at the place of temporary stay.

Refusal to attach due to the lack of registration at the place of temporary stay, if the necessary documents are available, is unlawful.


When receiving specialized, including high-tech, medical care

The choice of a medical organization when providing specialized, including high-tech, medical assistance in a planned form is carried out by the patient, including, in accordance with the information provided by the doctor about medical organizations participating in the implementation of the territorial program, in which the necessary medical assistance is provided to the patient. The doctor issues a direction in which the name of the medical organization is indicated, as well as the period during which the medical organization must be contacted. The doctor is obliged to warn the patient about the possible timing of waiting for medical care in the chosen medical organization. If a citizen independently chooses a medical organization in which the waiting period exceeds the one established by the territorial program, then the attending doctor makes an appropriate note in the patient's medical documentation [2] In case of difficulties in providing medical care, including consultations with a specialist doctor, it is necessary to contact the head of the medical organization or the insurance medical organization that issued the patient with a compulsory medical insurance policy.


If you have difficulty attaching to the selected clinic, sending to a medical organization providing specialized medical care, as well as in the presence of any questions related to receiving services in the field of compulsory medical insurance, you have the right to contact the insurance medical organization that issued you a compulsory medical insurance policy. The number of the 24-hour hotline is listed on your compulsory medical insurance policy, as well as on the website of your insurance medical organization.

MHI (Compulsory Health Insurance)

Main article: Compulsory medical insurance

Federal MHI Fund

Main article: MHI Federal Fund "

See also

Notes

  1. [1] In accordance with article 21 of Federal Law No. 323 of November 21, 2011 - Federal Law "On the basics of protecting the health of citizens in the Russian Federation
  2. [2] Order of the Ministry of Health and Social Development of Russia dated 26.04.2012 No. 406n "About the statement of the Order of the choice by the citizen of the medical organization when rendering medical care to it within the program of the state guarantees of free rendering medical care to citizens" (Registered in the Ministry of Justice of the Russian Federation 21.05.2012 No. 24278).