Preparing for surgery in private clinic differs from the usual speed and price. If the patient plans to exercise their right to free medical care, he will have to prepare for a long wait. The pause before hospitalization for a planned operation can last up to six months, but despite the duration of the procedure, carry it out in general order is quite real. However, it should be taken into account that federal budget does not always cover all costs. So, for example, the search for a donor is carried out by the patient at his own expense. Is it possible to count on free operations on compulsory medical insurance policy? What categories of citizens are entitled to free operations? How do I get a referral for surgery? We will try to answer these and other questions in this article.
The list of free CHI operations is reviewed and supplemented annually within the framework of regional health care programs. Further, this information descends from above to those medical institutions that provide such services. This list is open and must be displayed on information boards in clinics and hospitals. Under the CHI policy, any citizen Russian Federation(employed, unemployed, child, newborn) can receive a free operation in case of:
It should be noted that this is only a short list of all possible medical services under the policy. Every year, the list is replenished not only with diseases, but also with clinics that provide free treatment using high-tech equipment. To fully familiarize yourself with the list, you should ask your doctor or the head of the department at the hospital for help. This information is also available to the CHI insurance company, whose manager can answer all questions on the hotline.
In order to get to a free operation, first you need to make sure that it is included in the list of services provided under compulsory medical insurance. And then the procedure is quite simple, although getting a referral for a preferential operation will take some time. So, the insured person has to go through several stages:
In the hope of free treatment, you will have to sit out impressive queues. The waiting period for a decision on the issue of hospitalization can last up to six months. After 6 months of delay, the patient has the right to write a complaint to the MHIF. If a citizen wants to be operated on in any particular hospital, he should voice his wishes at the first consultation with the attending physician. The therapist can take into account the patient's request when issuing a referral, if the indicated institution has the possibility of performing a free operation under the MHI policy. The final decision on the distribution of the patient is made by a specialist, so the patient's wishes may not coincide with the actual designated point of the operation.
After a free operation, the patient is also entitled to additional free rehabilitation under the CHI policy. How to get it? To do this, you need to come to the attending physician, get a referral for additional examination and laboratory tests, and after receiving the results, issue a ticket to a sanatorium and resort institution for recovery, of course, if the results of the study allow it. At the same time, rehabilitation measures may be denied due to complications after the treatment of sexually transmitted, oncological, psychiatric diseases, incapacity, drug addiction or alcoholism.
OMS is one of the components common system insurance services provided by the state. This insurance provides an opportunity to receive medical care on equal terms to citizens of different income levels and social status.
For a complete list of insurance options, see federal law No. 326 dated November 29, 2010. According to this normative act allocate a basic package of medical services provided to the insured population within the framework of compulsory medical insurance. Thus, free assistance to each person is provided within the framework of the basic program, but in an amount that does not go beyond the territorial rules.
Free treatment under compulsory medical insurance is possible in the following cases:
The CHI policy covers the cost of treating most of the most common diseases.
Three types of medical care are provided under the CHI policy:
Important! Medications for treatment are not covered insurance policy. If necessary, they are bought at their own expense.
Free assistance in a hospital under insurance is provided in the following cases:
Free care includes accommodation in common wards, standard medicines, observation and examination. Other services (anonymous examination, consultation on the patient's personal initiative, medical care using alternative technologies, medicines that are not available in the hospital, etc.) are provided on a paid basis.
Also, the basic package does not include dental prosthetics, homeopathic treatment and vaccinations, but some can be obtained under the CHI policy.
The list of free operations under the MHI policy is set out in the same Federal Law (No. 326). It is annually reviewed, modified and supplemented within the framework of regional programs.
The main areas of free surgery include:
The list includes most of the surgical operations, as well as rehabilitation activities.
Important! The list is updated annually, supplemented with new items. It may also vary by region, as local adjustments are possible.
note
Free eye surgery to replace the lens under the policy is not done by all ophthalmological clinics. First of all, find out what conditions this or that medical institution offers. we will tell you more about CHI services in private clinics
If you need surgery, make sure the procedure you need is on the list.
If it is there, then further action quite simple, although it takes some time:
In total, the entire specified process of preparing for a free operation can take up to six months. If it took more time to get a referral for the MHI operation, then file a complaint with the MHIF.
If you want to be hospitalized for surgical treatment in a certain clinic, then your wishes should be reported already at the first appointment with the doctor. But there is no clause in the law that obliges the doctor to fulfill your wish, so there is no guarantee that it will be taken into account. Firstly, not all clinics work with CHI, and secondly, the queue to the indicated hospital can be very long.
Coupon - a document that guarantees you a free operation. It is he who is the goal when going to doctors and conducting examinations. To obtain it, you need to collect the following package of documents:
There are cases when a patient may be denied a free operation.
Reasons for rejection:
If the operation is urgently needed, and you were denied free treatment, agree to a paid operation, and then apply for compensation. Remember that you will have time to return the money for the CHI operation, but you cannot risk your health.
Refusal can also be received for rehabilitation after surgery. Rehabilitation may be denied for the following reasons:
More information can be obtained by asking questions in the comments to the article.
Free medical care is provided by state insurance. Acting as an insurer government bodies all levels: from federal to territorial. The insurer is the federal, municipal, settlement budget. The insured persons are Russian citizens of all ages, working and non-working.
Emergency medical care can be obtained throughout the Russian Federation.
Planned - at the place of registration of the CHI policy. To receive free medical services, it is required to issue an insurance medical policy for compulsory medical insurance.
Conclusion of an agreement for compulsory insurance, unlike , occurs automatically upon receipt of insurance. Compulsory medical insurance policies are issued at enterprises and organizations or in Territorial funds (FOMS). When applying for compulsory medical insurance, and, it is required: a passport with a stamp of registration, a work book.
The register of free medical services that a citizen can receive is approved for each territory annually. The clinic has a register of such services, which can be found by anyone. He will tell about article 326 fz, about compulsory medical insurance of the Russian Federation.
On the video - what is included in the OMS policy:
State program for the provision of medical care for 2017-2019. includes:
Types of first aid and specialists:
Primary care is provided in the clinic, day hospital and at home.
The clinician must:
Medicines for therapy are not included in the list of mandatory medical services, they are purchased by the patient at his own expense. 
Medical specialized care can be obtained at a day hospital from narrow profile doctors. At the same time, high-tech methods and tools are used (genetic engineering, robotic complexes).
Day hospital means receiving medical care in the form of intramuscular and intravenous injections, physiotherapy, massage, additional instrumental examination, minimally invasive surgical intervention (removal of warts, papillomas, etc.), which does not require hospitalization and health monitoring. About the policy health insurance Rosno find out.
Citizens can receive all types of ambulance:
Emergency ambulance - when a sharp deterioration in health does not threaten the life of the patient. Emergency is assistance in conditions that are life-threatening for the patient.
Hospitalization, which is part of the MHI, is prescribed for acute conditions, such as: 
Palliative services are provided in hospital and outpatient settings. What is the duration of the maximum sick leave period?
In the Program for 2017-2019 provided:
The list of types of high-tech assistance is approved in the Appendix to the Program for 2017-2019.
The main areas of free high-tech assistance: 
An addition to the basic list of high-tech medical care is the second register, which expands the list of care (for example, removal of a limb, eyes) and adds new sections (treatment of all types of burns, organ transplantation). What group of disability is required, with oncology, will tell.
Dental care included in the CHI system:
On the video - what is included in the OMS dentistry policy:
In this case, medicines are used according to the approved registry.
Teeth alignment and silvering is done for children. Find out where and how to get a medical insurance policy by.
All other types of dental care, drugs and materials that are not included in the preferential list are paid.
For each territory at the local level, within the framework of the state program, their own measures for protecting health are being developed. Settlements in remote, hard-to-reach areas can receive free medical care with the help of medical aviation, television facilities, and mobile ambulance stations.
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Under the MHI policy, you can not only go to a therapist or get tested for free, but also do more expensive procedures, such as correcting your nose or jaw.
Veronika Netsova
talked to those who saved money with the CHI policy
The heroines of this article told how they saved 100,000 rubles or more with the help of a regular policy that every citizen of the Russian Federation has.
Katerina from Moscow fixed the nasal septum under the policy for free and saved 100,000 rubles.
Septoplasty is the name of the operation to correct the nasal septum. It can be done for free under the CHI policy, because it's not about beauty, but about health.
Septoplasty is not a plastic surgery. After it, the nose outwardly remains the same as it was, but it becomes easier to breathe. If not only the septum is curved, but also the nose itself, it makes sense to do rhinoplasty. This is a plastic surgery that is not done under compulsory medical insurance.
Indications. The main indication is a deviated septum. With such a pathology, it is difficult to breathe through the nose, sometimes snoring appears.
Due to the curve of the nasal septum, a person often suffers from rhinitis, sinusitis, sinusitis and other diseases associated with inflammation of the nasal mucosa. If the nasal septum is curved, these diseases can become chronic, that is, they practically do not end and cannot be cured.
100 000 R
Katerina saved money by correcting the nasal septum according to compulsory medical insurance
People with a deviated septum now and then drip vasoconstrictor drops that allow them to breathe normally for only a couple of hours. But frequent instillation can cause headaches.
An ugly, irregularly shaped nose is not an indication for surgery. Katerina went to an ordinary Moscow clinic to an ENT doctor because it was hard for her to breathe through her nose.
Only the operation costs from 13 to 150 thousand. You will also need a preliminary consultation with an otolaryngologist: this is from 1 to 3 thousand rubles for a couple of visits. Analyzes, anesthesia and hospital stay are also at your own expense. In St. Petersburg, such an operation is cheaper. The average price for it is 48 thousand rubles.
Prices for septoplasty in private clinics in Moscow. Source: zoon.ru 
Prices for septoplasty in private clinics in St. Petersburg. Source: zoon.ru It is possible according to OMS. Septoplasty can be done under the MHI policy for free. This requires the testimony and conclusion of an otolaryngologist. The conclusion is necessary in order to get a referral to a clinic or hospital in which such operations are performed with money from the federal compulsory health insurance fund.
Katerina turned to an otolaryngologist from the outpatient clinic. First, the doctor sent her to take an x-ray of the septum to make sure it was deviated. With the finished picture, Katerina returned for a conclusion.
An otolaryngologist from the polyclinic gave Katerina a written referral for septoplasty and sent her to a doctor from the hospital where the operation was being performed. He offered to stand in line. The operation under local anesthesia had to wait 10 days. Under the general - a month. Katerina opted for general anesthesia because she was afraid to have surgery under local anesthesia.
Before septoplasty, you need to take an x-ray and pass tests, the list will be given by the doctor. If you have the desire and time, you can take a picture and donate blood during the opening hours of the hospital laboratory, it will be free. Faster and more convenient for money.
5500 R
Katerina paid for tests and x-rays
Katerina paid 1,500 rubles for the X-ray because she did not want to wait in line for a free X-ray. She paid another 4,000 rubles for the tests for the operation in order to take them at a convenient time for herself and be sure that they would be prepared on time.
After passing the tests, you need to come to the final consultation before the operation. Katerina came for a consultation 3 days before the septoplasty. She was given the exact date and time. After the operation, Katerina was in the hospital for another four days.
Now Katerina lives in Europe. She never regretted that she had an operation under the compulsory medical insurance policy before moving.
Outcome. Katerina spent: 5500 R on tests and x-rays. Saved: 100 000 R.
Contact an ENT doctor at a state clinic with a complaint of difficulty breathing.
Get a referral for surgery.
Take tests, take an x-ray and go to the hospital.
Natalya from Moscow changed the upper jaw under the policy and saved 300 thousand rubles.
The operation on the jaw is called orthognathic and refers to maxillofacial surgery. Its goal is to correct malocclusion and address the problems it causes: painful chewing, joint pain, facial asymmetry and speech impairment.
First, Natalia put braces at her own expense. A year later, when they had to be removed, she noticed that her face had become asymmetrical. Protruding jaws and asymmetry in the lower part of the face are the first sign that something is wrong with the bite. Usually, malocclusion is corrected after wearing braces, but sometimes it is braces that aggravate it. So it was with Natalia.
Indications. The main indication for upper jaw surgery is a narrow or too wide jaw. A sign of a narrow jaw is crooked teeth that do not fit in the dentition. Wide - the gap between the teeth. An underdeveloped jaw that is too small from birth can lead to problems with maxillofacial joints and facial asymmetry.
340 000 R
worth orthognathic surgery on the jaw in Moscow. Natalia paid only 40,000 R
Natalia turned to the maxillofacial surgeon with the problem of facial asymmetry. He said that there is a defect in the upper jaw: it is too narrow. An operation is needed to fix it.
The operation to expand the jaw belongs to the category of orthognathic, but not plastic, despite the fact that the face from it still changes a little. The upper jaw is expanded using a special apparatus - a distractor. This is such a metal plate that is installed on the palate and attached to the chewing teeth. It needs to be untwisted from time to time: in this way it expands the jaw. The distractor is worn from several weeks to one and a half years, depending on the size of the jaw and the testimony of the doctor.
This is what a jaw dilator looks like. Source: dentalmagazine.ru The removable distractor can be removed, for example, during a meal. There is also a non-removable analogue - the Derichsweiler apparatus, which is surgically installed in the palate. It was such an apparatus that Natalya needed to be supplied with.
In order for the treatment to be effective, you need to additionally take pictures and casts of the jaw and pay for the consultations of the maxillofacial surgeon, hospital stay and anesthesia. The distractor, or jaw expansion apparatus, costs from 10 to 40 thousand rubles, depending on whether it is removable or not. A complex orthognathic operation in Moscow will cost 200-300 thousand rubles. The price is affected by the volume and method of treatment.
Fixation of the distraction apparatus in the Clinical Center "Maxillofacial, reconstructive and plastic surgery" of the clinic of the Moscow State Medical University named after. A. I. Evdokimova costs 45 thousand rubles. The cost of the device itself is not included.
It is possible according to OMS. You can do orthognathic surgery to expand the upper jaw and correct the bite by budget funds according to the quota according to the Order of the Ministry of Health of December 2, 2014 No. 796n. It's completely free: the money is allocated not from the fund, but from state budget.
The surgeon suggested that Natalya try to carry out the operation according to the quota. And he helped her prepare all the necessary documents.
First you need to get a medical report with a confirmed diagnosis, for example, an overbite - an underdeveloped, small jaw. When you have a diagnosis from a doctor on hand, you need to get an extract from the medical history and a referral for surgery. These documents must be signed by the head physician of the hospital where the diagnosis was made.
Collected Documents must be taken to the Ministry of Health at the place of permanent registration. The following documents will be required:
Natalia collected the documents and submitted them to the Moscow Department of Health. The quota was approved and a month later the operation was performed.
See an oral and maxillofacial surgeon at a public clinic with a problem related to the jaw, bite or facial asymmetry.
Collect documents for a quota.
Take the documents to the Ministry of Health in your region.
This is not the end of Natalia's story. She corrected the upper jaw, and it turned out that the lower one also had defects. You need to do another operation to reduce the lower jaw. You can also get a quote for it.
Our next heroine, Daria, did such an operation.
Daria from Moscow changed her lower jaw under the policy and saved 400,000 rubles.
The operation to change the jaw and correct malocclusion is called an osteotomy. It is different from the one that Natalya did. Thanks to it, you can not only change the shape and size of the jaw, but also change the location of the facial joints.
Osteotomy can also be done at the expense of funds from the state budget: get a quota for the procedure under the high-tech medical care program. Jaw osteotomy belongs to the category of plastic surgery: after it, the appearance faces. With its help, both physiological anomalies and aesthetic defects are corrected.
Indications. The main indication is an incorrectly developed jaw or underdevelopment of the chin, which leads to malocclusion. Jaw defects and malocclusion can also be the result of trauma or infection, and this is also considered a serious indication for surgery.
The wrong jaw is given out by a strongly advanced lower or upper jaw or a noticeable asymmetry of the face as a whole. Because of the wrong jaw, it is painful to chew, the face hurts and the teeth deteriorate.
400 000 R
is an operation to correct the lower jaw. Daria received a quota and performed the operation for free
Darya had a joint pain in her jaw, and she went to free consultation to the maxillofacial surgeon. Daria found reviews of his work on the Internet.
The surgeon confirmed that there are indications for surgery - the asymmetry of the branches of the lower jaw, which affects the joints. Behind this stretches a whole bunch of other problems: with bite, teeth and speech.
The doctor said that quotas are allocated for such operations. To get a quota, it was necessary to conduct additional examinations.
Price per operation depends on the complexity and method of its implementation. It can cost from 40 to 200 thousand rubles, excluding consultations, additional examinations and hospital stay. During one operation, several surgical methods can be used, so the cost of the surgeon's work can reach 400 thousand rubles. Separately from the operation, the removal of casts of the jaw, a stay in the hospital for 3-10 days, dressings and removal of sutures are paid.
Width="1840" height="1840" class="" style="max-width: 920.0px; height: auto">Fix an adult's jaw at the Central Research Institute of Dentistry and Maxillofacial Surgery in Moscow costs 60,000 R width="1840" height="700" class="" style="max-width: 920.0px; height: auto">Operation on a child's jaw costs more - 74,000 Р 
will cost from 45 to 170 thousand rubles, excluding tests, hospital stay and other additional expenses
It is possible according to OMS. It is possible to correct the jaw and occlusion at the expense of the Compulsory Medical Insurance Fund under the quota. To get a quota, you need a referral from the medical commission. And before that, you need to address the problem of malocclusion or pain in the jaw to the clinic by registration and undergo a series of examinations.
A doctor from a local hospital will make a diagnosis and refer you for additional examinations to a specialized center.
Daria made an MRI and an orthopantomogram for a fee - a panoramic picture of the jaw. It cost sixteen thousand rubles. She handed over the results of the examinations to her doctor, who confirmed the diagnosis - an osteotomy. They began to prepare documents for obtaining a quota.
43 000 R
Daria paid for MRI, images and tests
When the documents were ready, Daria took them from the hospital from her doctor and took them to the Ministry of Health. A week later, she received a call, confirmed the quota and set a date for the operation.
Before hospitalization, Daria once again took pictures and an MRI and passed tests for a fee for 11 thousand rubles. All this could be done at the clinic for free, but time was running out, and the queues were huge.
On the appointed day, she arrived at the hospital and did not pay for anything else. The operation was carried out and, as planned, he was discharged after 10 days.
Daria is lucky because the quotas are scheduled until 2020, and such an operation in a private clinic costs four hundred thousand.
See an oral and maxillofacial surgeon at a public health clinic complaining of facial pain or other jaw or bite problems.
Confirm the diagnosis with your doctor, take a referral for additional research in a specialized center.
Pass research and take the referral of the medical commission for a quota.
Take the documents to the Ministry of Health in your city.
Pass tests and go to the hospital.
What medical services are free, and what will you have to pay for? Why do I need a health insurance policy and how to get it? How to attach to the clinic and how long to wait for an appointment with a specialist? Why can you be denied an ambulance call and where to complain if you are faced with rudeness or negligence of doctors?
The right to free medical care is guaranteed by Article 41 of the Constitution of the Russian Federation. But what is included in the concept of "free medicine" if in practice you have to pay for a lot?
By law, patients are entitled to the following free medical services:
A complete list of cases in which you are entitled to free medical care is included in the basic program of compulsory health insurance. To check this list, you can contact your insurance company(you can find the company's phone number on your policy).
Please note that you are also entitled to free receipt medicines if your condition is rare, life-shortening, or disabling. The list of vital and essential drugs is approved by the state and spelled out in the text of the law.
You will have to pay for other services and medicines.
A compulsory medical insurance policy (OMS policy) is a document that allows a person to receive free medical care in hospitals and clinics throughout the Russian Federation. It is issued by insurance companies that are licensed to work in this area. The insurance company that issued you the CHI policy pays for medical services and protects your interests in conflicts with medical institutions. Keep in mind that in order to receive legally free medical services, you must have a policy with you. Without presenting it, only emergency assistance is provided. Anyone who is on the territory of the Russian Federation, including foreigners and refugees, can receive a CHI policy.
To do this, you need to contact an insurance company that has the appropriate license. The official rating of insurance medical organizations will help in its choice. Over time, you can change the insurer if you are dissatisfied with the quality of his work. Remember that by law this can be done no more than once a year and no later than November 1st.
For a citizen of the Russian Federation under 14 years of age,:
For a citizen of the Russian Federation over 14 years of age,:
For citizens of the Russian Federation, the policy is unlimited, a temporary policy is made for refugees and foreigners temporarily residing on the territory of the Russian Federation.
Despite the fact that the policy is indefinite, it can be replaced with a new one.:
Upon receipt of the compulsory medical insurance policy, a polyclinic is selected to which you will seek medical help (that is, you are “attached” to it). You have the right to choose any clinic that will be convenient for you to visit (closer to home, work, summer cottage). The only condition is that she must be able to accept a new patient (the planned load is determined by the standards).
Your attachment to the polyclinic at the place of residence occurred automatically if:
For self-attachment, you will need to write an application to the administration of the clinic. Keep in mind that if you are attached to a polyclinic not at your place of residence, then you will not be able to call a doctor at home.
Remember that according to the law, you can change the clinic no more than once a year, with the exception of cases of changing the place of residence or stay.
List of documents for a child under 14 years old:
List of documents for citizens over 14 years old:
They can refuse to attach if the selected polyclinic is overcrowded and is not located in your area of residence. You have the right to demand a written refusal, on the basis of which you can complain to the insurance company, the Ministry of Health or Roszdravnadzor.
You can make an appointment with a doctor (get an appointment coupon) in person through the registry of a medical organization or remotely through an electronic registry (if available). But doing this is often quite difficult. The next appointment with doctors can be only in a few months or not at all (“no coupons”). How long can you wait according to the law, and what to do if you are not provided with a service on time?
Each region independently sets the waiting time for medical care in its territory. For information on the dates applicable in your area, please contact territorial fund statutory health insurance or your insurance company (you can find the company's phone number on your CHI policy).
As an example, let us cite the deadlines set in Moscow. According to the decree of the Government of Moscow, the maximum terms are set:
If the medical organization cannot meet the specified deadlines, there is no necessary specialist or equipment, then by law the patient must be sent to the nearest medical institution for diagnostics, and absolutely free of charge. If these provisions are violated, then you can file a complaint against the medical organization with your insurance company or other institutions, which we talk about in the "Where to complain?" section.
Yes, according to the law, you can change not only the medical organization, but also the attending physician (district doctor, general practitioner, pediatrician, general practitioner and paramedic). To do this, you need to apply to the head of the medical institution. You can change a doctor no more than once a year, except in cases of a change in place of residence or stay.
Free medical care also includes ambulances. Everyone on the territory of the Russian Federation can use it, including those who do not have a compulsory medical insurance policy. Many complain about the waiting time for an ambulance, but not everyone knows that the arrival time of the medical team primarily depends on its type, their two:
It is up to the dispatcher to decide what type of assistance to send to you.
We all remember the memorized truth from childhood that to call an ambulance it is enough to call the number "03". Landline telephones eventually become a thing of the past, they are replaced by mobile communications. Almost everyone has a mobile phone at hand, but not everyone knows how to call an ambulance from it.
You can call an ambulance by calling:
Number 112 is universal. By this number you can call the fire brigade, police, ambulance, emergency gas service, rescuers. You can call this number even with a zero balance, a blocked SIM card, or if it is not in your phone. However, this service does not work in all regions of the Russian Federation today.
When will an ambulance arrive?:
In which case the ambulance will not arrive:
The arriving team will provide emergency medical care and, if necessary, hospitalize you in the hospital. The doctors of the brigade can give verbal recommendations for treatment, but they do not write out certificates and sick leave.
There are times when a conflict arises between you and your doctor. What to do in such a situation? Complain.
Keep in mind that the period for consideration of applications in each case, according to the law, is 30 calendar days.
