State guarantees and compulsory medical insurance

State guarantees and compulsory medical insurance

— TARIFF AGREEMENT FOR COMPULSORY MEDICAL INSURANCE IN THE TERRITORY OF THE PERM REGION FOR 2022

— Resolution on the approval of the territorial program of state guarantees of free medical care to citizens for 2022 and for the planning period of 2022 and 2023

— LIST OF MEDICINAL DRUGS DISCLAIMED TO THE PUBLIC IN ACCORDANCE WITH THE LIST OF GROUPS

— LIST OF VITAL AND IMPORTANT DRUGS FOR MEDICAL USE

List of services provided under the compulsory medical insurance policy

General types of work for all areas of dentistry

Therapeutic appointment

Surgical appointment

We work in the compulsory medical insurance system

Medical examinations and preventive examinations for the assigned population are available in the evening hours on weekdays until 19:00 and on Saturdays from 9:30 to 15:00.

How to make an appointment with a specialist?

1. By phone 200-96-90
2. Electronic referral from the hospital
3. Through electronic registration https://k-vrachu.ru/

Have with you:

1. Passport
2. Compulsory medical insurance policy
3. SNILS

Specialists included in the compulsory medical insurance system:

1. Therapist. Reception: Tuesday/Thursday from 16:00-19:00, Monday/Wednesday/Friday from 09:00-12:00, Saturday from 10:00-12:00
2. Dermatologist. Reception: Tuesday/Thursday from 11:00-13:00
3. Endocrinologist. Reception: Saturday from 10:00-12:00
4. Ultrasound Appointment: by appointment

Vacant positions in the compulsory medical insurance department
In case of temporary disability, the patient is issued a certificate of incapacity for work (on paper or in electronic format)

The clinic can be changed

–
once a year
or more often when changing place of residence. To do this, you need to contact the selected clinic with an application for attachment addressed to the chief physician.

A citizen does not have the right to refuse to be assigned to the clinic of his choice at the place of his actual residence (work, study). If necessary, outpatient medical care is provided by doctors at home. When a citizen is assigned to a clinic at his place of work or study, medical care at home will be provided by doctors of the clinic in whose service area he actually lives.

IT IS IMPORTANT TO KNOW! If the municipality cannot provide a citizen with the necessary planned medical care within the above-mentioned time frame, then it is obliged to refer him to another medical organization included in the list of municipalities participating in the implementation of the Territorial Compulsory Medical Insurance Program.

If a citizen agrees to provide medical care beyond the established time limits, his consent must be in writing.

• Federal Law of November 21, 2011 No. 323-FZ (as amended on July 13, 2015) “On the fundamentals of protecting the health of citizens in the Russian Federation”
• TERRITORIAL PROGRAM OF STATE GUARANTEES OF FREE PROVISION OF MEDICAL CARE TO CITIZENS FOR 2022 AND FOR THE PLANNING PERIOD 2022 AND 2022 (Decree of the Government of the Perm Territory of December 20, 2022 N 1048-p)
• LIST OF VITAL AND ESSENTIAL DRUGS FOR 2022
• LIST OF MEDICINES DISSELLED TO THE POPULATION IN ACCORDANCE WITH THE LIST OF POPULATION GROUPS AND CATEGORIES OF DISEASES FOR WHICH OUTPATIENT TREATMENT MEDICINES AND MEDICAL PRODUCTS ARE DISCHARGED BY REC TO EPTA DOCTORS FREE OF CHARGE, AND ALSO IN ACCORDANCE WITH THE LIST OF POPULATION GROUPS FOR WHICH OUTPATIENT TREATMENT MEDICINES ARE DISCHARGED ACCORDING TO PRESCRIPTIONS DOCTORS WITH A 50 PERCENT DISCOUNT
• Federal Law of November 29, 2014 No. 326-FZ “On Compulsory Health Insurance in the Russian Federation”
• TARGET VALUES FOR AVAILABILITY AND QUALITY CRITERIA OF MEDICAL CARE FOR 2019-2020
• DISPANSERIZATION - view
• Order dated October 23, 2017 No. 2323
• Waiting times for medical care
• Link to the questionnaire for assessing the quality of medical services
• Register of medical insurance organizations operating in the field of compulsory medical insurance in the Perm Territory

Who has the right to medical examination?

Citizens over the age of 18 who are working, unemployed and studying full-time in educational institutions are subject to clinical examination.

You can undergo a medical examination once every 3 years at the clinic to which you are assigned.

To do this, you need to contact your local doctor, local nurse or receptionist.

You need to have your passport and compulsory medical insurance policy with you.

It is important to know that:

Disabled people of the Second World War, military actions, as well as participants of the Second World War, former minor prisoners of concentration camps, ghettos, who became disabled due to a general illness, work injury, men and women over 40 years old can undergo medical examinations ANNUALLY

.

• REGISTER OF INSURANCE ORGANIZATIONS WORKING IN THE COMPLIANCE SYSTEM view
• CITIZENS' RIGHTS view
• INFORMATION FOR REFUGEES ARRIVING FROM UKRAINE
• USEFUL LINKS view

Medical has been working since January 1, 2017 in the compulsory medical insurance system.

Procedures for the provision of medical care and standards of medical care

The procedure for free provision of medical care (medical services) to citizens of the Russian Federation outside the territory of their insurance, persons who do not have registration at their place of residence and place of stay, foreign citizens, stateless persons, and other categories of citizens

Information about qualifications and certification of specialists

Compulsory medical insurance work schedule

Memo

Statement on personal data

Questionnaire to assess the availability and quality of outpatient medical care

Head nurse's work schedule

Who can become a hospital patient?

Hospitalization of patients in a hospital is carried out:

• Planned
  - upon the direction of the attending physician in accordance with clinical indications requiring hospitalization, active therapy and round-the-clock medical supervision.
• For emergency and urgent indications:
  Emergency medical care for urgent medical reasons.
• When a patient self-refers to life-threatening conditions, and if a particularly dangerous infection is detected (or suspected).

How is hospitalization carried out?

Examination of a patient brought to the hospital for emergency medical reasons

, carried out
immediately
, diagnostic studies and provisional diagnosis must be carried out
within 2 hours
, clinical diagnosis must be established
within 24 hours
.

Planned hospitalization

carried out on the direction of the attending physician of the clinic.

When referring for hospitalization, the attending physician is obliged to inform the citizen about the possibility of choosing a medical organization and which hospitals provide medical care in the relevant profile.

Waiting period

a patient of planned medical care in a hospital (day hospital) -
no more than 30 calendar days
from the date of receipt of the referral for hospitalization.

Initial examination

The doctor of the emergency department establishes a preliminary diagnosis of the patient
no later than 2 hours
from the moment of admission of the patient, the doctor forms
an examination and treatment plan
.
The clinical diagnosis
of the disease is established by the attending physician of the specialized department
within 72 hours
.

Examination of the patient by the head of the department

carried out within
48 hours
of the patient’s admission, then as needed.

The volume, timing and timeliness of diagnostic and therapeutic measures for a particular patient are determined by the attending physician

in accordance with the procedures and standards of medical care.

Patients are provided with free therapeutic meals

at least 3 times a day.

If it is not possible to conduct diagnostic tests necessary for the patient, the medical organization provides free transportation.

to another medical organization (accompanied by a medical worker).

Medicine provision

When providing medical care, including high-tech and palliative care, in all types of hospitals, patients are provided with free medications

in accordance with the List of vital and essential drugs, approved.
The Government of the Russian Federation, and medical products
provided for by the standards of medical care.

The use of drugs not included in the List of Vital and Essential Drugs, if their prescription is due to vital indications or replacement due to the patient’s individual intolerance, is carried out free of charge based on the decision of the medical commission

.

What are the features of hospitalization of children?

One of the parents or a legal representative may be in the hospital with a sick child, regardless of his age. When staying in the hospital together with children under four years of age, and with an older child if there are medical indications, the family member who is actually caring for the patient is hospitalized free of charge. He is provided with a place to sleep and food.

Who is treated in the day hospital?

Hospitalization in a day hospital is carried out on the direction of the attending physician, if there are medical indications for treatment during the day that do not require round-the-clock medical supervision.

• The duration of daily therapeutic and diagnostic activities in a day hospital is from 3 to 6 hours in one or two shifts.
• During the treatment period, the patient is provided with a place (bed).
• Supervision by the attending physician daily.
• Drug therapy, including intravenous, intramuscular, subcutaneous injections, medical manipulations and procedures, consultations with medical specialists are provided according to the doctor’s indications.

The ambulance comes in the following forms:

• urgent - in case of sudden acute diseases, conditions, exacerbation of chronic diseases without obvious signs of a threat to the patient’s life;
• emergency - in case of sudden acute diseases, conditions, exacerbation of chronic diseases that pose a threat to the patient’s life.

The time it takes emergency medical services to reach a patient when providing emergency assistance should not exceed 20 minutes from the moment it is called.

Ambulance is provided in the following conditions:

• outside a medical organization - at the place where an ambulance team is called, including specialized emergency medical care, as well as in a vehicle during medical evacuation;
• outpatient;
• stationary.

It is important to know! If the health condition poses a threat to life, examination of the citizen and treatment measures are carried out at the place of his application.

Other information

Dental care within the framework of compulsory medical insurance in the specified INTERSTOM clinics is provided in accordance with the issued license for the provision of medical care: provision of dental care to children and adolescents under 18 years of age, therapeutic care to the adult population in accordance with medical and economic standards using chemically cured materials of domestic production.

Emergency dental care in INTERSTOM clinics is provided free of charge if you have a valid compulsory medical insurance policy:

• When complaining of acute pain caused by acute dental diseases, caused by acute inflammatory diseases of the gums, caused by diseases of the oral mucosa.
• When providing dental care, medications and consumables are used in accordance with the “List of Essential Medicines.”

A citizen insured under compulsory health insurance is required to present a compulsory health insurance policy along with an identification document when applying to a dental clinic for routine dental care.

When applying for free help, remember that you have every right to receive quality services.

What should the dentist inform you about?

About the results of your examination, treatment methods and expected results, possible complications, medical services provided free of charge to you under the compulsory medical insurance policy, as well as your responsibilities for following the dentist’s recommendations, which is very important and affects the results of treatment.

How much dental care should you be provided free of charge under your compulsory medical insurance policy?

In the Komi Republic, the list of dental services paid for from compulsory medical insurance funds is determined by the Law on State Guarantees. Services are reflected in more detail in the Classifier.

The following assistance is provided free of charge under the compulsory medical insurance policy in Interstom clinics (details about the name of services and tariffs can be found in the document “Dentistry Tariff Directory” (2020) - source komifoms.ru):

• Examination and consultation with a dentist
• Treatment of dental caries, pulpitis, periodontitis, periodontal diseases
• Removing dental plaque in the area of ​​one tooth requiring treatment
• Coating teeth with varnish
• Oral hygiene training
• Anesthesia for dental treatment

For children, in addition to the above, the following is provided:

• Treatment of non-carious lesions of hard dental tissues
• Remineralizing dental treatment
• Drawing up a plan for the prevention of dental and oral diseases
• Silvering of carious cavities

Additional explanations about the possibility of receiving specific dental services under the compulsory medical insurance policy will be provided to you by your insurance company and dentist.

From August 1, 2022, Dental LLC (Lenin St., 89) provides the following medical services free of charge as part of the ENT department under compulsory medical insurance:

• Opening a paratonsillar abscess
• Removing a foreign body from the ear canal
• Removal of a foreign body in the nose
• Paranasal sinus puncture
• Washing the lacunae of the tonsils
• Opening a nasal boil
• Mechanical control of bleeding (anterior and posterior nasal tamponade)
• Removal of a foreign body from the pharynx or larynx
• Intranasal blockades
• Rinsing the maxillary sinus
• Repositioning of the nasal bones
• Anterior nasal packing
• Posterior nasal tamponade
• Drainage of a boil of the external ear
• Curettage of the external ear

Additional explanations about the possibility of receiving specific ENT services under the compulsory medical insurance policy will be provided to you by your insurance company and an otolaryngologist.

List of types of medical care and medical services subject to payment from the personal funds of citizens, funds of employers, enterprises, organizations, societies and other sources

1. dental prosthetics
2. treatment of dental anomalies using braces
3. dental therapeutic care using imported materials
4. medical services provided without medical indications, at the request of the citizen

The dental clinic may offer you certain medical services for a fee. In this case, the following requirements must be met:

• The dentist explained to you the possibilities and procedure for obtaining this type of medical service at the expense of compulsory medical insurance funds
• Paid medical care is provided in rooms intended for the provision of paid medical services
• When providing paid services, an agreement must be concluded with you, you must read and sign the Informed Voluntary Consent for the provision of medical services
• You must be given documents confirming payment for dental services and, of course, a Certificate of Completion of Work Completed

You can familiarize yourself with the “Territorial program of state guarantees of free medical care to citizens in the territory of the Komi Republic for 2022 and for the planning period 2022 and 2021” on the website of the Ministry of Health of the Komi Republic or on the website of the TFOMS RK.

You can view the “List of medicines, medical products, consumables, disinfectants for the provision of free medical care to the population in healthcare institutions of the Komi Republic” on the website of the Ministry of Health of the Komi Republic.

Familiarize yourself with the “List of medicines and medical products used in outpatient treatment of citizens entitled to free drug provision in accordance with Decree of the Government of the Russian Federation of July 30, 1994 No. 890 “On state support for the development of the medical industry and improvement of provision for the population and institutions health care with medicines and medical products”, Law of the Komi Republic of November 12, 2004 No. 55-RZ “On social support of the population in the Komi Republic”, you can visit the website of the Ministry of Health of the Komi Republic.

Read the order dated April 26, 2012. No. 406n “On approval of the procedure for a citizen to choose a medical organization when providing him with medical care within the framework of the program of state guarantees of free provision of medical care to citizens” you can on the website of the State Budgetary Institution of the Republic of Kazakhstan of the Territorial Compulsory Medical Insurance Fund of the Republic of Kazakhstan.

List of vital and essential drugs for medical use for 2022