Contents
- Fillings, anesthesia and other services that are actually free
- 1. Ask to pay extra for pain relief
- 2. They offer to pay for the seal
- 3. Require to pay for the installation of an intraocular lens
- 4. Asking to pay for stitches after childbirth
- 5. Do not do free hormone testing
- 6. They offer to pay for an instrumental examination in order to shorten the waiting period
- 7. Do not give a referral to a specialist
- 8. The attending physician sends for paid examinations to another clinic, since this hospital does not have equipment
- 9. The hospital says to buy supplies
- 10. Do not give a referral for a free massage
Fillings, anesthesia and other services that are actually free
Affiliate material
10 common situations in hospitals in which patients are illegally asked for money.
When applying for medical care under a compulsory health insurance policy (MHI), many people forget or do not know that some of the services that are sometimes offered to be paid for in a polyclinic are provided free of charge.
What should the patient do in such cases, he told Artem Buzinov, executive director of the St. Petersburg branch of JSC “Insurance company … So what to do if:
1. Ask to pay extra for pain relief
The State Guarantee Program (SGBP) provides not only local anesthesia (including epidural anesthesia), but also anesthesia. So you should be provided with pain relief free of charge.
2. They offer to pay for the seal
Since January 1, 2018, light-cured fillings (the most modern types of fillings that are particularly durable and have a wide range of shades) are included in the SGBP and must be installed for patients free of charge. Only in some situations, for medical reasons, it may be necessary to install a different, non-light-curing type of fillings. Then it must be justified and recorded on the card.
3. Require to pay for the installation of an intraocular lens
With a valid compulsory medical insurance policy in hand, a patient can receive all expensive treatment using a high-quality lens for free and regardless of age.
4. Asking to pay for stitches after childbirth
According to the SGBP, for citizens of the Russian Federation, outpatient and inpatient care during pregnancy, pathology of pregnancy, childbirth and abortion, inpatient care during the neonatal period, as well as medical care in accordance with the law are provided free of charge.
5. Do not do free hormone testing
If hormonal research is carried out as prescribed by a doctor (for example, for diseases of the endocrine system, miscarriage, infertility, and so on), then you do not have to pay. But to check the level of hormones for prevention will have to be paid.
6. They offer to pay for an instrumental examination in order to shorten the waiting period
– The timing of the examinations is prescribed in the Decree of the Government of the Russian Federation of 08.12.2017 No. 1492 “On the Program of State Guarantees of Free Provision of Medical Care to Citizens for 2018 and for the Planning Period of 2019 and 2020”. So, the timing of diagnostic instrumental (X-ray examinations, including mammography, functional diagnostics, ultrasound examinations) and laboratory examinations in the provision of primary health care should not exceed 14 calendar days from the date of appointment.
The timing of computed tomography (including single-photon emission computed tomography), magnetic resonance imaging and angiography in the provision of primary health care should not exceed 30 calendar days from the date of appointment, and for patients with cancer – 14 calendar days from the date of appointment.
7. Do not give a referral to a specialist
Suppose you want to get an appointment with a pulmonologist, endocrinologist or other narrow specialist, and the therapist does not give a referral because he sees no reason. In fact, this means that you will have to pay for a consultation with a specialized doctor. Neither the “second opinion” service, nor the consultation on the initiative of the patient are provided under the CHI. You can write an application to replace the attending physician or change the medical organization (such transfers are allowed no more than once a year).
If you are sure that your attending physician is mistaken in the diagnosis and you really need the advice of a specialized specialist, you can write a statement of disagreement with the doctor’s actions and with the diagnosis he made addressed to the head of the clinic or to the medical commission. The term for consideration of the application is 30 days.
8. The attending physician sends for paid examinations to another clinic, since this hospital does not have equipment
In accordance with the legislation of the Russian Federation, if there are medical indications for conducting a study that is not available in a medical institution, the patient should be referred to another medical organization, where all the necessary studies are provided free of charge under the compulsory medical insurance program.
9. The hospital says to buy supplies
Often, the relatives of a patient who is in the hospital are informed that there are no medicines, needles, syringes, droppers, contrast agents for examination, and so on. In fact, drugs and medical devices for hospitals go through a very strict selection process and must be provided free of charge.
10. Do not give a referral for a free massage
Massages, physiotherapy exercises and other rehabilitation activities should be provided free of charge if they are medically indicated. However, due to large queues, the waiting time can take some time.
First of all, you need to contact the management of the medical institution. This may be the head of the department, the deputy chief physician for medical work or the chief physician, who can resolve the situation on the spot.
If the agreement did not work out, contact the medical insurance company that issued you the compulsory medical insurance policy (the phone number is indicated on the compulsory medical insurance policy).
If you still had to pay for the service and it is possible to prove the fact of payment, despite the fact that free assistance was denied (this must also be proved), it is possible to demand reimbursement of material costs by contacting your insurance company. If the money was transferred to the doctor personally in an envelope, then it will be impossible to return the money.
If you are insured with SOGAZ-Med and you have any questions related to the receipt of medical care in the compulsory medical insurance system or the quality of medical services, please contact SOGAZ-Med by calling the 8-hour contact center phone number 800-100-07-02 −XNUMX (call within Russia is free). Detailed information on the website .