Not everything is free: experts explained which diseases and services are not covered by the compulsory health insurance policy.

      What the compulsory health insurance policy provides without additional payments

      The compulsory health insurance program allows free visits to therapists and specialists, undergoing medical check-ups and preventive examinations, getting vaccinations according to the national calendar, taking basic tests, and receiving inpatient treatment.

      This also includes most surgical operations, pregnancy management, childbirth, and some dental care (treatment of caries, tooth extraction — at the clinic in the place of residence, without expensive materials).

      It seems like an impressive list. However, there are a number of diseases and medical services that are not funded by the compulsory health insurance program — at least not in full.

      What remains "off the board" of compulsory health insurance

      According to healthcare experts, the following are outside the basic program:

      treatment of HIV infection (some therapy may be provided under special regional programs, but not everywhere and not always);

      tuberculosis therapy (in the acute period — yes, but some stages of rehabilitation and supportive treatment — at the patient's expense);

      a number of sexually transmitted diseases (syphilis, gonorrhea, and others — their treatment is selectively funded, often only at the initial stages);

      certain types of psychiatric care (especially long-term psychotherapy, rehabilitation, and non-drug methods);

      palliative care (pain relief and home care — only partially, much has to be paid for by the patient);

      air ambulance (helicopters and planes for emergency evacuation of patients — in most regions are not included in compulsory health insurance).

      An important nuance: emergency care — outside the rules

      Experts emphasize: if it concerns a life-threatening condition, they cannot refuse assistance. In case of a heart attack, stroke, severe accident, or sudden exacerbation of any disease — even one not included in the compulsory health insurance list — the ambulance team and emergency room doctors are obliged to do everything necessary.

      However, bureaucracy may begin afterward: the payment procedure for such treatment depends on the region, and some procedures may later be attempted to be billed as paid. Patients or their relatives often have to prove that the assistance was emergency.

      Regional differences: what is free in Moscow is paid in Magadan

      The main problem that experts warn about is the territorial compulsory health insurance program. Federal law only sets a basic minimum, and each subject of Russia can expand or narrow the list of free services at the expense of its budget.

      As a result, what is provided for free in one city (for example, an expensive drug for HIV or a palliative bed at home) will cost tens of thousands of rubles in another region.

      Therefore, the specialists' advice is clear: before counting on a free service (especially a specialized or expensive one), it is necessary to personally contact the territorial compulsory health insurance fund of your subject or the hotline of the insurance company. They will provide an accurate list for the current year.

      How to avoid unexpected bills: three steps

      To avoid unexpected bills after treatment, experts recommend:

      When planning hospitalization — request written confirmation in advance that all prescribed procedures and medications are included in the territorial compulsory health insurance program.

      If the hospital demands payment for what should be free by law — call the hotline of your insurance representative (the number is indicated in the policy).

      If assistance is refused (even for a disease not included in compulsory health insurance) — demand a written conclusion and appeal to the prosecutor's office or the territorial body of Roszdravnadzor, reports karelinform.ru.

      The compulsory health insurance policy is a powerful but not all-encompassing tool. A lot can be obtained for free, but treatment for HIV, tuberculosis, venereology, palliative care, and air ambulance should be checked separately. And remember: in case of a life-threatening situation — refusal is illegal, and for planned assistance — the rule "trust, but verify" applies in your regional compulsory health insurance fund.