Experts predict that in the coming year, Russians will seek medical care under the CHI policy more frequently than the year before.
Photo: Svetlana MAKOVEEVA
Experts predict that in the coming year, Russians will seek medical care under the CHI policy more frequently than the year before. In a difficult economic situation, people more actively use state guarantees, including free medical care. What changes in health care will 2023 bring us? We understand the most important novels together with the expert of the working group on the organization of compulsory medical insurance of the All-Russian Union of Insurers Lyudmila Romanenko.
IT IS POSSIBLE TO GO TO ANOTHER REGION FOR AN OPERATION OR EXAM
Until now, those who need so-called high-tech medical care, VMP, have been sent to medical centers in other regions (that is, not in their place of residence). These are complex and expensive surgeries and tests, what people call “treatment by fee.” If a “regular” operation (planned specialized medical care in the official language) is needed, in order for it to be carried out in another region, it was often necessary to change the compulsory medical insurance policy, re-register the attachment to the clinic and hospital . In general, there are a lot of problems, and it is not yet a fact that everything will “grow together.”
– Today, the patient’s right to receive specialized planned medical care outside the region in which he lives is legally enshrined, – says Lyudmila Romanenko. – You do not need to change CHI’s policy for this.
And how should one act? However, the patient’s desire alone is not enough. He will need a referral for treatment to one or another medical organization in a particular region, explains the expert. You can give instructions:
– the attending physician of the polyclinic in which the patient is currently receiving medical care under the compulsory medical insurance;
– the medical commission of the hospital where the patient is already being treated. In this case, a referral is issued about the need to transfer to another medical organization (including in another region).
MORE COMPLEX OPERATIONS IN CHARGE OF THE STATE
For this year, the list of expensive complex operations to be carried out by federal medical centers under compulsory medical insurance was completed.
“First of all, we are talking about unique methods of treatment used in cardiovascular surgery and organ transplantation,” says Romanenko. – For example, an operation for the simultaneous replacement of the entire aorta of the heart, transplantation of a complex of organs in various combinations, etc.
Today, such operations are carried out using modern technologies that make it possible to do without a long period of rehabilitation, experts say.
DEPANSERIZATION AND REHABILITATION
Those who have been sick with covid and want to improve their health to avoid dangerous long-term consequences will be able to undergo a free in-depth post-covid medical examination. By 2023, the amount of funding was not only extended, but also increased. In the list of exams there are those that in commercial clinics will cost you a lot of money. For example, tests and studies to determine the state of blood vessels, heart, lungs. A complete list is in the “Health” section on KP.RU
In addition to the clinical examination, a medical rehabilitation system will be developed. For the first time in detail, and not in general terms, the details of the provision of this type of medical care and its financial support are explained, says Lyudmila Romanenko. Medical rehabilitation, including free treatment in sanatoriums for medical reasons, will be available, in particular, for patients after a severe form of covid, people with severe diseases of the musculoskeletal system. Medical rehabilitation is also provided to SVO participants.
WHO GOES TO FREE TESTING FOR COVID
In 2023, coronavirus tests at the expense of compulsory health insurance are based on such cases:
– if the patient has signs of an acute cold, “not excluding the presence of a coronavirus infection.” As doctors explain, this can be, in particular, an increase in temperature, accompanied by coughing, a runny nose, sore throat;
– if the patient has already been diagnosed with covid and it is necessary to verify the results of the treatment (for example, upon discharge from the hospital);
– if the rapid test showed a positive result – in this case, a more accurate PCR test may be prescribed to confirm or refute the diagnosis.
But if you want to take a test for antibodies to coronavirus, for example, to find out if you have had it or another ARVI, then you will not be able to do it under the basic program of compulsory health insurance under the policy ( the regions, if they wish , may additionally provide such a service within the framework of territorial compulsory health insurance programs for their residents).
– Greater availability of in vitro fertilization (IVF) for women with infertility. The number of free procedures in the next year will increase by 18% (compared to 2022) and will amount to more than 89.5 thousand.
– The health care system for patients with hepatitis C is being developed. In particular, 18 drug therapy regimens will be used for the treatment of such patients from 2023 as part of the compulsory health insurance.
– Expanded neonatal screening program – research on hereditary and congenital diseases in infants. Newborns will be screened free of charge for 36 groups of diseases instead of 5, as it was before.
TO THE POINT
Politics goes digital
At the end of last year, the rules on the issuance of digital MHI policies came into effect. Those who issue or replace their policy for the first time in 2023 will no longer receive paper documents or plastic cards. The medical insurance organization will email you a statement with the CHI policy number, policy barcode, and patient contacts. Or, as an option, it will be possible to enter your personal account on the portal of State Services and print from there or save to your smartphone a document with a barcode of a digital compulsory medical insurance policy, Dmitry Kuznetsov, vice president of All – Russian Union of Insurers, told KP.
When a child is born, the policy will be generated automatically based on information received from government agencies. So the baby will not need to write any documents at all, the expert explained.
As for previously issued paper and plastic policies, they are still valid. For now, no time limit. By the way, Dmitry Kuznetsov also advises owners of newfangled digital documents to contact clinics with a printed version. During the transition period, barcode scanners may not be available everywhere.