About children, coronavirus and medicines: the FSMS answered the most common questions among the population
The Social Health Insurance Fund receives hundreds of questions every day about the procedure for providing medical care and participating in the OSMS system. We have selected the most frequently asked questions for your attention.
-Where can I see which clinics are working on health insurance? Can I choose the clinic where I will be treated?
— The list of medical organizations that provide medical services for GOBMP and OSMS can be found on the official website of the Social Health Insurance Fund. Everyone has the right to freely choose a doctor and a polyclinic. During the registration campaign, a medical institution can be replaced with the right of free choice once a year, and also if a person changes the place of permanent or temporary residence, work or study, moves to another locality or the polyclinic to which he belongs is reorganized.
— I want to undergo rehabilitation after a coronavirus infection. What do I need to do for this?
— First of all, contact your doctor. The doctor in the polyclinic gives a referral for a consultation of a rehabilitation doctor or a multidisciplinary group, who assess the condition and select the necessary course of rehabilitation measures. They are aimed at normalizing breathing, reducing complications, improving the quality of life and relieving the symptoms of anxiety and depression. If there are indications, citizens who have received treatment at home and have not applied to medical organizations can also undergo rehabilitation. The algorithm of actions is the same for them. It should be noted that medical rehabilitation, depending on the degree of functional impairment, can be carried out both in inpatient and outpatient conditions.
— I'm on maternity leave. Does my child have the right to OSHI services?
— Children belong to the privileged category of citizens-the state makes monthly contributions for them. The OSHI package for children includes: preventive examinations, specialist consultations, dynamic monitoring for chronic diseases, dental and diagnostic services, specialized care, medical rehabilitation after chronic diseases.
— I don't officially work, my youngest son is about 2 years old. For the third year I have been registered with an endocrinologist with a pituitary microadenoma. This year I want to undergo an MRI with the introduction of a contrast agent. Will this procedure be free for me? Before that, I always passed a paid check.
— Yes, since you belong to the privileged category of citizens, you can undergo this procedure for free. To do this, you need to contact your doctor and get a referral: it is important that he has an explanation «with contrast».
— The doctor gave me a referral for an MRI, but all the days are busy, and my turn comes in a month. Why wait so long to get a service?
— The maximum period of admission by specialized specialists and waiting for receiving diagnostic services is 10 days, for urgent indications-two days. If the appointment was scheduled for a later date, the patient has the right to contact another medical organization that performs MRI according to the OSMS. After receiving the service, the co-execution agreement is concluded automatically in the Fund’s payment system.
— I'm pregnant, I'm worried about a toothache. Is it possible to undergo treatment for OSHI and if so, how to do it?
— Yes. To get dental care, you need to contact a dental clinic that provides services for OSMS. You can find a list of them on the FSMS website. At the same time, the presence of a referral from the polyclinic is not necessary. In addition to pregnant women, emergency assistance – tooth extraction and installation of a chemical seal-is provided to children under 18 years of age, participants of the Great Patriotic War, disabled people of groups 1, 2, 3, mothers with many children, awarded with «Altyn alka», «Kumis alka» pendants, recipients of targeted social assistance, pensioners by age. Planned care is available to children, except for pregnant women. It includes: anesthesia, filling, therapeutic reception, treatment of pulpitis, treatment of periodontitis, full functional restoration of the anatomical shape of teeth with hypoplasia, fluorosis.
— Please tell me, where can I find a list of free medicines for children?
— The list of medicines and medical devices available for free under the GOBMP and OSMS, approved by the order of the Minister of Health of the Republic of Kazakhstan dated August 29, 2017 No. 666. It can be found in the information and legal system «Adilet».
— I am registered in an oncological dispensary, I need to undergo a routine examination in the near future, can I pass it for free? I don't work, I don't pay dues.
— Dynamic monitoring of patients registered in the oncological dispensary is carried out within the framework of the GOBMP. Accordingly, in order to pass a planned examination for illness, the insurance status in the OSMS system is not required.
— The child is 3 months old, feels bad, but there is no fever. Do we have the right to call a doctor at home?
— Children under five years of age, pregnant women and women in labor with any deterioration in their health are provided with a service at home. You need to call a medical worker at least 2 hours before the end of the working day, otherwise there is a risk that he will not have time to be served. Depending on the symptoms, a district nurse or a doctor may come.
— I am an individual entrepreneur, I paid a fee for the OSMS and inadvertently indicated an amount exceeding the required amount. Is it possible to return the funds?
— To return the wrongly or excessively paid funds, it is necessary to contact the state corporation» Government for Citizens», write an appropriate application and provide a receipt or a receipt for payment. Then you have to overpay the fees for the months during which the error was made.