RGS-Medicine
Medicine

Mandatory Medical Insurance (OMS) in Penza / KDC "Clinic-City"

- March 18, 2022 | April 22, 2022 - Kate

KDC "Clinic-City" enters the register of medical organizations operating in the field of compulsory health insurance in the territory of the Penza region

OMS (Mandatory Medical Insurance)

Mandatory Medical Insurance (OMS.) – This is a state system of social protection of the interests of citizens in health.

The goal of the OMS is to provide citizens in the event of a situation that requires medical care, its receipt by funds accumulated in funds (territorial and federal) compulsory health insurance.

The OMS provides all citizens of the Russian Federation, regardless of gender, age, place of residence and social status. Equal opportunities in obtaining medical care provided at the expense of financial resources of OMS in the amount and on the conditions corresponding to OMS programs.

Detailed information on compulsory medical insurance can be obtained from experts in an insurance company that serves you or in the territorial Fund of the OMS of the Penza region.

Contact Center for OMS on the Penza Region

From June 1, 2016, a single "contact center" began the work in the Penza region, uniting the hot lines of the OMS Territorial Fund and the Insurance Medical Organizations operating in the region.

Questions regarding the sphere of compulsory health insurance are accepted by calling 8-800-100-80-44 (free call).

Specialists "Contact Center" will provide reference and advisory assistance and will take operational measures to protect the rights of insured persons when providing free medical care in the Policy of the CHI.

Rights of insured persons

(FZ of 29.11.2010 N326-FZ "On compulsory health insurance in the Russian Federation")

The insured persons are entitled to:

  1. Free provision of medical care medical organizations when an insured event occurs:
    a) throughout the Russian Federation in the amount established by the OMS basic program;
    b) on the territory of the subject of the Russian Federation, which issued an OMS policy, in the amount established by the territorial program of compulsory medical insurance;
  2. the choice of an insurance medical organization by submitting an application in the manner prescribed by the Rules of Compulsory Medical Insurance;
  3. Replacement of the insurance medical organization in which a citizen was previously insured, once during the calendar year no later than November 1 or more often in case of changes in the place of residence or termination of the financial support contract of compulsory health insurance in the manner prescribed by the rules of compulsory medical insurance, by filing applications for the newly selected insurance medical organization;
  4. selection of a medical organization from medical organizations participating in the implementation of the territorial CHI program in accordance with the legislation of the Russian Federation;
  5. choosing a doctor by submitting an application personally or through his representative addressed to the head of a medical organization in accordance with the legislation of the Russian Federation;
  6. obtaining from the territorial fund, insurance medical organization and medical organizations reliable information about the types, quality and conditions for the provision of medical care;
  7. protection of personal data necessary for maintaining personalized records in the field of compulsory health insurance;
  8. compensation by the insurance medical organization for damage caused in connection with the non-fulfillment or improper fulfillment of its obligations to organize the provision of medical care, in accordance with the legislation of the Russian Federation;
  9. compensation by a medical organization for damage caused in connection with its failure to perform or improper performance of its obligations to organize and provide medical care, in accordance with the legislation of the Russian Federation;
  10. protection of rights and legitimate interests in the field of compulsory health insurance.

Obligations of the insured persons

(FZ of November 29, 2010 N326-FZ "On Compulsory Medical Insurance in the Russian Federation")

The insured person is obliged:

  1. present a compulsory medical insurance policy when applying for medical care, except in cases of emergency medical care;
  2. submit to the insurance medical organization personally or through his representative an application for the choice of the insurance medical organization in accordance with the rules of compulsory medical insurance;
  3. notify the health insurance organization of a change in last name, first name, patronymic, details of an identity document, place of residence within one month from the day these changes occurred.
  4. to select an insurance medical organization at a new place of residence within one month in the event of a change in the place of residence and the absence of an insurance medical organization in which the citizen was previously insured.

CHI and Clinic City

Medical centers "Clinic City" – LLC "CDC" Clinic City (Penza) and LLC "Neuron-Med" (Kuznetsk) are included in the Register of medical organizations operating in the field of compulsory medical insurance under the territorial program of compulsory medical insurance of the Penza region in 2022 (http://www.omspenza.ru/doc-408.html).

In our medical centers, the patient, if there are medical indications, has the opportunity to undergo magnetic resonance imaging (MRI) both with the use of a contrast agent and without the use of a contrast agent;

In addition, within the framework of the compulsory medical insurance program in the CDC Clinic-City LLC (St.Penza), the patient can be provided with specialized medical care by a dermatovenereologist. To do this, you need to make an appointment with a doctor by calling 8 (8412) 643-103. On the day of admission, have a passport and a valid CHI policy with you.

Volumes of medical care in accordance with the program of state guarantees of free provision of medical care to citizens and the territorial program of state guarantees of free provision of medical care to citizens (decision of the Commission, Protocol No. 25 dated December 29, 2021 (http://www.omspenza.ru/doc-437 .html)):

  • MRI studies – 5 255 (with the use of a contrast agent – 3,498, without the use of a contrast agent – 1,757);
  • Ultrasound of the cardiovascular system – 67.
  • specialized medical care of a dermatovenereologist – 152.

The procedure for providing medical care in accordance with the CHI program. How to do an MRI, ultrasound within the CHI program

To receive services under the MHI program, you must:

  • receive a referral for a study of the established form, certified by the signature of the head and the seal of the medical organization, which is issued by the attending physician at the clinic at the place of attachment;
  • an appointment is made by a representative of the medical institution that issued the referral for the study. Registration is carried out by phone:
  • in Penza – 8 (8412) 643103, 89674471106 from Monday to Saturday from 7.30 to 20.00, on Sunday from 8.00 to 13.00;
  • in Kuznetsk – 8 (84157) 31523, 8 (84157) 20023 from Monday to Friday from 7.30 to 18.00, on Saturday and Sunday from 8.00 to 14.00

You must have with you:

  • compulsory medical insurance policy;
  • passport;
  • direction for research.

Organizations participating in the CHI program in the Penza region

List of insurance organizations operating in the field of CHI in the Penza region in 2022 (http://omspenza.ru/doc-435.html):

⁃ branch of MAKS-M JSC in Penza;

RGS-Medicine

⁃ Capital Medical Insurance LLC

In connection with the renaming of RGS-Medicine LLC into Capital Medical Insurance LLC, all CHI policies previously issued by RGS-Medicine LLC, which are in the hands of citizens, are valid and are not subject to replacement or reissuance.

With the Decree of the Government of the Penza Region dated December 29, 2021 No. 929-pP "On the Territorial Program of State Guarantees of Free Medical Assistance to Citizens in the Penza Region for 2022 and for the planning period of 2023 and 2024, approved by the Decree of the Government of the Penza Region dated December 29, 2021 No. 929-pp", as well as other regulatory documents on CHI in the Penza region, you can find on the official website of the Territorial Compulsory Medical Insurance Fund of the Penza Region (http://www.omspenza.ru/doc-37.html).

BEFORE VISITING OUR MEDICAL CENTERS, PLEASE CHECK THE VALIDITY OF YOUR MEDICAL POLICY.