About the fund
Purchase of medical services
- Asthma refers to socially significant diseases that require dynamic monitoring. The patient must be provided with the necessary medicines, regardless of whether he is insured or not. You do not have the right to refuse medical care or medication that is included in the guaranteed amount of free medical care.
- the installation of braces is not provided according to the OSMS package, since the alignment of teeth is an aesthetic task and is carried out for a fee.
However, medical dental care for children under 18 years of age is provided within the framework of medical insurance. Children have access to services for anesthesia and tooth extraction, filling, treatment of pulpitis, periodontitis, complete functional restoration of the anatomical shape of the tooth in hypoplasia, fluorosis, plastic frenulum of the lips and tongue, radiography of the jaw and anesthesia.
orthodontic services are also Available for young patients, but only in the presence of congenital pathologies of the maxillofacial region.
- The algorithm of actions is as follows: you need to go back to the therapist and take a referral to another clinic. The patient can also independently find an organization where a particular examination is available in a shorter period of time, and report it to their doctor. It is worth noting that the clinic and the selected organization do not necessarily have to be bound by mutual obligations. If there is a referral from a PHC doctor to any medical organization with which the polyclinic does not even have a contract, the fact of performing the service is the basis for automatically forming a co-execution contract. It is important to remind that the clinic should be included in the FSMS Database and provide social health insurance services.
- Foreigners with a residence permit have the same rights as Kazakhstanis, so they can easily attach themselves to a polyclinic and receive assistance under the OSMS, provided that they regularly pay contributions and have the status of "insured".
Migrant workers must apply for a voluntary health insurance policy that will provide them with access to primary health care and specialized medical care. In its absence and the development of acute diseases that pose a danger to others, they can count on a guaranteed amount of free medical care.
- If, for example, a patient in a polyclinic was given a referral for tests in one laboratory, but he wants to pass them in another, because it is located closer to his home or work, he has the right to do so. After receiving the service, a co-execution agreement is automatically formed in the Fund's payment system.
The main condition is that the medical organization must be in the FSMS Database and provide social health insurance services. This list of suppliers can be viewed on the Foundation's website.
Recall that the consultative and diagnostic assistance includes receptions of narrow specialists (cardiologists, endocrinologists, ENT specialists, oculists, etc.), laboratory tests (biochemical blood analysis, enzyme immunoassay, antibody detection, etc.), diagnostic services (endoscopic examinations, electroencephalography, echocardiography, x-ray, ultrasound, etc.).