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Video: MRI, Hormone Tests: What Else Must Be Done For Free
MRI, hormone tests: what else must be done for free
The compulsory medical insurance system has been working for a long time, but many of us do not fully understand the principles of providing medical care in this coordinate system. We figure out what expensive services should be provided for free.
Photo: pixabay.com / 7459
The compulsory medical insurance system has been working for a long time, but many of us do not fully understand the principles of providing medical care in this coordinate system. We figure out what expensive services should be provided for free
The volume of medical care under the compulsory medical insurance policy is regulated by the federal law N 326-FZ "On compulsory medical insurance in the Russian Federation." The law lists all medical services that the insurance company pays for, and the insured person, that is, you and I, receives free of charge.
Subjects of the Russian Federation can expand this list at the expense of the local budget; there are also a number of services that are paid for from the regional budget. Among them are high-tech, palliative, oncological and other types of care.
The program stipulates that in case of accidents, injuries and acute conditions, medical care should be provided, regardless of the availability of the policy, free of charge.
I need expensive research, what should I do?
The first step to getting free help is to see the GP of the clinic you are assigned to.
The therapist will study the clinical picture of the disease, collect an anamnesis of life and illness, and, if necessary, prescribe basic tests and consultation with a specialized specialist. And already he will decide whether you need expensive medical care or not, and give a referral. The exception is dental care, doctors of this profile are consulted bypassing the local therapist.
Let's talk specifically, what tests will they do for me for free?
Each disease has what are called standards of care. If hypothyroidism is suspected, tests for thyroid hormones will be prescribed, for iron deficiency anemia - for ferritin and YSL, and for osteoporosis - an analysis for vitamin D.
However, if you came to the therapist with a complaint of increased fatigue and he did not see the signs of these diseases, you will not be able to pass popular tests for free.
And what, MRI will also be done for free?
High-tech examinations such as magnetic resonance imaging (MRI), computed tomography (CT) are included in the insurance program and are performed free of charge for the patient.
The doctor makes the decision on the expediency of research In order to do an MRI free of charge, you need a referral in the form 057 / u-04, an extract from the medical record indicating the diagnosis, indications for the study, the location of the study, a full history, including allergic reactions. If the study is carried out with contrast, then the direction should indicate the presence of cardiovascular diseases and pregnancy.
All cases in which free MRI is possible are indicated in the treatment standards, for example, a referral for a study is given to confirm or deny the presence of neoplasms.
According to the law, the waiting period for the study should not exceed 30 days, the results of the study are not handed over to the hands, but sent to the medical institution that issued the referral.
Okay, but modern fillings and pain relief will also be done under compulsory medical insurance?
Dental care under compulsory medical insurance policies is provided in a relatively wide range. You can get a doctor's consultation, take an X-ray, remove a tooth and tartar, and treat teeth. At the same time, the program of coverage with the OMC policy includes not only old-generation fillings (silicate and phosphate-cement), but also modern glass ionomers.
The compulsory medical insurance program also includes the use of antiseptics and anesthetics of domestic production. Dental implants are not included in the CHI program. Dental prosthetics under compulsory medical insurance is performed for privileged categories of citizens.
Before starting treatment, the doctor may suggest the use of other consumables for an additional fee, the patient may refuse or agree.
A neighbor had an operation on a quota, can I also?
The Government of the Russian Federation has determined a list of high-tech assistance for 2020, available under compulsory medical insurance.
It includes costly care, including neurosurgery, cancer surgery, and transplantation.
In order to perform a quota operation, you will need:
· Get a referral from your doctor.
· Collect a package of documents.
· Send a referral and documents to the medical organization that will perform the operation.
· Obtain a ticket for high-tech assistance from a medical organization.
· When the turn comes: come to the commission that will decide on hospitalization.
The main problem is that quotas are allocated at the beginning of the year. And by the time this help is needed, the quota may no longer be available.
And how to do IVF under compulsory medical insurance?
Infertility treatment by in vitro fertilization is available to any woman under the compulsory medical insurance policy and with an appropriate diagnosis. Treatment is carried out according to a regional quota and is repeated exactly as many times as needed.
To get help, you need to get a diagnosis of "infertility" in the district consultation at the place of registration. After that, the doctor must make an extract from the medical history and give a referral to the territorial Commission. The commission examines the documents, and in case of a positive decision, puts them on the waiting list. You can check the movement in the queue on the website of the regional department of health.
The basic IVF program for compulsory medical insurance includes all the necessary research, but does not include the storage of frozen biological material (sperm, eggs, embryos); obtaining donor materials; examination of the embryo for genetic diseases; surrogacy; examinations before and after the procedure of artificial insemination.
Everything is fine, but the polyclinic refuses to provide these services for free, what should I do?
If the doctor does not prescribe what you think is necessary research, the first thing to do is call your insurance company - its contacts are printed on the policy - and state all the facts in detail.
If the insurance company has not clarified the situation, then you can contact the "hot line" of territorial health insurance funds, which are superior in relation to insurance companies.
The last instance is the Federal Compulsory Medical Insurance Fund.
However, before getting involved in this whole story, it is worth checking the standard of medical care, which is the main document governing the provision of assistance under compulsory medical insurance.