Health insurance: what is a policy?

To date, every person from the moment of birth must have a medical insurance policy. But have you ever wondered what guarantees it provides? And anyway, what is a policy? Let's look into these issues.

Terminology

Initially, it is necessary to understand the term. We will clarify the meaning of the word "policy". Since ancient Greek the term is literally translated as "city". Denotes the word a special form of political and socio-economic organization of society, which was characteristic of ancient Greece and Italy. Also, the policy (translated from French means "receipt, receipt") is a document that indicates the conclusion of a contract for both personal and material insurance. There is one more term. The general policy is an insurance document that provides services for systematic insurance.

OMC in Russia

Mandatory medical insurance is part of the state structure of social services. It guarantees equal opportunities in obtaining medication and medical care. This type of services is allocated from the MHI funds in the required amount in accordance with state programs. When studying the question "what is a policy", we should talk a little about the territory of its action. In Russia , compulsory medical insurance is made in accordance with the Federal Law, approved on November 29, 2010. The legislation of the Russian Federation stipulates that every citizen who owns the MHI policy has the privileges to receive medical assistance throughout the country absolutely free of charge in the amount of the basic state program. And if the policy is issued on the territory of the regions of the Russian Federation, then in accordance with the framework of regulatory provisions of a particular area. The base volume is approved by the order of the Government of the Russian Federation within the limits of the State Support Program for the provision of free medical care to citizens. In the regions, on its basis, the framework of the territorial compulsory health insurance is established and approved. These programs can not be less in terms of volumes and types of the Basic Program. But the territorial scope may include special types of medical care that are provided at the expense of the subject of the Russian Federation. From all that has been said, it can be concluded that any Russian citizen insured under the MHI in his region has the right to receive medical care in an increased amount (if stipulated in the territorial program) and in the amount provided for in the Basic Program if he is on the territory of others Regions of the country.

Voluntary health insurance

Now let's see what the VHI policy is? What is it for? This type of policy is a type of individual insurance, which allows you to receive medical assistance in medical and preventive treatment facilities that are not included in the CHI program. Voluntary insurance is divided into 2 categories: collective and individual. In the first case, the risk of various diseases in a group of people is taken into account. And individual insurance covers the complexity of a particular disease in a particular person. In this case, either individuals (according to the individual program) or employers (according to collective programs) act as subjects providing services. The role of the insured is played by citizens.

Protection and protection of the rights of insured persons

When studying the question "what is a policy", special attention should be paid to protecting and securing the rights of insured citizens. According to the legislation of the Russian Federation, this type of protection is dealt with by:

1. Employer.
2. Organs of executive or legislative power of RF regions.
3. Fund of territorial importance of MHI.
4. Insurance medical institutions and their communities.
5. Organs of health care control.
6. Medical institutions of a professional type.
7. Hospitals and polyclinics.
8. Antimonopoly Committee and Prosecutor's Office.
9. Roszdravnadzor.
10. Subjects of judicial and pre-trial settlement of disputes.

So we have studied what is the MHI policy, why it is needed and what are the main types of insurance for citizens.