Ninety-seven percent of Kazakh population included in compulsory health insurance database

NUR-SULTAN – Ninety-seven percent of the Kazakh population is included in the compulsory health insurance database, reported PrimeMinister.kz. Since Jan. 1, hospitals nationwide have provided medical care according to the guaranteed volume of free medical care (GOBMP) and compulsory social health insurance (OSMS).

“The work will continue with the remaining 3 percent, or about 550,000 people. More than 88 percent of people already have insurance status, including 54 percent or 10 million people that belong to the preferential categories of people, and others are employees, sole proprietors, persons working under civil agreements and self-employed citizens. The number of self-payers is 2.2 million people, or 12 percent of the population,” according to the release.

All citizens have conditional insurance regardless of whether they contribute to the Health Insurance Fund by April 1. Free procedures include magnetic resonance tomography, computer tomography, enzyme immunoassay and polymerase chain reaction.

According to the Ministry of Healthcare, it is too early to provide any significant results from social health insurance, but most patients feel hospital service has improved and consultative and diagnostic assistance has become more accessible.

The Social Health Insurance Fund received approximately 250 billion tenge (US$660 million) in payments from July 1, 2017-Dec. 31, 2019. Almaty, the capital and the Karaganda Region led in total contributions. All OSMS funds are kept in the National Bank.

The medical information systems were tested as part of the pilot project in the Karaganda Region and identified deficiencies were eliminated. Twenty accounting contribution and service payment information systems were integrated using the fund’s systems, Ministry of Healthcare, specialised government agencies and National Bank.

Employers will pay 2 percent of employee salaries this year and 3 percent after 2022. In addition, 1 percent will be deducted from salaries this year and 2 percent in 2021. Those who are self-employed contribute a single payment equal to one monthly calculation index (MCI) (2,651 tenge (US$7)) in cities or 0.5 MCI (1,326 tenge (US$3.50)) in villages. Thirty percent is designated for pension savings, 40 percent for the Social Health Insurance Fund and 10 percent for income tax.

All other population categories contribute 5 percent from their minimum salary (2,225 tenge (US$5.80)) as independent payers.

GOBMP includes primary healthcare and emergency and ambulance services. An individual can make an appointment with a local doctor and receive referrals to local diagnostic testing services or for a doctor’s consultation.

In case of socially significant, chronic or deadly diseases, a patient will receive a full range of medical services such as specialists’ consultations, diagnostic examinations, hospital treatment, medical rehabilitation and palliative care regardless of his or her participation in OSMS. The list includes diseases such as cancer, diabetes mellitus, arterial hypertension, coronary heart disease, HIV, hepatitis and tuberculosis.

If a doctor refuses to provide medical services, the patient can contact Medical Insurance Fund single contact centre at telephone number 1406.

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