The compulsory medical insurance policy entitles its owners to receive several medical services in the country and abroad for free. Every year, the list of procedures and the requirements of the hospitals’ changes. For this reason, you should know what is included in the compulsory medical insurance in 2020. It is important to familiarize yourself with the information that will protect your rights when necessary.
On the other hand, if you fail to get health insurance for any reason the state can impose a penalty on you for not having one. Therefore you should check with your insurance provider to guide you with the best health insurance plan that meets your family’s requirement.
Following are the list of services for the compulsory medical insurance policy for the year 2020:
The Basic Program of Compulsory Medical Insurance in 2020
The main service of the standard policy is emergency assistance. If there is a threat to the life or health of the insured person, the hospital staff handles it. Therefore, you must have some health coverage plans.
Treatment for compulsory medical insurance covers the following services:
- Medical examination.
- Get an appointment with a doctor who accepts in the clinic to which the insured person is attached.
- Get gynecological services.
- Therapeutic examination at home or in a clinic.
The list of free services includes:
- Surgical intervention.
- Medical advice.
- Services in the field of dentistry and gynecology.
- Other examinations.
Surgical intervention for compulsory medical insurance is possible with the detection of eye diseases:
- Retinal deformation due to injury;
- Strabismus or strabismus (in a child);
- Other anomalies that make life difficult.
The basic compulsory medical insurance program includes surgery of a curved nasal septum. Rhinoplasty is used only according to the doctor’s recommendations.
The doctor must notify you that the surgery of the nasal septum led to:
- Trouble in breathing
- Loss of sense of smell.
- Swelling of the mucosa.
- Frequent SARS.
- Abnormal snoring during sleep.
- Dryness and constant pain in the sinuses.
The compulsory health insurance policy also allows you to remove the gall bladder free of charge. This implies in case of the detection of cholecystitis or malfunctioning of the gastrointestinal tract. Within the framework of the basic program, surgical intervention is available for oncological, gynecological, venous diseases, and the presence of any pathologies.
Free operations eliminate harm to human life and health. Cosmetic surgery within the framework of the basic program is not possible.
Diagnostics by the Compulsory Medical Insurance Policy
It includes the following procedures:
- Ultrasound of the thyroid and mammary glands, pelvic organs.
- MRI and CT.
List of Medical Services for Compulsory Medical Insurance Policy
Free medical examination, according to medical insurance policies, applies at the age of 21 or more. A complete medical examination is necessary every three years.
As part of this policy, there is:
- Blood pressure checkups.
- Tests for glucose, cholesterol in the blood.
- Fluorography (performed annually).
- Dental examination.
- Examination of feces for blood.
- Identification of the risk of cardiovascular disease (for patients under the age of 63 years).
- For women: mammography and general examination by a gynecologist.
- For men: determining the level of prostate-specific antigen and visiting urologist.
After reaching 36 years of age, the list of medical examination services includes:
- Conducting extensive analyzes of urine, feces, blood.
- Examination by an otolaryngologist and an ophthalmologist.
- Consultations with a proctologist, neurologist, and a surgeon.
- Ultrasound of the abdominal cavity.
After 60 years, additional features include:
- Examination by an ophthalmologist and measurement of intraocular pressure.
- Consult with the best neurologist.
- Duplex scanning of arteries.
- For women: cytological diagnosis of a cervical smear.
Which Tests Can be Taken for Free in 2020, Using the Policy
Most of the insurance companies allow getting many tests for free. They are divided into two groups: general clinical and special clinical. The general clinical includes:
- Feces for the presence of blood, protozoa, parasites, pathological changes in the digestive tract.
- Synovial fluid.
- Blood for parasites that cause malaria.
- To identify the phenomenon of “lupus erythematosus”.
- Departments of the urethra and prostate.
- Female genital secretions.
The special clinical group of tests available for free consists of urine and blood tests.
The special clinical group includes:
- General analysis.
- Zimnitsky test.
- The protein level in the morning or afternoon urine.
- Counting shaped elements.
- Determination of the level of calcium, potassium, sodium, phosphorus, alpha-amylase.
- Test for blood in the urine.
In addition to general and comprehensive blood tests, medical institutions conduct studies to determine the level of:
- Hemoglobin in plasma.
- Erythrocyte granularity.
- Mononuclear cells.
- Platelet count.
Often medical institutions can take a blood smear to detect dirofilariasis.
Getting Dental Health Insurance Services
Before visiting a dentist in a state medical institution, check out what is included in the compulsory medical insurance policy for dentistry in 2020:
- Initial inspection and consultation.
- Treatment of diseases of the teeth and gums.
- Removal of tartar.
- Reduction of jaws with dislocations and subluxations.
- Tooth extraction.
- Operations in the oral cavity.
- Disposal of a foreign body located in the dental canal.
List of Free medical services provided to the children:
- Silvering of the tooth surface.
- Enamel saturation with mineral substances.
- Orthodontics using removable products.
Before going to the dentist for the treatment of dental caries, you should know which fillings and other materials are included in the compulsory medical insurance policy:
- Silicate, glassinomeric filling, and phosphate cement.
- Varieties of pastes for polishing teeth.
- Antiseptics and anesthetics of domestic origin.
- X-ray film.
- Other consumables (cotton, bandages, burs).
Free MRI Procedure
Holders of compulsory health insurance policies can do an MRI for free. To do it, it is necessary to check with the insurance company that issued you the compulsory medical insurance policy. You must also ensure whether magnetic resonance imaging is included in the list of services it pays.
If magnetic resonance imaging is included in the policy, you should obtain a referral from the district or head physician of the polyclinic (with the signature of the doctor and the hospital).
These services are provided due to the following reasons:
- Suspected cancer or organ pathology.
- Problems with the heart and blood vessels.
- Ligament rupture.
- Impaired functioning of the brain.
- Determination of further treatment after surgery.
There are a few more benefits that are considered as an extended list of free medical services. The state pays a payment for these facilities at the hospital expense. Each group of people has a different list of procedures and coverage.
People belonging to the following class can apply for additional government benefits:
- Disabled people.
- Members of large families.
- Citizens who took part in hostilities.
For families in which three or more children are raised, on a preferential basis, the following is carried out:
- Free distribution of medicines for children under six years old with prescriptions.
- Service in polyclinics and hospitals out of turn.
- Trips to sanatoriums.
- Gratuitous receipt of vitamins.
Benefits for retired people include:
- Dentures installation.
- Spa treatment.
- Free annual medical examination with an expanded list of services.
The list of preferential procedures and coverage for people with disabilities depends on the disabled group. Moreover, orphans can apply for medicines prescribed by their doctor, free of charge. Besides, representatives of this social group are required to issue vouchers to sanatoriums, camps, and rest homes according to doctors.
You must check with your health care provider to guide you through the list of benefits and free services a certain insurance plan entails. And then select the one which meets your family’s needs.
Disclaimer: The statements, opinions, and data contained in these publications are solely those of the individual authors and contributors and not of Credihealth and the editor(s).
Call +91 8010-994-994 and talk to Credihealth Medical Experts for FREE. Get assistance in choosing the right specialist doctor in India and clinic, compare treatment cost from various centers and timely medical updates