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Budget to finance Social Health Insurance benefits is defined for 2022 - P4H Network

Budget to finance Social Health Insurance benefits is defined for 2022

As part of regular communication with the public, the Social Health Insurance Fund of Kazakhstan publishes explanatory materials for the purpose of awareness building.

A ecent publication reminds readers that mandatory social health insurance system was introduced to improve access to medical care.

The total budget to finance Social Health Insurance benefits is defined and published for 2022. In 2022, it is planned to allocate 2 049 trillion tenge (about 250 USD per person per year as of January 2022) to finance medical care to the population, including the breakdown by benefits packages:

  • 1.2 trillion tenge for the guaranteed free medical care package provided to all regardless of the insurance status, and
  • 838 billion tenge for the mandatory health insurance package available to the insured population.

Guaranteed free medical care is provided to both insured and uninsured citizens, and includes medical care in emergency cases, primary health care, urgent surgical care, treatment of socially significant diseases (the full list can be found here).

Services under mandatory health insurance package are provided free of charge to the insured population. The state pays contributions for 11 million people of the 19 million total population of the country for defined 15 categories of people. Services under this package include:

  •  Outpatient medical care (diagnosis and treatment of diseases):
  1. screenings;
  2. consultations by specialist doctors as referred to by a PHC doctor;
  3. diagnosis and treatment of diseases;
  4. emergency and planned dental care for certain categories of the population;
  5. day hospital and home care; 
  6. procedures and manipulations;
  • Treatment and diagnosis of diseases in acute care hospitals Here we are talking about medical care for all diseases, including expensive surgeries, such as cardiological, orthopedic, hearing surgeries, etc.
  • Medical rehabilitation for all diseases provided for by the diagnostic and treatment protocols;
  • Pathological anatomical diagnostics, which includes histological, cytological and other studies, for which the biomaterial is sent during screening studies, operations, etc.;
  • Diagnostic studies during transplantation;
  • Provision of medicines and medical devices:

“Having the status of an insured person, the patient has access to the greatest number of medical services. Specialist doctor consultations, various tests and studies, such as CT, MRI, ultrasound, X-ray, ECG, diagnosis of most diseases, rehabilitation services, elective operations are included in the insurance benefits package. Insured citizens can now receive these services free of charge when previously they could get them only on an out-of-pocket payment basis,” reminds the Social Health Insurance Fund of Kazakhstan .

It is also reminded that to obtain the insured status, employed people have to have made contributions for the previous 12 months, and the self-employed who pay the Single Integrated Payment, have to have at least three timely payments for the last months, including for the current month.

 Source: Social Health Insurance Fund