The healthcare structure in Russia

Explore how the healthcare setup in Russia operates and how to locate a pharmacy, physician, or medical center in the nation.

The healthcare framework in Russia may appear akin to other structures in Europe, with the availability of both governmental and private health coverage for availing medical services in Russia. In reality, comprehending the functioning of the Russian medical system and ensuring adequate health coverage for Russia can be a perplexing and time-consuming task for expatriates moving to Russia.

This comprehensive guide to Russian healthcare comprises of:

• Overview of medical care in Russia;
• The Russian healthcare paradigm;
• Who is eligible for healthcare in Russia?;
• Pricing of healthcare in Russia;
• Health protection in Russia;
• Enrollment process for healthcare in Russia as an expat;
• Exclusive healthcare amenities in Russia;
• Physicians and experts in Russia;
• Women’s medical services in Russia;
• Pediatric healthcare in Russia;
• Consulting a dentist in Russia;
• Medical facilities in Russia;
• Health establishments and centers in Russia;
• Locating a pharmacy in Russia along with operational times;
• Mental wellness services in Russia;
• Alternative medical services in Russia;
• Emergency healthcare in Russia;
• Health assessments for expats in Russia;
• Individuals required to undergo medical evaluations;
• Medical examination procedure;
• Consequences of not undergoing tests;
• Emergency terminologies in Russian healthcare;
• Helpful references.

Overview of healthcare in Russia

The healthcare system in Russia

Healthcare in Russia is complimentary for all inhabitants through a compulsory state medical insurance initiative. Nevertheless, the state healthcare structure has been subject to significant critique due to insufficient organizational planning, meager government funds, outdated medical tools, and underpaid personnel.

Consequently, several expatriates in Russia opt for private medical care, widely accessible in many regions. Patients seek consultations with physicians, dentists, and medical specialists either through the government framework or via private channels. In recent times, a few state establishments have commenced offering private services to those with insurance coverage. Certain private providers also render public medical facilities.

The oversight of the Russian public healthcare framework is managed by the Ministry of Health (Ministerstvo Zdravoohraneniya – in Russian), employing over two million individuals. Moreover, federal regions possess their respective health departments (e.g., Moscow Health Department) overseeing local governance.

European Health Insurance Card in Russia

The European Health Insurance Card (EHIC)
A study by Bloomberg positioned Russian healthcare at the lowermost rank out of 55 developed nations based on the efficiency of state healthcare setups. Russian citizens seemingly share a similar sentiment, with merely 2% expressing pride in the Russian medical system in a 2016 survey conducted by Moscow-based polling agency Levada Center.

Although not devoid of drawbacks, the healthcare standard in Moscow surpasses that in numerous parts of Russia, where approximately 17,500 towns and villages lack any substantial medical infrastructure.

Who can avail healthcare services in Russia?

Every Russian national and resident is entitled to cost-free public healthcare through the Russian healthcare system via Obligatory Medical Insurance (OMI).

Foreign nationals residing in Russia, spanning both permanent and temporary residents, are eligible for public healthcare services under OMI. Several expat residents are also covered by voluntary healthcare insurance (VHI), an additional coverage generally facilitated by employers.

Unemployed foreign nationals holding a residence permit may be qualified for an OMI policy under specific criteria; it is advisable to verify this through a medical insurance provider that is part of the Russian healthcare system.

Starting from January 2016, the previous healthcare reciprocity agreement between the UK and Russia ceased to be valid. Consequently, UK visitors to Russia must procure private medical insurance. EU citizens holding a European Health Insurance Card (EHIC) should consult their respective governments to ascertain if they have access to Russian healthcare prior to their visit.

For individuals not from the EU, it is essential to confirm whether their home country has a mutual healthcare arrangement with Russia. If not, usually one must furnish evidence of healthcare coverage while applying for a Russian visa.

Healthcare Expenses in Russia

In 2019, Russia allocated 5.65% of its annual GDP towards healthcare. This figure is below the current global average but surpasses all EU countries except Romania.

OMI contributions are primarily covered by employers. Once you commence employment in Russia, your employer will allocate approximately 2–3% of your earnings towards a social tax. A portion of this tax is then directed into a national Russian healthcare pool. Upon payment of this compulsory medical insurance by the employer, you are entitled to free medical services from public healthcare facilities in Russia.

Those unable to contribute to OMI due to joblessness (e.g., unemployed individuals, retirees, minors, incapacitated individuals) still qualify for cost-free basic healthcare.

Health Coverage in Russia

Upon your employment in Russia, your employer will enroll you in OMI and commence regular contributions. Many employers additionally provide VHI as a component of their benefits package, which covers certain services not encompassed by OMI like dental treatments and specific outpatient services.

Individuals in Russia may also opt for individual private health insurance schemes. Private insurance confers access to a broader spectrum of healthcare options. Typically, with private insurance, individuals are obligated to make upfront payments and subsequently seek reimbursement from their insurance provider.

Certain insurance companies mandate pre-authorization, necessitating policyholders to contact their insurer before utilizing medical services in Russia.

Guide for expats regarding healthcare registration in Russia

If you are employed in Russia, usually your employer will handle your registration for state healthcare in Russia.

You can also personally register for Russian healthcare by visiting a local healthcare facility or physician’s office. However, it is advisable to have a Russian speaker accompany you. Essential documents to present include:

• personal identification or valid ID;
• Russian residence permit;
• Proof of residence.

You can enlist your child in your OMI scheme by submitting your passports, residence permit, and your child’s birth certificate to the Ministry of Health (Ministerstvo Zdravoohraneniya).

Private Healthcare in Russia

The private healthcare segment in Russia has expanded significantly in recent years, particularly in major cities such as Moscow and St. Petersburg. To access private medical services, individuals must acquire private health insurance.

Several private insurers operate in Russia and offer coverage that includesprocedures like oral care, expert care, and mental well-being therapies. Payment of fees in advance is usually required, followed by seeking reimbursement.

A mere 5% of the populace in Russia opts for private healthcare, whereas numerous expatriates opt for private health protection. If not covered by insurance, private treatment is accessible, but you will need to fund the entire expenditure by yourself. A rough estimate of standard charges comprises:

– $25-50 for an initial assessment with a private general practitioner or expert;
– between $150-700 for private therapy
– up to $50 for an oral examination;
– between $50-100 for an overnight stay in a private medical facility

Medical professionals and experts in Russia

Russia is distinguished for its exceptional medical professionals and experts, yet amenities in public hospitals are frequently inadequate, and wait times can be extensive. Usually, you can schedule an appointment by contacting your clinic, and appointments can be arranged during regular daytime hours as well as evenings in specific cases.

You have the liberty to select the family physician (vratch) you want to be affiliated with. Nevertheless, if you are utilizing a public healthcare system, you must ensure that your physician is contracted to deliver public healthcare. Upon registration with the physician (and subsequently during your visit), provide evidence of your Russian health insurance.

Physicians in Russia

Certain health establishments (polyklinika) in Russia are linked with hospitals and employ both general practitioners and specialists. Similar to many other nations, a primary care physician can refer you for further therapy or provide a prescription, enabling you to procure medication from a Russian pharmacy.

As a foreign national, during your visit to your family physician, it is wise to always have the contact details for your insurer, the clinic, and your embassy on hand in case a situation arises. If you necessitate the support of an English-speaking family physician, refer to our manual on discovering English-speaking physicians overseas.

Women’s medical services in Russia

Women’s healthcare in Russia consists of access to gynecologists and maternal care facilities, although countless expatriate women prefer private health coverage for comprehensive services. Maternal care encompasses regular examinations and prenatal classes. Even though most hospitals conduct classes in Russian, you can inquire at your global healthcare center regarding prenatal classes offered in English.

Childbirth in Russia

Contraceptives are readily accessible over-the-counter from pharmacies without the need for a prescription. During the Soviet era, these were commonly distributed at no cost, but presently, they usually require payment. Officially, emergency contraception necessitates a prescription, yet it can often be procured from a pharmacy without one.

Testing for sexually transmitted infections (STI) is offered by both public and private clinics, although the availability may vary among different regions. The quality of facilities is likely to be superior in larger, more densely populated cities.

Russia does not implement nationwide cancer screening programs. In metropolitan areas like Moscow, routine screenings for breast cancer and cervical cancer are conducted.

Abortion is legally permitted up to the 12th week of pregnancy in Russia. In special circumstances, such as jeopardy to the mother’s life or health, abortions can be performed up to the 28th week of pregnancy.

Healthcare services for children in Russia

Comparable to the general populace, children’s healthcare in Russia exhibits significant diversity across various regions. Healthcare amenities are more widespread in urban areas.regions and metropolitan areas, while the rural regions often lack adequate infrastructure.

In Russia, children benefit from complimentary healthcare through the OMI program. This encompasses dental services in the country. Major urban centers like Moscow and Saint Petersburg boast a plethora of pediatricians, specialized clinics, child therapists, and dedicated children’s wings in medical facilities. Routine health check-ups are a standard practice during their formative years. Health provisions are also extended through educational institutions and nurseries.

Expatriates have the option to secure healthcare coverage for their children via private insurance policies in Russia. This grants them access to a broader spectrum of medical professionals, pediatric specialists, and treatments, including some that are not offered under the state-run healthcare system.

Russia boasts a commendable vaccination rate for children, ranging between 92-95%, with vaccines being covered either by OMI or private insurance plans. The national vaccination regime includes immunizations against various ailments like:

• Diphtheria and Tetanus;
• Measles, Mumps and Rubella;
• Hepatitis B;
  Polio;
• Influenza.

Seeking dental care in Russia

Dental treatments in Russia are typically self-financed or included as an optional add-on in private health insurance schemes. Should you opt for a non-private dental clinic, it may be advisable to have a Russian-speaking companion. Dental establishments in Russia cater to a wide array of services, ranging from preventive and corrective procedures to aesthetic enhancements, with some operating round the clock.

There are numerous dental clinics in Moscow catering to expatriates, including:

• American Dental Centre;
• Dental Art;
• European Medical Center.

Hospitals in Russia

There are typically three categories of hospitals in Russia – public institutions, locally-owned private facilities, and internationally-oriented private establishments. Private hospitals generally offer superior customer service, minimal waiting periods, and staff proficient in English. However, some clinics may only handle uncomplicated cases and lack inpatient care capabilities, necessitating a transfer to a different medical facility in instances of severe health concerns.

Moscow hosts a majority of the renowned hospitals in Russia, as per rankings by the CSIC. Notable facilities include the Center of Neurology Moscow, the European Medical Center Moscow, the American Medical Center Moscow, and the Russian Children’s Hospital Moscow.

Healthcare centers and medical facilities in Russia

Every province in Russia has its own government-funded healthcare centers (polyklinika). These may operate autonomously or in conjunction with state hospitals. Physicians commonly practice at polyklinika, as well as specialized practitioners in Russia.

In the private sector, numerous health institutions and medical centers offer both inpatient and outpatient services. The availability of facilities would be contingent on your locality and the resources accessible in your vicinity.

Finding a pharmacy in Russia and its operating hours

Russia hosts over 17,000 pharmacies, with municipal bodies owning 60%, regional governments possessing 23%, and the remaining 17% being privately held. A pharmacy in Russian terms is referred to as apteka, while a prescription is known as a retsept. Pharmacies are distinguished by the globally recognized green cross symbol.

In addition to standalone pharmacies, pharmacy kiosks are also prevalent in major supermarkets and certain metro stations in Russia, albeit with limitations on the types of medications they can dispense.require a prescription. The pharmacies in Russia typically operate during similar hours as stores, yet Moscow boasts numerous 24-hour pharmacies. You can access a compilation of pharmacies and pinpoint the nearest Russian pharmacy via the mapping service offered at vapteky.ru.

There are certain medications that may require a prescription back home but can be purchased over the counter in Russia. Nevertheless, specific Russian medications like pain relievers and anti-depressants will necessitate a prescription from your physician. While pharmacists can provide basic medical guidance, they are not permitted to issue prescriptions.

The expenses for medications have surged significantly in Russia. As per the research conducted by Moscow’s Higher School of Economics, the cost of essential Russian-made medicines escalated by a whopping 28.9% in 2015, whereas imported drugs experienced a price increase of 4.9%.

Mental health services in Russia

Russian legislation ensures the entitlement of citizens to psychiatric care as a fundamental right. Nonetheless, the state’s provision of mental health services has been inadequately funded in Russia since the dissolution of the Soviet Union. The quantity of mental health professionals has dwindled in recent times. According to the World Health Organization, there are presently 8.5 psychiatrists and 4.6 psychologists for every 100,000 individuals in the population.

Session for group therapy

If you require mental health therapy in Russia, you can consult your general practitioner who will then recommend the necessary treatment. This may involve outpatient care at a specialized hospital, psychotherapy, community-based treatment, or admission to a psychiatric facility for more severe conditions. General practitioners and specialists are authorized to prescribe medications when deemed necessary.

The treatment plan will be contingent on the type of illness and the services accessible in your vicinity. Expatriates have the option to select private insurance, granting them access to private facilities like psychotherapists and alternative therapy options. In metropolitan areas such as Moscow, English-speaking therapists can be found. It’s advisable to check with your insurance provider in advance to ascertain the extent of coverage for treatments.

Additional healthcare options in Russia

Alternative and complementary medicine practices are unlikely to be integrated into the state healthcare system in Russia. However, there is a prevalent culture of alternative remedies and unconventional treatments in various regions of the nation.

Therapies such as homeopathy, acupuncture, herbal medicine, and chiropractic care can be obtained and occasionally reimbursed through private health insurance. If the treatment you desire is not covered under your insurance plan, you can opt for additional coverage at an added cost or pay for the treatment upfront at the time of service.

Emergency medical services in Russia

In the event of an emergency in Russia, dial 112 and request an ambulance. Regrettably, these phone lines are exclusively operated in Russian, so having a Russian speaker present to detail your location and the nature of the emergency is advisable.

A medical professional will accompany the ambulance and if necessary, transport the patient to the nearest hospital, or to a private facility if the patient holds comprehensive private insurance. Furthermore, there is a fee-based ambulance assistance available in Moscow, accessible by dialing (495) 777 4849.

Irrespective of your health insurance status, initial medical attention during emergencies is provided free of charge.

Below are some essential numbers for emergency situations:

Medical emergency hotline: 112
Emergency number for Moscow:Healthcare services: 103

Discover a compilation of emergency contact numbers in Russia for various accidents and crisis situations.

Health assessments for foreign nationals in Russia

Starting in late 2021, Russia has mandated that expatriates and long-term guests must provide biometric data and undergo obligatory health evaluations.

Who is required to undergo health check-ups?

These evaluations are applicable to individuals residing in Russia for more than 90 days, except for diplomats, personnel of international groups (along with their families), children below six years old, and citizens of Belarus. The tests need to be done within 30 days of arrival in Russia or when applying for a work permit. It is not yet certain how frequently foreigners will have to update their evaluations, so it is essential to monitor the Ministry of Internal Affairs website.

Process of health evaluations

The health assessments aim to identify narcotics and mind-altering substances, in addition to severe contagious ailments like leprosy, HIV, COVID-19, tuberculosis, and sexually transmitted diseases. The procedure may encompass:

• Blood examinations;
• Urine analysis;
• Chest X-ray.

Upon your appointment, you must bring your identification, migration document, and registration. Generally, the tests are priced between 4,200 to 6,600 rubles. Depending on the outcomes, you will be issued a medical report that contains a declaration of being examined and an HIV absence certificate.

After receiving the documents from your medical test, you will be required to provide your biometrics; such as your fingerprints and image. This can be done either through the Ministry of Internal Affairs or an authorized institution. Additionally, you must exhibit your ID and a document confirming your HIV negativity and successful completion of the other health tests.

It is worth noting that these health tests hold validity only if conducted at an accredited medical facility. Currently, there are very limited such facilities, and determining where valid tests can be conducted isn’t always straightforward. Some sources indicate that the sole option in the Moscow area is the Sakharovo migration center, while others argue that alternatives are available. Therefore, it is recommended to consult with your employer to ascertain where other expatriates have undergone their assessments.

What are the consequences of not undergoing the tests?

If you fail to undertake the evaluations on time, it is possible for authorities to restrict your duration of stay. Notably, discovery of drug use or contagious diseases in your tests could lead to a prohibition on entry or residence in Russia.

As expected, the new protocol for foreigners residing in Russia has faced criticism for being ‘discriminatory,’ ‘disheartening, and scandalous.’ There have also been objections from employees regarding the intrusive nature of the tests.

Essential medical terms in Russian for emergencies

Haven’t yet grasped Russian completely? No worries, here are some fundamental medical phrases to assist you in times of need:

Support! – Pomogitye!

Dial an emergency service! – Pozvonitye v skoruyu pomosh’!

Medical facility – bolnitsa

Pardon me, I require help! – Izvinitye, mnye nuzhna pomosh’!

Physician – vrach

Primary Care Physician (PCP) – terapevt

On-call physician – dezhurniy vrach

Dental specialist – zubnoiy vrach

Pharmacy – apteka

Medicine – lekarstvo

Recipe – ryetsyept

Healthcare clinic – polyklinika

Insurance – strakhovka