Compulsory Social Health Insurance (CSHI)

Representatives of the Al-Farabi District akim’s office visited the Peoples’ Friendship University and provided staff and students with information about compulsory social health insurance —  CSHI. First Vice-Rector Жумахан Жаркынбекович gave the floor to the guests, who answered numerous questions. They explained that university faculty and students are entitled to register voluntarily with outpatient clinics and receive medical services.

The event was moderated by the Head of the Social Protection and Cultural Development Department of the Al-Farabi District akim’s office, Салиев Бахтияр Рустембекович. The Head of the Pension and Social Security Department of the Shymkent City Directorate of the Ministry of Labour and Social Protection of the Republic of Kazakhstan, Илеспаев Анвар Амангельдиевич, explained retirement rules in light of recent changes. A representative of the Shymkent branch of the State Social Insurance Fund JSC, Еркимбеков Ыдырыс Сактаганович, described how the state provides benefits.

Compulsory Social Health Insurance (CSHI)

Compulsory Social Health Insurance (CSHI)

The Deputy Director of the Shymkent branch of the Social Health Insurance Fund, Shalkhar Шекимович, provided the following information:

Key principles of the CSHI system:

•  equal access to medical care — every insured person is entitled to the necessary scope of medical care regardless of the amount of contributions paid;

• money follows the patient — patients may choose the medical organisation from which they wish to receive a service, provided it is a Fund provider;

• protection of patients’ rights — the Fund pays medical organisations for services only after monitoring the quality and volume of the care provided.

The guaranteed package of free medical care is provided from public funds to:

• citizens of the Republic of Kazakhstan,

• kandas repatriates,

• refugees,

• foreign nationals permanently residing in the Republic of Kazakhstan and holding a residence permit,

• stateless persons permanently residing in the Republic of Kazakhstan and holding a residence permit.

The guaranteed package of free medical care includes:

1. Emergency ambulance services, including air ambulance services in certain cases.

2. Primary health care services, including:

1) diagnosis, treatment and management of the most common diseases;

2) preventive examinations of target population groups, including children and adults;

3) immunisation (vaccination);

4) development and promotion of healthy lifestyles;

5) reproductive health protection measures;

6) monitoring of pregnant women and women after childbirth;

7) sanitary, epidemic-control and preventive measures in infectious disease outbreak areas.

3. Specialised outpatient medical care:

1) prevention and diagnosis of HIV infection and tuberculosis;

2) services for injuries, poisoning and other urgent conditions, including mobile team services for diseases that worsen the epidemiological situation in the country and suspected cases of such diseases, for everyone regardless of insurance status;

3) diagnosis and treatment of socially significant diseases;

4) diagnosis and treatment of chronic diseases requiring ongoing monitoring.

4. Specialised care in settings that substitute for inpatient hospital care:

1) treatment of socially significant diseases;

2) hospital-at-home services for diseases that worsen the epidemiological situation in the country and suspected cases, for everyone regardless of insurance status;

3) treatment of chronic diseases requiring ongoing monitoring.

5. Specialised inpatient medical care provided:

1) during the isolation of people who have been in contact with someone with an infectious or parasitic disease posing a risk to others, as well as bacterial and viral carriers and people suspected of having a dangerous infectious or parasitic disease;

2) during the treatment of infectious, parasitic and other diseases posing a risk to others;

3) as emergency care regardless of insurance status, including diagnostic and treatment measures in the admissions department of a round-the-clock hospital;

4) on a planned basis.

6. Medical rehabilitation:

1) during treatment of the underlying disease;

2) for patients with tuberculosis.

7. Palliative medical care.

8. Provision of blood products and blood components when medically indicated during specialised medical care.

9. Pathological diagnosis during specialised outpatient, inpatient-substitute and inpatient medical care.

10. Referral of Kazakhstan citizens for treatment abroad and/or engagement of foreign specialists to provide treatment in domestic medical organisations.

11. Provision of medicines, medical devices, specialised therapeutic food products and immunobiological medicines.

Representatives of the Al-Farabi District akim’s office, Шайманова Сандугаш and Алжанова Акбота, provided comprehensive information about the state Bilim life programme, which allows people to save for their children’s future education and receive an annual reward from the state.