In Russia, health insurance is either compulsory (OMS) or voluntary (DMS). Almost everyone has an OMS policy, and it costs the insured person nothing. DMS is bought separately or provided by an employer. Here is what each one gives you and how they work together.
What is OMS
Compulsory health insurance (OMS — obyazatelnoe meditsinskoe strakhovanie) is governed by Federal Law No. 326-FZ of 29 November 2010 "On Compulsory Health Insurance in the Russian Federation". It is a state system: contributions for working people are paid by employers, and for non-working people by the regions of the Russian Federation. The insured person receives medical care within the OMS programme free of charge.
What the basic programme includes
The basic OMS programme is part of the Programme of State Guarantees of Free Medical Care, approved annually by the Government of the Russian Federation. It includes:
- primary health care, including prevention, medical check-ups (dispanserizatsiya) and preventive examinations;
- emergency ambulance care (except air medical evacuation);
- specialised inpatient and day-hospital care;
- some types of high-tech medical care — according to an approved list;
- medicines during inpatient treatment.
Regions approve their own territorial programmes, which may be broader than the basic one. The basic programme applies nationwide, so an OMS policy also lets you receive care in another region.
Emergency medical care in life-threatening situations is provided by medical organisations immediately and free of charge — whether or not you have a policy.
The OMS policy: how to get it and what has changed
For Russian citizens the OMS policy is open-ended. Since 1 December 2022, data on insured persons has been kept in a single register of insured persons, and the policy can be obtained in digital form — as an extract from the register. Previously issued paper and plastic policies remain valid.
You can get a policy at a health insurance organisation (SMO — strakhovaya meditsinskaya organizatsiya), at a multifunctional public service centre (MFC) or on the Gosuslugi public services portal. Parents apply for a child's policy.
Your rights as an insured person
- choose or change your SMO — once a year, by applying before 1 November; more often if you move or the SMO ceases operations;
- choose your clinic and doctor — as a rule no more than once a year, except when you move;
- receive care free of charge within the OMS programme and demand that waiting time limits be respected;
- contact your SMO if you are refused care or asked to pay for something included in the OMS programme — the SMO must protect the insured person's rights.
OMS for foreigners
OMS covers foreign nationals who permanently or temporarily reside in Russia (holding a residence permit or a temporary residence permit), as well as workers from Eurasian Economic Union (EAEU) member states. Foreigners temporarily staying in Russia and working under a patent (work permit) need a DMS policy to obtain the patent. Tourists and visitors are not entitled to OMS — they need medical insurance for their trip to Russia.
What is DMS
Voluntary health insurance (DMS — dobrovolnoe meditsinskoe strakhovanie) is a contract with an insurance company under which it pays for medical services at clinics on its list. The terms are set by the programme: the range of services, list of clinics, limits and exclusions. DMS does not replace OMS but complements it.
What a DMS programme may include
- outpatient care: doctor appointments, tests, diagnostics;
- home doctor visits and telemedicine consultations;
- planned and emergency hospitalisation;
- dental care;
- additional options — rehabilitation, pregnancy care, programmes for children.
DMS usually does not cover treatment of chronic conditions outside exacerbations, cosmetology and a number of expensive treatments. Specific risks such as cancer can be insured under critical illness programmes.
OMS vs DMS: comparison
| Parameter | OMS | DMS |
|---|---|---|
| Who pays | the employer or the region | the client or the employer |
| Scope of care | state guarantee programme, the same for everyone | according to the chosen programme |
| Clinics | public and private clinics working within the OMS system | from the insurer's list, often private |
| Term | open-ended for Russian citizens | usually one year |
| Limitations | queues and waiting times under the programme | exclusions, limits, health questionnaire |
When you really need DMS
- you value your time and want to see a doctor without long waits;
- you need a specific clinic or specialist;
- your employer offers DMS as part of the benefits package — then it is worth asking whether relatives can be added;
- you are a foreign national and need a policy for your patent or simply for peace of mind.
An individual DMS policy is usually issued after a health questionnaire; for some conditions the insurer may limit cover or decline.
Tax deduction
Premiums under a DMS contract that covers only medical services can be included in the social tax deduction for medical treatment. Its overall limit is 150,000 rubles a year together with other social expenses. You will need the contract, the insurer's licence and proof of payment.
DMS for employees
Companies arrange employee DMS as part of the benefits package. Premiums under DMS contracts of at least one year can be deducted as expenses up to 6% of the payroll.
What about travelling abroad?
OMS does not work abroad, and a standard DMS policy usually does not either. For trips you need travel insurance — it can be bought online on the website through Polis Re's partner, the Cherehapa service.
How to choose a DMS programme
Compare the list of clinics near your home and work, the programme content, limits, deductible and exclusions. If it is hard to figure out on your own, submit a request — Polis Re specialists will select DMS programmes from several insurance companies and explain the differences.