Medical insurance in Russia is either compulsory (OMS) or voluntary (DMS). The first guarantees free care under a state programme; the second expands the choice of clinics, waiting times and scope of services at the policyholder's expense. Let's see how they work and when it makes sense to combine them.
Compulsory medical insurance (OMS)
OMS is governed by Federal Law No. 326-FZ "On Compulsory Medical Insurance in the Russian Federation". The system is financed by the Federal Compulsory Medical Insurance Fund and territorial funds, while insurance medical organisations (SMOs) deal with insured persons.
Who is insured and who pays
- For working citizens, OMS contributions are paid by the employer as part of social insurance contributions.
- For non-working people — children, pensioners, the unemployed — contributions are paid by the constituent entities (regions) of the Russian Federation.
- Insured persons include Russian citizens, foreigners with permanent or temporary residence rights and some other categories established by law.
The OMS policy
Since 1 December 2022, OMS policies have been issued electronically: a person can obtain an extract from the unified register of insured persons, and a passport is usually enough to visit a clinic. The policy is valid throughout Russia.
What OMS covers
The scope of free care is defined by the basic OMS programme within the State Guarantees Programme: primary health care, emergency care and specialised care, including some high-tech care. The programme also sets maximum waiting times for appointments and tests.
Your rights under OMS
- to choose an insurance medical organisation and change it no more than once a year (before 1 November) or when you move;
- to choose a medical organisation and a doctor — as a rule, no more than once a year;
- to contact your SMO if you are refused free care, waiting times are breached or you are asked to pay for services covered by the programme. The SMO is obliged to protect the insured person's interests.
Voluntary medical insurance (DMS)
DMS is a contract with an insurance company under which it pays for medical services at clinics on the programme list. It is bought by individuals themselves or by employers for their staff.
What DMS gives you
- Choice of clinics. The programme includes specific medical facilities, often private ones in convenient locations.
- Waiting times. Appointments with specialists and tests are usually faster.
- Service. Tests and consultations can often be done in one place; the insurer arranges care through its medical assistance desk.
- Quality control. The insurance company monitors the scope and quality of services and resolves disputes with the clinic.
DMS limitations
- only services included in the programme are paid for — read the list and the exclusions;
- chronic and some serious illnesses are often excluded or covered only partly;
- there are limits and sometimes a deductible;
- for serious illnesses there are separate products, such as critical illness insurance.
OMS vs DMS
| Parameter | OMS | DMS |
|---|---|---|
| Mandatory or not | Mandatory, free for the citizen | Voluntary, paid by the policyholder |
| Scope of care | Basic OMS programme | Programme under the contract |
| Clinics | Medical organisations working within the OMS system | Clinics on the programme list |
| Waiting times | Maximum times under the State Guarantees Programme | Usually shorter, depending on the clinic |
| Where valid | Throughout Russia | Territory specified in the contract |
Taxes and DMS
- For individuals. Premiums under a DMS contract that covers only payment for medical services can be included in the social tax deduction for personal income tax (Article 219 of the Russian Tax Code). Since 2024, the overall limit on social deductions has been RUB 150,000 per year.
- For employers. Expenses on employee DMS under contracts of at least one year are deductible for profit tax purposes within 6% of the payroll. More details in the Employee DMS section.
Foreigners and travel
Foreign workers who are not entitled to OMS must have a DMS policy or a contract with a medical organisation for the provision of care. An OMS policy is not valid abroad — for trips you need travel insurance.
Which to choose
You have OMS in any case — it is worth using and knowing your rights. DMS makes sense if speed, convenient clinics and service are important, especially for families with children and company employees. You can choose a programme by sending a request — Polis Re specialists will compare insurers' offers.