Obtaining a quota for an operation. Obtaining a quota for high-tech medical care. When can I get a quota for treatment?

03.04.18 53 226 0

To worry only about health

My niece has a weak heart, so she has been under the care of a cardiologist since she was three years old. When she turned eleven, the doctor said it was time to operate.

Svetlana Fateeva

helped my niece get a quota for surgery

This is normal practice: surgery is always a risk, so doctors try to do without it until the last minute. The niece was getting worse, and there was nothing more to wait for. The cardiologist reassured us: the operation was planned and not very complicated. The problem is different: it is not covered by the compulsory medical insurance policy, and the cost is almost 300 thousand rubles.

We are lucky that there is a quota for such treatment. Now my niece rides her bike in the yard, but we didn’t pay a penny for the operation.

What's the quota?

Quotas are not issued in money: instead, the Ministry of Health distributes them among clinics at the beginning of each year. Therefore, getting a quota means getting a referral for surgery to a clinic that will treat you using quota funds. There are 139 clinics in Russia that have the right to treat under a quota.

You can only get a quota for high-tech medical care, VMP, which is not covered by the compulsory health insurance policy. For example, there are no quotas for removing the appendix - it will be done free of charge. compulsory medical insurance policy. And if we are talking about heart surgery, then you will first have to get a quota.

Operations on open heart.
Organ transplantation.
Joint endoprosthetics.
In vitro fertilization.
Neurosurgical interventions.
Treatment of hereditary diseases, leukemia, severe forms endocrine pathology.
Surgical interventions high degree difficulties.
Nursing newborns using modern methods.

Quotas are allocated for elective surgeries. It is not yet very clear how everything works if, to save the patient’s life, VMP is needed, which is not included in the compulsory medical insurance. On the one hand, medical lawyers explain on forums that the system is simple: no quota - no operation. On the other hand, by law, clinics are required to provide emergency medical care free of charge.

The doctors interviewed were unable to comment on the situation. If you were saved with the help of VMP and you didn’t pay anything for it, tell us how you managed it without receiving a quota.

On its website, the Ministry of Health describes what the process of obtaining a quota looks like. To do this, you need to go through three commissions: at the referring medical institution, at the Ministry of Health and at the clinic where the operation will take place.

Commission at the referring medical institution

The commission is collected at the hospital or clinic. Doctors study the results of examinations and, if there are indications, give a referral for VMP.

Before the commission, you need to undergo all examinations, take tests and obtain a doctor’s opinion. Sometimes a clinic is enough for this: go to your local physician, do everything he says, and get a diagnosis. But usually the clinic does not do complex examinations, so the doctor refers you to a specialized clinic. For example, in case of cardiovascular pathology, coronary angiography is needed. With a referral through compulsory medical insurance, the clinic will do it for free. Based on the results of the examinations, a diagnosis will be made at the clinic.

After this, your doctor submits the documents to the medical commission and they decide whether there are indications for VMP. If so, you receive a referral to a VMP with the signature of the head physician and an extract from the medical record. With them you can already apply for a quota.

Commission in the Ministry of Health

An application for a quota must be submitted to the appropriate health system authority. Depending on the region, these may be departments of the Ministry of Health, committees, and health departments.

Please attach the following documents to your application:

A copy of the child's passport or birth certificate.
A copy of the Compulsory Medical Insurance and SNILS.
An extract from the medical record is made by the referring medical institution.
The results of studies confirming the disease are obtained based on the results of diagnosis in a clinic or hospital.
Referral to VMP, signed by the head physician of the referring medical institution.

An application for a quota can be submitted independently or with the help of a referring medical institution. You can apply yourself through government services, the MFC or the reception desk of the Ministry of Health.

If a medical institution submits an application on your behalf, it uploads your documents to information system Ministry of Health, so you don’t need to receive them in your hands.

The Ministry of Health commission checks the documents and decides whether there are indications for VMP. If yes, they issue a quota. This process takes up to 10 days, but sometimes it can be sped up. If the medical commission decides that with the usual procedure you will not live to see the operation, it will put a note about this in the referral and your application will be considered faster.

It will take another 10 days to select a clinic where you will be operated on according to the quota. After this, the Ministry of Health sends your documents to this clinic.

The clinic and date of hospitalization can be tracked in the information system of the Ministry of Health using the quota number:

Commission at the clinic

When the clinic receives your documents and quotas for treatment from the Ministry of Health, they will assemble another medical commission. She decides whether you have contraindications for VMP, and if there are none, sets a date for hospitalization and issues a call. You are usually not called for this: the results of examinations and diagnosis are enough. An extract from the protocol with the commission’s decision and the call are sent back to the Ministry of Health through the information system.

You receive your quota for VMP, along with the date of hospitalization and a call for surgery, from the Ministry of Health - in the way that you indicated in the application when submitting documents.

This is where the instructions end - then hospitalization, additional tests, surgery and rehabilitation. The doctors of the clinic where you have registered a quota will guide you on how to properly fill out sick leave upon discharge and give recommendations for further treatment.

It's difficult to get a quota

In the instructions of the Ministry of Health, everything looks smooth, but in reality there are many nuances. Because of them, we performed a bunch of unnecessary actions, and as a result we received the quota the day before the operation. This well illustrates the fact that doctors and officials view the process differently, and it is the patient who suffers.

Payment and treatment are two parallel and independent processes. Doctors handle the treatment, and the patient deals with the payment. A quota is just a type of payment. Until there is a quota, the doctor will not be able to operate on you.

Officials understand that for a person, treatment and receiving a quota is a single interaction with the healthcare system, which ordinary life doesn't concern him. Therefore, they are trying to build a consistent scheme, but so far it is crude and the patient constantly stumbles upon the fact that some kind of certificate is missing.

It happens that doctors meet patients halfway and coordinate their work with officials or even take it upon themselves to obtain a quota. If the system works perfectly, this is how it should be. But for now this is rather an exception.

The experience of people who received a quota helps, but it is different for everyone. Depending on the disease, interpretation of the rules regional authorities and the experience of doctors, it can be months of running around or a simple visit to a specialist at the clinic, who will fill out an application in the information system and notify you when the Ministry of Health confirms it.

There is no guarantee that my family’s experience will save you from bureaucracy, but it will help save time and nerves.

Operation code

This is not mentioned in the instructions, but before applying for a quota it is not enough to obtain a diagnosis and a doctor’s opinion. You need an operation code - without it a quota will not be given. We didn’t know this, and the doctors at the clinic lost sight of it. Because of this, we made an extra circle and lost a week.

At the Bakulev clinic, the niece was diagnosed and told that she needed to get an extract from her medical card at the clinic and collect documents for the quota. We did everything, and the clinic submitted our application to the Ministry of Health. She had to enter documents into the information system for registration, but it didn’t work: she didn’t have enough VMP code.

The fact is that the state allocates money not for correcting the interatrial septum, but for the method by which this problem will be solved. The method is written in the system as a numeric code, for example 14.00.37.005. This is the VMP code. While he is not there, the state does not know how much treatment costs, so it cannot issue a quota.

We called the clinic to determine the VMP code. They explained to us that when the doctor knows exactly how he will operate, then there is no problem: the code is indicated in the direction. But in our case, there were two treatment methods and the surgeon was going to choose the optimal one at the pre-hospitalization consultation. There was a false start with the application.

We were offered the following plan: wait for a call for hospitalization from Bakulev by mail, come when called with documents for a quota and hospitalization, immediately undergo a consultation to determine the method of surgical treatment and receive a referral for VMP. After this, you will have all the documents on hand to submit your application to the Ministry of Health. And there will be a day left before the operation to get your quota.

How to quickly submit an application to the Ministry of Health

We did not know that if we submit an application in person to the Ministry of Health, the documents will be reviewed on the same day. Bakulev explained that this is possible: we have all the documents for the quota ready, and there is no need to select a clinic, because it is already known where we will be operated on.

We went to the Moscow reception of the Ministry of Health at MONIKI and stood in line for several hours. The registration itself took 5 minutes: checking documents, filling out an application with a specialist - and we have a quota.

How to have surgery in a specific clinic

According to the instructions, the Ministry of Health selects the clinic, but, as it turned out, it is possible to have surgery in a specific clinic. To do this, it needs to be included in the list of institutions that provide the medical care you need under a quota.

If you are already being observed in a specialized clinic where you were diagnosed, then the scenario will be similar to ours.

The doctor in Bakuleva told me what documents need to be attached to the application in order for the quota to be given specifically to them. Essentially, you take on part of the work of Ministry of Health officials in selecting a clinic. In this case, the clinic is the sending and receiving institution - two commissions take place in one place. Based on the results of the first, you receive a referral to VMP. Based on the results of the second, an extract from the protocol with the decision of the commission, which verified that there were no contraindications for hospitalization. The date of the operation is also indicated there and it is indicated that the clinic is ready to accept you according to the quota. With this document, you will be given a quota to the clinic you need.

If you have not been observed at the clinic, but want to have surgery there according to the quota, then simply sign up for initial appointment in the advisory department. You will need test results - full list Please check the documents when making an appointment or on the clinic’s website. Based on them, the doctor will make a conclusion and submit it to the selection committee for VMP, which will issue a referral, a call for hospitalization and an extract from the protocol with the decision of the commission.

Now about how to get an appointment at the clinic.

If you don’t want to pay, you will have to go to the clinic and get a referral for a consultation at the clinic using form 057/u-04. It is used to send a patient to another medical institution within the framework of compulsory medical insurance for examinations, clarification of the diagnosis, consultations and hospitalization. Without this form free reception I couldn’t make an appointment even with a call from the clinic.

With the diagnosis from Bakulev, we went to a cardiologist at our clinic and received a referral in form 57/u-04. We went with him on call to the Bakulev clinic to clarify the method of treatment and hospitalization.

After consultation with the referral and an extract from the protocol of the clinic commission, we went to the Ministry of Health and received a quota in Bakuleva. The next day there was surgery.

Certificates and tests for hospitalization

Formally, hospitalization is not associated with receiving a quota, but in reality we had to do everything at the same time.

To be in the clinic you need certificates and tests. Each diagnosis has its own list, which is indicated in the call for hospitalization. Tests can be done free of charge under the compulsory medical insurance policy; directions will be issued by a therapist at the clinic.

It will not be possible to take tests in advance, because the certificates have an expiration date. For example, expert opinions, tests for AIDS and RH factor are valid for a month, clinical analysis blood and urine - 10 days, certificate from an epidemiologist confirming the absence of contact with infection - 3 days.

Doctors understand that some deadlines are too strict, so they try to meet them halfway. For example, we received a certificate from an epidemiologist on Friday, June 9, the working day before the holidays. The hospitalization was on June 13, right after the holidays, and the certificate had already expired. The clinic treated this with understanding and accepted the expired certificate.

But it’s better not to take unnecessary risks. If during hospitalization it turns out that a certificate has expired, you will not be able to be admitted to the hospital.

For hospitalization, you can also use the results of tests that you took before, for example, to obtain a quota. Therefore, just in case, keep the originals of all tests and examination results. If they do not expire before hospitalization, they will come in handy.

Who pays for what?

If everything works out, the state will pay for consultations, examinations, tests, the patient’s hospital stay, food, surgery and rehabilitation if completed within a year after the operation. If you belong to a preferential category, you will pay for travel to the clinic and back.

400 R

it is worth spending the night in the rest room in Bakuleva for one of the parents

But you will have to pay for some services. For example, if a child is being operated on, the parents’ meals and accommodation in the clinic are paid for. In Bakuleva, an overnight stay in a rest room cost 400 R per night, and we ate in a cafe on the hospital grounds.

In addition, there are special procedures that are not regulated by law. For example, radiation therapy can be done for free, but markup for it will be paid. Searching and activating a donor in foreign registers is also paid. In theory, you can get your money back for this, but you will need a good lawyer, who will cost more than the procedures themselves.

If the patient is a child

Hospitalization with a parent. In order for a child to be hospitalized accompanied by a parent, you will need the parent’s passport, SNILS, a compulsory medical insurance policy for issuing sick leave and tests for being in the hospital - a list of them is in the call for hospitalization.

If it's 18 the other day. If you applied for a quota at the age of 17, and by the time of the operation you turned 18, then the quota is invalid. In this case, it is easier to wait until you turn 18, get a referral from an adult clinic or referring institution, and then submit documents to the Ministry of Health.

If there are not enough quotas

Quotas are distributed at the beginning of each calendar year and their number is limited. If they run out, as a rule, you have to wait for the next one. Therefore, it is easier to get a quota at the beginning of the year. You can find out about the availability of quotas in the department of the Ministry of Health in your region or in the quota department of the clinic where you plan to have the operation.

But something can still be done.

Submit documents for a quota- you will be put on a queue and notified as soon as the state allocates new ones. Sometimes patients refuse a quota: for example, when an urgent operation is needed and there is no time to wait for registration. This quota may be given to you.

Check with the Ministry of Health about quotas in other regions. It happens that similar operations are carried out in neighboring regions and there may still be quotas left there. You can apply for treatment there, but you will have to go through the commission again.

Apply for an additional quota to the regional Ministry of Health. This option is only suitable if the operation is not urgent, because the application will be processed for three months or longer.

If you were unable to obtain a quota and time is pressing, save all documents, certificates and receipts - you can use them to get tax deduction for treatment. Judicial practice shows what to return full amount There is almost no chance through the Ministry of Health, and a 13% deduction is better than nothing.

If there are no places in the clinic

It happens the other way around: the quota is in hand, but there are no places in the clinic. The waiting period for help is not regulated by law: you can wait a month or a couple of years - depending on your luck. The plan of action is the same as when there is a shortage of quotas: get in line and at the same time look for a clinic that performs the operation you need and will take you according to the quota.

The Ministry of Health will begin searching for a clinic abroad after federal clinics respond to two of its requests with an opinion on the availability of indications for treatment abroad. There is no list of diseases for which treatment is impossible in our country.

If the decision is positive, the commission sends the documents to the partner clinic abroad, enters into an agreement with it and transfers funds for housing, travel and daily allowances to the patient’s account. Upon return, the patient reports expenses.

What's the result?

If the doctor said that you need an operation for 300 thousand, check to see if the state will pay for it.

In order for the state to pay for treatment, you need to get a quota: in essence, this is a coupon for an operation. To do this, you will have to go through three commissions: two medical and one commission of officials. The system doesn't work perfectly yet, so don't expect everything to go smoothly.

But in some places you can lay straw:

After the first medical commission, the application for a quota is sent to the Ministry of Health - check that the operation code is included in the direction of this commission. He is the one who is quoted. It looks something like this: 14.00.37.005.
If you apply for a quota in person, through the reception desk of the Ministry of Health, you will have to stand in line for several hours, but the documents will be reviewed on the spot and a quota will be immediately allocated. It will take up to 10 days to select a clinic if you do not resolve this issue yourself in advance.
To be operated on in a certain clinic, you need to go through three circles of hell. First, ask the doctor at the clinic for a referral to a consultation at this clinic. Then go through all the examinations and take all the tests that the clinic asks for. And finally, the clinic’s doctor will make a diagnosis, make a conclusion and transfer your documents to the clinic’s quota commission. If VMP is indicated for you and there are no contraindications, you will receive a referral for VMP and an extract from the protocol with a decision to treat you according to the quota. Attach all this to the application for a quota, which you will submit to the Ministry of Health. Only then will the quest “Getting a Quota in One Day” be credited to you.
And at the same time, make sure that your tests do not expire before hospitalization. If there is such a risk, go to the clinic to see a therapist, ask for a referral and take it again.

I understand that all this is like juggling, when you have to hold a tray with a glass of water on your head and not spill anything. If you have to get a quota, do not hesitate to ask questions to doctors, acquaintances and friends on social networks until it becomes clear. For example, if a friend told you that the clinic did not give him documents, try to find out why this happened and how this may affect you. Your region may have its own application process. It also happens.

Try to gather your courage and treat receiving a quota as a solution to a work problem. This will help you not to switch to emotions, concentrate and avoid mistakes.

The quota for the operation implies that high-tech medical care will be provided with the help of funds allocated from the federal budget. Everyone has the right to take advantage of a certain number of quotas for different types issued by the Ministry of Health. We are talking about a list of services that are not available but are expensive.

The fact is that such operations (on the heart, blood vessels, aorta, its main branches, organ transplantation and a number of others) are very resource-intensive, which is why the state provides financial support in order to perform a certain number of such surgical interventions. But you need to keep in mind that quotas for operations do not include the treatment of varicose veins lower limbs, as he believes a large number of patients.

Every year, the Ministry of Health puts forward a plan that determines the volume of assistance based on the number of patients and the distribution of quotas by region. This document is compiled in accordance with applications received from regional health organizations from all over the country. As a rule, its compilation is a very complex process. The fact is that in addition to patients who are included in the so-called Waiting List, there are emergency situations when the provision of assistance occurs unscheduled, in accordance with the existing referral for urgent hospitalization.

Obtaining a quota for an operation includes a number of clearly defined stages, a list of documents and strict requirements, the compliance with which will determine the speed of its receipt. Let's look at this in more detail.

The operation quota will not be issued to all those who simply want to receive it. At the initial stage, there must be a referral issued by the attending physician, which must indicate strict indications for receiving free high-tech assistance. This is the primary link. Next, you will need a conclusion from a regional specialist and, finally, the patient must undergo a commission in regional Ministry healthcare. Without these three steps, a quota for the operation is not allocated.

The list of required documents is as follows:

pension insurance certificate;
passport;
insurance policy;
pensioner's certificate;
certificate of disability.

The following should be kept in mind. There is a certain time period, which includes consultations and paperwork. It lasts at least twelve weeks, from diagnosis to referral. Situations often arise when it is necessary to undergo further examination. Then this period will increase to fourteen weeks. Therefore, you will need to wait and complete all stages of obtaining a state quota.

This subsidy may be denied at one level or another. In the same case, if the patient believes that this violates his rights and current legislation, then he can appeal the inaction or actions of officials.

A written appeal must be drawn up and sent to the relevant authority or addressed to the official.
Within thirty days, this appeal will be reviewed and the result communicated.
It is possible that this period may be extended. In this case, the citizen who sent the appeal must be notified accordingly.

There are more than a hundred operating centers in Russia, which, in accordance with the permission of the Ministry of Health, have the right to provide high-tech medical care when a quota for an operation is issued.

A quota is a certain amount of money that the state allocates to a person for treatment. Absolutely everyone has the right to a quota, Art. 34 Federal Law “On the fundamentals of protecting the health of citizens in the Russian Federation.” The quota from the Ministry of Health is not issued in real money, but represents a referral for surgery. That is, treatment in the clinic is carried out at the expense of quota funds, the patient himself does not pay anything. In Russia, more than 130 clinics work according to this principle. Further about who and how can count on free medical care under the quota.

Getting a quota: important to know

It will be possible to use the quota only if we are talking about high-tech medical care (HTMC). The procedure should cost more than what is provided for in the compulsory health insurance policy. For example, you can remove the appendix free of charge under the compulsory medical insurance policy, and for open surgery the heart will need a quota. In addition, such state support is possible for organ transplantation, in vitro fertilization, joint replacement, and neurosurgical interventions.

People with leukemia should receive free treatment under the quota, hereditary diseases, severe forms of endocrine pathology. Quotas are issued for planned operations, nursing newborns and complex surgical intervention. Treatment outside the country is subject to quotas. In this case, the commissions that should be passed will be determined by the Ministry of Health, and the decision-making process will take up to 3 months. Representatives of the ministry will begin to look for a clinic abroad after several federal clinics confirm that the required treatment cannot be provided in Russia. If all is well, the documents are provided to foreign colleagues. An agreement is concluded with the partner clinic, and funds covering, among other things, travel expenses are transferred to the patient’s account.

In Russia, an applicant for a quota undergoes a commission at the medical institution that sends him, at the Ministry of Health, and directly at the clinic where the operation will be performed. Let's look at each step in more detail.

How to get a quota?

To begin with, the patient is examined, takes tests (it is important to remember that, for example, a blood test is valid for 10 days, and for AIDS and RH factor - 30 days), and receives a statement with the diagnosis. If the examination is complex, the therapist sends him to a specialized clinic. Compulsory medical insurance is useful here, under which you can do all the necessary manipulations for free. A conclusion based on the results obtained is issued at the clinic. Next, the attending physician submits the papers to the medical commission, where they decide whether VMP is indicated. If yes, the corresponding direction with an extract from the medical record is signed by the head physician. The documents allow the applicant to apply for a quota to the department of the Ministry of Health in a specific region.

In addition to the application, extract and referral, you will need a passport with a birth certificate (if the child is being treated). You need copies of SNILS and compulsory medical insurance. When the patient is a child, his parent provides the listed documents in his name, not forgetting about taking tests. Consent to data processing is signed. The research results are attached. When submitting documents not by the applicant himself, but by the medical institution on his behalf, everything necessary will be uploaded into the information system of the Ministry of Health, so there is no need to receive documents in hand. After checking and approving the VMP, the ministry commission issues a quota. IN serious cases The review process is accelerated, although in general it lasts up to 10 days.

Together with a quota from the Ministry of Health, you can apply to the clinic where you will undergo treatment. By law, the ministry must choose a clinic themselves, but this takes about 10 days. In addition, in practice, the patient often decides this issue himself. If you choose a clinic on your own, you will need to get a referral there from your therapist (form 057/у-04).

The medical commission will review the documents and issue a call for the operation, as well as set a date for it. Usually the patient at this stage they don't call. A protocol is drawn up with the specialists’ decision, an extract from it, a summons is attached to it, and all this is sent to the Ministry of Health.

In order for the quota to be issued for sure, in the direction that is issued by the first commission, it is important to have an operation code. It is indicated if it is known what method will be used to treat. It is the code that is quoted. Simply put, the benefit is given for the technique, and not for the treatment itself as such. It is better to submit an application to the Ministry of Health in person, since the documents will be examined on the spot and immediately issued a special piece of paper, which is a quota.

If everything works out, the state will pay for the tests, consultations, food, stay in the clinic and surgery with rehabilitation. But this does not apply to the parents of a sick child. There are also special procedures that are not subject to government regulation. For example, markup for radiation therapy paid, while the procedure itself is provided free of charge.

If there are not enough places or quotas

Quotas are distributed at the beginning of the year. Since their number is limited, they often have to wait for a new opportunity. Therefore, it is easier to obtain a quota in the first months of the calendar year. You can find out how many are left through the Ministry of Health or the quota department of the clinic where the operation will be performed. As a rule, the applicant is put on a waiting list and informed if someone has refused the quota. It wouldn’t hurt to find out about the availability of benefits in neighboring regions. Then you will have to go through the commission again.

If there is a quota, but there are no places in the clinic, the patient gets on the waiting list and simultaneously searches for other medical institutions on the Ministry of Health portal. When you manage to find another clinic, the necessary papers (application for a quota, etc.) will have to be submitted again.

Finally, we note that even if you save receipts and supporting documents, it is almost impossible to return the funds spent on treatment. Most likely, you will have to spend more on the services of a lawyer than on the treatment itself. Therefore, if the quota was refused, you can use the right to a 13% tax deduction. Better than nothing.

Sometimes situations arise when a seriously ill patient needs high-tech medical care, but does not have the necessary financial resources. It is for this category of citizens that the quota is designed - a document through which, at the expense of state appropriations, the patient is provided surgery.

The validity of this document applies only to government agencies.

What operations can you get a quota for - the main types of diseases that give you the right to receive a free quota

All points regarding the provision of quotas to the population for treatment are prescribed in Order of the Russian Ministry of Health of December 29, 2014 (No. 930n).

The list of ailments for which a patient can receive a quota is very long. You can find out more about this list from your doctor, or search online sources - Appendix 4 to the Order of the Ministry of Health and Social Development.

Quotas for treatment are provided only disabled people ! Those who do not have a group must first undergo a Medical and Social Examination.

In general terms, the pathologies for which benefits for surgical intervention are requested from the state can be characterized as follows:

Serious disruptions internal organs, which requires their transplantation.
Various
Carrying out manipulations on the open heart.
Errors in the functioning of the brain, which can be eliminated through surgery.
Congenital pathologies, diseases endocrine system, leukemia.
Surgical procedures on the spine.
Violation of the functions of the visual organs.

In the above mentioned Order of the Ministry of Health and Social Development There is a column about emergency situations.

For example, if a patient has an extensive myocardial infarction that requires the installation of a stent, but relatives cannot give the clinic guarantees about payment for this very operation, the administration of this medical institution does not have the right to refuse hospitalization.

The patient is required to provide necessary help with further informing the health authority (at the place of registration) about the procedures performed.

Full list therapeutic measures is formalized, and in the future the clinic is paid money for the work performed.

Preparatory examination for obtaining a quota - where to undergo a medical examination?

To obtain the quota in question, patients with a serious illness should visit several medical commissions:

1. Commission at the clinic at the place of registration

Here the relevant specialist prescribes an examination, after which a meeting of the first commission is held. At positive result the patient is given a document signed by the head physician of the clinic stating that the patient needs high-tech treatment. An extract from the medical history is attached to this document.

2.Commission of the regional health department

If the decision is made in favor of the patient, he is provided with a document-coupon with detailed information about the diagnosis and medical history.

3. Commission at the medical institution where they plan to provide treatment

The main points that are clarified during the meeting:

Is this institution capable of providing the patient with the necessary medical care?
Does the patient have any contraindications to hospitalization?

List of documents for obtaining a quota for a free operation

When planning to begin the procedure upon receiving a quota for surgical treatment, the patient should prepare the following documents:

Statement , which contains the patient’s full name, home address, contact phone number, Email(if any), series and number of passport/birth certificate.
Written consent to the processing of personal data .
Photocopy of passport or birth certificate (if the patient is under 14 years of age).
Extract from the patient's medical record about the history of his illness. This document is issued by the clinic at the place of residence on behalf of the head physician.
Results of hardware and laboratory tests , on the basis of which the diagnosis was established. According to Russian regulations, the patient has the right to keep the originals of these documents with him, and the commission is provided with copies.
Photocopy of compulsory health insurance and/or pension insurance policy . This applies to patients who have such evidence. In the absence of policies, the package necessary documents comes without them.

If the patient does not have the opportunity to personally prepare and submit documents, and uses the services legal representative, to the list discussed above are additionally attached:

A copy of the legal representative's passport.
Statement on his behalf.
Official confirmation of representation. It may also be a duly certified power of attorney.

Instructions for obtaining a quota from the Department of Health - where to go and what will be needed?

The procedure in question is as follows:

Visiting your doctor (at the clinic at the place of registration). The doctor decides what tests need to be taken and writes out a referral for diagnostics.
Execution of an extract from the medical history by the doctor mentioned above. The results of the survey are also included here. The specified document must be certified by the signature of the head physician and the seal of the medical institution.
Sending the prepared set of documentation to the local health department. This is done by the clinic staff upon completion of the medical examination. It would not hurt the patient to clarify and remember the date of dispatch. If a negative decision is made, the applicant is given a protocol explaining the reasons for the refusal.
The Department of Health makes a decision on issuing a quota. In some cases, this procedure requires the patient’s personal presence, but often they do without it. All this takes 10 working days: after this period, the applicant must contact his clinic and find out about the answer. In emergency situations, when surgical intervention must be performed urgently, the attending physician attaches a corresponding note to the package of documents: this speeds up the process of obtaining a quota.
Sending documents to a specialized clinic. Often the patient has to wait in line for hospitalization. About the date of appearance medical institution can be found on the website talon.gasurf.ru. Upon hospitalization, the patient must present originals medical documents.

Instructions for obtaining a quota in the clinic through the quota committee

This method of obtaining a quota is more preferable: the patient can personally choose a medical center for treatment, and the procedure itself lasts, on average, 2 weeks.

The algorithm of actions in this situation is as follows:

After receiving the required package of documents from the clinic at the place of registration with a positive decision of the commission, the patient independently looks for an institution where he will be provided with high-tech treatment.
Specialists from the specified medical institution consider the patient’s request, convene a “quota committee”, which considers the possibility of hospitalization under a quota.
An officially issued decision, along with a list of other documents, is sent to the local health department.

Queue for quota surgery – what do you need to remember?

Those who are planning to receive a quota for surgical treatment need to remember the following points:

It is better to start the procedure for obtaining a coupon at the beginning of the year. Nowadays, seriously ill people who need urgent operations quite a lot: quotas run out quickly.
You can find out how the queue is progressing on special websites (one of them has already been mentioned above) or in the clinic where assistance will be provided.
You can find out about the availability of quotas from your local health department or medical facility. , where high-tech treatment will be carried out. Each such institution has its own quota department, where specialists will tell you whether there are still coupons for free operations and how many are left.
If surgery is needed urgently , and the quotas have ended, the patient can pay all expenses, and in the future - submit a set of documents to the health department. In this way, you can offset the costs of treatment.
At difficult situations, when an operation is urgently needed and there is a quota, the clinic has no right to refuse help. In other cases, patients will wait their turn: the legislation does not provide for any benefits to help speed up the provision of treatment.

The most popular questions about obtaining quotas for free surgery - answered by specialists

— What is the best way to get a quota - in the department or through the clinic?

— It is definitely better to receive a quota through the clinic: the patient will have the opportunity to personally familiarize himself with the institutions, and processing the request will take less time than carrying out the same procedure through the department.

— How to find out about the availability of quotas and what to do if there are no longer quotas for the operation?

— Vouchers for free surgical intervention are distributed among several medical institutions. If some institutions have run out of them, this does not mean that the opportunity to get the help you need lost as soon as possible.

You can find out exactly how many quotas remain and which clinics have them at your local health department.

If quotas have expired, the patient must still go through the procedure for obtaining them. If the answer is positive, they are put on a waiting list.

Applicants will receive the long-awaited quota as soon as the state allocates a new portion of coupons.

— What may be charged for during a free operation under a quota?

- If medical institution where the operation will take place is in another city, the patient must pay for travel independently. Although these expenses can be covered by a compulsory health insurance policy.

To receive a free travel voucher, you need to contact the Foundation with a package of documents.

In addition, the quota is not always completely free. For some nuances of treatment, the patient will have to pay out of his own pocket.

Modern medicine is extremely expensive, especially for surgical interventions, dental procedures and treatment of serious and fatal diseases. Despite the existing medical insurance system in Russia, you often have to pay for treatment yourself, since the policy does not even cover part of the costs. In this regard, residents of the country have the right to count on a quota for operations, which require modern equipment, which is not available in regional hospitals. The number of quotas and the scope of their application are reviewed by the Ministry of Health of the Russian Federation annually. Procedures for providing free treatment the completion of examinations and medical procedures at the patient’s place of permanent residence, and only sometimes it is possible to get the opportunity to get an operation in the capital. Let's figure out how to get a quota for surgery in Moscow for nonresidents in 2019.

Types of quotas for treatment and operations

The law guarantees any citizen of the country to receive a quota if the need for treatment or surgical intervention arises. Social status, financial situation and age are not important. The following types of quotas are distinguished:

to carry out an operation (organizing the necessary surgical intervention for citizens in need of material support at the expense of the federal budget);
for the treatment of disease ( free provision all necessary for the treatment of the patient medicines);
for IVF or in vitro fertilization (free artificial insemination procedure);
for high-tech medical care or high-tech medical care (provided to patients whose candidacy was approved by the commission of the Ministry of Health).

In what cases can you get a quota?

Everyone cannot get a quota, otherwise the queues would be so long that the patients who need help most would not wait for surgery. Therefore, the Russian Ministry of Health has developed a closed list of diseases, if identified, you can receive a quota for treatment. To the main types of diseases and surgical interventions relate:

complex surgical operations, requiring high professionalism of the doctor, extensive experience of the specialist, high-tech equipment (including operations on the eyes, spine);
serious illnesses inherited, leukemia (bleeding);
neurosurgical operations to detect a brain tumor;
installation of a prosthesis hip joint(for dysplasia) or another type of prosthesis (endoprosthetics only);
internal organ transplantation (priority heart, liver, kidney transplantation);
nursing firstborns during the first days of life;
open heart surgeries (including repeated ones).

In total, the list includes 140 diseases and types of operations, the identification of which is subject to a quota for treatment in Moscow.

Each medical institution in the capital receives a certain number of quotas and undertakes to organize treatment or surgery only if medical center there is an appropriate specialist with experience, as well as all the required equipment. The clinic must meet the requirements and standards.

How to get medical care in Moscow for nonresidents

Residents of many Russian cities believe that it would be fair to receive medical care in the capital as soon as the need for it arises, since, unlike small cities, Moscow has a huge number of clinics that have installed equipment that has no analogues in any other populated area point. That is, the capital has the opportunity to provide medical care to all Russians, however, the number of quotas is still limited.

At the legislative level, it is determined that the quota is allocated exclusively at the place of registration, since their number for each city is limited. And since large cities have their own waiting lists for operations, quotas for out-of-town patients would force patients to wait years for treatment.

To obtain a quota in Moscow, you must receive a referral from the Ministry of Health or the regional health authority, and you must also provide all documentary evidence of the diagnosis.

You can get a quota for an operation in Moscow only if there is no suitable specialist or equipment in the patient’s city of residence. Otherwise, it will be impossible to get a referral to the capital.

Conditions for obtaining a quota for surgery in Moscow

There is a certain procedure for registering a quota for an operation, it is as follows:

The patient must receive a referral for surgery signed by the head physician of the clinic at the place of registration. You will also need an extract from the medical history, which will be studied by a commission authorized to refer patients for surgery.
The commission, if the application is approved, issues a coupon for hospitalization in a regional clinic located in the region of registration of the applicant. There, the papers will be examined by a second commission for no more than 10 days, after which they will be sent to a clinic specializing in this disease, located in any city in the country. That is, first the patient is examined in a local hospital, then in a regional one, and only then in a specialized one.
Specialized clinic will independently decide through the third commission whether it is possible to carry out the operation. If the decision is made in favor of the patient, he will receive a notification indicating the timing of his appearance.

The procedure for obtaining a quota for an operation in Moscow, the necessary documents

In order for you to be allocated a quota to conduct medical procedures or operation, you must proceed as follows:

Go to the attending physician at the clinic at your place of registration, ask him to draw up an individual examination plan for you.
Take the examination, even if it is paid (no one will compensate for its cost, even if the quota is not received in the end).
Collect all the required documents (the list will be discussed below), send the papers to the local medical commission.
Wait for the commission’s decision (you won’t have to wait more than 3 days).
If the commission approves your candidacy, you will have to wait about 10 more days while the papers are reviewed by the regional commission.
If the second commission confirms the need to allocate a quota, your documents will be sent to a specialized clinic, where you will undergo treatment or wait for surgery.

Document	Where to get it
	–
Photocopy of Russian passport (for adult patients)	Ministry of Internal Affairs of the Russian Federation
Child's birth certificate (for children under 14 years old)	Civil registry offices
Photocopy of medical policy	Insurance Company
Certificate of compulsory pension insurance (SNILS)	Pension Fund
Photocopy of insurance account	FSS
Extract from the medical history (signed by the chief physician of the local clinic)	At the place of observation of the course of the disease
Original certificates with the results of examinations and analyzes	Medical laboratory
If you plan to receive a free travel voucher to the clinic, please also prepare:
Original referral for surgery or treatment under the allocated quota	Medical commission
A document indicating the existence of rights to such a benefit (conclusion of a medical and social examination for disabled people, pension certificate for pensioners, veteran’s certificate, etc.)	USZN and other government agencies, depending on the type of certificate

A quota for IVF can be obtained by completing following instructions:

Contact your local gynecologist or antenatal clinic.
Complete the prescribed medical examination (payment for procedures and tests is at the patient’s expense).
Collect everything Required documents(the list will be presented below), send the papers for consideration by the medical commission.
Wait first for the decision of the regional commission, then the regional one (in total no more than 2 weeks).
If the decision is positive, you will receive a quota for IVF in a specialized clinic.

You will need to prepare the following documents:

statement about the need for IVF under a quota;
photocopy of Russian passport;
social security card;
original extract from the medical history (signed by the chief physician);
original certificates of medical examination and laboratory tests.