System Analysis and Design New Century Health Clinic

Discover how the Russian healthcare system works and how to find a Russian pharmacy, doctor, or hospital in the country.

The Russian healthcare system might seem similar to other systems elsewhere in Europe, with both state and private health insurance available for accessing healthcare in Russia. In truth, though, understanding how the Russian healthcare system works and ensuring you have adequate health insurance coverage for Russia can be a confusing and time-consuming business for expats relocating to Russia.

This guide to Russian healthcare includes:

• Russian healthcare system overview
• Costs of healthcare in Russia
• Health insurance in Russia
• How to register for healthcare in Russia as an expat
• Private healthcare in Russia
• Doctors and specialists in Russia
• Women's healthcare in Russia
• Children's healthcare in Russia
• Visiting the dentist
• Hospitals in Russia
• Health centers and clinics in Russia
• Finding a Russian pharmacy and opening hours
• Mental healthcare in Russia
• Other forms of healthcare in Russia
• Russian healthcare in an emergency
• Useful resources

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COVID-19 in Russia

The COVID-19 pandemic has been a difficult time for everyone. Many expats find themselves separated from family and loved ones in their home countries. As a foreigner, it is also sometimes difficult to find critical information regarding coronavirus infection rates, local measures and restrictions, and now, thankfully, vaccinations.

• For general coronavirus health information in Russia, consult our guide to the COVID-19 pandemic in Russia.
• For official COVID-19 measures, rules, and vaccine schedule in Moscow, visit the official Moscow Mayor's COVID-19 website.

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Overview of healthcare in Russia

The Russian healthcare system

Healthcare in Russia is free to all residents through a compulsory state health insurance program. However, the public healthcare system has faced much criticism due to poor organizational structure, lack of government funds, outdated medical equipment, and poorly paid staff.

Because of this, many expats in Russia choose private medical treatment which is widely available in many areas. Patients access doctors, dentists, and medical specialists through the state system or privately. In recent years, some state facilities have begun to offer private treatment to those with insurance. Some private providers also offer some public healthcare services.

The Russian Ministry of Health (министерство здравоохранения in Russian) oversees the Russian public healthcare system, and the sector employs more than two million people. Federal regions also have their own departments of health (e.g., Moscow Department of Health) that oversee local administration.

The European Health Insurance Card (EHIC)

A Bloomberg report ranked Russian healthcare last out of 55 developed countries based on the efficiency of state healthcare systems. Russian citizens seem to be of a similar opinion, with only 2% saying they were proud of the Russian healthcare system in a 2016 survey by Moscow-based polling agency Levada Center.

While it is by no means perfect, healthcare in Moscow is far better than in many parts of Russia, where some 17,500 towns and villages across the country have no medical infrastructure to speak of.

Who can access healthcare in Russia?

Every Russian citizen and resident receives free public healthcare under the Russian healthcare system via Obligatory Medical Insurance (OMI).

Foreign residents in Russia, both permanent and temporary, can access public healthcare through OMI. Many expat residents are also covered by voluntary healthcare insurance (VHI) which is supplementary insurance usually offered through employers.

Unemployed foreign citizens with a residence permit may eligible for an OMI policy under certain conditions; you will need to check via a medical insurance company that is subscribed to the Russian healthcare system.

As of January 2016, the previous reciprocal healthcare agreement between the UK and Russia is no longer in effect, meaning that visitors to Russia from the UK need to take out private medical insurance. Other EU residents who carry a European Health Insurance Card (EHIC) should check with their home government whether they can access Russian healthcare before coming to Russia.

For non-EU citizens, you must check if your home country has a reciprocal healthcare agreement with Russia. Otherwise, you will typically need to show proof of healthcare coverage when applying for a Russian visa.

Costs of healthcare in Russia

Russia spent 5.27% of its annual GDP on healthcare in 2016. However, this is below the current global average of around 10%. It is also lower than all EU countries except Romania.

Employers finance OMI through contributions. Once you begin working in Russia, your employer will pay around 2–3% of your salary into a social tax, a percentage of which is paid into a national Russian healthcare fund. Once an employer pays this compulsory medical insurance, you have the right to free medical assistance from public Russian healthcare clinics.

Those who cannot contribute to OMI due to not working (e.g., unemployed, pensioners, children, those too ill to work) can still access free basic healthcare.

Health insurance in Russia

When you start working in Russia, your employer will register you for OMI and start making monthly contributions. Many employers also offer VHI coverage as part of their benefits package. This covers some treatments not included in OMI, such as dental care and some outpatient treatments.

Individuals in Russia can also take out separate private health insurance plans. Private insurance entitles you to the full range of healthcare services. With private insurance, you generally have to pay upfront and claim reimbursement from your insurance company.

Some insurance providers require pre-authorization, meaning that you must contact your insurance company before using medical services in Russia.

Some of the largest private health insurance companies in Russia include the following:

• Allianz Care
• Cigna Global

How to register for healthcare in Russia as an expat

If you are working in Russia, your employer will usually ensure you are properly registered for state healthcare in Russia.

You can also register for Russian healthcare yourself by visiting your local health center or doctor's surgery, although it is advisable to take a Russian speaker along with you. You will need to provide your:

• passport or valid ID
• Russian residence permit
• proof of address

You can register your child on your OMI plan by supplying your passports, residence permit, and your child's birth certificate to the Ministry of Health (министерство здравоохранения).

Private healthcare in Russia

The private healthcare sector in Russia has grown over the past couple of decades, especially in the bigger cities such as Moscow and St Petersburg. To access private treatment, you will need to take out a private health insurance plan.

There are many private insurers operating in Russia that will cover treatments such as dental care, specialist care, and mental health treatments. You will usually need to pay fees upfront and claim reimbursement.

Only around 5% of Russians use private healthcare but many more expat residents take out private health coverage. Private treatment is available without insurance but you will have to cover full costs yourself. A rough guide of general costs is:

• $25-50 for a consultation with a private GP or specialist;
• between $150-700 for private treatment
• up to $50 for a dental check-up;
• between $50-100 for an overnight stay in a private hospital

Doctors and specialists in Russia

Russia boasts some excellent doctors and specialists, although facilities in state hospitals are often substandard and waiting times can be very long.  You can usually make an appointment by calling your clinic, and appointments are available both in the daytime and in the evening in some cases.

You can choose which family doctor (vratch) you register with, although if you're using a state healthcare scheme, you'll need to ensure your doctor is contracted to provide state healthcare. When you register with the doctor (and later when you visit), you should provide proof of your Russian health insurance.

Some health centers (polyklinika) in Russia are associated with hospitals, and employ both GPs and specialists. As in many other countries, a family doctor can refer you for further treatment, or provide you with a prescription allowing you to pick up medicine at a Russian pharmacy.

As a foreign citizen, when visiting your family doctor, it makes sense to always have phone numbers for your insurer, the clinic, and your embassy in case something goes wrong. If you require the assistance of an English-speaking family doctor, read Expatica's guide on how to find English-speaking doctors abroad.

Women's healthcare in Russia

Women's healthcare in Russia includes access to gynecologists and maternity care services, although many expat women choose private health insurance to access a full range of services. Maternity care includes regular check-ups and childbirth classes. While most hospitals run classes in Russian, you can ask your international healthcare center about English-speaking pre-natal classes.

Contraceptives are easily available over-the-counter from pharmacies without a prescription. However, whereas these were often provided for free during the Soviet era, they usually have to be paid for nowadays. Emergency contraception formally requires a prescription, but you can often obtain this from a pharmacy without one.

Both state and private clinics provide testing for sexually transmitted infections (STI), but availability varies across regions. Facilities are likely to be better in the more populated bigger cities.

There are no nationwide cancer screening programs in Russia. In cities such as Moscow, breast cancer screening, and cervical cancer screening is carried out routinely.

Abortions are legal in Russia up to 12 weeks into the pregnancy. They can be carried out up to 28 weeks into the pregnancy in special cases, such as if there is a risk to the life or health of the mother.

Children's healthcare in Russia

Similar to healthcare for the population as a whole, children's healthcare in Russia varies greatly across the regions. Services are far more prevalent in urban areas and big cities, while infrastructure is lacking in many rural parts.

Children receive free healthcare in Russia under the OMI system. This includes dental care in Russia. In cities such as Moscow and St Petersburg, there are many pediatricians, specialist services, child psychologists, and children's wards in hospitals. Children receive regular screenings during early years. Health services are also delivered through schools and kindergartens.

Expats can cover their children through private health insurance in Russia. This will give them access to a wider range of doctors, pediatricians and services, including some services not available through state healthcare.

Russia has a high percentage of vaccinated children – between 92-95% – and vaccinations are covered through either OMI or private health insurance. The Russian vaccination schedule includes inoculations against diseases such as:

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

Visiting the dentist in Russia

Dental care in Russia is usually paid for either separately or as an additional extra on a private healthcare insurance package. If you decide to go to a non-private dental clinic, you might need to take a Russian speaker with you. Dental clinics in Russia offer everything from preventative and restorative treatment to cosmetic treatment, and some even open 24/7.

There are many dental clinics in Moscow for expats, including:

• American Dental Centre
• Dental Art
• European Medical Center

Hospitals in Russia

There are generally three types of available hospitals in Russia – state facilities, private national facilities, and western-oriented private facilities. Private hospitals generally provide the highest level of customer services, shorter waiting times, and English-speaking staff, but some clinics are only able to deal with non-complicated cases and can't provide inpatient care, so would need to transfer you to a different hospital if you have a more severe medical issue.

Moscow boasts the vast majority of Russia's best hospitals, according to rankings from the CSIC, Some of the top-ranked facilities include the Centre of Neurology Moscow, the European Medical Center Moscow, the American Medical Center Moscow and the Russian Children's Hospital Moscow.

Health centers and clinics in Russia

Each region of Russia has its own state-funded health centers (polyklinika). These can be independent facilities or linked to state hospitals. Doctors often work out of polyklinika, as do specialists in Russia.

In the private sector, there are many health centers and medical centers that provide both inpatient and outpatient care. What facilities you have access to will depend on your location and what is available in your area.

Finding a Russian pharmacy and opening hours

In total, Russia has more than 17,000 pharmacies, with 60% belonging to municipal authorities, 23% to regional governments and 17% owned privately. A Russian pharmacy is known asapteka, and a prescription is called aretsept. Pharmacies are identified by the internationally-recognized green cross sign.

In addition to standalone pharmacies, you can also find Russian pharmacy kiosks in major supermarkets and some metro stations, although medical kiosks can only sell medicine that doesn't require a prescription. Russian pharmacies are usually open the same hours as shops, but Moscow has many 24-hour pharmacies. You can find a list of pharmacies and locate the nearest Russian pharmacy using the map service provided at vapteky.ru.

Some medicines for which you might need a prescription back home can be bought over the counter in Russia, although you will need a prescription from your doctor for certain types of Russian medicine such as pain killers and anti-depressants. While pharmacists can give basic medical advice, they can't write you a prescription.

Medicine costs have increased steeply in Russia. According to research by Moscow's Higher School of Economics, the pride of Russian-made essential medicines increased by a staggering 28.9% in 2015, while imported drugs increased in cost by 4.9%.

Mental healthcare in Russia

Russian law guarantees the rights of citizens to psychiatric care as a civil right. However, state-provided mental healthcare has been poorly funded in Russia since the break up of the Soviet Union. The number of mental health professionals has reduced in recent years. According to the World Health Organization, there are currently 8.5 psychiatrists and 4.6 psychologists per 100,000 of the population.

If you need mental health treatment in Russia, you can visit your GP who will refer you onto necessary treatment. This could be for specialist outpatient treatment at a hospital, psychotherapy, community-based treatment, or a stay in a psychiatric unit for more serious problems. GPs and specialists can prescribe medication if necessary.

Treatment will depend on the nature of the illness, as well as what is available in your region. Expats can choose private insurance which will give them access to private facilities such as psychotherapists and alternative therapy treatments. In cities such as Moscow, you can find English-speaking therapists. Check with your insurance company first to see what treatment is covered.

Other forms of healthcare in Russia

Forms of alternative and complementary medicine are unlikely to be found through the state healthcare system in Russia. However, there is a culture of alternative treatment and non-traditional medicines that exists in many parts of the country.

Homeopathy, acupuncture, herbal therapy, and chiropractic treatment can be sourced and sometimes covered through private medical insurance. If your insurance package doesn't cover the treatment you want, you can usually pay extra for this an add-on or pay the full cost of the treatment at the point of service.

Emergency healthcare in Russia

In an emergency in Russia, you should dial 112 and ask for the ambulance service. Unfortunately, these lines are operated entirely in Russian, so it's best to have a Russian speaker with you if possible to explain exactly where you are and what the problem is.

A doctor will come with the ambulance and if required take the patient to the local hospital, or a private hospital if they have adequate private insurance. There is also a paid ambulance service in Moscow, which can be reached by calling (495) 777 4849.

Regardless of your health insurance status, you can receive initial medical care for free in emergency situations.

Here are some useful numbers in case of emergency:

• Medical emergency number: 03
• Moscow emergency medical care: 628 0003
• Find a list of emergency phone numbers in Russia for all types of accidents and emergencies.

Useful resources

• Ministry of Health of the Russian Federation
• Moscow Department of Health
• St Petersburg Department of Health

Emergency Russian healthcare terms

• Help! –Pomogitye!
• Call an ambulance! –Pozvonitye v skoruyu pomosh'!
• Hospital –bolnitsa
• Excuse me, I need help! –Izvinitye, mnye nuzhna pomosh'!
• Doctor –vrach
• General Practitioner (GP) –terapevt, semeynoy
• Duty doctor–dezhurniy vrach
• Dentist –zubnoiy vrach
• Pharmacy –apteka
• Medicine –lekarstvo
• Prescription –ryetsyept
• Health centre –polyklinika
• Insurance (s) –strakhovka

System Analysis and Design New Century Health Clinic

Source: https://www.expatica.com/ru/healthcare/healthcare-basics/healthcare-in-russia-104030/