An expat guide to healthcare and health insurance in Russia

With the dissolution of the Soviet Union in 1991, the health of the Russian population greatly declined (the levels of tuberculosis, cancer, and heart disease are among the highest in industrialised countries). The government has therefore undertaken a succession of reforms since the mid-1990’s and the health statistics have been improving.

The most important reform was the introduction of a national healthcare system, made compulsory in 1996. It offers healthcare to Russian citizens, as well permanent and temporary residents.

This system covers: primary care, preventative care, emergencies (except for specialised emergencies such as air ambulance), and specialised care in all public medical establishments. However, some services are not offered, such as dental, prosthetics, rehabilitation and convalescence, as well as prescribed medicines. In order for these to be covered you would need to sign up to a private health insurance.

The structure of health services

In Russia, there are no private surgeries and all practitioners see their patients in either a clinic or a hospital.

The administration of the health services is divided into different levels: federal, regional, and municipal.

• Health posts: run at a municipal level, they offer out-patient treatment: routine check-ups, vaccinations, and the treatment of non-serious accidents.
• Health centres: with teams of nurses, gynaecologists, paediatricians, and mid-wives; these establishments are usually specialised in maternity and also basic routine surgery. They are also usually run by the local municipality.
• Urban polyclinics: these are regional establishments, offering a wide-range of services: screening, treatment of chronic conditions, follow-up care. Depending on their size they may even have on-site specialists (cardiologists, oncologists, obstetricians etc).
• Specialised medical hospitals: usually found in large cities, these establishments offer all medical services and are open 24 hours a day. Federal hospitals represent 4% of the number of beds available within the public sector.

Quality of healthcare

The Russian healthcare system has seen some difficulties, in particular linked to a lack of funds. Today, healthcare in Russia remains below the standard of other industrialised countries: there is a lack of medical equipment, differing standards of care depending on the medical establishment, shortfalls in primary care etc. The well-reputed hospitals in Moscow or Saint Petersburg do not offer all services (e.g. contagious illness and maternity complications are not treated).

In the public sector, English speaking doctors are few and far between. In order to see an English speak doctor it is advisable to seek treatment at a private clinic, however fees in the private sector can be high.

For these reasons, expatriates are advised to have a medical insurance in order to enable them to be treated in private facilities abroad.