More than 6.5 million children are insured in the compulsory health insurance system
More than 6.5 million children are insured at the expense of the state and can receive all the necessary medical care in the compulsory health insurance system. On Children’s Day, the Social Health Insurance Fund spoke about the financing of children’s medicine.
Children under 18 are included in the preferential category of the population, therefore they are insured at the expense of the state.
For each child, the state pays contributions in the amount of 2,989 tenge monthly. According to the Fund, currently 6 million 549 thousand children are insured in the compulsory health insurance system. Thanks to this, small citizens have access to a wide range of medical care in the compulsory health insurance package. The Foundation pays special attention to financing children’s health in all necessary areas.
Caring from birth
An important role is given to the prevention of diseases and health promotion of the child population from the moment of birth. This year, additional funds have been allocated for neonatal screening and assessment of the psychophysical development of infants. In general, for 2021, 12 billion tenge is planned for conducting preventive examinations in the compulsory health insurance system for children from birth to 5 years old. From January to April, children underwent screening tests for the amount of 3.6 billion tenge. In general, for the timely detection of diseases and developmental disorders, preventive examinations covered 4.4 million children, screenings – more than 900 thousand young children. 523 child development rooms have been set up to provide counseling on the issues of caring for young children.
We treat teeth
The OSMS system allows children under 18 years of age to treat their teeth both on an emergency basis and as planned. In doing so, they can count on the following types of dental care: – anesthesia and tooth extraction; – imposition of a seal; – opening of abscesses; – treatment of pulpitis, periodontitis; – complete functional restoration of the anatomical shape of the tooth in case of hypoplasia, fluorosis; – plastics of the frenulum of the lips and tongue; – X-ray; – orthodontic services: in the presence of congenital pathologies of the maxillofacial region and cleft palate (cleft palate). If your child needs the help of a dentist, then you can contact both your polyclinic and private dentistry, which is a potential supplier of the Fund. Their list can be viewed on the website fms.kz in the section
“Purchasing medical services”
– “Providers of KDU services”. In 2021, more than 3.5 billion tenge is allocated for the provision of orthodontic care to children with congenital pathologies. More than 14.2 billion tenge is planned to finance dental services in a planned manner (for children and pregnant women). According to the results of 4 months of this year, children received dental services for 7.3 billion tenge.
From school
With the introduction of health insurance, school medicine also developed. It is aimed at providing medical assistance to children of school and preschool age. It includes conducting preventive medical examinations directly in preschool and secondary educational institutions, disease prevention, vaccination and other measures aimed at protecting and strengthening the health of the child population. From January to April, school medicine services were rendered in the amount of 6.3 billion tenge. In general, in 2021, 22.5 billion tenge is provided for school medicine. It should be noted that funding for school medicine has increased 2.6 times. Within the framework of the compulsory health insurance, since 2019, an additional per capita standard for a student has been introduced, which has now been increased by 1.7 times. The equipment of medical offices has improved from 52% in 2017 to 70% in 2020. The number of doctors increased by 16%. 367 school dental offices were opened for comprehensive examination, prevention and treatment.
Medicines for children
The compulsory health insurance system provides for outpatient drug provision for children. For 65 nosologies, including orphan diseases, diseases of the nervous system, circulatory system, musculoskeletal system, developmental delay, 244 drugs and medical products are provided. And within the framework of the guaranteed volume of medical care, children are provided with 274 drugs and medical devices for 35 diseases, including oncology, including malignant neoplasms, hereditary deficiencies of blood coagulation factors, autoimmune diseases and immunodeficiency states, etc. You must contact your local doctor or pediatrician to get medications. In addition, children undergo both emergency and planned expensive surgeries using high technologies free of charge. Neonatal surgery is developing, more than 1,000 surgical interventions are performed annually on newborns with congenital malformations, the effectiveness of which was 88.5%. Over 2,000 cardiac surgeries per year are performed on children with congenital heart defects, of which 77.0% were children in the first year of life; earlier, babies were sent only abroad. The efficiency of open heart surgeries was 95%, endovascular interventions – 99.5%. Also, little patients can count on medical rehabilitation, and for children with special needs the Fund finances the Kamkorlyk rehabilitation program, which is implemented by the Fund of the First President of the Republic of Kazakhstan. There are 34 rehabilitation centers in the country, 3 of which are at the republican level.
Financing of children’s rehabilitation within the framework of the implementation of the compulsory health insurance system has almost doubled in one year. This made it possible to expand the bed capacity by 45.6%, which improved the availability of rehabilitation treatment and medical rehabilitation services by 22%. Also, children under the age of 18 undergo free ultrasound, X-ray, CT and MRI, ECG, pass the necessary tests and receive, if necessary, other consultative and diagnostic services. For 4 months of 2021, children in the compulsory health insurance system were provided with these services in the amount of 18.5 billion tenge.
To receive consultative and diagnostic services, you must contact your local doctor in your clinic. If for any reason your child is not insured or you are denied the necessary medical care for your child, please contact the Social Health Insurance Fund through the following communication channels: Qoldau 24/7 mobile application, 1406 Single Contact Center, SaqtandyrýBot in Telegram, website fms.kz.