TOP-10 questions about medical care for children within the compulsory health insurance package
The Social Health Insurance Fund regularly receives hundreds of questions about the procedure for providing medical care to the child population through the Qoldau mobile application 24/7, the @SaqtandyryBot telegram bot, and the 1406 contact center. Frequently asked questions are in our next selection.
– Do I need to pay contributions for compulsory social health insurance for children?
– No, children under 18 belong to the privileged category, for which the state makes contributions for compulsory health insurance. Therefore, medical assistance in the medical insurance package is available to children in full.
– Are dental services for children included in the compulsory health insurance package and can you list which dental services we can get for free?
-Children under 18 years of age dental care is provided free of charge, both emergency and planned. The dental health insurance package includes:
– 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 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).
For dental care, you can contact both the clinic and the dental clinic. At the same time, it is important that the clinic providing dental services is a potential supplier of the Fund and is in the register of potential suppliers.
The list of dental service providers can be viewed on the Foundation’s website https://fms.kz/zakupki/postavshchiki-kdu-uslug/
– In what cases are children provided with powdered milk formula free of charge?
For children under one year old, adaptive dry mixtures are issued in polyclinics at the place of attachment in the following cases:
– adoption of a nursing baby;
– the mother has HIV infection or an active form of tuberculosis, acute mental illness, congenital and acquired heart defects, diseases accompanied by decompensation of the cardiovascular system, severe forms of endocrine and allergic diseases;
– the child has confirmed congenital lactase deficiency, galactosemia, phenylketonuria, maple syrup disease;
– taking by the mother of cytostatic, radioactive, thyroid, psychotropic and narcotic drugs;
– the birth of several children and the lack of breast milk;
– training women in full-time education;
– finding a woman for treatment in a hospital.
Depending on the condition of the mother, she can be prescribed both exclusively artificial and mixed feeding. For more details on the list of drug provision, please follow the link: Order of the Minister of Health dated January 09, 2020 No. ҚR DSM-1/2020.
– What rehabilitation measures are provided for children with chronic diseases?
Children and adolescents with chronic illnesses can receive supportive medical rehabilitation on a regular basis two to three times a year. This is done with dynamic observation in clinics in order to avoid complications.
Rehabilitation of the third stage is carried out in polyclinics, day and round-the-clock hospitals, rehabilitation centers and hospitals at home on the direction of medical workers of the polyclinic, depending on the patient’s illness.
In 2020, 58 thousand rehabilitation measures were carried out for children, more than half were carried out for chronic diseases.
– Is it possible to undergo an ECG, ultrasound of the heart and get a cardiologist’s opinion for a child for free before signing up for a sports section?
– Sure. To do this, you must make an appointment with the local doctor / pediatrician at the place of attachment, during the consultation, indicate the reason for the appeal. The doctor will give a referral to a cardiologist, and he will prescribe the necessary examinations in order to exclude contraindications for playing sports.
– In what cases can you call a pediatrician at home?
– Children under 5 years of age are served at home by a local doctor in case of any deterioration in their health.
A call to children over 5 years old is served by a primary health care specialist – a doctor, a paramedic, depending on the reason for the call and the child’s well-being.
– Is it possible to get a routine vaccination in private clinics for free, what needs to be done for this?
– According to the decree of the Government of the Republic of Kazakhstan dated September 24, 2020 No. 612, routine preventive vaccinations against infectious diseases (tuberculosis, hepatitis, poliomyelitis, whooping cough, diphtheria and tetanus, hemophilic infection type b, pneumococcal infection, measles, rubella and mumps (mumps) – for children are carried out free of charge in a medical organization at the place of attachment, regardless of its form of ownership.
Recall that in Kazakhstan, the timing of vaccination is determined by the National Vaccination Schedule according to age.