Inshorensi yempilo: uhlobo, injongo kunye neentlobo-inshorensi yempilo kweli Russian Federation

imeko elibonisa, ukutshintsha eziphambili urhulumente kummandla iinkcitho mali kuye kwakhokelela ekwandeni indima imithombo imali yokhathalelo lwempilo yabucala. Kuwo onke amazwe apho ngokukhawuleza asakhulayo inshorensi yezempilo, kukho iimveliso esingabizi ukukhusela ubomi kunye nempilo iinkonzo. Russia akuyona umnyinyiva. Cinga iintlobo eziphambili inshorensi yempilo kweli Russian Federation.

intliziyo

Kuyimfuneko ukuba ukwahlula phakathi elithi "amayeza inshorensi" yaye "i-inshorensi yezempilo". Kwimeko yokuqala sithetha indlela yokhathalelo lwempilo ngezimali, kwaye eyesibini - malunga nomsebenzi. Esiza kuxubusha ngayo ngokweenkcukacha uhlobo kunye neentlobo ze-inshorensi yezempilo.

Eli gama libhekisela uhlobo zokukhusela intlalo yoluntu kwimpilo yabemi. Injongo yayo - xa kuthe isiganeko benefits ukubonelela abemi ithuba lokufumana unyango ngenxa ukuqokelela imali zemali iinkqubo zokuthintela. Iintlobo-inshorensi yezempilo ukhuseleko esisinyanzelo kwaye kungokuzithandela.

Undoqo yale nkqubo kuxhomekeke ingozi yokosulela ezinxulumene izibonelelo zempilo (okwexeshana okanye isigxina) kunye neendleko ezinxulumene yokuyikhangela. Le deal ne-inshorensi ekhutshwe ikhontrakthi. Injongosenzi emngciphekweni ukufumana iindleko ezenziweyo ngokunxulumene yonyango uMntu oKhuselwe ngeInshorensi ukuya kwiziko lonyango uncedo lonyango. Ixabiso igalelo libalwa ngokusekelwe ngenene ingenzeka le isiganeko benefits, imeko yempilo emntwini, ubudala bakhe kunye nezinye izinto. Izifundo zezi: zabemi, i-inshorensi, umbutho zonyango.

Imigaqo nokusebenza inshorensi yezempilo ayinakutshintshwa kwinqanaba mthetho:

• inxaxheba Russian inxaxheba kwiinkqubo ze-inshorensi yezempilo ezinyanzelekileyo (CHI) ;
• imali kunye nemiqathango lokubonelela uncedo kwi labemi kwi sikhokelo OMC;
• inani leenkonzo free;
• PB uluntu ukuba luthathe inxaxheba inshorensi ngokuzithandela (LCA), ejongana iinkonzo phezu lwenkqubo MLA;
• ukuhlanganiswa DMS ne oms.

Icala lomthetho komba

Amalungelo entsimini nempilo yabemi ezifakwe Art. 41 loMgaqo-siseko Russian kunye nomthetho "Kwi-inshorensi yezonyango kwi Russian Federation". Kule migaqo ithi: ukuba bonke abemi banelungelo kukhathalelo lwempilo. Xa amaziko karhulumente kunye kamasipala ukuba isimahla, oko kukuthi, ngeendleko lwabiwo-mali, iintlawulo ze-inshorensi kunye nezinye inzuzo. Abahlali kunye non-nabahlali kummandla Russian Federation, ngokuxhomekeke MLA. Oko kukuthi, ukhathalelo lwempilo kufuneka ahlangabezane neemfuno zabantu ekulondolozeni umgangatho wempilo kungakhathaliseki zabo zemali.

inshorensi yempilo: iintlobo, iiyantlukwano

Kwi kwintsimi Russian uya kukhutshwa umgaqo-inshorensi yezempilo enyanzelekileyo, ngokuzithandela ngamazwe. Zonke iintlobo ezintathu ezahlukeneyo kwexabiso, umgangatho nobungakanani kwiinkonzo ezinikiweyo. nkqubo MHI inyanzelekile kubo bonke abantu abahlala kummandla we-Russian Federation. Ngaphandle kwalo, ngaphandle kwentlawulo kuphela unyango olungxamisekileyo. Ukuba insurer ufuna ukufumana uluhlu lweenkonzo kumgangatho ngakumbi okanye ngcono, kuba VHI. Abakhenkethi abahamba ngaphandle kummandla Russian Federation uya kunyanzeleka ukuba akhuphe inshorensi ngamazwe ngokwayo.

CHI

umngcipheko ukukhubazeka ubhekiselele kumngcipheko, ukuba isiganeko komntu akuxhomekekanga ekuzithandeleni komntu, kodwa ikhokelela iindleko ebonakalayo. Zichaphazela abantu nje kuphela kodwa kuluntu luphela. Kuyinto unomdla ekugcineni impilo onke amalungu.

inshorensi yempilo esisinyanzelo na uhlobo lwe-inshorensi yoluntu. Liqinisekisa ukhuseleko xa Kwimeko yokugula bonke abantu ngokulinganayo. inshorensi yempilo esisinyanzelo - luhlobo ukukhuseleka kwempahla, nto leyo eqinisekisa ukuba bonke abemi, nokuba ngesondo, ubudala kunye nobume ekuhlaleni, ufikelelo olulinganayo kukhathalelo lwezempilo. Oku kwenziwa ngenkqubo kwemali (yase kanye kagunyaziwe) kunye nemibutho ezizodwa. Le yokugqibela umsebenzi oms ukusebenza ngokwemiba yorhwebo. Inshorensi ke abalamleli phakathi imali kunye namaziko abonelela ngeenkonzo kubemi. Umbutho nokulawulwa kwenkqubo yonke yenziwa ngokusebenzisa iziseko - Amaziko non-nzuzo, asebenza ngokungqinelana nomthetho Russian.

MHI ngezimali yi-inshorensi (iminikelo kwirhafu werhafu olunye 3.6%), iintlawulo ukusuka mali. Kule nkqubo, inshorensi ezi abaqeshi, ekufuneka ukungena kwizivumelwano ngokunceda abasebenzi, oosomashishini kunye namagunya olawulo karhulumente kuwo onke amanqanaba.

nkqubo MHI

Olu xwebhu makangqinisise ilungelo ummi ukufumana unyango simahla enikwe kwi-sikhokelo yenkqubo. Iqulethe idatha malunga nomnini-nkqubo, inombolo isivumelwano kunye inkampani yeinshorensi, uphawu yofakelo ukuya kwikliniki ethile.

Iziqulatho zomgaqo-inshorensi kuyo nayiphi na inkampani ye-inshorensi phakathi kwabo zifakiwe kubhaliso CHI. Yena enza wonke ummandla Russian Federation. Ukuba utshintsha okanye igama elipheleleyo, indawo yokuhlala, data uxwebhu ukuchonga nakuphi na ukungangqinelani, lo mgaqo-nkqubo kuyimfuneko ukuphinda-babhalise ngaphakathi inyanga. Malunga ekulahlekeni nkqubo kufuneka baziswe ngendlela ebhaliweyo inshorensi, yaye badlule inkqubo replacement.

inkqubo iinkonzo

Imali kunye nemiqathango yokufumana yindlela aqinisekiswe loxwebhu ekhethekileyo eqhotyoshelweyo. Inkqubo esisiseko iqulunqwa yi-Ofisi yoMphathiswa wezeMpilo yavunywa yi-Government. Ngenxa yesi sizathu kuphuhliswa iinkqubo engingqi. Baya ucacise iintlobo eziphambili inshorensi yezempilo, inani kunye nomgangatho weenkonzo, kumaxabiso, iindlela uncedo intlawulo. Amalungelo abantu inshorensi ukuya MLA zixhaphakile kulo lonke Russian Federation.

Njengenxalenye yenkqubo esisiseko ibonelela nezempilo, zothintelo, unyango ezikhethekileyo abantu izifo ezifana:

• Ezasulelayo, olwaye lwamfimfitha (ngaphandle izifo ezifana neegcushuwa, isifo sephepha kunye AIDS);
• umhlaza, isikhumba, izifo inkqubo yonyango;
• yokudla, i-luvo, indlela womchamo;
• izifo kwegazi;
• iliso, indlebe kunye nokuphefumla izifo;
• ukuphatheka;
• izifo yenkqubo musculoskeletal;
• mgaqweni bekhubazekile abadala;
• ukuphazamiseka kwenkqubo omzimba;
• ukungaphili chromosomal;
• lokukhulelwa, ngexesha lokubeleka kunye isisu.

Inkqubo Territorial ibandakanya:

• uluhlu izifo kunye neentlobo uncedo ezinikwa abemi kwi ngokuncama Ulwabiwo mali kunye neendlela mali sendawo CHI;
• inkqubo yokubonelela unyango ukuba iindidi ezithile labantu;
• uluhlu lwamayeza ayimfuneko kunye nezibonelelo zonyango, leyo ibalulekile ukuze ukunikwa unyango;
• uluhlu amayeza amayeza simahla okanye i-50% isaphulelo;
• uluhlu lwemibutho ukuba bathathe inxaxheba kule program.

Medorganizatsii inxaxheba kule nkqubo yengingqi, bakwazi ukubonelela ngeenkonzo ahlawulwe:

1. Xa iimeko ngaphandle kwaleyo kubonelelwe kule nkqubo, kubandakanywa ngesicelo:

• nokusekwa mednablyudeniya isithuba ngamnye ngexesha esibhedlele;
• ukusetyenziswa kweziyobisi ukuba musa zinxulumene ukuya kubalulekile.

2. Ukubonelela ngeenkonzo ngemfihlo.

3. Non-abahlali, abantu abangenambuso abangenazo nkqubo MHI.

4. Ngenxa self-unyango lwe uMntu oKhuselwe ngeInshorensi ngaphandle kwiimeko ezingxamisekileyo, olulodwa, ukhathalelo.

Iinkonzo ehlawulelwayo ngaphandle ngaphezu imiqulu kuqinisekisa CHI. Isivumelwano esicacisa iintlobo kunye imiqulu unyango, nto leyo inikezelwa simahla. Ukwala ukuba asayine isivumelwano kuba unobangela anciphise ubuninzi okanye umgangatho weenkonzo phantsi kwinkqubo karhulumente.

inshorensi yonyango Voluntary

Ukuze ufumane iinkonzo zonyango ngaphezu ubuncinane eziyimfuneko ukuze akhuphe LCA nkqubo. Va client kunye kwinkampani ye-inshorensi wenza isivumelwano phantsi apho, ibe sisananelo eyintlawulo ehlawulwa yi insurer uthembisa ukuhlawula iindleko nokunyanga izifo okanye ukulimala.

Kuxhomekeka kuhlobo kweentlawulo ukwabela ezi ntlobo ze-inshorensi yempilo ngokuzithandela: eziziiprayimari nezikolo ezongezelelweyo. Kwimeko yokuqala sithetha ngokuhlawula iindleko zonyango (okt. E. I insurer akafumani imali esandleni). Ukongeza, i-inshorensi ubonelela iinkqubo yentlawulo, ezingaqukwanga kwi OMC (unyango yokulinga, zamazinyo kunye neenkonzo busebenzisa, unyango lomhlaza njalo njalo. D.), Yaye iindleko ngqo (ukulahleka umholo ngenxa yokukhubazeka, unonophelo kubeleka, njalo njalo. D.) .

LCA uyakwazi ukusebenzisa ngamnye okanye ewonke. Le ndlela yesibini zithandwa kakhulu ehlabathini lonke. Kulo mzekelo, i-inshorensi isebenza njengoko inkampani (umqeshi) kwaye uMntu oKhuselwe ngeInshorensi - abasebenzi bakhe. Ngokungqinelana nesivumelwano, abemi uyakwazi ukufumana unyango kwiimeko ezithile. Ezi ntlobo ze-inshorensi yezempilo kwi Russian Federation asebenza ngokuzithandela. Oko kukuthi, umgaqo-nkqubo zithengwa ngumxhasi, kunokuba kwenziwe.

iintlawulo

intlawulo ye LCA zibalwa ngokusekelwe manani zonyango, izalathisi ezingundoqo ngokwedemografi (ukuba ubomi, izinga lokufa), okugula kunye nokulaliswa esibhedlele. Intlawulo kuxhomekeke ithuba lemvumelwano. Kuba rates nkqubo ngonyaka zibalwa ngokusekelwe yano i zeinshorensi kwiqela lobudala elithile. Iintlawulo ezenziweyo ngeendleko iminikelo yangoku. Iirhafu for izivumelwano zexesha elide uthathe ingqalelo kuphela ubudala, kodwa izinto ngokwedemografi, amanani okugula ngexesha lesivumelwano. Ngezimali yi iminikelo ezivela kwiintlawulo zangoku kunye noovimba kwabunjwa iintlawulo elizayo.

uluhlu lwamaxabiso

Medical -inshorensi, injongo, iintlobo ezithe ekuxoxwe ngazo ngaphambili, ijolise ekukhuseleni iimfuno impahla abantu xa kuthe yokukhubazeka. Kodwa LCA kubantu aneempawu zempilo ngamnye ezahlukeneyo ukusuka ngumndilili kunye namathuba okuba ngenene sifo iphezulu.

intlawulo kwi-nkqubo loo umohluko kakhulu. Bona kuyalungiswa kwiqela onjalo, kuxhomekeke kwiziphumo axilongwe:

• Group 1 - abantu phantse enempilo akukho imbali yosapho. Kukho abantwana, izifo zemiphunga, appendicitis, Ithemba; imikhuba emibi; alisebenzi imisebenzi ezinobungozi.
• Group 2 - abantu kunye nengozi eyonyukileyo sifo, imbali yentsapho seswekile, sentliziyo, pochechnymi- kunye gallstone, isigulo sengqondo. A imbali yokwenzakala kwengqondo ebuhlungu; Kukho imikhwa emibi; ukusebenza phantsi kweemeko eziyingozi kwimveliso.
• Group 3 - abantu omeleleyo abanezifo ezingapheliyo; ukusebenzisa kakubi utywala, okudambisa; abaphethwe neurosis, lwegazi, isifo sentliziyo kobuchopho ngaphandle angina.

intlawulo umahluko kuzo zonke ezi parameters, kwaye ibalwa ngokwahlukeneyo kwicala ngalinye.

lunyhasho lwamalungelo

Zonke ezi ntlobo ze-inshorensi yezempilo ngokuxhomekeke kwimigaqo efanayo. Kwimeko enye kwezi zibakala ilungelo labemi ukuba ukufumana unyango olusemgangathweni zijongwa kwephulwa:

• ukuqokelelwa mthethweni imali ukuba abasebenzi bezonyango ukuncedisa kule mali ebekwe yi-nkqubo karhulumente;
• ukuqokelelwa okungekho mali kwizibonelelo zonyango imali ukuze ufumane uncedo, ukuthunyelwa, yimimiselo yazo amayeza;
• ukuthengwa amayeza kunye nemveliso mednaznacheniya kuluhlu oluvunyiweyo kweenkqubo ngeendleko lwezigulane;
• ukulibaziseka ekunikeni ukhathalelo lwezempilo;
• ukwala ukunika uncedo phantsi MLA.

Ukuze ufumane inkcazelo engakumbi koko iintlobo-inshorensi yezempilo asebenza kummandla othile ingafunyanwa,-mali sendawo CHI kwiKomiti Health.

umkhuba International

ngokufumaneka kweenkonzo zezempilo - ngumba ophambili kulo naliphi ilizwe. iintlobo ephambili ye-inshorensi yezempilo uxhomekeke kakhulu izithethe zembali. Kwi-US, nazo zonke iintlobo-inshorensi yezempilo isetyenziswa ngeminikelo yokuzithandela. Kumazwe amaninzi, hayi inkqubo inkxaso-mali karhulumente. Kubo, i LCA imfuneko engxamisekileyo. Abantu abadala kunye namahlwempu inxaxheba kwiinkqubo zikarhulumente. Ke bonke abantu abaqeshiweyo, abaqeshi ahlawule VHI. Kwi-UK imisebenzi Service yezeMpilo yeSizwe. VHI akhiwa ngendlela yokuba abathengi ungahlawula unyango okungacetywanga utyando okanye ukuphucula umgangatho weenkonzo zonyango. Kwamanye amazwe kwimarike zasesekondari nokuphuhlisa iintlobo ze-inshorensi yezonyango kwabemi ezijolise iintlawulo ezongezelelweyo leyo ingabandakanywanga yi-nkqubo njengesiqhelo. EYurophu, kukho iinkqubo zenkxaso karhulumente. Kodwa mthombo obalulekileyo-nkqubo ngemali ye-inshorensi esisinyanzelo.