Healthcare

Primary health care (PHC)

All the country residents have access to primary health care services. Primary health care is a service designed to coordinate all medical care for the population.

PHC facility attachment is at the place of permanent or temporary residence, work, study, taking into account the right to freely choose a doctor or health facility within one administrative-territorial unit. The citizen freely chooses a MD and outpatient facility so that the outpatient attachment is permitted no more than once a year. Primary health care (PHC) is provided at the level of rural outpatient centers, family health centers, municipal outpatients and diagnostic centers. Making a choice about an outpatient facility for medical care, the one shall take into account territorial proximity of the facility location to the home. The proximity of outpatient facility location is also convenient for a district MD: upon patient visit at home, he will be able to provide timely and high-quality service.

The Kazakhstanis can use the services “Call a doctor at home”, “Make an appointment with a MD” and “PHC facility attachment” in e-format on the e-government website. An electronic digital signature and visiting the e-government website www.gov.kz are required.

The PHC includes the following medical services:

• visit and examination by a PHC MD or nurse
• emergency care provision
• basic lab and instrumental diagnostics
• chronic diseases prevention and management training course
• family planning and childbirth delivery training school
• medical rehabilitation 3 stages

These services aimed at the most common, chronic and socially significant diseases prevention and care.

In addition, the PHC facility is committed for ensuring an access to specialized medical care for the attached population, which includes both outpatient services and inpatient hospitalization.

 

Specialized outpatient care

There is a wide range of free outpatient services that is a guaranteed state benefit package and compulsory social health insurance. To receive the latter the one needs to be insured.

The main outpatient services include the following:

• visit and consultation of a wide range of specialists - endocrinologists, urologists, oncologists, hematologists, psychiatrists, dermatologists, etc.
• a wide range of lab tests - blood test, urine test, PCR, biochemical blood test, TSH, tumor markers, hormone analysis, reticulocyte analysis, MCV, MCHC, culture, etc.
• diagnostic studies - ultrasound, radiography, computed tomography, etc.
• medical treatment procedures and manipulations - inhalations, electrophoresis, minor surgical interventions, care for sprains, fractures and all major diseases.

As a whole, two packages together (GSBP and CSHI) include all the services required for the diagnosis, treatment and rehabilitation of the most common diseases.

Guaranteed state benefit package

In Kazakhstan, every citizen can receive free medical care within guaranteed state benefit package (GSBP).

The GSBP is provided to the citizens of the Republic of Kazakhstan, ethnic Kazakhs (“kandas”), foreigners and stateless persons permanently residing in the territory of the Republic of Kazakhstan, funded by the state budget, imbedding preventive, diagnostic and treatment services of the highest proven efficacy, as well as drug provision.

The guaranteed state benefit package includes the following:

• emergency medical care, including medical aviation;
• primary health care, including diagnosis, treatment, preventive examinations, sanitary-anti-epidemic and sanitary-preventive measures in hotbeds of infectious diseases;
• specialized medical care in outpatient setting, including HIV infection and tuberculosis prevention and diagnosis, emergency care services, diagnosis and treatment of socially significant and chronic diseases;
• specialized medical care in inpatient substitute settings, including socially significant and chronic diseases treatment; inpatient services at home;
• specialized medical care in inpatient settings, including treatment of infectious, parasitic diseases that pose a danger to the environment and are of suspicion;
• provision of drugs, including supplies, immunobiological drugs for specialized PHC in accordance with a list of diseases against which preventive vaccinations are carried out and specialized medical care in outpatient settings.

The difference between the GSBP and CSHI is that the GSBP is for the entire population, regardless of their status in the health care system with a minimum social standard (emergency medical care, air ambulance, emergency inpatient care and palliative care). The CSHI is consultative and diagnostic care, including expensive lab services, outpatient drug provision beyond the GSBP, inpatient substitute and planned inpatient care, rehabilitation and remedial treatment.

Compulsory social health insurance

The insured in the compulsory social health insurance system receive an enlarged access to medical care of compulsory social health insurance.

The compulsory medical insurance includes the following medical services:

• preventive medical examinations;
• visit and consultation of specialist MDs upon a district MD’s referral;
• dynamic care by disciplinary specialists of patients with chronic diseases;
• provision of emergency and planned dental care to certain population categories;
• diagnostic services, including lab diagnostics (ultrasound, x-ray, CT, MRI);
• specialized, including high-tech, inpatient care;
• medical rehabilitation;
• drug provision under specialized medical care in inpatient settings.

Check your status in CSHI

There are several ways to check the status in the compulsory health insurance system.

• Qoldau 24/7 mobile application. To do this, you need to select “Check insurance status” section in the menu, enter an IIN. The window will display the status and information about the availability of payments for the previous 12 months. The one can download the application from PlayMarket and AppStore.
• Telegram bot@SaqtandyryBot. Launch a mini-program, you need to open a link: https://t.me/SaqtandyryBot or enter a name in the search bar, then select the “Determine an insurance status” section, enter an IIN.
• E-government portal gov.kz. To do this, in the “Healthcare” section, find the service “Issuance of information on the participation as a consumer of medical services and on the amounts transferred of deductions and (or) contributions in the compulsory social health insurance system,” click on the “Order the service” button, enter an IIN. The result will appear within 10 minutes.
• Official website of Social Health Insurance Fund. The “Determine the status” pop-up window is on the right. Just click on it and enter an IIN.

The compulsory social health insurance (CSHI) is a set of legal, economic and organizational measures to provide medical care to consumers of medical services funded by the social health insurance fund assets.

The right to medical care in the compulsory social health insurance system is granted to the persons for whom deductions and (or) contributions to the fund were paid, as well as those exempt from contributions to the fund in accordance with paragraph 7 of Article 28 Law of the Republic of Kazakhstan “On compulsory social health insurance”.

Health Insurance Fund

Compulsory health insurance is a form of social protection of the Republic of Kazakhstan citizens’ interests in their health care and represents relations for the medical care provision within the framework of basic compulsory health insurance program at the expense of the Compulsory Health Insurance Fund.

Non-profit Joint Stock Company NJSC "SOCIAL HEALTH INSURANCE FUND" (official website fms.kz)

Mission

Ensure financial protection of every citizen of the country from high contingency fees for medical care by increasing its accessibility and quality

Vision

The Fund is a socially-oriented transparent organization that operates on the principles of sustainable development, enjoys the trust of the population and contributes to the medical services market development

Objectives

1. Ensuring universal coverage of the population with medical care in the compulsory medical insurance system
2. Strengthening the Fund's role as a strategic buyer
3. Protecting the patient rights
4. Ensuring sustainable functioning of the Fund