Insurance program - Standard Plus (B). Accident insurance Insurance standard plus

VOLUNTARY HEALTH INSURANCE PROGRAM “STANDARD PLUS”

The procedure for the provision of medical services under voluntary health insurance programs as part of the pilot project

“Voluntary medical insurance” for the period from December 1, 2011. until 12/31/2012 for the territory of the Perm urban district

General terms of provision:

1. Voluntary medical insurance programs provide additional medical services (AMS) and additional service services (SAS), which are provided in addition to the territorial Compulsory Health Insurance Program (TPOMS), i.e. not included in TPOMS, or included in TPMOS, but provided on conditions more favorable to the citizen than the conditions provided for by TPOMS.

2. VHI and DU are provided to the insured in medical institutions that have contracts for the provision of medical and preventive care to the insured (in accordance with the voluntary health insurance program), and both working in the compulsory medical insurance system and not working in the compulsory medical insurance system in the territory of the Perm Territory with mandatory compliance with uniform medical and economic standards established in the territory of the Perm Territory (MES) (The list of medical institutions is an integral annex to the contract (policy) of voluntary health insurance).

3. DMU are provided exclusively outside the working hours of medical workers, during which they are obliged to provide medical care under compulsory medical insurance, and without prejudice to the medical care provided under compulsory medical insurance.

4. Planned medical treatment is provided subject to a referral from the attending physician of the medical organization-fund holder, with the exception of cases of medical care provided by a local physician or general practitioner (family doctor).

5. Payment for voluntary medical insurance and remote control is made exclusively from voluntary health insurance funds.

DMU and DU provided in outpatient settings:

1. Providing primary health care on a local basis, including servicing home calls, under the conditions of compulsory health insurance and mainly in privately owned medical institutions specified in the voluntary health insurance agreement (policy).

2. DMU and DM are provided to the insured person at a time convenient for him, including in the evening, on weekends and non-working holidays.

3. List of DMU and DM: diagnosis, diagnostic procedures, consultation and treatment by medical specialists, including specialists with an academic degree and (or) academic title, working in the clinical departments of medical universities; procedures performed by doctors; services provided by paramedical personnel; services provided in a day hospital at a clinic, including conservative and surgical, including using innovative techniques, methods of treating the disease that caused the person to seek medical help.

DMU and DU provided in a hospital setting:

1. Planned hospitalization of the insured person is carried out for medical reasons in the presence of a referral from the attending physician, the results of a pre-hospital examination and the presentation of other documents established by legal acts in the field of healthcare.

2. Emergency hospitalization of the insured person is carried out in the event of the development of life-threatening diseases and requiring immediate treatment in a hospital setting. In emergency cases, the insured person is hospitalized in accordance with the established procedure in a medical organization, which, as a rule, has a contractual relationship with the Insurer.

3. The provision of primary care in a hospital is carried out for the disease that served as the basis for hospitalization, its complications, as well as concomitant diseases that determine the severity of the underlying disease.

4. List of DMU and DM: diagnosis, diagnostic procedures, consultation and treatment by medical specialists, including specialists with an academic degree and (or) academic title, working in the clinical departments of medical universities; procedures performed by doctors; services provided by paramedical personnel; conservative and surgical, including the use of innovative techniques, methods of treating the disease that caused hospitalization, its complications and concomitant diseases that determine the severity of the underlying disease; diagnostics, course treatment of a concomitant disease (beyond exacerbation) at the request of the insured in the presence of medical indications during the period of treatment for the underlying disease in agreement with a representative of the Insurer; diagnostic services for the underlying disease that caused hospitalization, beyond the standards of medical care at the request of the insured in agreement with a representative of the Insurer; accommodation in superior rooms (no more than 2 beds) with a separate bathroom, TV, cutlery and personal hygiene items, with additional therapeutic nutrition taking into account the diet prescribed by the attending physician (menu of the patient’s choice). If there is no possibility of emergency hospitalization in a ward of the specified category, the Insurer will arrange for the insured to be hospitalized in a free bed in a ward of a different category, followed by, no later than 2 days from the date of hospitalization, transfer to a ward of the above category. Provision of medicines (by trade name) in excess of the List of vital and essential medicines approved by the Law of the Perm Territory on the State Guarantee Program for the provision of free medical care to the population of the Perm Territory for the current financial year, but within the framework of the MES as prescribed by the attending physician and in agreement with the representative Insurer; Organization of individual (additional) nursing care as prescribed by the attending physician and in agreement with a representative of the Insurer.

List of medical services provided under the voluntary medical insurance program "STANDARD PLUS"

1. Outpatient care

1.1. Advisory assistance:

Primary, repeated, consultative appointments with medical specialists, including candidates and doctors of medical sciences in the following specialties: therapist, surgeon, neurologist, otolaryngologist, ophthalmologist, urologist, dermatovenerologist, obstetrician-gynecologist. At the direction of the attending physician, consultations are held with doctors: a cardiologist, an endocrinologist, an infectious disease specialist.

1.2. Issuance of medicaldocumentation

Issuance to the Insured of the necessary medical documentation in accordance with current regulatory documents (except for certificates for swimming pools, certificates for applicants to educational institutions, for a driver’s commission, foreign business trips, for carrying weapons), including:

Extracts from outpatient cards;

Prescriptions, except for preferential ones;

Issuance and extension of certificates of incapacity for work.

1.3. Diagnostic tests

Laboratory research methods: tests of blood and other biological media of the body: general clinical (clinical blood test, general urine test), biochemical (blood glucose, ALT, AST, GGT, creatinine, urea, bilirubin and its fractions, cholesterol, CK MB), bacteriological (primary diagnosis of diphtheria and intestinal infections), bacterioscopy of a smear from the genitourinary organs, cytological examination of a gynecological smear.

hormonal: no more than 3 thyroid hormones TSH, T3, T4 - 1 time during the contract period);

X-ray research methods (except MRI, CT);

Ultrasound research methods: ultrasound of the abdominal organs, ultrasound of the thyroid gland, ultrasound of the kidneys and bladder, ultrasound of the female genital organs, ultrasound of the prostate gland, ultrasound of the lymph nodes)

Endoscopic research method: esophagogastroduodenoscopy (FGS)

Functional diagnostics (including electrocardiography (ECG), examination of external respiratory function, electroencephalography (EEG).

All of the above diagnostic studies are carried out for medical reasons for a specific insured event.

1.4. Therapeutic outpatient procedures

1.4.1. Therapeutic and diagnostic procedures in surgery, otorhinolaryngology, ophthalmology, gynecology, urology, aimed at relieving and diagnosing acute or exacerbation of chronic diseases.

1.4.2. Treatment in a hospital for one day - outpatient manipulations and procedures (except for urological, gynecological, surgical and endoscopic operations under general anesthesia); conservative treatment (dressings, intravenous infusions and droppers, other injections).

1.5. Physiotherapeutic treatment

Electro-, magnetic, light and heat treatment, laser therapy (except LOK), inhalations (10 sessions of one of the types of treatment during the validity period of the insurance contract)

Services provided in a day hospital at a clinic, including conservative and surgical, including using innovative techniques, methods of treating the disease that caused the patient to seek medical help.

1. Inpatient care: medical care in a hospital setting is provided for the main and concomitant (if medically indicated) disease

1.1. Stay in a hospital (food, care of medical personnel, medication provided by the hospital), accommodation in 1-2 bed rooms ;

1.2. Providing medical care and consultations with medical specialists in the following specialties: therapy, cardiology, neurology, rheumatology, gastroenterology, pulmonology, nephrology, endocrinology, anesthesiology and resuscitation, gynecology, urology, surgery, coloproctology, otolaryngology, traumatology and orthopedics, ophthalmology, dermatology, proctology , hematology, allergology, immunology, infectious diseases.

1.3. Laboratory research methods for medical reasons: clinical, biochemical, serological, hormonal, immunological, cytological, histological.

1.4. Instrumental diagnostic studies: functional (ECG, ECHO-CG, FCG, ECHO-EG), endoscopic, ultrasound, radiological (including MRI CT), radioisotope.

1.5. Therapeutic procedures, including physiotherapeutic: - electro-, magneto-, light-, balneo-, heat - laser therapy (except LOK), inhalations, therapeutic massage, exercise therapy, manual therapy.

1.6. Drug treatment provided by a medical institution; use of dressings in accordance with existing medical indications.

1.7. Anesthetic benefits;

1.8. Surgical interventions;

1.9. Resuscitation measures;

2.10. Treatment in the intensive care unit

2.11.Care of medical personnel.

Exclusions from insurance coverage

1. An insured event is not and is not paid for the Insured’s visit to a medical institution regarding:

alcohol, drug or toxic intoxication, as well as injuries received by the Insured in this state, burns, frostbite, acute poisoning, damage to internal organs or other health disorders; intentional self-infliction of bodily harm, including attempted suicide.

2. Medical services not included in the Insurance program and not paid for by the Insurer: Diagnosis and treatment of male and female infertility, impotence, family planning issues (including contraception issues), insertion and removal (without medical indications) of the IUD. Termination of pregnancy (without medical indications).

Monitoring pregnancy beyond 8 weeks. Obstetrics. Cosmetology services and dermatology office services: removal of benign neoplasms (papillomas, condylomas, etc.) Therapeutic measures related to contact vision correction. High-tech methods of examination and treatment of diseases of the heart, blood vessels, nervous system, visual and sensory organs, musculoskeletal system, requiring their transplantation, autotransplantation, prosthetics, including endoprosthetics, reconstructive surgical treatment. Extracorporeal treatment methods (plasmapheresis, hemosorption, LOC, UV-blood). Psychotherapy (including dowsing diagnostics and correction, suggestive therapy, neurosensory unloading). Consultations with a nutritionist, cosmetologist, audiologist, somnologist, homeopath, barotherapist - after diagnosis of a disease that is a non-insurance case. Ozone therapy. Immunoprophylactic measures. The following types of massage and physiotherapeutic rehabilitation: classical massage, percussion massage; massage using a mechanical couch; periosteal massage; connective tissue massage; massage using massagers; Acupress massage; acupressure; massage using medications. Gymnastics for obesity; gymnastics to strengthen muscles using fitness balls; Individual exercise therapy classes. Covers the costs of glasses, contact lenses, hearing aids, implants, and other additional medical devices and supplies. Any genetic and cytogenetic studies, studies of metabolic disorders, mineral metabolism and markers of bone resorption. Densitometry. Methods of traditional medicine: hirudotherapy, homeopathy, herbal medicine, acu-, auriculo-, electropuncture, irridology, breathing exercises, qigong gymnastics, any medical services not prescribed by a doctor. Any medical services not covered by this insurance program.

3. Diseases and conditions that are not an insured event and the treatment of which cannot be paid for by the Insurer: Sexually transmitted diseases (HIV infection, syphilis, gonorrhea, chancroid, etc.) and their complications.

Mental illnesses and their complications, organic mental disorders (including symptomatic), alcoholism, drug addiction, substance abuse and their complications, epilepsy and its complications. Diabetes mellitus type I and II and its complications. Tuberculosis, sarcoidosis, cystic fibrosis, regardless of the clinical form and stage of the process. Chronic renal and liver failure, requiring extracorporeal treatment methods. Diseases of organs and tissues requiring transplantation, autotransplantation, prosthetics, including endoprosthetics. Acute and chronic radiation sickness. Chronic hepatitis, liver cirrhosis. Systemic connective tissue diseases (scleroderma, systemic lupus erythematosus, dermatomyositis, rheumatoid arthritis, polymyalgia rheumatica) and their complications, systemic vasculitis and their complications, demyelinating diseases of the nervous system, autoimmune diseases and their complications. Immunodeficiency conditions, deep and widespread mycoses, psoriasis and its complications, eczema, neurodermatitis, especially dangerous infections, occupational diseases.

LIST OF TREATMENT AND PREVENTIVE PARTNER INSTITUTIONS

IN THE PILOT PROJECT “MEDICAL CERTIFICATE”

1. Basic health care facilities

Name of health care facility

Address

MEDSI companies Perm branch

G. Perm, st. Pushkina 109

Center "Philosophy of Beauty and Health"

G. Perm, st. Kim, 64

clinic"

G. Perm, st. Makarenko, 21

"UralMed" ("Nadezhda")

G. Perm, st. Krisanova, 13

ANO "MO "Realmed"

2. Name of health care facility for receiving inpatient care

Name

Address

MUZ "City Clinical Hospital No. 2 named after. The doctors "

Perm, Kirova st., 111

State Healthcare Institution “Perm Regional Clinical Hospital No. 2 “Heart Institute”

State Healthcare Institution "Perm Regional "Order of the Badge of Honor" Clinical Hospital"

MUZ "City Clinical Hospital No. 1"

MUZ "City Clinical Hospital No. 7"

Perm, st. G. Hassan. 24

MUZ "Medical Unit No. 7"

MUZ "City Clinical Hospital No. 4"

MUZ "City Clinical Infectious Diseases Hospital No. 1"

Federal State Institution "Medical and Sanitary Unit No. 000"

State Healthcare Institution "Perm Regional Hospital of War Veterans" State Healthcare Institution of Perm

St. Gorky, 15

MUZ "City Clinical Hospital No. 6"

MUZ City Clinical Hospital No. 3

MUZ Medical and Sanitary Unit No. 9 named after.

Medical unit No. 000 of the Federal Medical-Biological Agency, Federal State Healthcare Institution

Perm, Gagarin Boulevard, 68

MUZ "City Hospital No. 21"

MUZ "Medical and Sanitary Unit No. 11"

G. Perm, A

3. Name of the health care facility involved for advisory services

No. P.

Name

Address

MUZ "City Clinical Hospital No. 2 named after. The doctors "

Perm, Kirova street, no. 228

MUZ "PKOD"

"Medlife", "Medlife"

State Healthcare Institution “PKKB No. 2 “Heart Institute”

G. Perm, st. Lenina, 40

State Healthcare Institution "PKKB" "Order of the Badge of Honor"

MUZ "KMSCH No. 1"

MUZ "Medical Unit No. 7"

G. Perm, st. Pisareva, 56

MUZ "GP No. 2"

Perm, Brothers Ignatiev st., 3

MUZ "City Clinical Hospital No. 1"

MUZ "City Clinical Hospital No. 7"

Perm, st. G. Hassan. 24

MUZ "City Clinical Hospital No. 4"

MUZ "City Clinical Hospital No. 6"

"Dentist"

MUZ "GKIB No. 1"

"Doctor-experience and competence"

"Diapazon" center

clinic"

Perm, Gagarin Boulevard, 49

FGUZ "MSCh No. 000"

MUZ "GB No. 21"

MUZ "GP No. 7"

"PKGVV" GUZ Perm

G. Perm, st. Podlesnaya, 6

Director of the Perm branch

The policy under the insurance program, which provides for a limited number of days of validity of the contract within the entire insurance period, implies the beginning of the Insurer's liability from the moment the Insured crosses the border of the country of permanent residence (for citizens of the Russian Federation, the exception is limited to a radius of 90 km inside the administrative border of the permanent place of residence) for the entire the duration of the contract, but in total no more than the number of days indicated in the column “Number of days”.

Health insurance rates for multiple trips under the Standard Plus (B) program

Insurance of additional risks to the Standard Plus (B) program

Additional risks can be selected when insuring under the Standard Plus (B) program or insured separately

Age and sport correction factors

Age coefficient:
- age from 65 to 80 years - 2.0;
- age from 80 years - 4.0

Sports risk insurance:
- non-hazardous sports (surfing, windsurfing, diving at a depth of up to 40 meters, etc.) - 1.5;
- dangerous sports (alpine skiing and snowboarding, etc.) - 2.5

• Payment for necessary medical care as a result of complications of existing and exacerbation of chronic diseases, sunburn and allergies;
• Insurance of active recreation and extreme tourism with increasing coefficients
• Insurance of expenses associated with complications during pregnancy;
• Payment for search and rescue assistance;
• There are no age restrictions (insurance for persons over 80 years old);

When the Insured contacts the service center, the operator immediately begins organizing assistance.

Full list of risks:

1. 1. outpatient treatment and inpatient treatment;
2. 2. relief of acute toothache;
3. 3. medical transportation and evacuation;
4. 4. return of the Insured and his accompanying person on the trip;
5. 5. return home of the Insured’s minor children;
6. 6. assistance as a result of terrorist attacks;
7. 7. assistance as a result of natural disasters (floods, tsunamis, tornadoes, etc.);
8. 8. repatriation in case of death;
9. 9. visit of a third party in an emergency situation with the Insured in case of his hospitalization for more than 7 days;
10. 10. payment for telephone conversations with the service center;
11. 11. early return of the Insured;
12. 12. temporary return of the Insured
13. 13. search and rescue activities;
14. 14. outpatient and inpatient expenses as a result of a sudden complication during pregnancy or an accident that threatens the life and health of the Insured;
15. 15. payment of expenses in case of loss or theft of documents
16. 16. legal assistance (first legal consultation and translation services in case of litigation);
17. 17. expenses in connection with breakdown, loss (hijacking, theft) or damage to a land vehicle
18. 18. expenses due to the delay of a regular flight.

The cost of the insurance policy is 1 EUR/USD per day per person.

Insurance cover:

• Medical insurance for 30,000 Euro
• Health care 24/7

What to do if an insured event occurs?

1. Upon the occurrence of an insured event (while on a trip)

Call the Service Center using the phone numbers specified in the insurance policy or insurance information, be prepared to provide the following information:

• Last name, first name.
• Insurance policy number or insurance information number.
• Location and contact number.
• The circumstances under which the insured event occurred.
• What kind of help is needed?

2. In the event of an insured event (upon returning from a trip and paying for expenses yourself)

If you independently pay for expenses associated with an insured event, collect the documents necessary to consider the issue of insurance payment:

• medical statement indicating the diagnosis, results of examinations, prescribed treatment;
• a paid invoice from medical and other institutions indicating the list of services provided, indicating the cost of each service, the date of its provision;
• prescriptions for drugs;
• documents confirming the fact of payment for medical and other services, medicines;

For tourists over 65 years old, medical insurance rates increase 2 times, over 80 years old - 4 times

The price of all tours includes standard medical insurance (in ski tours - ski insurance) for tourists under 65 years of age.

The cost of standard medical insurance for tourists under 65 years old is 1 USD/day (currency depends on the currency of the country of travel)
The cost of standard ski medical insurance for tourists under 65 years old is 2 $/day

For tourists aged 65 to 79 years inclusive, additional payment for standard medical insurance + 1 USD/day (currency depends on the currency of the country of travel)
Ski standard medical insurance for tourists from 65 years to 79 years inclusive additional payment+ 2 USD/day (currency depends on the currency of the country of travel)

For tourists aged 80 years and older, additional payment for standard medical insurance + 3 USD/day(currency depends on the currency of the country of travel)
Ski standard medical insurance for tourists 80 years and older additional payment+ 5 USD/day (currency depends on the currency of the country of travel)

No matter how careful we are, it is not possible to predict everything that might happen. Unfortunately, it is impossible to completely protect yourself from unwanted accidents. But you can make sure in advance that, if necessary, you are provided with timely financial support.

Accident insurance in the Belneftestrakh company is just the solution that will help you quickly deal with an unpleasant situation that has arisen and at the same time save your nerves.

Accident insurance at Belneftestra: basic conditions

From us you can purchase an insurance policy for one person (including a child) or for several persons.

By applying for a voluntary insurance policy, you will be able to receive appropriate financial assistance for rehabilitation and treatment in the following insured events:

• injuries and various types of damage, including bruises and fractures;
• asphyxia (suffocation caused by foreign objects entering the respiratory tract);
• poisoning caused by toxic substances, medications, etc.;
• burns and frostbite;
• and other accidents.

What insurance programs does Belneftestrakh offer?

All our programs are reasonably priced and at the same time provide you with full insurance protection. Thanks to the availability of different insurance options, you can choose the most optimal option for you.

Program "Standard". The object of insurance can be one person or several persons. You can take out a policy for an amount from 1000 to 6000 Belarusian rubles. It is important to remember that, if desired, such insurance can be purchased for 2 or 3 years, which will help you save both money and time on its registration. At the same time, you can be sure that you are under reliable protection 24 hours a day, 7 days a week.

"Standard Plus". This program is designed for 1 year of continuous validity, and depending on how many people are included in the policy, its cost will depend. The insured amount is indicated in foreign currency (US dollars), but contributions are accepted in Belarusian rubles (for currency conversion, the rate of the National Bank of the Republic of Belarus on the day of payment is used). If you want to insure 1 person, the insurance amount can be 3000 or 5000 US dollars. When taking out a policy for 2 or more people, the insured amount may be higher - up to $10,000.