If you are going to be living and working in Russia, you may need to access healthcare services while you’re there. The quality of the provision you receive will depend on whether you choose to access the public or the private healthcare sector. We will look at both sectors below and consider some of your options.
Public healthcare in Russia
Russia has a state health insurance system, called OMI/OMC (обязательное медицинское страхование). You will be entitled to use this as an expat, as long as you are paying national insurance contributions. OMI is limited, however. It often applies only to a specific hospital and is not transferable.
Many Russians therefore opt either for comprehensive private cover, if they can afford it, or for top-up cover to deal with anything beyond basic treatment. Voluntary health insurance (VHI) – known as добровольное медицинское страхование (ДМС) – acts as a supplement to the basic policy and is sometimes offered by employers.
The national system will cover:
- Visits to your GP
- Hospital treatment
- Specialist consultations
- Maternity care and gynaecological services
- Preventive care
- Emergency care
- Laboratory services
- Free appliances and medicine
- Breast cancer screening
- Cervical cancer screening (screening is not nationwide, however)
- Childhood vaccinations
- Basic dental care (free for children)
It has to be said, however, that Russia has a reputation for a low standard of public healthcare. In 2019, Bloomberg ranked Russia as the world’s 95th healthiest country. It fell significantly behind European nations and also most Eastern European states and other nations as well. It scored worse than Cape Verde, for instance.
You are likely to find the best quality of healthcare in Moscow and other large cities, but very limited provision in rural and more remote areas. Many regions have no provision at all. Corruption is also said to be present in some hospitals, with bribery being common.
There are shortages of beds, equipment and medical personnel across the national healthcare system, as well as some well-publicised horror stories about poor facilities. Medical treatment itself is often of a high standard; Russia has some highly trained and very capable medical personnel. However, you are likely to face overcrowding and long waiting times in clinics.
Alcoholism used to be a major problem in Russia, but it is now less so, due to some local initiatives. For instance, villages in Siberia have converted bars into gyms and have insisted on a dry policy. Obesity, however, is on the rise, and there have been indications that over half of Russian deaths are related to poor diet.
In 2018, the infant mortality rate in Russia was at about 6.1 deaths per 1,000 live births. Coronary heart disease, strokes, and vascular diseases are the leading causes of deaths. Life expectancy in the country is 71.9 years. Russia comes 105th out of a surveyed 183 countries for life expectancy, and ranks better than mainly African nations. It does not compare well with Europe and other Eastern European countries in the area. The UK ranks 22nd, for instance, with an average life expectancy of 81.
The government recognises that there is a problem and intends to put 1.7 trillion rubles ($26.3 billion) towards solving it. Vladimir Putin has expressed his aim to improve healthcare by the end of his term in 2024. Currently, GDP expenditure on health falls well below the global average. However, so-called ‘May Decrees’ have led to unrest and dissatisfaction, which have resulted in strikes. Staff say that the attempt to modernise the system has led to overworking, cutbacks in staff and shortages.
The aim of the May Decrees has been in part to transfer financial responsibility to regional units and cut off federal grants. Pay rises for public sector personnel are now linked to pay and performance targets. Medical staff say that this has resulted in increased workloads and has placed strain on an already highly challenged system.
All of the above means that expats resident in the country usually opt for private healthcare and health insurance.
Private healthcare in Russia
Private healthcare in Russia has not been without controversy. Critics say that private local health insurance companies have a parasitic role, operating between the compulsory health insurance fund and state healthcare institutions. These companies, even though they are private, can dictate where the state funded money from regional health insurance schemes goes. Critics also say that local insurance companies do not monitor the quality of healthcare and are mainly concerned with fining clinics for insufficient paperwork.
Most expats opt for insurance with big international providers, who are much more reliable when it comes to the bureaucracy, and who are more strictly regulated. Private sector clinics usually offer a high standard of care, and there are a number of flagship operations, such as the European Medical Centre in Moscow. This is a growing market sector, as private healthcare in Russia has been catching up with that in the West and other nations, since the fall of the Soviet Union.
You will still find the most reliable provision in the cities, where you will also stand a higher chance of encountering personnel who speak English. Organisations such as the MD Medical Group (MDMG) have been building new maternity hospitals across the country, and provision is increasing swiftly.
Russian private health insurance generally does not cover pre-existing conditions or terminal illnesses. It will, however, cover most primary and hospital care, including specialist consultations and elective surgery, such as cosmetic surgery. Dental plans will also be available.
Medical tourism is on the rise and most patients – around 44% of medical tourists – visit the country seeking dental treatment. The Russian Association of Medical Tourism (AMT) says that in-vitro fertilisation (IVF) is currently one of the most popular procedures among overseas clients. This is around 2.5 times cheaper than in Europe or the USA.
The Russian healthcare minister reports that 20,000 foreign patients entered the country in 2016. This number rose to 120,000 in 2017 and to over 300,000 in 2018. Despite political tensions, it is likely to keep on rising, due to high quality provision. This is the result of significant private investment and comparatively low costs.
If you are intending to give birth in Russia, you will need to make a decision early on regarding whether to use the public or the private sector. The standard of the public healthcare system in Russia is not as high as what you may be used to in Europe. Many expats therefore opt for private cover.
Most expats recommend that you should avoid the public healthcare system if at all possible, and private sector maternity care is currently booming, with some top of the range maternity clinics and hospitals being built across the country. We will look at some of your options below.
How to decide on a birth plan
A birth plan is a list of what you would like to have happen during labour and afterwards. It is written so that your doctor knows what your wishes and expectations are.
- Where do you want to give birth?
- Who do you want to have with you (e.g. your partner)?
- What kind of birth do you want (e.g. vaginal birth or a Caesarian)?
- Do you need any birthing aids?
- Do you want pain relief, and if so, what kind?
- What kind of birthing environment would you prefer?
Most births in Russia take place in hospitals. Water births and home births are uncommon and unregulated. Recent reports suggest, however, that home birthing is becoming increasingly popular, as a result of the poor provision in state-run hospitals. Russian women prefer to take risks at home than in hospital.
In 2018, the infant mortality rate in Russia was at about 6.1 deaths per 1,000 live births, compared with the OECD average of 3.6 deaths (the UK and the USA also have somewhat higher rates than this average, but not as high as Russia).
If you are in a large urban centre, such as Moscow, you should be able to access the services of a doula. A doula will be able to help you with the birth plan and other aspects of your pregnancy. Some centres will provide some alternative birthing methods, such as yoga balls. It is wise to translate your birth plan into Russian, but some midwifery centres offer services in other languages too, including English, French and German.
Private maternity provision in Russia has been increasing in recent years. The leader in private maternity care in Russia is the MD Medical Group (MDMG), which started operations in 2003 and has been building maternity units across the country. It opened a flagship $150 million private maternity hospital in Moscow in 2006 and has continued to expand.
Note that, in the public sector, medical personnel may not speak much, if any, English. You are more likely to be allowed to have your partner with you during the birth and afterwards in a private institution.
Maternity care in Russia
Many Russian women give birth in maternity hospitals, known as ‘maternity houses,’ which are run by the state but often have private contracts.
Public healthcare in Russia covers maternity care, but hospitals tend mainly to be in cities, and they are often overcrowded. If you think you might be pregnant, your first point of call should be your GP, who will issue you with a certificate of your pregnancy. You will need to take this to future appointments at the hospital of your choice.
Your GP/gynaecologist will make appointments for scans, blood tests and ultrasounds throughout the course of your pregnancy.
The International Federation of Gynaecology and Obstetrics (FIGO) can put you in touch with the Russian Society of Obstetricians and Gynaecologists, who can supply you with details of obstetric care while you are in the country. You will need to register your pregnancy with the city gynaecological office, which will organise your tests. It will also provide you with the relevant documentation for the maternity hospital.
You can access antenatal classes that are geared towards English speakers in Moscow. For example, the EMC Maternity Hospital at the European Medical Centre in Moscow runs them. However, you may have problems finding any elsewhere.
Once you have given birth, you can expect to remain in hospital for around three days. This will obviously be longer if you have a C-section. Ask for details of breastfeeding groups, as you should find a number of these in Russia. You should also be able to access postnatal classes in the larger cities, and some of these will be English-speaking. Yoga classes for mums are also available.
You will need to obtain a birth certificate from the local civil registry office. Take along your proof of identity, plus your marriage certificate and a copy of your visas. You will also need to alert your national embassy. It is advisable to do this before the birth, as they can then give you advice regarding registration.
The Social Insurance Fund (Fond Socialnovo Strahovanya Rosiyskoy Federaciy/ Фонд Социального Страхования Российской Федерации) regulates maternity leave, which is 140 days at 100% of your salary – 70 days before the birth and 70 days after. During maternity leave, women receive an allowance from the Social Insurance Fund from insurance contributions. This corresponds to 100% of your average salary over the previous two years. A maximum amount is determined every year (RUB2,301.37 per day in 2020). Paternity leave is not regulated by law in Russia, and if the father does take time off, he will not be paid.
Will my baby be a Russian citizen?
Even if one of their parents is Russian, your child will not automatically be a Russian citizen. The Russian parent will need to submit a formal request for citizenship to the Russian authorities for the baby to be recognised as a Russian citizen.
If you are applying for a Russian visa, you will need to demonstrate that you have some form of health insurance, before you enter the country. Once on the ground, you will be eligible to access public healthcare, as long as you are making contributions into the Russian social security system.However, as we shall see below, most expats opt for private health insurance with an international provider. If this is something that you’d like to do, you will naturally want to access the most cost effective policies, and we will look at some of your options below.
Personalising your health insurance cover
You will be able to access the state health insurance system, обязательное медицинское страхование (OMI/OMC), as an expat employed in Russia. If you are simply visiting the country, however, you will have to pay out of pocket or seek emergency treatment, unless you have private international coverage.
OMI is limited. It often applies to a specific hospital and is non-transferable. Thus, many Russians and most expats opt for either comprehensive private cover or top-up cover to deal with anything beyond basic treatment. Check with your employer to see whether they offer voluntary health insurance (VHI) or добровольное медицинское страхование (ДМС), which acts as a supplement to the basic policy. Russian local insurance is geared towards the corporate sector; the bulk of its market consists of group policies purchased by employers.
Russia has a reputation for a low standard of healthcare, falling significantly behind European nations and most Eastern European states. You are likely to find the best quality of healthcare in Moscow and other large cities, while there is often very limited provision in rural and more remote areas.
Your other option is to pay out-of-pocket expenses in the private sector. Remember, however, that costs can escalate rapidly if you have a chronic condition or need to see a specialist.
It is advisable to take out medical evacuation insurance as part of your policy during your stay in Russia.
Check the small print of any private health insurance policy to see whether it covers treatments that you may want to access, such as specialist surgical treatment or more advanced dental care, like crowns or dental implants.
Remember to check whether your potential policy covers pre-existing conditions; the definition of a pre-existing condition will vary between insurers. Usually, the term applies to any conditions that present symptoms or for which you’ve been treated in the last five years. This normally includes any conditions you were diagnosed with over five years ago, but some insurers have different time limits on when the diagnosis must have been given.
You may want to check whether your policy has a ‘hospitalisation’ clause covering you for occasional hospital visits. You may need to discuss this directly with your insurer. You may also wish to check whether there is a medical evacuation clause.
Take a good look at your potential policy for any cover relating to healthcare that does not apply to you. Some policies have provision for maternity care, for instance, and if you are not intending to become pregnant (or would prefer to rely on the cover provided by the Russian maternity system), then you may wish to reduce your policy costs by having such options removed.
You may also be able to reduce the cost of your premium through cost sharing. This is where you and your insurer share the costs of any treatment. You will pay up to an agreed limit, and your provider will cover the rest. Different insurers will have different ways of arranging cost sharing.
Co-pay: where you pay a fixed sum for your treatment and your insurer covers the rest. For instance, if the total cost of your treatment is €85, and your co-pay amount is set at €40, then you will pay €40 and your insurer will pay €45.
Co-insurance: where you pay a fixed percentage of the total cost and your insurer covers the rest. For instance, if your co-insurance is set at 20%, you will pay 20% of €85 and your insurer will cover the remaining 80%.
Deductibles: where you pay the entire amount allowed for all services provided until the deductible is met. For instance, if your policy has a €1,000 annual deductible, you would pay €85 for each visit to your GP for 11 visits (€1000/€85 = 11.8), after which your insurance would pay out to the doctor directly.
You may also need to take a look at whether there is an out-of-pocket maximum that you would be expected to pay after your deductible has been met.
Let’s say that your plan above, with a €1000 deductible, also has a co-insurance option of 20% and an out-of-pocket maximum of €1500. You will thus pay €85 for 11 visits to the doctor under your deductible until it is met. You will then pay €17 for each visit as your 20% coinsurance, until you reach the co-insurance ceiling of €500 (€1,500 minus the deductible of €1,000), or about 29 more visits (€500/€17 = 29.4). At that point (40 total visits in a year), you would pay nothing more for the remainder of the plan year.
It’s worth doing the maths, especially if you don’t think that you’ll need to make more than a couple of visits to your GP in any one policy period. For example, if you just want dental check-ups with an occasional filling, it might be worth working out whether one or two out-of-pocket costs might be cheaper than full dental cover.
As so many variables have an effect on the cost of international private medical insurance it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.
Russia is not always considered to offer the healthiest lifestyle on the planet, but if you are going to be living and working there, then you will find plenty of opportunities to keep fit and well.Russia is an enormous country. You will find a diverse range of landscapes there, and there are opportunities for sailing, white water rafting, swimming, skiing and hiking. Many Russians like sports, as well as getting out into nature and visiting their swathes of forest. Take the chance to explore, therefore, and get fit at the same time.
Russia’s main sporting passion is football – the FIFA World Cup was held there in 2018 – along with a popular traditional sport known as Bandy. Bandy is informally called “Russian hockey” and is sometimes considered to be the country’s national sport. It is one of the biggest spectator sports in Russia. Also popular are Lapta, a Russian traditional bat and ball game, and Moscow Broomball, which is a variation of broomball (a form of ice hockey played in Moscow).
Also played is Gorodki, a folk sport in which competitors knock down a group of cylindrical wooden objects by throwing a bat. Russian Pyramid is a cue sport played across Russia, and there is also Bunnock, a form of skittles played with bones (also known as “Game of Bones”).
Also popular are basketball, ice hockey, handball, rugby league, wrestling, martial arts, weightlifting, gymnastics, figure skating, boxing, volleyball, rugby union, and skiing. Russian athletes are dedicated and tend to do well in the Olympics. Russian athletes first competed at the Olympic Games in 1900, and they have been winning numerous gold medals ever since. The country has a number of world-famous sporting stadiums.
There are over 100 ski resorts in the country, and the Sochi Winter Olympics sparked additional interest in skiing. The season runs from December to April. The leading resort is Krasnaya Polyana (Sochi), although experienced skiers say that it is not infrastructurally up to Western standards. It is, however, supposed to be good for powder.
Many Russian resorts offer snowboarding, some also offer mountain yoga, and some favour rather eccentric practices. At Dombay, you can stay at a hotel shaped like a UFO, and at Bolshoi Vudyavr, you can, conditions permitting, ski in the light of the aurora borealis. The Cheget ski park, in the south of the Elbrus region, has a season from November to May and is dedicated to extreme skiers. Sheregesh, in the Kemerovo region, has an annual mass downhill bathing-suit run in April.
Russia also scores when it comes to unusual surfing. The most famous surfing there is in the volcanic Kamchatka Peninsula, in Russia’s Far East, bordered by the Sea of Okhotsk, Pacific Ocean and Bering Sea. Sochi and Vladivostok are also well known. This kind of surfing is for very experienced surfers, and you should expect some very low temperatures. Sochi is said to have great conditions for a range of board sports.
Russia is a great country if you like hiking, with some gentle trails around local woods and forests – you’ll find some opportunities wherever you are based, although you might need to travel beyond the cities. If you are feeling adventurous, you can take guided treks to Mount Elbrus in the Caucasus (the country’s highest peak), the Altai region on the border with Mongolia, and the Kamchatka Peninsula. Summer to early September is the time for Mount Elbrus, which has both gentle and steep hikes. You may have to camp on the way, however; Russia’s tourist infrastructure is often quite rudimentary, although you will find some hotel and B&B provision as far away as Siberia.
The northern part of the Urals, in the Yugyd-va National Park and the Pechora-Ilych Nature Reserve, is a UNESCO World Heritage site and very beautiful, but it is perhaps more suitable for experienced hikers.
Vottvovaara in Karelia is a gentle place for hiking and a sacred place to the Saami people, who chose it as their place of worship because of its remarkable glacial stone formations.
Russia’s famous Lake Baikal also has some excellent hiking trails.
Yoga is popular in Russia, although there were some issues in 2015, when Russian officials apparently targeted yoga as part a crackdown on activities associated with “religious cults” and issued desist letters to yoga studios. However, this attempt at repression does not seem to have lasted, and the country has a number of yoga retreats. Costs are, for example, around €900 for just under a month.
Gym-based fitness is very popular in Russia. The international chain of Gold’s Gym opened its first club in Russia in 1996. Currently, the network is represented in five regions. TrainAway also runs gyms around the country. You may find gyms attached to the larger hotels, but be prepared for limited English-speaking provision outside the big cities.
Golf is not widespread, due to the major capital investment needed, but it is a growing market sector, and you will find over 30 courses in the country. Moscow Country Club runs one of these, and Mill Creek Golf Club opened in St Petersburg in 2017.
You will need to consider your diet while you are in Russia. It has to be said that the country does not have one of the world’s healthiest diets, although if you are vegetarian you can base your consumption around rice and kasha. Russian cuisine features a lot of salads, but these often contain meat! Ham is regarded as a sort of vegetable. Check out vegan travel sites for how you can find the best provision. Veganism is growing quickly in the country, and Moscow has a number of vegan restaurants.
Alcohol intake has been an issue in Russia for a long time, although a surprising number of Russian communities have now decided to go dry. Watch your intake all the same, particularly if you are in a working environment. Russians may expect you to keep up. However, fruit juice and mineralnaya voda are also available.
How much you will pay for healthcare in Russia will depend on whether you access the public sector or the private sector. In general, state healthcare in the country is not of a high standard – it is not as high quality as you may be accustomed to in the West. The system is underfunded and overcrowded, and it suffers from corruption and limited resources. Many expats prefer to use the private sector.There is a state health insurance system, обязательное медицинское страхование (OMI/OMC), and you will be able to access this as an expat employed in Russia. In theory, OMI covers all Russian citizens and residents. Therefore, if you are working in the country and/or have a residence permit, you will be able to access public healthcare. You will also be treated in an emergency.
However, OMI is limited. It often applies to a specific hospital and is non-transferable. Therefore, many Russians choose to opt either for comprehensive private cover, if they can afford it, or for top-up cover to deal with anything beyond basic treatment. However, if you are simply visiting the country, you will only be able to access emergency treatment or pay out-of-pocket, unless you have private international coverage.
The provision of the private sector in Russia is continuing to grow. The care you will receive in private sector clinics will usually be of a high standard, and there are a number of flagship operations, such as the European Medical Centre or the American Medical Centre in Moscow. This is a growing market sector, as private healthcare in Russia has been catching up rapidly with that in the West and other nations, since the fall of the Soviet Union.
You will find the most reliable provision in the cities, where there will also be a higher chance of personnel speaking English. Organisations, such as the MD Medical Group (MDMG), have been building new maternity hospitals across the country, and provision is increasing swiftly as investment in this sector expands.
Medical tourism is on the rise, and most patients – around 44% of medical tourists – visit the country seeking dental treatment. You can expect savings of around 15% to 36% in comparison with the States for a variety of dental procedures:
• Dental crown: US$200 to US$700
• Dental implant: US$2588
• Teeth whitening: US$386
• Tooth filling: US$173
• Veneers: US$654
• Sinus lift: US$1720
• Root canal: US$100 to US$200
The Russian Association of Medical Tourism (AMT) says that in-vitro fertilisation (IVF) is also currently one of the most popular procedures among overseas clients, and it is around 2.5 times cheaper than in Europe or the USA. An IVF cycle will cost from around US$3150, with consultations costing in the region of US$60 and egg donations from around US$2500. The country currently has around 140 fertility clinics, mainly in Moscow and St Petersburg. These must be licensed, and they are quite heavily regulated by the state.
Optical treatment is also a growing sector, with LASIK costing around US$600 per eye and lens replacements costing in the region of US$1600 to US$2500.
Hip replacements cost between US$5K and 13K. Knee replacements cost from US$5300 to US$13K. Facelifts cost from around US$5900. Breast implants cost from just under US$3K, and breast reduction costs begin at around US$1870. Neck lifts cost in the region of US$1150. Eyelid surgery costs from around US$600. Liposuction costs vary between areas, but they begin at about US$360.
Therefore, if you choose to access private sector treatment in the country, you will find some state-of-the-art clinics, as well as competitive prices that compare favourably with those in the UK and the USA. Obviously, you should do your research, and ask your selected clinic for information regarding outcomes. Ask also for testimonials, references and proof of qualifications. No reputable provider will object to providing you with this information.
You should also check with your policy provider that your insurance will cover your procedures, particularly if you would like elective ones. Check, too, that your clinic will accept your insurance and your means of payment.
Overall, oncological care in the public sector in the USA is substantially better than in the public healthcare system in Russia. Russian healthcare suffers from a number of challenges: poor infrastructure, overcrowding, corruption and underfunding. In saying this, the quality of the actual medical provision is often good, and Russian oncological research is forging ahead. Most expats resident in Russia opt for private treatment.
Oncological treatment in the USA
If you need to seek cancer treatment in the US, and you are not eligible for Medicare or its sister program, Medicaid, you will need a health insurance policy that covers you for oncological treatment. The care that you receive, however, will be of a high quality. The American Society of Clinical Oncology has conducted surveys, and these show that patients are very satisfied with their care in collaborative practice models.
David Chan, at the UCLA Oncology Centre, told Forbes that, overall, survival rates for cancer are better in the USA than anywhere else in the world, due to overtesting and aggressive treatment, caused by fears of litigation from patients. Some countries beat the USA in regard to certain types of cancer (Japan, for instance, has a better track record for treating stomach cancer). Chan also notes that new treatments, such as immunotherapy, are more widely available in the US than in nations that have budget-capped national health systems.
However, the US system is under strain, due to the insurance-based nature of American healthcare. Providers noted that payer pressures were at the top of their list of challenges, with oncology practices experiencing issues in day-to-day operations, often related to payment, reimbursement, and competition.
Pain management for oncological patients has also become an issue in the US, a result of the recent opioid crisis. Cancer survivors report that ‘anti-opioid sentiment can be pervasive and hurtful.’
Oncological treatment in Russia
Public sector healthcare in Russia is, overall, of a poor quality compared to in other OECD nations, and this has an impact on oncological care also. In 2014, The Lancet reported the results of a survey, which indicated that cancer mortality rates in Russia were considerably higher than those in Europe and the United States. The overall risk of dying from cancer ran at about 60%, compared to 40% in the United Kingdom and 33% in the United States.
Lung cancer and prostate cancer are the most common forms of the illness. The former is probably related to the high rates of smoking in the country, and it results in around 3.6% of deaths. The poor rate of survival is almost certainly a consequence of late detection, as waiting times for appointments in Russia are long, and there are also limited facilities, resulting in late diagnoses.
The level of healthcare spending is poor, and patients do not experience the same level of treatment in Russia as they do in other developed or developing nations. According to The Lancet, only 30% of patients had radiation therapy, and despite some regional variations, around a quarter of all cancer patients were estimated to die within a year of their diagnosis. Most specialist oncological centres are in Moscow and St Petersburg. Medical provision in rural areas is extremely limited, with large areas having little or no provision.
You are advised not to seek oncological treatment in the public sector. There are a number of private clinics throughout the country. St Petersburg has a proton treatment centre, and there are a number of clinics that offer gamma knife treatment. The European Medical Center (EMC), one of Moscow’s best-known English-speaking clinics, offers oncological treatment, and the Federal State Budget Scientific Research Center for Radiology offers HIPEC chemotherapy treatment. Da Vinci surgery is also available for people with prostate cancer.
Private provision has been increasing in recent years. Europe’s largest radiotherapy centre has recently opened in the city of Dimitrovgrad, and it uses a cyclotron to offer proton therapy.
Complex treatment costs start at around US$7K. The EMC offers oncological consultations from US$200. If you are resident in the country and are diagnosed with cancer, you have the choice of being treated in situ or returning to your home nation for treatment. This choice will depend on your location in Russia. You may also wish to check whether you have a medical evacuation clause in your existing insurance.
If you opt for treatment in Russia, check your chosen clinic carefully. Do not be afraid to ask them about outcomes, and make sure they will accept your insurance. You will also need to consult your insurance provider to find out whether they will fund your treatment. Some insurers will not cover pre-existing conditions, so it is worth discussing any new policy with them if you have a history of the disease.
If you are intending to visit the country as a medical tourist, you will need to factor in accommodation, depending on the length of your treatment. In addition, you will need to think about aftercare, as some of the worst side effects of treatments like chemotherapy can occur some time after your course has ended.
Some medical tourism companies can arrange accommodation and flights for you, but with an illness as serious as cancer, you should think about whether you might not be better off seeking treatment in your home nation, particularly one that has such advanced oncological care as the USA.
If you are living and working in Russia, and you need to access dental and ophthalmological care, then what are the best options for you? Russian public healthcare, unfortunately, has a poor reputation. Provision is often very limited outside the big cities, such as Moscow and St Petersburg, and the scheme is underfunded and often lacks up-to-date equipment.Therefore, to avoid these issues, most expats resident in Russia opt for private sector healthcare across the board, even if they are covered by national health insurance, and this covers dental and optical care. We will look at the situation in greater detail below.
How to register with a dentist
You can find a local dentist (зубной врач/zubnoiy vratch) online. Alternatively, you could contact your local expat community for recommendations, particularly if you are intending to have corrective or cosmetic treatment during your stay in Russia. As above, this is likely to be in a private practice. You should find plenty of provision, particularly in urban areas. Moscow has in the region of 2000 dentists.
There are three main types of dental clinic in Russia:
• Economy class polyclinics: basic state-funded clinics, covered by OMI (see below), with extra services available for a fee
• Business class polyclinics: public or private, with a wider range of services, for which you will have to pay
• VIP clinics: mainly in Moscow, with the highest proportion of English-speaking dentists; this is the sector for international dental tourism
The European Medical Centre, which is one of the largest and oldest English-speaking clinics in Moscow, the American Medical Clinic (AMC) and the French Dental Centre all provide a wide range of dental care. The AMC, for example, which has been in operation since 1995, carries out over 500 implants and over 950 crowns per year.
Health authorities report that the boundary between state polyclinics and private clinics is being blurred, and dental costs in Russia can be comparatively high, resulting in unequal charges across clinics. Do not be afraid to shop around, therefore.
Many dental clinics in Russia are open 24 hours a day, particularly in Moscow.
To what extent does national insurance cover dentistry?
OMI/OMC (обязательное медицинское страхование), the Russian state national insurance scheme, covers children for free dental care and very basic treatment, but nothing else. You will need to take out a dental policy or pay out of pocket. Check-ups are in the region of US$50.
Accessing private dental treatment
Russian private health insurance generally does not cover pre-existing conditions or terminal illnesses. It will, however, cover most primary and hospital care, including specialist consultations and elective surgery, such as cosmetic surgery. Dental plans will also be available. However, you may prefer to opt for a policy with an international provider, as this is likely to be more comprehensive.
Medical tourism is on the rise, and around 44% of medical tourists come into the country seeking dental treatment. Some sample costs are as follows:
• Dental crown: US$200 to US$700
• Dental implant: US$2588
• Teeth whitening: US$386
• Tooth filling: US$173
• Veneers: US$654
• Sinus lift: US$1720
• Root canal: US$100 to US$200
You can expect to save between 15% and 36%, in comparison to similar treatments in the USA.
Check for references, qualifications and testimonials. If your private policy covers dental treatment, check with your provider to see whether a particular procedure is covered under your insurance (for example, cosmetic dental surgery) and with the clinic to make sure that they accept your insurance.
Make sure you are aware of any hidden costs, and discuss the full details of your chosen treatment with the clinic. For example, if you are visiting the country specifically for the treatment, find out how long you will need accommodation for, whether there will be any follow-up appointments, etc.
How to register with an optometrist in Russia
You can find a local ophthalmologist (оптик/optik) online, or contact your local expat community for recommendations. You can also contact one of the organisations officially devoted to optical care in the country, such as the Association of Ophthalmologists, the Optical Association (businesses working within eyewear), and the Russian National Committee for the Prevention of Blindness.
To what extent does national insurance cover optical care?
National insurance will only cover optical treatment to a very limited extent, such as in an emergency where you have injured your eye. You will usually need to seek treatment in the private sector.
Accessing private eye treatment
Check online to find your local ophthalmologist. You will find plenty of private provision. There are independent stores, as well as chains, such as Eyekraft, Optic Trade, Lensmaster and Okcharik. The private optical sector is continuing to grow, despite the economic downturn, with optical shops remaining the main retail channel for eyewear in 2019. International producers of eyewear dominate the market, such as Johnson & Johnson and Novartis.
You will also find online retailers, and these tend to be cheaper. Some of them are affiliated with bricks-and-mortar ophthalmological stores and chains. You may also find opticians in larger drugstores. Look for signs saying, “сеть салонов оптики” or “сеть магазинов оптики.”
If you are visiting the country for corrective eye surgery, you will find extensive provision, as this, too, is a growing sector. For example, LASIK costs around US$600 per eye, and a lens replacement costs from US$1600 to US$2500.
There are a number of complementary therapies available in Russia, from Eastern healing therapies to traditional Russian forms of relaxation. If you are living and working in the country, then you may want to learn more about your options.The use of complementary and alternative medicine (CAM) is widespread in Russia and can be found in mainstream medical establishments. A study in 2008, involving three urban academic hospitals in St. Petersburg and 192 physicians, found that 100% of the respondents had either practiced CAM or referred patients for at least two CAM therapies. 99% had themselves practiced at least two therapies, and on average, each physician had practiced or referred patients for 12.7 therapies. This reflects the interest in CAM in medical establishments throughout the country.
This is in part due to the poor quality of Russian state medicine. Although individual doctors are often highly competent and well trained, the public healthcare sector suffers from some serious deficiencies, and in rural areas in particular, primary care provision may be limited or non-existent. Therefore, people feel that they need to turn to traditional remedies, many of which may be regarded as tried and tested. In addition, Russians tend to be spiritually curious and enjoy trying new and interesting practices.
Many Russians seek out traditional healers, who may rely on practices such as herbalism, astrology and divination, plus some outright spell work, in order to cure patients. Mainstream medics, such as one doctor working at the European Medical Centre, one of Moscow’s largest private practices, use traditional healing techniques alongside conventional Western medicine.
Herbalism is an ancient practice in Russia and is taught in medical schools. Many pharmacists also study herbal medicine.
The Cossacks used hypericum for treating wounds (the herb’s historical name is dzherrabai, which means “wound healer”).
Tavolga (meadowsweet) was known as a ritual plant of the Scythians, and in ancient Rus it was used as a painkiller and medicine. Tavolga tea is said to relieve pain and treat stomach ulcers, diarrhea, nausea, rheumatism, and gout.
Currant leaves (Smorodina) have been used from the 11th century in ointments, infusions, brews, and tea.
Reiki is popular throughout Russia, and you will find classes and workshops in Karuna Reiki, among other forms in the country, particularly in the larger cities.
Yoga is also popular, although there were some issues in 2015 with Russian officials apparently targeting yoga as part of a crackdown on activities associated with “religious cults” and issuing desist letters to yoga studios. However, fortunately, this attempt at repression does not seem to have gone too far, and the country has a number of yoga retreats. Costs can be in the region of €900 for just under a month.
Shamanism is gradually making a comeback in Russia, and if you are in one of the more remote areas, particularly if you are in Siberia or the East, you may encounter this ancient, if revivalist, practice. Yakutsk, for instance, has a large new shamanic temple. These practitioners may also specialise in healing.
There are also a number of traditional healing methods associated with Christianity, such as the practice known as ‘the laying on of hands’, in which energy is communicated from the practitioner to the patient. If you are going to embark on a course of such treatment, then make sure you are not too quick to believe a healer’s claims, whichever tradition they say they are from.
This is particularly pertinent if you consult a psychic; there are many working in Russia, and some will be of dubious provenance, to say the least. Counselling/psychotherapy are relatively new concepts in Russia, even today, and although you will find therapists in the cities, these roles are often taken, in the provinces, by traditional healers or the Church.
Apitherapy, also practiced in some Eastern European countries, is a possibility, if you want to try a more unusual form of alternative medicine. Bashkir Scientific Research Center for Beekeeping and Apitherapy (Башкирский научно-исследовательский центр (БНИЦ) по пчеловодству и апитерапии) is a research institute based in Ufa, in the Republic of Bashkortostan, and it specialises in beekeeping and apitherapy.
The banya, or steam bath/sauna, is a major part of Russian life, and you will find them all over the country. The country also has a large number of thermal spas and hot springs, many of them in the Caucasian Mineral Waters region, where there is a quartet of spa towns: Pyatigorsk (Russia’s Baden-Baden), Kislovodsk, Yessentuki and Dheleznovodsk.
Massage is commonly available across the country (although you may draw the line at being beaten with birch leaves or bunches of nettles!). Massage was traditionally a form of rehabilitation in Russia, so the idea of it as a form of relaxation is relatively recent.
Hydrotherapy/balneotherapy is also found in Russia, and you can access a number of thermal/steam treatments for conditions such as rheumatism and arthritis. The Russian Ministry of Health runs a Scientific Research Institute of Medical and Thermal Rehabilitation.
You will find acupuncturists and crystal healers in Russia, as well as homeopaths, although, as with yoga, homeopathy has attracted some negative attention from the authorities, and accusations have been made that it is a ‘pseudo-science.’ As a potential client, you must do your own research and make up your own mind. In 2017, the Prosecutor General responded to the National Homeopathy Council of Russia, to the effect that using homeopathic methods of treatment does not contradict the law, as they are in an advisory capacity.
Overall, you will find that you can access a range of complementary therapies in Russia, some of which are integrated into the conventional medical system. If you are intending to access these, then it is advisable to do your research, and ask for qualifications, testimonials and references. This is particularly important if you plan to access them for purposes of healing rather than simply for relaxation.