Russia has a two-tier health insurance system, comprised of mandatory public health cover and private insurance. Whether you choose to rely on public health insurance or take out private cover will depend on your own circumstances; we will look at some of your options below.

Russian healthcare is governed overall by the Russian Ministry of Health (министерство здравоохранения) but is regionally organised. The country has a reputation for a low standard of healthcare and was ranked by Bloomberg in 2019 to be the world’s 95th healthiest country: significantly behind Western European nations but also falling behind most Eastern European states as well.

You are likely to find the best quality of healthcare in Moscow and other large cities, but provision in rural and more remote areas is very limited. Corruption is also said to be present in some hospitals, with bribery being not uncommon. There are severe shortages – of beds, equipment and medical personnel – across the national healthcare system and some well-publicised horror stories about poor facilities.

There is a state health insurance system, OMI/OMC (обязательное медицинское страхование), and you will be able to access this as an expat employed in Russia. If you are simply visiting the country, however, emergency treatment or paying out of pocket will be your only available options if you do not have private international coverage.

In theory, national health insurance (OMI) covers all Russian citizens and residents. If you are working in the country or have a residence permit, therefore, you will be able to access public healthcare. In an emergency, you will be treated regardless.

However, OMI is limited, often applying to a specific hospital and being non-transferable. Thus 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.

You should check with your employer to see if they offer VHI – voluntary health insurance (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.

If you are not employed, you may still be able to access public services under limited circumstances.

If you are British and travelling in Russia, you will need to take out private insurance: the European Health Insurance Card (EHIC) is not valid in Russia, and the reciprocal healthcare agreement between the UK and Russia ended in 2016.

Your employer will sign you up with OMI when you start your job, but check that this has been done, and check, too, whether you are to be offered VHI.

You can also register yourself through your GP’s surgery. You will need to submit your:

• passport
• residence permit
• proof of address

The national system will cover:

• visits to your GP
• hospital treatment
• specialist consultations
• maternity care and gynecological services
• preventive care
• emergency care
• laboratory services
• transportation
• free appliances and medicine
• rehabilitation
• breast cancer screening
• cervical cancer screening (not available in some regions)
• childhood vaccinations

Check that your GP’s practice is signed up to the state system.

You may need a referral from your GP in order to see a specialist.

In theory, OMI covers the elderly but it is advisable to take out private cover if you are planning on spending any significant amount of time in Russia.

Due to the limitations of OMI, students are advised to take out international health insurance, including policies with a medical evacuation clause.

You can register your children on your OMI plan: contact your GP or the Ministry of Health directly to register them.

Anything above very basic dental care will not be covered by OMI. You will need to take out a dental policy or pay out of pocket: check ups are in the region of US$50.

Children receive free dental care under OMI.

If you are resident and working in Russia, as opposed to having a temporary residency (183 days spent in the country), around 5% of your salary will be deducted on a monthly basis by your employer for your health insurance. You may need to pay more, however, if your employment package includes VHI.

If you are applying for a Russian visa, you will need to demonstrate that you have some form of health insurance already.

Given the severe limitations of the Russian public healthcare system, many expats choose to take out private health insurance cover with a medical evacuation clause. However, you should note that some private clinics have limited facilities as well and may need to refer you to a hospital. The best standard of healthcare is in Moscow and you may encounter a lower standard of care elsewhere even in the private sector.

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.

The price of private health insurance in Russia from local insurers varies from 10,000 to 45,000 rubles per year (US$159 – 715), usually offered through your employer.

You will also be able to pay out of pocket, although many doctors and hospitals will require cash. A night in a private hospital will cost around US$50-100. A visit to a private GP will cost you in the region of US$25-30.

Some of the main international insurers cover Russia in addition to some big local providers, including:

• AlfaStrakhovanie
• Allianze
• Cigna
• RESO-Garantia
• Rosgosstrakh (RGS/ Росгосстрах)
• SOGAZ (these latter two are former state-owned companies, now private providers)

добровольное медицинское страхование, ДМС - VHI – voluntary health insurance

обязательное медицинское страхование - obligatory medical insurance