Rights and obligations of insured persons (Article 16 of the Federal Law No. 326 “On Compulsory Medical Insurance in the Russian Federation”)
Article 16. Rights and obligations of insured persons
1. Insured persons have the right to:
1) free provision of medical care to them by medical organizations in the event of an insured event:
a) throughout the territory of the Russian Federation in the amount established by the basic program of compulsory medical insurance;
b) in the territory of the subject of the Russian Federation in which the compulsory medical insurance policy was issued, in the amount established by the territorial program of compulsory medical insurance;
2) selection of an insurance medical organization by submitting an application in the manner prescribed by the rules of compulsory medical insurance;
3) replacement of the insurance medical organization in which the citizen was previously insured, once during the calendar year no later than November 1, or more often in the event of a change in the place of residence or termination of the agreement on the financial provision of compulsory medical insurance in the manner established by the rules of compulsory medical insurance, by submitting an application to a newly selected medical insurance organization;
4) selection of a medical organization from medical organizations participating in the implementation of the territorial program of compulsory medical insurance in accordance with the legislation in the field of health protection;
5) choosing a doctor by submitting an application personally or through his representative addressed to the head of the medical organization in accordance with the legislation in the field of health protection;
6) receiving from the territorial fund, insurance medical organization and medical organizations reliable information about the types, quality and conditions for the provision of medical care;
7) protection of personal data necessary for maintaining personalized records in the field of compulsory health insurance;
8) compensation by the insurance medical organization for damage caused in connection with its failure to perform or improper performance of its obligations to organize the provision of medical care, in accordance with the legislation of the Russian Federation;
9) compensation by a medical organization for damage caused in connection with its failure to perform or improper performance of its obligations to organize and provide medical care, in accordance with legislation Russian Federation;
10) protection of rights and legitimate interests in the field of compulsory medical insurance.
The insured persons are obliged
present a compulsory medical insurance policy when applying for medical care, except in cases of emergency medical care;
2) submit to the insurance medical organization in person or through his representative statement on the choice of an insurance medical organization in accordance with rules compulsory medical insurance;
3) notify the medical insurance company about the change in the last name, first name, patronymic, data of the identity document, place of residence within one month from the day when these changes occurred;
carry out the choice of an insurance medical organization at a new place of residence within one month in the event of a change in the place of residence and the absence of an insurance medical organization in which the citizen was previously insured.
3. Compulsory medical insurance of children from the date of birth and until the expiration of thirty days from the date of state registration of birth is carried out by an insurance medical organization in which their mothers or other legal representatives are insured. After thirty days from the date of state registration of the birth of a child and until he reaches the age of majority or until he acquires legal capacity in full, compulsory medical insurance is carried out by an insurance medical organization chosen by one of his parents or another legal representative.
4. The choice or replacement of an insurance medical organization is carried out by the insured person who has reached the age of majority or has acquired legal capacity in full (for a child until he reaches the age of majority or until he acquires legal capacity in full - by his parents or other legal representatives), by submitting an application to the insurance medical an organization from among those included in the register of insurance medical organizations, which is placed on a mandatory basis by the territorial fund on its official website on the Internet and may be additionally published in other ways.
5. To select or replace an insurance medical organization, the insured person personally or through his representative applies with statement on the choice (replacement) of an insurance medical organization directly to the insurance medical organization chosen by him or other organizations in accordance with the rules of compulsory medical insurance. On the basis of this application, the insured person or his representative is issued a policy of compulsory medical insurance in okayestablished by the rules of compulsory health insurance. If the insured person has not submitted an application for the choice (replacement) of an insurance medical organization, such a person is considered insured by the insurance medical organization with which he was insured earlier, except for the cases provided for paragraph 4 of part 2 of this article.
6. Information about citizens who did not apply to the insurance medical organization for the issuance of compulsory medical insurance policies to them, as well as those who did not replace the insurance medical organization in the event of termination of the agreement on the financial provision of compulsory medical insurance in connection with the suspension, revocation or termination of the license of the insurance medical organizations, monthly until the 10th day, are sent by the territorial fund to insurance medical organizations operating in the field of compulsory medical insurance in a constituent entity of the Russian Federation, in proportion to the number of insured persons in each of them for concluding agreements on financial support for compulsory medical insurance. The ratio of working citizens and non-working citizens who did not apply to the insurance medical organization, as well as who did not replace the insurance medical organization in the event of termination of the contract on financial support for compulsory medical insurance in connection with the suspension, revocation or termination of the license of the insurance medical organization, which is reflected in the information sent to insurance medical organizations should be equal.
7. Insurance medical organizations specified in parts 6 of this article:
1) within three working days from the date of receipt of information from the territorial fund, inform the insured person in writing about the fact of insurance and the need to obtain a compulsory medical insurance policy;
2) ensure the issuance of a policy of compulsory medical insurance to the insured person in the manner prescribed by article 46 of this Federal Law;
3) provide the insured person with information about his rights and obligations.