The cost of public services and amenities for residents
In Kazakhstan, the Social Health Insurance (SHI) system is undergoing significant changes, aiming to improve access and quality of care for insured individuals. The SHI system operates as a two-tier system, consisting of the Guaranteed Volume of Free Medical Care (GVFMC) and the Expanded Mandatory Social Health Insurance (MSHI) package.
The GVFMC, available to all citizens, includes essential free medical care services. The MSHI package, on the other hand, is only accessible to insured individuals and offers additional medical services beyond the GVFMC. These additional services are defined within the SHI reforms initiated in 2020.
Starting from 2025, the MSHI package will cover planned inpatient and outpatient care for 12 chronic diseases under dynamic observation. It will also include outpatient hemodialysis, outpatient drug provision, and medical rehabilitation. Furthermore, the package will extend to cover other procedures and manipulations according to the list.
The MSHI package will also include preventive medical examinations, excluding those provided in GOMBP. Additionally, it will offer diagnostic services, including laboratory diagnostics according to the list, outpatient medical care (diagnosis and treatment of diseases, excluding those transferred to GOMBP), and reception and consultations by profile specialists on referral from primary care physicians.
The dynamic observation of individuals with chronic diseases by profile specialists is another key aspect of the MSHI package. Under the SHI system, a patient's journey begins with a primary care physician who assesses their condition, forms a preliminary diagnosis, and refers them for further consultative-diagnostic services. Insured citizens can then receive treatment or surgeries, including high-tech ones, based on medical indications.
The medical care procurement plan for 2025 allocates 2.96 trillion tenge, with 1.3 trillion tenge designated for medical services under the SHI system. The allocated budget for medical assistance under the SHI system in 2021 was over 1.3 trillion tenge. These funds support the system, which is funded by employer and employee contributions.
By 2026, the MSHI package is expected to cover other chronic and some socially significant diseases. However, the exact detailed service list for 2025 and 2026 is not fully enumerated in the accessible search results. For the most accurate and up-to-date information, consultation of Kazakhstan's official health ministry publications or the Social Health Insurance Fund's documentation would be required.
It's worth noting that without insurance, citizens can still call an ambulance, visit a primary care physician, receive emergency care, and undergo emergency surgery if necessary. However, the SHI system is designed to reduce disparities by expanding coverage for comprehensive services, notably including vital areas such as obstetrics and gynaecology, early screening programs (e.g., colorectal cancer screening), and other health services aimed at reducing out-of-pocket costs and improving patient satisfaction.
In summary, the SHI system in Kazakhstan is undergoing changes to improve the access and quality of care for insured individuals. The system currently consists of a basic free medical care package for all citizens plus an expanded insurance-based package available to insured individuals, with ongoing development expected in coming years. For the most accurate and up-to-date information on the new services for 2025 and 2026, consultation of Kazakhstan's official health ministry publications or the Social Health Insurance Fund's documentation would be required.
- The expanded mandatory Social Health Insurance (MSHI) package, undergoing development in Kazakhstan, will cover medical-conditions such as planned inpatient and outpatient care for 12 chronic diseases under dynamic observation, outpatient hemodialysis, outpatient drug provision, medical rehabilitation, preventive medical examinations, diagnostic services like laboratory diagnostics, outpatient medical care, and reception and consultations by profile specialists.
- In the future, the MSHI package is anticipated to extend to cover other chronic and some socially significant diseases, aiming to improve health-and-wellness outcomes for insured individuals by reducing out-of-pocket costs and offering therapies-and-treatments in vital areas such as obstetrics and gynaecology, early screening programs, and other health services.
