Health insurance in russia: double is better

Anyone who signs an employment contract with a Russian company is provided with Russian health insurance. But you should not rely on it in case of emergency. Experts explain how foreigners in Russia should best protect themselves.

The more complex the treatment, the more important the question of cost becomes in the event of illness. /Photo: Pixabay

In the beginning were the headaches. Then small dropouts. Finally the diagnosis: a tumor, which must be treated urgently. Russian insurance does not cover the cost of cancer treatment. But the German health insurance company cancelled the patient before the move abroad. A fictitious example though. But one thing you should at least have thought about when signing an employment contract in Russia. Because in this country, health insurance is not as self-evident as it is in Germany.

1. No reimbursement

In principle, the German statutory health insurance does not cover any costs in Russia. As a tourist you need therefore a travel health insurance. But this often applies only to temporary stays, for example, up to 42 days. If you live and work in Russia for a longer period of time, you have to take out a different kind of insurance. Unless he was sent to Russia by a German company on a temporary basis ("secondment"). Then the employer continues to pay social security contributions in Germany and initially pays for the necessary medical treatment of his employees. Subsequently, he can have the costs reimbursed by the employee's German fund.

2. Compulsory insurance

If you are employed by a Russian company on a work visa, your employer must take out and pay for Russian health insurance. This so-called additional health insurance (DMS) is a prerequisite for the work permit. This is also true if someone has private health insurance for abroad in Russia. How the insurance certificate has to look like is regulated by law. For example it must be watermarked. Therefore, you should not accept the offer of dealers who advertise such documents on the street, advises Tatyana Ignateva from the insurance company Reso.

The standard version is available for as little as 3000 to 4000 rubles a year, the equivalent of about 45 to 60 euros. "But you don't get much for it either," says the expert. A broken arm is plastered. But comparable with the protection of a German health insurance is not the offer. In addition, you are bound to certain clinics. Therefore, you can not necessarily choose a doctor who speaks German or English. Often these insurances only apply to the place of work, points out Andreas Setzepfandt, who as deputy general director of Burda in Russia is also responsible for personnel issues. From experience, he advises looking closely at the terms and conditions and topping them up in consultation with the employer: "For the equivalent of 500 to 600 euros a year, companies can buy insurance for their employees that covers more than the minimum rate."

3. Additional protection

All experts interviewed agree that the standard DMS is not enough. Elena Balashova, a lawyer who advises the German Embassy and the Austrian Trade Agency, among others, also recommends extended voluntary health insurance. This allows to choose for example international clinics or good Russian hospitals. It is also common practice for reputable Russian companies to take out such insurance policies for their foreign and Russian employees. So they do not have to be treated in the state institutions.

You can also buy such additional contracts as an employee yourself. However, the expert from Reso points out that the offers for private individuals are often limited. For example, planned hospital stays, such as for a knee operation that is not absolutely necessary, could be excluded. Even coverage in case of pregnancy or chronic diseases does not have to be included in such an offer. The conditions are usually better if companies conclude the contracts for their employees as a package. Therefore, it is advisable to negotiate with the employer before signing a contract yourself.

4. Private alternatives

Another option is to take out additional German or international health insurance. For example, Natalya Ryzhkevich, a migration expert at Siemens in Russia, explains that Russian expatriate insurance cannot replace German insurance. And Setzepfandt points out that employees who continue to take out insurance in Germany should take this into account when negotiating their salaries.

Care must be taken with the details. Some private insurance providers, for example, only cover the European part of Russia. Problems can also arise when someone gives up their residence in Germany. The contract can then become invalid. In addition, one should clarify beforehand whether treatments in Germany are covered.

5. Eligibility in Germany

As a rule, expats do not want to stay in Russia forever. That's why the experts surveyed advise retaining German insurance if possible. For those with statutory health insurance, there is the option of a qualifying period. In this case, significantly lower contributions are paid. In 2017, according to information from German health insurers, it is just under 30 euros per month. There is no entitlement to benefits for this. However, the qualifying period can be converted into an insurance policy if you are temporarily staying in Germany.

It can also be useful if you later want to switch to the health insurance for pensioners (KVdR) or receive benefits from the long-term care insurance, according to the German National Association of Statutory Health Insurance (Spitzenverband der Gesetzlichen Krankenversicherung). Likewise, the Anwartschaft can help if you do not immediately get an employment contract after returning home. In any case, you should discuss the possibility with your health insurance company.