Emergency Medical Service (Ambulance)

  • Insured employees are covered by round-the-clock service of a private emergency medical (ambulance) service in St. Petersburg.
  • Express diagnostics on spot.
  • Acuteconditionrelief.
  • Medical transportation in case of emergency indications to hospitals or first aid stations.
  • In Sosnoviy Bor ambulance service is rendered by municipal ambulance.
Outpatient Care

  • Community-Based Primary Healthcare (Premedical Care).
  • Consultation practice of primary care physician, assigned on permanent basis to the employees.
  • Outpatient care of specialized doctors: 
    physician, surgeon, urologist, otorhinolaryngologist, endocrinologist, dermatologist, ophthalmologist, neurologist, gastroenterologist, cardiologist and other specialists, excluding the cases stipulated in the insurance program, as exceptions.
  • Medical and diagnostics manipulations, performed by doctors and paramedical personnel at outpatient care.
  • House call of a physician in case of acute sickness or exacerbation of a chronic disease.
  • Laboratory tests and diagnostic examination:
    • Clinical, physicochemical analysis, biochemical analysis, immunology examination, cytologic screening, clinical bacterial examination, serology, hormonal examination, erythrocyte level test, coagulogram.
    • ПЦР - diagnostics – not more than 5 times in the course of the insurance contract.
    • cancer-specific marker – not more than 5 times in the course of the insurance contract.
  • X-rayexamination.
  • Computerized tomography and Magnetic Resonance Imaging (MRI).
  • Mammography
  • Physiologic examinations:
    • electrocardiography,
    • cycle ergometry,
    • EEG, rheoencephalography, phonocardiogram,
    • respiratory function,
    • ultrasound examination,
    • endoscopic ultrasonography,
    • X-ray examination,
    • Holter monitoring of ECG and arterial tension,
    • ultrasound dopplerography, duplex scanning.
  • Carrying out procedures, manipulations, the courses of treatment appointed by the attending physician.
  • Treatment at a day hospital, including the cost of necessary drugs.
  • Physical therapy:
    • electric therapy
    • chromophototherapy
    • thermotherapy
    • therapeutic massage (not more than 10 sessions a year),
    • laser therapy (not more than 5 sessions a year),
    • acupuncture (not more than 5 sessions a year),
    • hydrotherapy (not more than 5 sessions a year)
    • physiotheraphy in a group (not more than 10 sessions a year)
  • Efferenttherapy– on medical indications
  • Annual anti-flu vaccination by Russian made vaccines
  • Issue of sickeness certificates, prescriptions.
Emergency and planned hospital care

The emergency and planned hospitalization and hospital care of the following profile: anesthesiology and reanimation (intensive-care), traumatology and orthopedics, gynecology, surgery, neurosurgery, thoracic surgery, cardiovascular surgery, therapy, gastroenterology, hematology, dermatology, infectious diseases, neurology, cardiology, otolaryngology, ophthalmology, pulmonology, nephrology, urology, endocrinology, and others, excluding the cases stipulated in the insurance program, as exceptions.

  • Consultation practice and medical manipulations of paramedical personnel.
  • Conservative treatment carried out according to the adopted medical standards.
  • Surgical treatment carried out according to the adopted medical standards, including the operations performed with use of endoscopic techniques and lithotripsy.
  • Anaesthetic and reanimation (intensive-care).
  • Full provision of medicines during the hospital stay beyond the scope of the state guarantees program.
  • Dietary nutrition according to disease specifics.
  • Nursing (hypurgia) by medical personnel.

The level of service is 2-4-beds rooms at TsMSCh 38 and MPI SPb, including in higher comfort department at TsMSCh 38.

Dental Care

  • Routine checkup with issue of recommendations on required treatment and care of a mouth cavity.
  • Medical treatment:
    • Dental caries treatment by light cured materials
    • Treatment of complicated forms of caries (pulpitis, parodontitis).
    • Removal of old filling for medical purposes only.
    • tooth stopping using gutta-percha points
    • restoration of crown portion of the pulp, destroyed by less than 50%
  • Surgical treatment:
    • removal of a tooth on medical indications:
    • opening of inflammatory infiltrate, paradental abscess in case of acute condition of chronical parodontitis and periodontitis.
    • saturation during operations and removals.
    • reduction of occlusal pad in case of pericoronitis.
    • curretage of a wound in case of alveolar periostitis.
  • Conservative treatment of acute diseases and exacerbation of chronic diseases of parodontitis.
  • X-ray diagnostics:
    • radiodontics
    • radiovisiography.
  • Anaesthetic support:
    • local anaesthetic (conduction anaesthesia, infiltration anaesthesia and  application anaesthesia)
  • Scaling, fluorine treatment – according to medical indications
  • Dental prosthetic rehabilitation:
    • coating
    • resin
Dental services are paid at the amount of 50% of total treatment cost.

Drug provision

  • in case of hospital treatment – full drug provision.
  • in case of outpatient treatment – 50% discount on purchase of drugs in drug stores at Sosnoviy Bor, cooperating with the insurance company at presentation of the recipe from the entrusted doctor with the seal of the insurance company and the insurance policy.
Only medicines allowed by the Pharmacologic Committee for use in Russia are guaranteed to be paid.

The insurance company shall not pay:

  • biologically active supplements
  • vitamins
  • homeopathic medicines
  • contraceptives
  • immunomodulators
  • medication used in practice of sexual health specialist, narcologist, mental physician
  • medication for persons entitled for social benefits and discounts
The discount is applicable only to the medication prescribed in case of occurrence of insured event according to the insurance program.

Sanatorium & Resort therapy, rehabilitation and remedial treatment

  • Issuing of sanatorium certificate
  • Therapy at the sanatorium or a resort
  • Rehabilitation and remedial treatment
  • Practices, consultations and medical manipulations of medical personal.
  • Full medication provision during hospital treatment.
  • Dietetic nutrition according to sickness specifics.
  • Medical personnelnursing.
Services rendered by coordination–dispatcher and expert service of insurance company «SOGAZ»

  • Organizational and consultative support for dispatcher doctors.
  • Arrangement of house-calls to insured employees by private ambulance.
  • Booking an outpatient consultation and diagnostic and treatment procedures.
  • The organization of the emergency and planned hospitalization taking into account opportunities of a concrete hospital and control of its implementation.
The following are deemed as insurance events in this program:

An Insured person seeks medical services due to an acute disease or an exacerbation of a chronic disease and taking measures aimed at diagnosis specification, differential diagnostics and treatment of the following:

  • Respiratory diseases.
  • Sense organs diseases.
  • Diseases of locomotor system.
  • Circulatorysystemdiseases.
  • Digestive systemdiseases.
  • Endocrine diseases.
  • Diseases of genitourinary system.
  • Diseases of excitatory system.
  • Infectious diseases.
  • Skin diseases.
  • Hemopathy.
  • Injuries, burns and other damages of organs integrity as a result of accident at home and as a result of industrial accident
  • Acute poisonings with poisonous plants, chemicals (industrial and household), substandard foodstuff, drugs, food toxic infection.
  • Consequences of medical manipulations, resulting in development of iatrogenic disease.
  • Anaphylactic shock.
  • Inhalation of foreign bodies, swallowing of foreign bodies.
The following are not deemed as insurance events and not paid by the insurance company in this program:

  • malignant oncological diseases (including the haematogenic and lymphatic tissues), except for cases, when the disease is diagnosed for the first time during the validity period of insurance contract.
  • the diseases transmitted mainly sexually, and also ureaplasmosis, urogenital mycoplasmosis, gardnerellosis, papillomavirus infection
  • HIV-infection, immunodeficient diseases and its complications.
  • very dangerous infectious diseases, including: plague, cholera, smallpox, yellow and other viral hemorrhagic fevers.
  • mental diseases, psychoneurotic disorders, and also various injuries and somatic diseases caused by psychogenic diseases, epilepsy and its complications.
  • occupational diseases, listed in Order №№ 90, 83 of the Ministry Of Health of Russia.
  • tuberculosis, sarcoidosis, муковисцедоз.
  • deep fungal diseases, psoriasis and its complications.
  • insulin dependent diabetes mellitus and its complications.
  • chronic renal disease and impaired hepatic function, requiring extracorporal treatment methods.
  • diseases of organs and tissues requiring transplantation, autotransplantation, implantation and prosthetics of all types.
  • Acute and chronic radiation sickness.
  • congenital anomalies and malformations, hereditary diseases.
  • alcoholism, drug addiction, toxicomania of their consequence and complication.
  • systemic diseases, Bekhterev's disease, and also all undifferentiated collagenases, myelinopathy, vasculitides.
  • injuries, poisonings and their consequences which occurred or inflicted in a condition of alcoholic, drug or toxic intoxication.
  • intentional infliction of serious bodily injuries to oneself by an insured person, suicide attempts, except for the cases when an Insured person has been driven to such a state by misdoing of the third parties.
  • pregnancy at gestational age of more than 8 weeks, interruption of pregnancy without medical indications, obstetric aid.
The program does not pay for the following medial services:

  • any medical services, not prescribed by doctor.
  • any experimental or research treatment.
  • phytotherapy and treatment by other means of natural origin, homeopathy, energoinformatics, ozone therapy, bioresonance therapy, and other "traditional" systems of diagnostics, treatment and improvement, etc.
  • diagnostics, treatment, procedures, operations performed with esthetic or with the cosmetic purpose.
  • services of psychotherapist, geneticist and nutritionist.
  • cardiac and neurosurgical interventions, including preparation for them, except for the emergency operations for injuries incurred in the period of insurance validity.
  • operations on vessels, including preparation for them, except for the emergency operations for injuries incurred in the period of insurance validity.
  • family planning services, diagnostics and treatment of infertility and menstrual disorder, except for uterine bleedings, treatment of impotence, artificial insemination and others treatment and/or procedures facilitating or preventing impregnation including medically assisted procreation, introduction and removal of intrauterine contraceptive without medical indications.
  • vision correction by means of contact lenses, planned surgical treatment of short-sightedness, astigmatism, far-sightedness.
  • medical examination to obtain driving license certificates, the permit to carry a weapon, visit of the pool and so forth.
For dental services program:

  • Oncological oral cavity diseases subject to all types of conservative and surgical treatment.
  • Hereditary (chromosomal) and congenital dental illnesses and oral cavity mucous coat.
  • Siseases connected with professional activity and caused by impact on an organism of adverse physical, chemical, biological and other factors.
  • Sexually transmitted diseases with localization in a mouth.
  • Dental orthodontology
  • Restoration of crown portion of tooth with use of fiber glass and hydrocarbonic cores
  • Removal of teeth according to orthodontic and cosmetic indications
  • Dental cosmetology.
  • Surgical treatment of paradontosis.