What kind of medical insurance is better. Ratings of insurance companies operating in the DMS market. Comparative analysis of DMS programs

IN 2015 The Voluntary Medical Insurance Market formally grew up in reality. The volume of DMS fees grew by 1.6% in St. Petersburg. But it is necessary to take into account the price increase: the PMD policy went up by an average of 5-15%, services in the clinics of the city - by 10-12%.

Employers who form at least 90% of the total voluntary health insurance budget, buying PMD policies to their employees, reduced these costs. Many small companies simply excluded DMS from their social packages, large and medium-sized businesses optimized the DMS programs due to the reduction of the selection of medical institutions or refusal to insure the relatives of workers.

How these difficult conditions affected the cooperation of private medical clinics with insurance companies, and demonstrates this rating.

This time, another 11 major medical organizations that are actively working at the St. Petersburg market of the DMS were brought to a survey other than a private clinics included in the SRO "Association of Private Clinics of St. Petersburg. As a result, the total number of respondents amounted to 49 medical companies, which together manage more than 150 private clinics in our city. The questionnaires filled the heads of the clinics, experts, heads of departments and employees of financial services.

This year, the experts of the DMS market developed a fundamentally new method of drawing up a rating, which allows to combine indicators in several criteria that were previously evaluated separately separately.

1) The volume of payments listed by private clinics, this year was taken into account by both the clinics and information on the payment of insurance companies (on reporting for the Central Bank from the site insur-info.ru, see Table No. 1).

3) the availability of call centers (see Table No. 3).

4) Quality of DMS programs (see Table No. 4).

5) The quality of administration of the process of medical and economic expertise - in this ranking, were taken into account, on the one hand, the quality of expert opinions (see Table No. 5), and on the other hand - the timing of their provision to clinics (see Table No. 6).

6) Trust Clinic (see Table. No. 7).

For each of the criteria was drawn up its rating. These ratings were subsequently merged into the final, taking into account the weight coefficients whose value ranged from 3 to 30% (see Table No. 8). The biggest weight is 30% - at the indicator "The volume of payments by private clinics", the lowest weight - 3% - in the indicator "Compliance with the timing of the execution of expert opinions." The availability of the call center was estimated with a 5% coefficient. Obviously, private clinics are much more important than the availability of a call center.

Real market players of the DMS market participated in the ranking: 36 insurance companies (last year there were 39). From the register of insurers, in addition to the "dead souls", the UK was excluded, in 2015, a license was recalled or suspended. This is "Avesta", "ASK-Honey", "Hephaest", Insekoek, Oranta, "Help", as well as those with whom a significant part of the clinic has dissolved a contract due to the presence of financial problems.

Payments for private clinics

"Previously, the payments indicator of private clinics were not taken into account, but his importance was recognized, because It reflects the experience of the insurer and the size of the client portfolio. The rating of the current year is unique in the fact that for the first time the clinic provided information on the volume of payment by insurers for insurance cases. For this, a special software was used, which guarantees the confidentiality of collecting and storing data and automatically processes the results to the level of the consolidated report, "comments the director of the EMC clinic, Chairman of the Committee on Standardization and Informatization of the SRO" Association of Private Clinics of St. Petersburg "Tatiana Romanyuk.

Payment Discipline

The level of payment discipline of insurance companies reflects debts to clinics for 2015 as of April 1, 2016 and accuracy of compliance with the terms of payment in accordance with the terms of the contract during the entire 2015.

In the list of insurers who have on March 30, 2016, the debt for 2015 in front of the clinics of the Association entered only 13 insurance companies. It should be noted that this list has decreased compared with last year, and in general, the financial discipline of solid insurers has grown. This is a positive dynamics, she talks about the good financial condition of the St. Petersburg insurance market.

It is also important that the insurers have debt no more than 10% of the surveyed clinics.

"In the conditions of economic instability, the clinic must constantly monitor the situation in the market, assessing financial risks. These risks are always the same type: first the insurer begins to violate bills of payment, then the debts are accumulated, then the clinics will learn that the SC has already recalled the license and chances of the clinic to get money on debts from such insurers are zero. True, it should be said that, for example, the company "Help", who lost its license in 2015, has restored it at the end of the year. Now "Help" is making serious efforts to restore reputation and is calculated on debts with clinics, "Lev Averbach, CEO of Koriz Assistance (SPB) comments.

In general, doctors recognize that insurers have become more noticeable to advance medical services. On the one hand, the clinic is demanded, trying to reduce financial risks, on the other, the insurers themselves are ready to advance the clinics, subject to the provision of discounts.

Availability of call centers

The quality of the work of the coll centers of insurance companies was evaluated by their accessibility for the doctor's doctors if necessary for the coordination of medical services.

Rating of insurance companies operating in the DMS system

Quality of programs of the DMS.

The quality of medical programs was evaluated by such a criterion as the volume of coordination of medical services, which, in essence, reflects the amount of medical care to patients on the DMS or the level of restrictions (exceptions) on insurance programs.

"This indicator also reflects the specifics of the portfolio of insurance companies: companies capable of attracting solvent customers usually offer more filled programs. The presence of many SC abbreviated programs is talking about a certain market trend in the conditions of an unstable economy and reduced solvency, "Aleksey Vlasov emphasizes, the commercial director of Ava-Peter LLC (Ava-Peter's clinics and" Scandinavia ").

As clinics are interested in programs that do not limit the quality of treatment, then companies that have full programs have occupied a higher place in the ranking.

Rating of insurance companies operating in the DMS system

"In 2015, the trend was clearly traced, which appeared two years ago: Reducing the level of control by the Call Centers of Insurers. The insurers want to spend less on the content of the call center and give doctors more than the opportunity to make decisions on insurance events. In general, such a trend cannot but rejoice, since it is aimed at increasing the satisfaction of the insured patient, the growth of efficiency and reduced costs of both parties, training doctors to a better understanding of the principles of insurance and rules of work on DMS programs, "the Director General of the Private Clinics Association of St. Petersburg Alexander Solonin.

Quality of Administration of the Process of Medical Economic Examination

This rating was calculated in two parameters. The first is the quality of expert conclusions. The clinics evaluated the presence of reasonable reasons for refusal and how convincing for a physician form they were set out (see Table No. 5). "Often in acts simply lack reasonable arguments for the reasons for reference. Such a negligence in the work of experts and the lack of a dialogue between experts and doctors is a significant drawback, it forms a negative attitude towards the insurance company and leads to unwanted conflicts for us, "Konstantin Shako comments, the operating director of the" SMT "holding.

The second criterion is the deadlines for the design and transfer of expert opinions to clinics (see Table No. 6). "Recently, some insurance companies allow themselves to send acts of expertise six months later and more, without thinking about the fact that, according to the results, the examinations of the clinic are conducting financial and accounting, as well as explanatory work with doctors and that this work by clinics must be carried out in a timely manner." Lion Averbach, CEO "Corius Assistance (SPB)".

Rating of insurance companies operating in the DMS system

"We have certain difficulties in cooperation with some insurance companies in this matter. Medical and economic expertise is a process in which there are a lot of white spots, pitfalls and contradictions, tempting the parties to move away from the main objective of the examination, comments the deputy director of the Installation of the XXI Century Clinic, Oksana Adamenko. - And yet the main task is to provide high-quality medical care to the insured. And in this, our interests completely coincide with the interests of insurance companies. And the difficulties with the availability of call centers have both sides. We decide them, integrate the processes for faster communication. "

Rating of insurance companies operating in the DMS system

Sympathy clinics remained on the side of the SC "Reso-Warranty". It should be noted that the Troika Leaders also included "Renaissance Insurance" and "VTB Insurance", which last year occupied 5 and 6 positions in the rating of trust, respectively. They managed to move such large insurers as "Alliance", "Capital Police" and "Rosgosstrakh". However, taking into account all other criteria for assessing the final rating of insurance companies looks different.

In the final table, the place is distributed based on the multiplicative indicator of the business reputation in the 6rd criteria above. Thus, according to the results of 2015, the SK "Reso-Warranty" moved from the first place on the third, "Sogaz" remained at the second, and the Alliance became the leader of the rating.

In more detail with the method of surveying experts and the results of the rating, you can find on the website of the SRO "Association of Private Clinics of St. Petersburg" www.acspb.ru.

Medical insurance within the framework of the Insurance OMS system is available to everyone. The Polis of OMS allows you to get free help, but it is possible to wait for it indefinitely, because the queue of the suffering sometimes stretches for months, for example. DMS Insurance solves this problem, but the high cost of the policy often scares potential customers. What DMS programs have and whether a simple Russian can afford a voluntary medical staff?

The DMS programs differ from each other not only worth, but also a list of services, a list of medical and preventive institutions that can provide medical assistance and the amount of this aid. The PMC policy may include only those services that the client needs, the cost of insurance depends on their number and reputation of medical institutions.

How are the conditions for DMS programs formed?

Almost all offers about DMS Insurance are formed according to typical schemes. Thus, the insurance company independently determines the list of rendered basic services to which additional procedures or medical services can be added, coordinated individually with the client.

The basic services of the basic programs of DMS usually include outpatient polyclinic treatment, hospital services, a call to the doctor's house, dental treatment and ambulance. There are many restrictions in such policies. Here are just some of them:

• the basic programs do not provide expensive diagnostics (a number of analyzes, tomography or specialized studies requiring unique reagents);
• hospital services are usually limited in time (usually 10-15 days);
• emergency assistance The policyholder can cause no more than a certain number of times (3/5) for a specific period (week / month).

Insurance companies also sometimes offer round-the-clock help on the duty phone number ("Medical Remote"). In this case, the dispatcher will be able to advise on general issues, call an ambulance, record on reception to a specialist. Each client oversees the manager, if necessary, it will help solve controversial issues or orient the insured person during the occurrence of the insured event.

In addition to the main proposals, insurers are withdrawn to the market and special products aimed at helping in special cases. These include the PMD policies for the elderly; pregnant women; family programs; assistance programs athletes, tourists; Account assistance programs; protection against ticks; Polyses for rehabilitation treatment in sanatoriums or overseas clinics. The insurance premium in such programs may be higher than the basic ten times.

Comparative analysis of DMS programs

In order to be clearly seen how the DMS programs offered by various insurance companies are distinguished, comparative tables are presented below with the characteristics and cost of the services offered.

Company "Ingosstrakh".

One of the largest and oldest insurance companies in Russia, having a high rating of reliability A ++. Here are the main DMS insurance programs offered by Ingosstrakh Company:

The main programs of Voluntary Insurance of the company "Ingosstrakh"

A significant difference in the cost of servicing between policies of different types is formed by the list of services and the reputation of the LPU, which are maintained by the insured person.

Among the advantages of buying the PMC policy in Ingosstrakh's company, you can allocate:

• the possibility of treating individual diseases that are often exceptions in other insurance programs (diabetes, epilepsy, skin, professional diseases);
• carrying out expensive types of diagnosis (hormonal, genetic studies);
• dental treatment without surcharge;
• 24-hour help dispatcher on telephone;
• your network clinics "Be healthy";
• high level of service;
• payment of hospital services in the event of the expiration of the contract for this period;
• system of discounts when buying PMD policies;
• availability of special offers.

Company "Reso-Warranty"

A large insurance company providing a wide range of services having a high reliability rating at the A ++ level. Here are the basic DMS insurance programs offered by the company "Reso-Warranty":

The main programs of the DMS company "Reso-Guarantee"

The total cost of the PMD policy, the proposed "reso-guarantee" also depends on the reputation of the level of therapeutic medical centers. At the same time, the Basic Voluntary Insurance Program "Doctor Reso" includes the following services:

• outpatient maintenance;
• medical assistance at home;
• ambulance.

In addition to basic insurance in the PMD policy, you can include:

• diagnosis for adults and children;
• dental treatment;
• emergency hospital.

Among the benefits of buying a DMS policy in the company "Reso-Warranty" can be allocated:

• the ability to call the ambulance, a doctor to the house;
• receipt of consultations An unlimited number of times;
• emergency assistance is found throughout Russia;
• individual discounts in hospitals are possible;
• the amount of insurance premium does not change during the contract;
• the possibility of paying the insurance premium of parts;
• 24-hour dispatching service;
• discount programs at the conclusion of the contract of DMS;
• special policies for individual cases.

Company "ROSGOSSTRAKH"

The largest Insurance Company of Russia, which has been providing insurance programs since 1921. Works with private and corporate clients. Ranking Reliability is high - a ++. Here are the main DMS insurance programs offered by Rosgosstrakh:

The main programs of the DMS company ROSGOSSTRAKH

Complex medical insurance from Rosgosstrakh company includes the following services:

• polyclinic and outpatient activities;
• dentistry;
• ambulance;
• emergency hospital.

Depending on the number and quality of services, the status of therapeutic institutions the cost of the PMC policies will change.

Also, Rosgosstrakh offers customers special programs:

• to protect against tick bites;
• package "Guest" for foreign citizens;
• the Health Program will protect against the effects of injuries, acute or exacerbations of chronic diseases;
• policy "Hepatitis Protection";
• help with an accident.

Here is the list of the main advantages of DMS from Rosgosstrakh company:

• large selection of insurance programs;
• 24-hour help and support;
• highly qualified clinics and doctors;
• discounts and promotions when buying insurance;
• service in medical institutions throughout Russia;
• individual approach.

Company "Russian Standard Insurance"

Founded in 2003. It offers customers a lot of insurance products in a different price range. Our customers "Russian Standard Insurance" offers the following DMS programs:

The main programs of the DMS company "Russian Standard Insurance"

The cost of the PMC policy, the proposed companies depends on the quality and number of events held, medical centers for circulation. The basic program of DMS from the company "Russian Standard Insurance" includes the following services:

• techniques of doctors;
• analyzes, surveys;
• ambulance;
• call a doctor at home;
• registration of the hospital sheet;
• recovery treatment.

Expand the basic packages by adding the following services:

• emergency hospitalization;
• dentist services.

An emergency hospital can be added to the selected policy, which will cost 4,000 - 19,000 rubles, depending on the type and quality of assistance.

Company "Renaissance Insurance"

Since 2008, it has been providing services for insuring individuals and legal entities. The company has proven itself in the field of tourist insurance and has high reliability ratings. In the DMS segment, Renaissance Insurance offers several products, the cost of which changes when connecting and disable various options, and choosing certain medical organizations. Here is the comparative characteristics of some programs offered by Renaissance Insurance

The main programs of the DMS company Renaissance Insurance

For an additional fee, you can add ambulance services and emergency hospital.

Instead of imprisonment

Analysis of DMS proposals offered by various insurance companies shows a very large variation in both the volume of services and the cost of the policy. Obviously, it is not possible to withdraw some average values \u200b\u200bin this case - in some cases, the choice of one program or another will rather be due to the need of the insured in certain services, rather than a basic service package offered by the insurance.

However, the choice of insurance company and the insurance program should be approached. Of great importance is the reliability of the organization on which the scope and quality of the obtained medical services depends. After all, it is the company that will oversee every step of the insured person and the work of the physicians, in controversial situations will present and protect the interests of the client and guarantees (or does not guarantee) the payment of reimbursement on the insurance case in full.

General situation in the Voluntary Medical Insurance Market

According to the results of the 9 months of 2015, the increased by only 3%. Unlike other types of insurance -, or, which is pretty fever, for various reasons, the DMS remains a certain quiet harbor, where everything goes to his woman and without great upheavals.

According to DMS for 3 quarters, it has changed as follows. The insurance premium fees amounted to 108.5 billion rubles, an increase with the figures of 2014 by 3.2%. Payments to insurance compensation grew a little faster - plus 5.8% to 73.5 billion rubles.

The overall level of payments (the ratio of payments to fees) increased by 1.6 percentage points to 67.7%.

Market concentration

As for the concentration of the market in the hands of leading players, then the DMS goes to step with all other types of insurance.

For the first 9 months of 2015, the 30 largest companies accumulated 91.7% of all fees in the country. A year earlier, this figure was 90.1%.

The main reason for the growth of concentration is the policy of the Central Bank of the Russian Federation, aimed at the systematic cleansing of the market from unscrupulous insurers. The review of licenses releases market share, which is naturally distributed among the current players.

It is not necessary to talk about monopolization, because inside the "thirty" fees are distributed quite evenly. With the exception, which, thanks to the accent on the needs of the oil and gas sector, holds a third of the entire DMS market. What mirrors repeats where one third fees falls on.

Top 30 Insurers DMS

Now take a look at how the rating of the largest insurance companies on the DMS.

The first is to cast companies and, exchanged 3 and 5 places, respectively. Despite the fact that DMS has become the main priority of the alliance, the active rebuilding of the company and the refusal of a number of insurance species has also affected the preparations of medicine (minus 11%).

The second - pushing into the first ten. Announces the battle of auto insurance and opening an embrace for DMS, the company is actively increasing the turnover - an increase of more than 70% to the volume of fees in 2014.

The most interesting, as usual, at the bottom of the rating.

In the TOP-30, 4 newcomers appeared at once. Companies, an independent insurance group and significantly improved their fees and confidently occupied debut places in the "thirty" leaders.

From significant falls left the trace only, with the reservation that in 2014 the Insurer held 32 place with fees in 301 million rubles. In early 2015, the company fully turned a business for health insurance, and in November, the Central Bank of the Russian Federation recalled its license.

Keep for updates. Analytics on the ratings of insurers comes out on a regular basis.

The Central Bank of the Russian Federation calculated: the total monetary fees of Russian insurance companies on voluntary health insurance (DMS) in 2017 increased compared with the level of 2016 by 1.59% - from 137.8 billion to 140.0 billion rubles.

Recall: since 2010, the volume of federal fees and payments on DMS changed like this:

DMS. Volumes of fees / payments and their ratio. Russia (2010-2017)

today».

Thus, in 2017, the All-Russian Growth of DMS fees was minimal over the past 7 years - even worse than in the first "fully sanctions" 2015.

The federal experts will tell about the fundamental reasons for such a slowdown. We will begin to descend to your regional level.

The most insured regions

The top 5 Russian regions in the absolute sizes of DMS fees and payments in 2017 looks like this:

DMS. Fees, payments and their dynamics. Regions of the Russian Federation. Top-5. (2017 year)

Source: "City 812" according to the MiG "Insurance today».

As we can see, in some regions, the fees grew into a much more increasing degree than on average in the Russian Federation, but in some and fell (a wider list, see Insur-info.ru in the "Analytics" section). The same was with payments. At the same time, the dynamics of fees and payments in the same region coincided not always.

There is no regularity here, simply manifested the local short-term conjuncture.

For example, a year earlier (in 2016), fees in KMAO-UGRRE decreased by 47.1%, and payments are 46.6%. So, this district was where to grow in 2017. This happened: he increased both fees and payments 2 times. But if you discard this clearly extreme "breaking", it turns out that Petersburg in 2017, according to the total growth of fees and payments, it looked very decently well.

What, alas, you will not say about the ratio of these most payments and fees ("pay ratio").

A sharp question: pay ratio

In general, the pay ratio is a very important characteristic of the work of the insurance company. In a sense, even more important than the absolute size of its fees and payments. This coefficient characterizes the company from the point of view of its "willingness to pay". Alas, from all regions of DMSOVSKY TOP-5. In St. Petersburg in 2017, insurance companies were given the smallest share on the treatment of clients from the amount that was collected before that, 65.8%.

DMS. Payout coefficients. Top 5 Regions of the Russian Federation (2017)

Source: "City 812" according to the MiG "Insurance today».

Approximately the same "medium-low" pay ratio was in St. Petersburg and in 2016 - 66.4%. This is not the lowest figure in the country, but still not worthy of praise.

For comparison: in the last "full" 2013, he amounted to 78.2% on average; In 2016 (year of the universal reaction to the crisis) - 73%, and in 2017 - 75.6%. So by the latter year, you can even with satisfaction to note some growth of "payment readiness" of insurance companies.

This is how Petersburg looks like in this perspective:

DMS. Payout coefficients. St. Petersburg (2010-2017)

Source: "City 812" according to the MiG "Insurance today».

For comparison: the pay ratio in the West is 90%. True, it is necessary to take into account the "Western" level of inflation and the "Western" rates of the rise in price of medical services.

Of course, there were on the market and such companies that paid better than the rest. Compare their payable coefficients in St. Petersburg and in Russia.

DMS. Factors of paymentsc.attachments in St. Petersburg (Top-10) and in Russia as a whole (2017)

Source: "City 812" according to the MiG "Insurance today».

As can be seen, the "paid willingness" of the same DMS companies can noticeably differ at the level of the invention and at the level of "inside Petersburg". And the common degree of this willingness to pay from St. Petersburg Top 10 in 2017 was also lower than on average in Russia. What our city, of course, does not decorate.

The largest companies

The Federal Top-10 includes exclusively Moscow companies. Petersburg for the last 8 years have not appeared there.

At the end of 2010, the best DMS company from St. Petersburg was "MedExpress": then she ranked 19th in the country, having collected 792.3 million rubles. (0.92% of All-Russian volume). More in 2010, not a single Petersburg insurance company in the first thirty was not.

DMS. The largest insurance companies in Russia in terms of fees and payments. Top 10 (2017 year)

Source: Central Bank of the Russian Federation; MiG "Insurance today».

Sogaz dominates the Federal DMS market absolutely, overtaking its closest competitor in terms of federal collection of 4.19 times.

Petersburg Registration and Federal Ambitions

In the federal Top-100 there were 10 companies whose head offices are located in St. Petersburg. According to the results of their All-Russian work, they often occupy the inconsistent places in the "collective" and "paying" ratings, so they divor into these ratings to two tables:

DMS. Volumes of fees in the federal market. Top 10 registered in St. Petersburg Insurance Companies (2017)

Source: "City 812" according to the MiG "Insurance today».

DMS. Volume payments in the federal market. Top 10 registered in St. Petersburg Insurance Companies (2017):

Source: "City 812" according to the MiG "Insurance today».

History of renaming of the company: Welfare OS - "PPF Insurance" - "Generally PPF Insurance" - "Region".

Summary Easy and offensive: The share of the insurance medical companies born and prescribed in St. Petersburg at the Federal DMS market is insignificant (the largests do not exceed 0.6-0.7%). However, in all regions, except Moscow, the position of local insurance companies is the same.

Here you are not Moscow

We will again go down from the federal level to the regional and look at the results achieved by St. Petersburg offices (branches) of local and federal DMS-companies when they were working within the boundaries of the city.

Places engaged in these companies (their branches) in "Collective" and "Payable" ratings again often do not coincide, so again we will form two separate tables.

DMS. Fees of federal insurance companies in the SPB market. Top 10 (2017 year)

Source: "City 812" according to the MiG "Insurance today».

* Note: It seems that we have the only example of us when the assessment of the MiG "Insurance Today" is divided into an assessment given by the company's representative. So, Z.amvestler Director for Medical Insurance Branch SK "Alliance Life" In St. Petersburg, Majorova's Iphigenia claims: In 2017, the fees of this company in St. Petersburg increased by 8%. However, according toinsur.— info., For 2016, "Alliance Life" gathered 778.73 million rubles in St. Petersburg on DMS. True, for the 2015 rating, the regulator considered the results of the company with a little other name - just "Alliance". In 2016, these companies redistributed the DMS portfolios. Ms. Majorova is confident in its rightness and leads an argument: once the Central Bank of the Russian Federation "unsubscribed" a contract concluded by St. Petersburg branch in 2017, by 2016.

As we can see, only one local company has entered the St. Petersburg Top 10 - "Capital Polis", but it looks very worthy among the "federals" - as a very "strong middle pea", which has overtaken several famous "federals".

DMS. Payments for federal insurance companies in the SPB market. Top 10 (2017 year)

If, with thoughts about the state clinic, you already become bad, you can buy medical insurance and to be treated with comfort. We tell how much it costs and what to check before buying the policy, so as not to spend money in vain.

What depends on the price

Tariffs in the insurance business are quite difficult. The cost of the Voluntary Medical Insurance Policy (DMS) can affect several factors:

the level of the selected clinic;

additional options (dentistry, a doctor call to the house, the possibility of emergency hospitalization, etc.);

the state of your health;

your age.

Depending on all these circumstances, prices for annual service in the clinics range from several thousand to several hundred thousand rubles.

Clinic status

Everything is simple - the more prestigious clinic, the more expensive it is to be serviced. Thus, in the insurance company "Alliance Life", the policy can be purchased from 13.3 thousand rubles (service in the clinic "Oris") up to 165 thousand rubles (Clinic "Medsi" in Rorcholsky Lane), tells the head of the Individual Insurance Department of Innocent Maskaleson. In GK "Rosgosstrakh", the price variation is even wider: in the department of the insurer, correspondent comparable to.ru they said that the prices for policies begin from 17,000 in low-cost clinics up to 300 thousand in the status establishments.

Stomatology

Dental care increases the cost of the policy on average by 10-30%. Thus, in the company "Reso-Guarantee", the additional option of dental care will cost from 5.2 to 11.2 thousand rubles. And in the insurance company SCS, the addition of dental services will cost 2-15 thousand rubles.

Hospitalization

In the "Stuffing" of the Polis, it is also possible to include the possibility of emergency hospitalization - as a rule, these are several thousand rubles to the cost of insurance. For example, the CC "Consent" the possibility of emergency assistance within the Moscow Ring Road will cost an additional 3,420 rubles.

Individual parameters

To determine the exact cost of DMS for a particular person, the insurer will most likely offer to fill out a medical questionnaire. It takes several pages and contains health questions. For example, you may have to answer if you have a headache and how often do you take regularly any medicines, with what diseases you appeal to doctors before, etc. The older man, the greater the likelihood that such a survey will be mandatory.

Most of the insurers do not take into account the floor of the client. But there are exceptions. For example, in the company Ingosstrakh Polis for women is more expensive than for men.

"On the basis of statistics (not only our company, but also other insurers), women are more likely to seek medical attention. This is due to the fact that they are inclined to take care of their health. This is primarily expressed in "preventive" campaigns in a clinic with minor health complaints. Men have a certain psychological barrier in front of doctors. They seek help at much less often, but in more complex cases, which affects the severity of the disease, "explains the Deputy Director of the Ingosstrakh Medical Insurance Department Nikolay Owl.

How much is the policy standing

To understand how much the policy is on the average for people of different ages, we interviewed call centers and press services of the 10 largest insurance companies. Details about this process can be read at the end of the text. We learned the prices of insurance in which the dentistry is included, a doctor call to the house and, if necessary, the possibility of emergency hospitalization within the Moscow Ring Road. And that's what happened.

The average cost of the PMC policy in Moscow, rub.

It turned out that for people aged between the 20th and 50 years, within the framework of one company, the cost of the policy changes slightly. But the difference in the price of various companies can be significant. For example, the cost of the most affordable policy in the category of citizens up to 50 years - 29,470 rubles, the most expensive in the same category - 99,600 rubles.

The cost of the PMS policy is seriously increasing. Starting from 55-60 years, companies begin to use special coefficients that increase the price of insurance. For example, in the "reso-guarantee" for citizens over 60, the coefficient is valid, the increasing cost of the policy is 1.6 times, and for those who are over 70 years old - 2 times.

"For those who over 60, the tariffs will be individual and on average, 2-3 times higher than the standard," says Innokenti Maskaleson from Alliance Life.

There are situations in which the insurer may and at all refuse to sell the PMS policy. It has the right not to be insurance for persons who are registered in the drug treatment, psychoneurological, anti-tuberculosis, skin-venereological, oncological and other dispensaries, as well as in the Centers for the Prevention and Control of AIDS, or having the disability of the I-II group. "If we are talking about chronic diseases that lead to death, for example, diabetes of a certain group, then we have the right to not sell insurance," says Yegor Safrygin, director of the Marketing Department of the Block "Medicine".

What to check before buying

1. What is included in the policy

Each company has its own policy filling. For example, planned inspections (clovers, check up) in the classic DMS are not an insured event.

"This is a separate program developed by individual queries," says the managing director of the DMS Renaissance Insurance Group Natalya Kharina. Therefore, before buying, be sure to study, which is included in your policy, which is considered an insured case, etc. It may take time, but then you will not face unpleasant surprises.

2. In which polyclinics and hospitals can be addressed

Look at the list of medical facilities that are included in the program. "Make a choice in favor of a network clinic, which has the above-mentioned team, as well as the ability to visit not one, and at once several clinics of the network. It is better to choose those closer to geographically, "Egor Safrygin advises the director of the Marketing Department of the Block" Medicine ".

3. How can I sign up for doctors

It is important that you have the opportunity to quickly sign up for doctors. The fact is that many DMS polishes are built in such a way that you first need to call the insurance company, it can coordinate something for a long time and then gives direction. "The client should have the opportunity to directly call the clinic, which he chose, and promptly sign up for a doctor," says Yegor Safrygin.

4. What are the exceptions

Each company has its exceptions from programs. And sometimes the usual user they may seem completely illogical. Usually exceptions are prescribed at the end of the contract with the insurance. Spend time and read them.

Do not forget about the tax deduction!

If you bought a PMD policy for yourself or the closest relatives (spouse, parents, children under 18), then you can make a tax deduction and return 13% of its cost. However, you can return no more than 15,600 rubles.

You can apply for a tax deduction in the FTS Department, by mail, through the personal account of the taxpayer.

Set of necessary documents:

• declaration (available on the FTS website);
• copy of the passport;
• help 2-NDFL from work;
• application for tax refund;
• policy, license insurer, payments.

As we thought

We chose 10 insurance companies, which, according to the results of the first half of 2016, in terms of contributions in the DMS segment. In this ranking included insurance companies