Paying for Major Medical Procedures and Health Insurance in Russia
In the Eyes of Truth Update above, ESW Eurasia Editor Stanislav Krapivnik details his recent experience in Moscow with having a common medical procedure for middle-aged men: a colonoscopy. And how in Russia it cost him the equivalent in Rubles of $110 at current exchange rates (January 2025), whereas in the US it would've cost him without insurance 25 times more, and plenty more even if he were covered by major medical insurance through an employer. Stas mentions this comparison in the context of US salaries when actually adjusted for Purchasing Power Parity (PPP) being only three to four times higher than in Russia.
To summarize, "Americans, you're being screwed" by Big Pharma, Big Hospitals and Big Health Insurance companies. As Stas has written in a previous post, for medical tourism, even allowing for the higher plane ticket and travel time costs flying via Istanbul or Dubai, Russia is highly competitive with clinics and hospitals that serve gringos in Mexico.
– James Smith
Editor-in-Chief and Publisher, ExitStrategy.World
January 28, 2024
An important concern for anyone coming to Russia, be they traveling as a tourist or immigrant, is what happens in case of a medical emergency. In the US, unless you have insurance, the hospitals can quite seriously turn you away and deny you service, even if they aren't legally supposed to do so.
In Russia, the situation is quite different. To begin with, if a person is a tourist or traveling on a business visa, they must demonstrate that they have insurance from their home country or the company sending them. Of course, with today’s political situation, money hungry Western travel insurers, especially American insurance companies that are always looking for pretexts to deny payment, can do just that, deny payment on quasi-political basis that treatment occurred in Russia. Even if to date there are no direct sanctions on Russian hospitals or clinics (at least none that we're aware of).
Whether that is the case, or you simply do not have insurance, in the case of an emergency, no Russian hospital will turn you away. As a matter of fact, if you have to summon an ambulance, be assured that unlike American ambulances, where two EMTs at the most are present, Russian ambulances normally are dispatched with a third member, an actual doctor. The doctor, depending on the case, will try to treat the patient on the spot and if that fails, to stabilize and transport patients to the nearest available hospital for treatment. No one will willingly leave a person to die, even if that person is in Russia illegally.
Now on to the insurance part. All citizens and legal residents, such as temporary or permanent residency holders, but not guest workers, automatically have basic government insurance. This “insurance” is basically a guarantee of treatment at government clinics. Again, in the case of an emergency, as long as hospital beds are available, the person will be rushed into service and whatever procedures are needed will be performed as necessary.
In the case of non-life threatening needs, the person can get in line and wait for an available slot. How quickly availability arises depends on the procedure, hospital or clinic location and his social status. By social status, it means if he is in a preferred category: Great Patriotic War (there are only a few thousand left alive) or other Russian Army veteran, elderly, pregnant (in Russia only women can be pregnant) or children. The basic government “insurance” does not apply to private clinics. Additionally, not all government hospitals and clinics are created equally. While some especially in Moscow are absolutely world-class with the latest equipment, others can be run down and lacking needed expertise or equipment. To add to this, may be the simple issue of the inconvenience of having to wait. Such issues may drive people with non-life threatening illnesses or ailments to a private clinic.
Private clinics are a separate issue, one should choose wisely. Just as with any service, their quality and competencies can also vary. This is no different than choosing a proper mechanic for your car or a hairdresser for your appearance. Of course, the consequences of a poor choice can be much more serious than a broken down car or a bad hair week.
So how does one pay at a private clinic? There are usually three payment options: out of pocket, private insurance and the clinic’s plan or insurance. The latter has been a popular option for expats at the premier private clinics of Moscow such as the Intermedcentr. Most major clinics or private hospitals will allow you to purchase their select insurance or to place money into a fund for use in treatment, a kind of Russian counterpart to the Health Savings Accounts (HSAs) of the USA. They will usually offer you a discount rate on treatment, including sometimes for elective procedures. The down side is of course that this only works at that one particular clinic or network of clinics in one or two Russian cities.
The option that most Americans would be familiar with is private insurance, though in this case, it may not be all its cracked up to be. To begin with, not all private clinics are covered by various private insurance plans and it behooves one to do your research first. Then there is the issue of affordability. Many of the upper tier companies give private insurance as part of the bonus plan for their employees. In such cases, this is fine, since the employer picks up the tab. However, when considering private insurance for one’s self or family, do not get in a rush, take your time and do your due diligence.
If you are a young and healthy immigrant to Russia, in our opinion there is no reason to pay for private insurance--unless you and your wife are planning a child or she's already pregnant . If an emergency happens, you will more than likely end up in a government hospital anyways. As for expense, private insurance can easily run in the range of 70,000₽ ($700)–150,000₽ ($1,500) per individual and the question naturally arises, is it worth it? Most private insurances do not cover dental work, that's often either an add-on or a separate policy or a policy purchased from your favorite dental clinic.
Now for affordability, unlike the West especially insanely overpriced USA, where the average citizen is quite literally raped by insurance and medical costs, paying out-of-pocket is a very real and actual option in Russia. Some things to consider from a private clinic my family and I often visit for convenience. This clinic is located in the Moscow Region, but not too far from city limits, so costs are in line with those in Moscow. Going further out or to clinics or hospitals in regional cities like Tver, Yaroslavl or Kaluga, out of pocket costs are usually lower.
Recently, I had to do that medical procedure that all men dread: a colonoscopy. In the US, out-of-pocket costs for the procedure plus sedation runs on average $2500, but can range between a low of $1,700 and a high of $5,000. Now sit down, because this may be hard to swallow. In a top of the line Russian clinic, I paid 11,000₽….or at the USD-RUB exchange rate as of last week, $110. Its always hard for people to accept the reality of just how far the less-than-top-of -the-line US medical system vampirically sucks them dry.
Other procedures run at rates such as: doctor’s checkup/visit $15; chest x-rays $20; blood work $30; vaccines $15 to $30 (for staph infection for example), ultrasound of various organs $20 to $30; teeth cleaning $60; cavity fillings $60 to $70; crowns (without a root canal) but with a porcelain crown $450; implants $500 to $600 per tooth (roughly five to eight times less than the typical US price), and so on. Even complex procedures like abdominoplasty, which, as a usual elective plastic surgery, will not be covered by US insurance and runs $8,000 before sedation, with a stay at the hospital/clinic that can push the costs up to $15,000, in Russia runs on average between $3,500 to $5,000 total. A woman I know when to the city of Saratov, to a locally renowned clinic and paid out of pocket $4,000. Which included four nights stay at the clinic and daily checkups for another week afterwards. She also paid another $500 for the hotel she stayed in the rest of the time.
As one can see, if a young person or a family moving to Russia is generally healthy, there is no need for the expensive private insurance. Rarely will the cost of the insurance cover the combined yearly spend. But if you are older and moving to Russia with multiple middle-aged procedures coming up that you know you'll need, including major dental work or plastic surgery, buying major medical and dental coverage from a prestigious local clinic is well worth considering.