Free healthcare options available for uninsured residents.
Kazakhstan offers a **Comprehensive Package of Free Medical Care** to all its citizens, including foreigners and stateless persons residing in the country[1]. However, the exact details about the services covered under Out-of-Pocket (OOP) payments are not explicitly stated in the available information. Below is a summary of the known health service coverage and potential gaps:
## State-Funded Services (Not OOP)
- **Inpatient and home-based palliative care** for both cancer and non-cancer patients are provided free of charge[1]. - **Essential medicines**, including strong opioids for pain management, are provided without charge through the State package[1]. - **Primary care support** for severe, incurable diseases is available from district-level doctors and nurses at no additional cost[1]. - **Palliative care beds** are available in hospices or palliative care centers, with a standard of 10 beds per 100,000 population[1]. - **Clinical protocols** for palliative care and pain management are regularly updated and guide service delivery[1]. - **Pediatric care** has a specific roadmap to improve access and quality[1].
## Potential OOP Services and Coverage Gaps
- **Specialty care and complex interventions**: While the State covers basic and palliative care, advanced diagnostics, specialized surgeries, or high-cost medications not on the essential list may require OOP payment. - **Non-covered outpatient medications and diagnostics**: Analogous to neighbouring countries like Tajikistan, Kazakhstan’s package may not cover all outpatient medications or advanced diagnostics, potentially leaving these to be paid OOP[4]. - **Geographical and capacity limitations**: Some regions may have limited access to specialized palliative or intensive care, resulting in OOP payments if patients seek care in private clinics or abroad[1]. - **Non-covered dental and cosmetic services**: Generally, dental and cosmetic treatments are not part of the basic health package and would typically be paid OOP. - **Private and non-contractual services**: Any elective or non-acute care obtained outside the State system (private hospitals, non-contracted providers) would be OOP.
## Legal and Policy Framework
Kazakhstan has **11 clinical protocols** on palliative care, including pain management, which are reviewed and updated, and has created **roadmaps for adult and pediatric palliative care** to improve service delivery[1]. While these initiatives indicate a commitment to expanding access, the exact scope of services left to OOP payment is not detailed in the provided sources.
## Key Considerations
- **The State-guaranteed package covers a wide range of basic and essential services**, including palliative care and necessary medicines, for citizens and residents[1]. - **Services outside this package—such as certain medications, advanced diagnostics, and specialty interventions—are likely to be OOP** for patients, including foreigners and stateless persons. - **No explicit list of OOP services** is provided in the available material; the above is inferred from common gaps in similar health systems and the structure of the State-guaranteed package. - **OOP payments are expected for services obtained outside the State system** or not explicitly included in the guaranteed package.
For the most accurate and current list of which services are OOP, consulting the **official FCSHI documentation** or the Kazakh Ministry of Health is recommended, as public details on exclusions may not be widely published in English-language sources.
Foreigners and stateless persons temporarily staying in the RK, as well as those seeking asylum, have the right to receive OOP for diseases that pose a threat to others. Medical assistance is available for residents of Kazakhstan through OCM (Compulsory Medical Insurance) and OOP (Out-of-Pocket payments). Post-mortem donor preparation for organ or tissue removal, removal, conservation, preparation, storage, and transportation of organs and tissues for transplantation is a medical service covered by OCM and OOP. OOP includes various medical services, but the specific list was not detailed in the provided paragraph. Emergency Medical Care includes services provided by air ambulance. Indira Sarkenova, Deputy Chairperson of the FSMF, stated that there is a list of medical services that will be provided regardless of OCM status. The Patient Support Service is available in every clinic and hospital to help resolve unjustified refusals of medical assistance.
[1] Vechernyaya Astana reported on the clarification provided by the Fund for Compulsory Social Health Insurance regarding the medical services covered by OCM and OOP. [4] Based on the observation of neighbouring countries like Tajikistan.
In the context of Kazakhstan's Comprehensive Package of Free Medical Care, specialized care and complex interventions, such as advanced diagnostics, specialized surgeries, or high-cost medications not on the essential list, may require Out-of-Pocket (OOP) payments. Additionally, non-covered outpatient medications and diagnostics, which are typically inclusive in neighboring countries like Tajikistan, may also be paid for OOP in Kazakhstan.
