Costs borne by the populace
Starting from January 1, 2026, the Obligatory Social Medical Insurance (OSMI) system in Kazakhstan will undergo significant changes. The key adjustments include an increase in the income ceiling for calculating contributions, enhanced funding principles, extended benefit eligibility conditions for regular contributors, and stricter provider accountability.
The contribution bases will expand, with employees paying contributions based on up to 20 times the minimum monthly wage (MMW), and employers on up to 40 times the MMW. This marks a raise compared to previous limits, thereby increasing the insured income range for funding the system.
Legislative amendments, effective from January 1, 2026 (with some provisions from September 14, 2025), introduce new principles to the OSMI system. These principles prioritise self-payment of contributions by individuals, establish balanced funding participation among the state, employers, and citizens, and grant the fund the right to reclaim funds from healthcare providers who breach contracts.
For individuals who have contributed regularly for five years (60 months), their eligibility period for medical care after ceasing payments is extended from three to six months. Missed payments will still be due. Moreover, only those who have paid contributions regularly or are exempt may choose their healthcare provider.
The changes to the OSMI package are more explicit. From 2025, it will include consultative-diagnostic care, outpatient drug provision, and planned inpatient care for 12 chronic diseases subject to dynamic observation. From 2026, the rest of the chronic and some socially significant diseases, as well as outpatient hemodialysis, will be included in the OSMI package.
Planned inpatient care for certain chronic diseases and specialized, including high-tech, medical care in inpatient conditions are also part of the OSMI package. The provision of medicines and medical devices in the OSMS system is inclusive, covering specialized, including high-tech, medical care in inpatient and ambulatory conditions, and primary and specialized medical care in outpatient conditions for certain categories of citizens with specific diseases.
The OSMI package includes outpatient medical care, specialized medical care in ambulatory and inpatient conditions, medical rehabilitation, pathological anatomy diagnostics, post-mortem donor preparation, and provision of medicines and medical devices.
It is important to note that all citizens have access to the Basic Package of Guaranteed Free Medical Care (GFMC). However, the search results do not specify precise changes starting from 2025 or beyond. The amendments focus mainly on the OSMI system reforms and contribution calculations.
Without insurance, citizens can call an ambulance, visit a family doctor, receive emergency care for injuries, burns, poisoning, or acute conditions, and undergo emergency surgery if necessary.
The Fund for Social Medical Insurance has allocated over 1.3 trillion tenge this year for medical assistance under the Obligatory Social Medical Insurance (OSMI) system. The changes aim to improve the quality and accessibility of medical services in Kazakhstan.
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The expansion of contribution bases will also include payments based on science-backed health-and-wellness measures, ensuring a more comprehensive funding of the OSMI system. This could potentially lead to better medical-condition management for the insured population.
With the addition of outpatient hemodialysis and a broader range of medical services in the OSMI package, individuals may find more medical-conditions related to health-and-wellness covered, contributing to a healthier community in Kazakhstan.
