Impacted Parties in the OSMS Alterations
In Kazakhstan, significant changes are being made to the Social Medical Insurance System (SMIS) for 2025, with a focus on expanding coverage and maintaining financial stability.
City Polyclinic No. 4 in Astana, under the direction of Serik Shaimerdenov, is ready to help individuals understand and process the necessary documents for enrollment in the SMIS. Whether you are already a part of the system or seeking to join, the polyclinic is prepared to assist.
More than one million additional people, primarily those registered with employment agencies, will be covered under the SMIS. Local administrations will fund the insurance contributions from their budgets, an initiative aimed at increasing coverage for the low-income population.
For those who cannot afford to pay contributions, local budgets may provide financial support. The government aims to maintain financial stability without increasing contributions, ensuring that no extra payments will be required, even for citizens with chronic conditions such as diabetes.
The period for retaining insured status will also increase from three to six months if individuals have made regular contributions over the past five years. This extension provides a sense of security and continuity for those who contribute to the system.
The decision to increase the upper income threshold provides the system with an additional financial resource of around 200 billion tenge in 2026. For employers, the calculation base will rise to 40 minimum wages, and for employees, it will increase to 20.
The current SMIS covers 16.9 million people, representing 82.6% of the country's population. From January 1, 2026, citizens classified under crisis and emergency levels of social well-being (categories D and E) will have access to the social medical insurance system.
Starting in 2027, Kazakhstan will transition to a full-fledged insurance model where responsibility for health is shared between the state, employers, and citizens. The state currently contributes 2% to the SMIS for specific categories of the population, such as children, pensioners, pregnant women, individuals with disabilities, and other groups.
Voluntary enrollment in the SMIS is available for those not yet participating in the system, with the cost being insignificant compared to the expense of treating a serious illness. Expanding coverage, balancing the workload between income groups, and strengthening state and local government involvement are tools to ensure that anyone can receive timely, quality medical care.
All reforms in the SMIS are centered around the patient, with the goal of providing accessible, affordable, and high-quality healthcare for all Kazakhstan citizens. The Health Ministry describes this reform as necessary and strategic, marking a significant step forward in the nation's healthcare system.
[1] Local administrations to fund insurance contributions for low-income population
[2] Government of Kazakhstan focuses on financial stability in SMIS reform
[1] In an effort to increase coverage, local administrations in Kazakhstan will be funding the insurance contributions from their budgets for the low-income population within the Social Medical Insurance System (SMIS).
[2] The Government of Kazakhstan is concentrating on maintaining financial stability while implementing reforms in the SMIS, ensuring no extra payments are required, even for those with chronic conditions like diabetes.
