Impacts of OSMS modifications on involved parties
Kazakhstan is set to undergo significant changes in its compulsory social health insurance system, affecting citizens, employers, and the state's contribution. The reform, scheduled to take effect from 2026, aims to enhance the coverage and quality of health services, promote economic growth, and ensure social protection for all.
Citizens to Benefit from Enhanced Health Services
The reform promises to improve the transparency and efficiency of the system. From 2026-2027, citizens can expect exemptions and VAT reductions on certain medical services and pharmaceuticals. Moreover, free medical care services under the guaranteed volume will be VAT-exempt.
Simplified Tax Reporting for Employers
Employers stand to benefit from simplified tax reporting and reduced tax burdens. The reform aims to optimise tax benefits and fees, and adjust insurance contribution requirements, thereby reducing administrative costs and tax complexity.
Increased State Involvement and Oversight
The state's role in the reform is to increase its contribution and oversight to ensure broader health insurance coverage and protection for vulnerable groups. This includes integrating compulsory social health insurance more firmly under state regulation and possibly expanding state subsidies or guarantees to support the system.
Balancing Obligations and Contributions
The reform seeks to streamline financial and administrative aspects of social health insurance, balancing obligations and contributions among citizens, employers, and the state. The aim is to promote economic growth while ensuring social protection.
Expanding Coverage to Low-Income Population
As of January 1, 2026, citizens in crisis and emergency levels of social well-being (categories D and E) will be connected to the mandatory social health insurance system, increasing low-income population coverage by 5%.
Temporary Unemployment Protection
Individuals who are temporarily unemployed should register officially to receive protection from the local budget starting in 2026.
Upper Income Threshold Increase
The upper income threshold for calculating payments into the Social Medical Insurance System (OSMSS) will increase effective January 1, 2026, with the calculation base for employers rising to 40 minimum wages, and for employees, it will increase to 20.
Voluntary Enrollment and Online Check-in
Voluntary enrollment in the OSMSS is available for those not yet participating in the system, with the cost being considered insignificant compared to the expense of treating a serious illness. Individuals can check their status in the OSMSS system online or through the registration desk.
Assistance for Understanding and Processing Documents
City Polyclinic No. 4, led by Director Serik Shaimerdenov, is ready to assist individuals in understanding and processing necessary documents for their status in the OSMSS system. The registration desk can guide individuals through the enrollment process in the OSMSS.
Additional Financial Resource for 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.
Transition to a Full-fledged Insurance Model
Starting in 2027, Kazakhstan will transition to a full-fledged insurance model, where responsibility for health will be shared between the state, employers, and citizens themselves. The state contribution to the OSMSS will be gradually increased, starting in 2027 and reaching 4.7% by 2037.
Reaching Out to the Uninsured
Around 3.4 million remain uninsured, with working-age citizens from this "uninsured" zone having the opportunity to enter the system for 4,250 tenge per month (51,000 tenge per year).
Protection for Temporarily Unemployed Individuals
From 2026, official registration will provide temporary unemployed individuals and their families with protection from the local budget.
Expanding Coverage for Planned Medical Care
Starting January 1, 2026, around 1 million people will gain access to planned medical care through insurance. Local executive bodies will cover the contributions for these individuals upon their request for medical assistance.
The reform is centred around the patient, with the aim of ensuring that anyone, regardless of their wealth or employment status, can receive timely, quality medical care.
Advancements in Health Services for AllWith the reform, all citizens will have access to improved health services, as exemptions and VAT reductions on medical services and pharmaceuticals are set to take effect from 2026-2027. The reform also focuses on enhancing the coverage and quality of health services, thereby promoting health-and-wellness for all.
Integrated State Oversight and ScienceAs part of the reform, the state will strengthen its involvement and oversight in the social health insurance system. This includes integrating compulsory social health insurance more firmly under state regulation, potentially expanding state subsidies or guarantees, and utilizing science to drive improvements in health services for the benefit of citizens.
