Impact of OSMS Modifications on Affected Parties
In a significant move towards universal healthcare, Kazakhstan has announced a comprehensive reform to its social medical insurance system. Effective from July 14, 2025, the reform aims to expand coverage, enhance social equity, and strengthen the financial stability of the system.
The reform will extend coverage to over one million additional people, particularly those registered with employment agencies. Local administrations will cover their insurance contributions from local budgets, ensuring that these individuals gain access to essential healthcare services without bearing the direct cost of contributions.
The reform also extends the insured status retention period from 3 to 6 months for individuals with regular contributions over the past five years. This move protects continuity of medical coverage during employment gaps, benefiting insured employed individuals.
Lower-income and unemployed individuals stand to gain the most from this reform. Those registered with employment agencies, who may have previously been uninsured, will now gain coverage. This reduces disparities in access to care that arose under the previous mixed system where uninsured people faced barriers to timely, high-quality services and had higher out-of-pocket costs.
However, higher-income groups and informal workers may still face some coverage gaps. While the reform attempts to expand inclusivity, it may not fully address the needs of these groups, particularly those working informally or in sectors not automatically covered.
To ensure appropriate coverage, individuals are advised to confirm their registration status with local administrations, maintain regular contributions where applicable, stay informed about coverage options and eligibility, and keep documentation up-to-date and engage with local health authorities.
The reform is expected to provide the system with an additional financial resource of around 200 billion tenge in 2026. The government currently contributes 2% to the Social Health Insurance Fund (SHIF) for vulnerable population categories such as children, pensioners, pregnant women, individuals with disabilities, and other groups.
Starting from 2027, Kazakhstan will transition to a full-fledged insurance model where responsibility for health is shared between the state, employers, and citizens. The upper income threshold for mandatory contributions to the SHIF will increase as of January 1, 2026, affecting only 0.36% of all employed individuals in the country.
For those not yet participating in the OSMS system, voluntary enrollment is available, with the cost being insignificant compared to the cost of treating a serious illness. Temporarily unemployed individuals can also register officially from 2026 to receive protection from the local budget.
City Polyclinic No. 4 in Astana, led by Director Serik Shaimerdenov, is ready to help individuals understand and complete necessary documents for enrollment in the OSMS system. The changes aim to expand coverage, enhance social equity, and strengthen the financial stability of the system, ensuring that anyone, regardless of their wealth or employment status, can receive timely, quality medical care.
- The reform in Kazakhstan's health-and-wellness system will provide essential services to over one million previously uninsured individuals, primarily those registered with employment agencies, by covering their insurance contributions from local budgets.
- The upcoming transition to a full-fledged insurance model in Kazakhstan in 2027 aims to ensure that science and health-and-wellness are accessible to all, regardless of wealth or employment status, by sharing responsibility for health care between the state, employers, and citizens.
