Expat insurance and health insurance in Russia

The Russian health system relies on mandatory medical insurance (OMS, Обязательное медицинское страхование, ОМС), a single public regime that funds care for insured persons at public facilities and certain contracted private providers. Since the reform that took effect in 2023 (federal law No. 236-FZ), Russian social contributions — pension, social insurance and mandatory medical insurance — are grouped into a single contribution paid by the employer, with no public breakdown of the specific rate reserved for the health share. OMS affiliation requires resident status (Russian citizen or holder of a temporary or permanent residence permit): a visitor on a simple short-stay visa has no access to it and remains covered, if at all, solely by health insurance taken out before departure.

The OMS package covers primary care, common emergencies, and a large share of surgery and hospitalisation in the public sector; dental care, optical care, prosthetics and part of medicines usually remain the patient's responsibility. The public system suffers from marked regional disparities and a staff shortage outside major cities, with medical staff who generally speak neither English nor French. In response, an international private sector has developed in Moscow and Saint Petersburg, with facilities at Western standards, multilingual staff and shorter waits, at the patient's or their international health insurer's expense.

• Mandatory visa for any stay, whatever its length: passport valid for at least 6 months beyond the visa expiry date, with at least two blank pages. A migration card is issued on entry and must be kept until departure from the territory.
• Health insurance required from the visa application stage: proof of cover for at least €30,000 of medical costs and repatriation, valid throughout Russian territory, must be included in the file; its absence results in a refusal to issue the visa.
• OMS affiliation: reserved for people with resident status (temporary or permanent residence permit); a local employee is affiliated by their employer, with no personal steps to take.
• No France-Russia coordination: without a bilateral social security agreement, no card equivalent to the EHIC and no form allows a French insured person to exercise their rights locally; outside OMS and private insurance, care is billed at the full rate, not publicly disclosed in a uniform way.
• Seconded employee : in the absence of an agreement, staying on the French scheme falls solely under French law (unilateral secondment), for a period of 3 years renewable once, without exemption from any contributions due in Russia.
• Registration of accommodation: on arrival, the traveller must have their passport and migration card registered with their place of accommodation (hotel or host structure), which notifies the authorities of the arrival.

Overstaying the period authorised by the visa can lead to deportation accompanied by an entry ban of up to 5 years; regarding health, the risk remains above all financial in the absence of suitable insurance, with no help from the French embassy for medical costs.

France and Russia are linked by no bilateral social security agreement (CLEISS): there is neither an applicable European Health Insurance Card, nor an A1 or S1 form enforceable with Russian authorities, nor a direct reimbursement mechanism between the two systems.

• Temporary stay: no European or bilateral coordination applies; only health/travel insurance taken out before departure (required for the visa, for at least €30,000) covers costs locally.
• Secondment from France: in the absence of an agreement, French law provides for unilateral secondment of 3 years renewable once. The employee stays affiliated to the French scheme, with contributions paid in France, but without exemption from any contributions due in Russia. Care received locally is reimbursed retroactively by the French fund, within the limit of French rates, on presentation of receipts and form S3125.
• Long-term move: OMS affiliation is conditioned on obtaining a Russian residence permit; no transfer of rights from France is provided, including for retirees.
• Since 2022, most Western travel and health insurers (including French insurers) exclude Russian territory from their standard contracts, as economic sanctions have made transferring funds to Russia impossible; locally valid cover generally requires taking out a policy with an insurer licensed in Russia. Visa, Mastercard and American Express cards issued outside Russia have not been usable there since March 2022, which complicates paying medical costs directly on the spot.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Before applying for a visa: take out health/repatriation insurance covering at least €30,000, valid throughout Russian territory, and check with the insurer that Russia is actually covered.
3. Seconded employee: arrange unilateral secondment with your French fund with your employer before departure (maximum duration 3 years renewable once).
4. Put together the visa file (passport valid 6 months beyond the visa, at least two blank pages, proof of insurance) with the Russian consular authorities.
5. On arrival: have the passport and migration card registered with your place of accommodation.
6. Local employee: check with your employer that OMS affiliation happens, conditioned on obtaining a residence permit.
7. Keep receipts for care and form S3125 for any subsequent reimbursement request with the French fund (secondment case).
8. Register with the roll of French nationals living abroad (French embassy in Moscow or the relevant consulate).