Compensation for medicines for pensioners: how to get them in 2021

Who is entitled to benefits for purchasing medicines in 2021?

It is important to remember that persons who have reached retirement age according to the general rules cannot count on receiving benefits for the purchase of medicines from the state if they do not belong to preferential categories.
Benefits for pensioners on medicines are granted only to the following categories:

Pensioners who have 1st and 2nd disability groups.
Veterans and disabled people of WWII.
Combat veterans with disabilities.
Heroes of the USSR and Russia.
To the liquidators of the consequences of the Chernobyl accident.
Pensioners who have serious illnesses (Parkinson's disease, lupus erythematosus, diabetes, chronic autoimmune pathologies, the first six months after myocardial infarction, etc.).

At the moment, there are no plans to introduce new categories here in 2021. In addition to this list, categories established in regional regulations (for example, legislative acts of Moscow) can take advantage of benefits.

Exactly what pensioners can expect can be found out in local committees for social protection of the population (social security).

Benefit for pensioners on medicines: how to get it

The economic crisis and rising prices for food, utilities and medicines - all this has become commonplace in Russia in recent years.
These changes are reflected primarily on the most vulnerable segments of the population – pensioners. Every month, older people spend a quarter of their income on medical supplies. And few of them know that our country provides for the payment of special benefits for the purchase of medicine or reimbursement of funds already spent for these purposes. Another equally important issue for older people is the problems associated with obtaining free medications. Sometimes it turns out that on paper a pensioner has benefits for medicines, but in reality he cannot receive them. Therapists often refuse to write prescriptions, citing insufficient funding or lack of stock in pharmacies.

List of benefits for the purchase of medicines for pensioners:

Assistance in purchasing medications can be provided in the following ways:

50 percent discount

The order of the Ministry of Health determines that pensioners can receive the right to purchase medications at a 50% discount. Which categories receive the right to this are determined in the same regulatory act.

According to this act, pensioners for old age, disability or loss of a breadwinner can take advantage of this right if their pension is less than the minimum subsistence level established by law for pensioners.

Attention! In order to receive a medicine at a discount, you need a prescription written by your doctor.

List of free drugs for pensioners

The list of medications that can be provided free of charge is established by the Order of the Ministry of Health.
This list is periodically revised, new drugs are added or old drugs are excluded, etc.

The list of free medications intended for pensioners includes the following drugs:

Analgesics of non-narcotic and opioid groups.
Anti-inflammatory drugs, non-steroidal nature.
Medicines against allergies, gout, and parkinsonism;
Substances related to anxiolytic, anticonvulsant, antipsychotic drugs.
Antibiotics, antidepressants, sleeping pills;
Antiviral and antifungal drugs.
Medicines for the treatment of the cardiovascular, respiratory, and digestive systems.
Hormonal and other drugs.

Reimbursement for medicines

Preferential categories of citizens can choose to receive medicine for free, or write to the Pension Fund of Russia a waiver of this right in exchange for a monthly monetary compensation.

The pensioner makes a decision about this independently. It is important to remember that if a refusal of medications has been submitted, then the citizen will be able to receive them, if necessary, only on a general basis, since he is the recipient of compensation for expenses for medicines.

The essence of preferential provision of medicines

Regulation of issues related to preferential provision of medicines is subject to a separate law.

It operates throughout the Russian Federation, so any Russian can take advantage of the opportunity. The main condition is the presence of a prescription written by the attending physician. The Tax Code provides for a deduction for purchased medications.

In addition to providing medications, citizens can undergo medical examinations in hospitals free of charge once every three years. It allows you to check your health status with a number of doctors and make sure there are no serious pathologies or diseases.

To receive a cash refund in 2021, you must meet the following requirements:

The hospital where the beneficiary is being treated has a special license that allows medical services;
Availability of a prescription for the purchase of medications from the attending physician;
Medicines are included in the list of preferential goods approved by Russian legislation.

The amount paid by the government to the pensioner is fixed. It represents 13% of the funds spent by the payer. The exception is the presence of serious pathologies in the patient.

How can a pensioner receive compensation for money spent on medicines in 2021?

Refund Terms

In order to return the funds paid for medicines, a number of conditions must be met. Please remember that they may vary depending on the return method.

Most often, a refund can be made if the funds were paid personally by the applicant, and the medicines were used for their own treatment or for close relatives.

In addition, the prescription for the purchase of the medicine had to be written out in duplicate and issued in accordance with the requirements of the Ministry of Health.

Attention! If the return is planned to be made by receiving a social deduction, then the pensioner must have taxable income for the last 3 years.

How to get money back for subsidized medications purchased at your own expense

RIA Novosti, as part of the “Social Navigator” project, together with the non-profit partnership “Equal Right to Life” and the interregional social movement “Movement Against Cancer”, have prepared a leaflet that will tell you how you can return the money for the purchased medicine (at your own expense), when the free prescription didn't give it.

It often happens that, due to the risk of interrupting the course of expensive treatment (in this case, the entire effect of previously taken medications will be in vain), the patient and his relatives are forced to buy medicine at their own expense. But not everyone knows that this money can be returned, provided that you have a copy of the unsold prescription, for which the drug was never issued, as well as a sales receipt.

1 step. Check whether the drug is on the special list.

• List of medications dispensed according to prescriptions from a doctor (paramedic) when providing additional free medical care to certain categories of citizens entitled to receive state social assistance, approved by Order of the Ministry of Health and Social Development of the Russian Federation dated September 18, 2006 No. 665

and/or

• A list of medicines and medical products dispensed to the population in accordance with the list of population groups and categories of diseases, for outpatient treatment of which medicines and medical products are dispensed according to doctor’s prescriptions free of charge or with a 50% discount.

These lists can be found:

1. in a medical institution (upon request), 2. in the territorial compulsory medical insurance fund, 3. on the website of the Ministry of Health of the Russian Federation (www.rosminzdrav.ru).

Step 2. File a claim in court against the regional health authority1

Required documents:

1. A receipt with an exact indication of the purchased drug 2. An unsold prescription, written out in the prescribed form, with a pharmacy mark2 3. A certificate of health 4. Other documents confirming the prescription of the drug

1Federal Law of November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”, Federal Law of November 29, 2010 No. 326-FZ “On compulsory health insurance in the Russian Federation”, Criminal Code of the Russian Federation of June 13, 1996 No. 63-FZ

2You can verify the correctness of the prescription at the place of receipt.

Receipt options:

At the expense of the FSS

Refunds for medicines and medications to pensioners in social security are carried out for non-working persons who are not able to do this through their employer.

A complete list of such persons includes:

Children under 3 years of age who have a compulsory insurance policy;
Children who have not reached the age of 6 years and live in large families. This rule does not apply to disabled children.
Disabled children;
Citizens with confirmed disabilities;
Pensioners who have additional titles that provide the right to benefits.

At the expense of the employer for working pensioners

Legislation protects the rights of citizens who are injured or disabled while performing their work duties. Such persons receive the right to free treatment, rehabilitation course, as well as compensation for the cost of purchased medications.

To take advantage of this opportunity, the employee must undergo a professional examination and receive a conclusion about existing injuries, as well as a developed rehabilitation program.

It is the availability of the necessary medications in the program that will be the right to receive compensation.

To do this, you must provide the employer with documents and receipts confirming the purchase of medications. Refunds are made at the average market price.

Tax deduction

The law establishes that every citizen has the right to take advantage of a social tax deduction to compensate for part of the funds spent on the purchase of medicines or paid treatment.

The deduction amount is set at 120 thousand rubles per year. This means that you can get a tax refund of no more than 15,600 rubles per year.

Attention! To take advantage of the social deduction, you must fill out and submit a 3-NDFL declaration to the tax authority, to which you must attach documents confirming the expenses.

The peculiarity of this method of compensation for drug costs is that only citizens who had taxable income in the previous year can receive a deduction (pension does not apply here), and the amount of compensation is limited to 13% of the amount spent.

Tax deduction

This type involves a deduction for various medical expenses borne by the beneficiary. One of the costs is the cost of purchasing pharmaceuticals.

It should be noted that Russian legislation does not provide for a deduction in the case of the purchase of medicines. The main condition is to undergo a course of treatment in a clinic.

A common way to apply this benefit is as a final deduction at the end of the current year. The maximum amount is 120,000 rubles.

Only up to 13% of expenses spent can be returned to a bank card. In other words, the maximum possible deduction amount is 15,600 rubles.

The tax deduction can only be used if the pensioner works and pays taxes in the amount of 13% of wages. If he does not receive income, then he will not be able to apply for this benefit.

Is it possible to receive financial compensation instead of benefits?

The law establishes that every elderly recipient of the EDV has the right to refuse material benefits in favor of an additional supplement to their pension.

Where to go to receive the cash equivalent of benefits

The beneficiary must contact the territorial office of the Pension Fund at the location of the personal file of the recipient of the payment.

You can do this in one of the following ways:

Personal appearance at the PF office;
Contact the nearest MFC branch;
Send by post;
Submit through the State Services portal;
Submit through your personal account on the Pension Fund website (available only in certain regions).

How can you replace social benefits with money this year?

Since 2005, it has become possible to “monetize” social benefits - that is, in essence, to replace your right to demand from the state benefits provided by law with a certain monetary equivalent.

You can make your choice between cash and in-kind forms of receiving benefits once a year - from January 1 to October 1.

But recently, the procedure for choosing between money and benefits has been supplemented by a number of innovations, which should be discussed in more detail.

The main list of federal beneficiaries who participate in the system of “monetization” of benefits has not changed - they include:

— participants of the Great Patriotic War (including residents of besieged Leningrad and military personnel who were not in the active army), war invalids, veterans and combatants, members of their families,

- disabled people of 1st - 3rd groups, disabled children,

— persons affected by radiation exposure as a result of the disaster at the Chernobyl nuclear power plant, Mayak PA, Techa River,

- Heroes of the USSR, Russia, full holders of the Order of Glory and members of their families.

They receive a monthly cash payment from the federal budget (EDV), and with it a set of social services.
These are the very same benefits that can be replaced with a cash payment: - free medicine (cash equivalent in 2018 - 828 rubles 14 kopecks)
- sanatorium-resort treatment (cash equivalent in 2021 - 128 rubles 11 kopecks),
- free travel on commuter trains, as well as on intercity transport flights when traveling to the place of treatment and back (cash equivalent in 2021 - 118 rubles 94 kopecks).

Having received the right to benefits, a person can assign a monthly cash payment and at the same time decide whether to receive money instead of benefits or, conversely, refuse money and enjoy benefits.
Benefits are provided by default, i.e. To receive money, you need to submit a corresponding application to the territorial branch of the Pension Fund of the Russian Federation.

This can be done this year in several ways:

— submit a written application to the Pension Fund in person or through a representative (by power of attorney),

— submit an application through the multifunctional center,

— send an electronic application through the Unified Portal of State Services (for this you need to pre-register, receive a login and password for access),

— send an electronic application through the pensioner’s Personal Account on the official website of the Pension Fund (you also need to first register in it through the client service of any branch of the Pension Fund),

- send a written application by post (but the signature on the application in this case will have to be first certified by a notary).

Replacement of benefits with monetary compensation upon application will be made starting January 1 of the next year.

October 1 is the deadline for submitting applications for refusal of a set of social services, i.e. On this day, applications for the next year will no longer be accepted.

Therefore, the application deadline is September 30th.
But since this year September 30 falls on a day off (Sunday), the Pension Fund authorities have extended the acceptance of applications through customer services for one more day. So this year, on October 1, it will still be possible to submit an application to waive the social package for the next year.

But this only applies to written documents: electronic applications are still accepted only until September 30 inclusive.

An application received after the deadline will not apply to the next year, but to the second year after submission of the application.

The citizen’s choice remains for the entire period until his right to benefits ceases, or he submits a new application for the return of benefits and refusal of monetary compensation.

Source: channel “Legal Subtleties”

Upcoming free webinars

10.08.2021
What to do if you are summoned to the Federal Tax Service's commission on problem counterparties?
13.08.2021
Working with foreign counterparties: what is important to know
17.08.2021
Criminal legal and tax risks when participating in state tenders

What payments are pensioners entitled to in addition to the monthly pension?

Receiving medications from a state pharmacy. Unfortunately, in 2021, not all medications appear on the free list, and state pharmacies are only available in large cities.
Participation in the queue for free vouchers to a sanatorium is based on disability confirmed by documents. If a disabled person has the 1st group of disability or has been disabled since childhood, then exactly the same free accompanying voucher is issued for another 1 family member.
Free travel to the place of treatment and home by train.

If a pensioner has special services to Russia, he is entitled to a cash payment, and on a monthly basis.
A set of free services that can be used by certain groups of elderly people was created to provide social support to the poor.
A monthly material bonus issued regardless of your region of residence.
Social supplement to pension provision. Valid if the principal amount is below the subsistence level fixed in the region or Russia as a whole.
Additional payment related to the special conditions of professional work at the enterprise.
If a disabled, non-working citizen lives in the family, which is confirmed by official documents.
Funeral benefits for a deceased pensioner to his close relatives.
Maternity capital issued to parents at the birth or adoption of a 2nd or 3rd child in order to create a favorable environment for raising young Russians and overcoming the demographic crisis in Russia.

We recommend reading: Percentage for length of service

Payment amount

Pensioners who do not have disabilities have the right to take advantage of a 50% discount when purchasing medications prescribed by a doctor.
Once every 3 years, senior citizens aged 60 years and above can be examined free of charge in clinics.

In addition, pensioners can contact their local doctor for a free annual flu vaccination.

Pensioners and people near retirement age who work in hazardous jobs may qualify for preferential medications. This same category of beneficiaries also includes numerous families, children under 3 years of age and children kept in single-parent families.

Thanks to the program for reimbursement of costs for medicines, all beneficiaries living in the Russian Federation are partially reimbursed for medicines purchased with personal funds. Compensation is provided subject to the provision of relevant materials:

Checks and other receipts certifying the fact of purchase of the medicine according to the issued prescription.
Prescriptions for all medications. The form for filling out the prescription must correspond to form 107/у.
A certificate showing the amount of pension payments.

Also, pensioners of the Russian Federation can apply for a discounted voucher to a sanatorium or resort.

Supplement to pension

The amount of the increase is determined based on the official salary for the last 12 months before retirement. Individual coefficients are applied for each citizen. The condition for assigning the bonus is permanent employment in state and municipal institutions before entering a well-deserved retirement, lack of employment after retirement, residence in the territory of the Russian Federation and absence of a criminal record.

A citizen applies to the Pension Fund for a pension.
Fills out the required column in the application for transfer from one type of pension to another, with the provision of additional payment.
Employees of the Pension Fund or the executive body of the subject calculate the amount of the additional payment and the benefit itself, depending on the financial situation of the pensioner.
After calculations and verification of the citizen’s income, the pensioner begins to receive increased compensation from the first day of the next month .

The legislative framework

In accordance with the legislative norms of the Russian Federation, the state has taken measures to ensure compensation for costs when purchasing medications intended for rehabilitation in case of illness for a privileged category of persons.
In this option, you need to have a prescription from your doctor to purchase medications. The amount of compensation for preferential medicines varies and depends on the category of beneficiaries and their employment, which is regulated by the Federal Law on the Monetization of Benefits No. 122.

The general set of legislative norms regulating the procedure for issuing preferential medications includes Law No. 178 of 2015, which reflects the services that beneficiaries have the right to refuse - for example, free medicines or free travel in public vehicles. To do this, you must submit a request for refusal before October 1 of the current year. The application will be satisfied next year, through monetary compensation for the service.

The government has set a compensation limit that cannot be exceeded. Only the attending physician can prescribe a medication from the preferential list to a patient.

For pensioners in the medical field, the state has provided the following privileges:

Persons who have reached retirement age and do not have a disability have the right to apply for a 50% discount on the cost of medications specified in the preferential list.
According to the order of the Ministry of Health, pensioners have the right to undergo (once every 3 years) a full medical examination at the clinic at their place of residence.
A pensioner has the right to get a flu vaccination free of charge.
If a pensioner wishes to replace medications with monetary compensation, he will need to send a request to the Pension Fund office. A pensioner can receive such compensation twice a year.

The amount of monetary compensation for refusal of medications is set fixed and equal to 807.94 rubles.

As an additional privilege, a number of categories of pensioners have the right to refuse sanatorium-resort treatment, with financial compensation in the amount of 124.99 rubles.

The current list of medications in 2021 for the preferential contingent at the federal level and the rules for purchasing medications are approved by Government Order No. 2738-r, issued in December 2021. This list is reviewed annually and, therefore, in December 2021 the list of free medications for 2021

For more detailed information about benefits for pensioners, you are invited to watch the video