Status update for the day: What's happening now?

As of January 1, 2026, Kazakhstan's mandatory social medical insurance system will undergo significant changes, affecting eligibility, contribution rates, and state involvement.

Eligibility and Coverage Principles

The new legal principle prioritises individuals' self-payment of contributions over the state's participation. The funding responsibility will be balanced between the state, employers, and citizens. Individuals who have regularly paid contributions or are exempt from payments will have the right to choose a healthcare provider. For contributors with a continuous payment history of at least five years, the period during which they can receive funded medical care after stopping payments has been extended from three to six months, although missed contributions must still be paid.

Contribution Rates and Upper Limits

From January 1, 2026, the upper limit for income used to calculate mandatory health insurance contributions will increase significantly. Employees' contributions will be calculated up to 20 times the minimum wage (MZP), and employers will contribute based on income up to 40 times the MZP, thereby increasing the maximum contribution base and likely increasing overall funding for the system.

State Involvement and New Beneficiary Categories

A new beneficiary category is introduced for which local administrations (akimats) will pay insurance contributions, supporting coverage expansion. The financing model is shifting towards an insurance-based model for the entire healthcare system. By 2027, approximately 65% of healthcare financing will come from the social health insurance system (OSMS), while 35% will be funded through the guaranteed free medical care package from the state budget. The health insurance fund gains rights to reclaim funds from healthcare providers who fail to meet contractual obligations, enhancing financial accountability effective from September 2025.

Additional Context

Free medical care and social health insurance services remain VAT-exempt despite broader tax reforms impacting healthcare.

Key Points

The changes aim to strengthen Kazakhstan’s social health insurance system by expanding coverage, increasing financial resources through higher contribution limits, and balancing responsibilities between individuals, employers, and the state.
The changes will come primarily into effect from January 1, 2026, with specific provisions starting earlier in September 2025.
Only a limited group of people will have to pay more: roughly 20,000 workers with monthly incomes exceeding 3.4 million tenge.
From January 1, 2026, 1 million people in crisis or emergency levels of social well-being will gain access to planned medical assistance through insurance.
Entry into the system for working-age citizens remains relatively affordable at 4250 tenge per month.
The upper income threshold for calculating payments into the Social Medical Insurance Fund will be increased starting January 1, 2026.
The maximum base for employees in the Social Medical Insurance (OSMС) system will increase to 1.7 million tenge, setting a ceiling of around 34,000 tenge per month.
City Clinic No. 4 is ready to help individuals understand and complete all necessary documents for the OSMС system.
Starting from 2026, temporary unemployment will provide protection funded by the local budget if registered officially.
From 2027, Kazakhstan is transitioning to a full-fledged insurance model where responsibility for health is shared between the state, employers, and citizens.
A phased increase in the state's contribution to OSMС has been planned, starting in 2027, gradually increasing to 4.7% by 2037.
Currently, 16.9 million people are insured, covering 82.6% of the country's population.
Individuals not yet participating in the OSMС system are encouraged to consider voluntary enrollment, as the cost is insignificant compared to the expense of treating a serious illness.
The state's contribution to OSMС for privileged categories such as children, pensioners, pregnant women, individuals with disabilities, and other groups is currently 2%.
Around 3.4 million people remain outside the OMS system, with approximately 1 million in crisis or emergency groups.
In comparison, similar rates in Slovakia reach 14%, in Lithuania up to 9%, and in the Czech Republic up to 14.5%.

[1]: Link to source 1 [2]: Link to source 2 [3]: Link to source 3 [4]: Link to source 4 [5]: Link to source 5

The changes in Kazakhstan's mandatory social medical insurance system in 2026 aim to strengthen the system by prioritizing self-payment and expanding coverage, falling under the category of policy-and-legislation related to health-and-wellness.
The new system also involves a shift towards an insurance-based model for the entire healthcare system, aligning it with the general-news about global trends in healthcare finance and state involvement.
The economy implications of these changes are significant, especially for high-income earners, as contribution rates are set to increase for a limited group, making it a topic of interest in politics and economics.