The bill on the Federal Compulsory Medical Insurance Fund budget for 2026–2028 has been submitted to the State Duma.

Main characteristics

The Federal Compulsory Medical Insurance Fund's budget expenditures for 2026 are expected to increase by 7.1% to 4.795 trillion rubles, with the budget deficit projected at 82.1 billion rubles, compared to the planned 136.6 billion rubles in 2025.

The standardized insurance reserve for 2026 will amount to 289.8 billion rubles, significantly less than the 2025 level of 425.5 billion rubles. These funds are reserved for social payments to primary care physicians, co-financing of medical worker salaries, incentive payments for cancer detection, funding for certain government decisions, and other purposes. Specific amounts are not specified in the document, but in 2025, for example, the largest portion of the 425.5 billion rubles, or approximately 170 billion rubles, will be allocated to social payments, along with approximately 60 billion rubles as a subvention for medical care in new regions.

Subvention from the federal budget

Traditionally, the Federal Compulsory Medical Insurance Fund (FFOMS) receives significant support from the federal budget. However, in 2026, this support will be reduced by 56 billion rubles compared to 2025, to 481.4 billion rubles, primarily due to a 63.6 billion ruble reduction (from 239 billion rubles) in compensation for lost revenue due to reduced insurance premium rates.

In 2026, as before, 140 billion rubles are allocated for financial support for medical care for cancer patients, and 155.2 billion rubles (+7.2 billion rubles year-on-year) for non-insurance expenses, including high-tech medical care outside the basic compulsory medical insurance program, and maternity certificates.

Subvention for the Compulsory Medical Insurance Fund

Subventions to the TFOMS budgets for funding the basic compulsory medical insurance program in 2026 will amount to 3.992 trillion rubles, an increase of 352.6 billion rubles, or 9.7%, compared to 3.639 trillion rubles in 2025. This represents a significant slowdown in growth: in 2025, the subvention increased by 16.7% compared to 2024, meaning the growth rate has been almost halved. Moreover, this growth is below the rate of inflation for medical services – according to Rosstat, this figure was 10.5% by the end of 2024, and insurance market experts predict an increase in this figure in 2025.

An important feature of the 2026 budget is that the subvention already includes expenses for implementing the core program in Russia's new regions. Previously, this amount (58 billion rubles in 2025) was included in the standardized reserve fund.

The per capita standard for financial support for the basic compulsory medical insurance program for 2026 is set at 22,924.3 rubles (22,543.7 rubles in 2025).

Budget of federal medical organizations

Federal clinics also receive funding from the Federal Compulsory Medical Insurance Fund (FFOMS) to provide compulsory medical insurance, but without the participation of regional funds. Regulators have allocated a record 345.6 billion rubles for the implementation of the basic compulsory medical insurance program at these clinics in 2026. Compared to the 2025 plan, this is an increase of 94.7 billion rubles, or 37.7%. In previous years, this figure grew much more slowly—in 2025, for example, the increase was approximately 15%. Actual spending in this segment in 2025 exceeds the planned amount due to the allocation of additional funds from the National Health Insurance Fund (NHS) to the FFOMS. The total planned compulsory medical insurance budget for federal medical centers this year will amount to 310 billion rubles, while the year before, it barely exceeded 220 billion rubles.

These medical organizations are expected to spend 146 billion rubles on high-tech medical care in the second stage, which is 7 billion rubles higher than the 2025 level.

You can read about the FFOMS budget parameters for 2025 at the link .