Free joint replacement

• The state pays for the operation, the implant and the hospital stay under the State Guarantees Programme.
• The route: local clinic → orthopaedic surgeon → referral on form 057/u → commission → admission.
• A VMP voucher is needed only for high-tech care; the waiting time depends on the region.
• The implant comes from models the hospital has bought; a refusal can be appealed via your insurer and Roszdravnadzor.

Joint replacement is one of the most common planned operations in Russia. In 2019, 147,061 primary operations were performed[6]6Эпидемиология эндопротезирования тазобедренного и коленного суставов и перипротезной инфекции в Российской Федерации — Травматология и ортопедия России, 27(3):84–93, 2021To the list of sources →. A large share of them is paid for by the state.

What free care covers

Joint replacement is part of the State Guarantees Programme for 2026–2028. The state pays for the operation, the implant, anaesthesia, the hospital stay and the first stage of rehabilitation[1]1Травматология и ортопедия по квоте (ВМП): как получить — gosmed.ru, 2025To the list of sources →.

Funding follows one of two routes. Confusing them costs time.

• OMS: compulsory health insurance, your policy. Most primary operations, meaning first-time replacements, fall under section I of VMP. They are paid from OMS funds[1]1Травматология и ортопедия по квоте (ВМП): как получить — gosmed.ru, 2025To the list of sources →.
• VMP section II: high-tech care paid by the federal budget. This is the quota. It covers complex cases: repeat operations, severe deformities, replacement after injury or tumour[1]1Травматология и ортопедия по квоте (ВМП): как получить — gosmed.ru, 2025To the list of sources →.

For you the difference is where the documents go and how long you wait[1, 10]1Травматология и ортопедия по квоте (ВМП): как получить — gosmed.ru, 202510Приказ Минздрава России от 02.10.2019 № 824н «Об утверждении Порядка организации оказания высокотехнологичной медицинской помощи» — Минздрав России, 2019To the list of sources →. Both routes are free.

Usually not covered:

• travel to the hospital;
• accommodation for relatives;
• a private room;
• an implant model of your choice;
• a sanatorium stay without a separate referral.

Travel to a federal centre is paid only for benefit holders who kept their social package, through the Social Fund[1]1Травматология и ортопедия по квоте (ВМП): как получить — gosmed.ru, 2025To the list of sources →.

Indications

The indications are the same whether the operation is paid or free. Replacement is considered at Kosinskaya stage III osteoarthritis, which is Kellgren–Lawrence grade III–IV[2, 3]2Клинические рекомендации «Коксартроз» (ID 870_1) — Минздрав России, 20243Клинические рекомендации «Гонартроз» — Минздрав России, 2024To the list of sources →. Surgery is discussed when treatment without surgery no longer helps. The stage is graded from the X-ray and your symptoms.

There are no absolute age or weight limits: the doctor weighs your general health and risks[4]4Total Knee Replacement — AAOS OrthoInfo, 2024To the list of sources →. Your orthopaedic surgeon decides whether you need surgery, and a medical commission confirms it. The navigator is not a doctor: diagnosis and treatment stay with your own doctor.

The implant on a quota

Under OMS and VMP the hospital uses implants bought under contract[1]1Травматология и ортопедия по квоте (ВМП): как получить — gosmed.ru, 2025To the list of sources →. These are certified models from Russian and foreign makers. Your choice is usually limited to what is in stock.

• You cannot be charged for an implant that is provided free. A private room is arranged separately. Ask the hospital and your insurer about a specific model.
• Fixation and bearing surfaces are chosen by the surgeon for your age and bone quality, not for price. This means cemented or cementless fixation, ceramic or polyethylene. Ask what you are offered and why.
• Lifespan depends on more than the brand. Surgical technique, your age, weight and activity all matter. Ask how many such operations the hospital does a year.

OMS or a VMP quota

The route depends on your answers to two questions.

Is it a first or a repeat operation? A first joint replacement is usually paid from OMS as VMP in the basic programme: the documents go to the admitting hospital, which issues the voucher[1, 10]1Травматология и ортопедия по квоте (ВМП): как получить — gosmed.ru, 202510Приказ Минздрава России от 02.10.2019 № 824н «Об утверждении Порядка организации оказания высокотехнологичной медицинской помощи» — Минздрав России, 2019To the list of sources →. A repeat operation is done on a federal quota, and the documents go through the regional health authority[1, 10]1Травматология и ортопедия по квоте (ВМП): как получить — gosmed.ru, 202510Приказ Минздрава России от 02.10.2019 № 824н «Об утверждении Порядка организации оказания высокотехнологичной медицинской помощи» — Минздрав России, 2019To the list of sources →.

Is the case routine or complex? Ordinary specialised care under OMS needs no VMP voucher: the referral and record extract go to the hospital you chose[1]1Травматология и ортопедия по квоте (ВМП): как получить — gosmed.ru, 2025To the list of sources →. A complex case, such as a severe deformity, goes on a federal quota, and the regional commission decides which hospital admits you[1, 10]1Травматология и ортопедия по квоте (ВМП): как получить — gosmed.ru, 202510Приказ Минздрава России от 02.10.2019 № 824н «Об утверждении Порядка организации оказания высокотехнологичной медицинской помощи» — Минздрав России, 2019To the list of sources →.

Build your own route →

Waiting times

There is no single waiting time: weeks in some regions, many months in others. It depends on the region, the hospital’s queue and how many operations are funded this year. Late in the year the funded volume sometimes runs out, and admission moves to January.

What helps you wait less:

• Ask several hospitals. Article 21 of Law 323-FZ gives you the right to choose a medical organisation[5]5Федеральный закон № 323-ФЗ «Об основах охраны здоровья граждан», ст. 36.2 — КонсультантПлюс, 2011To the list of sources →.
• Submit a complete package. An incomplete one is sent back, and you lose weeks.
• Renew tests on time. Each test has its own expiry date. If it expires before admission, the date is moved.
• Call the hospital yourself. Check that it has your voucher and when admission is expected.

Discuss with your doctor whether it is safe for you to wait. Your doctor can note rapid worsening, pain at rest or loss of walking ability in the referral.

Regions

The procedure is the same across the country, but details differ.

• Moscow. The clinic you are registered with issues the referral. City hospitals and federal centres both operate. An electronic referral usually shows in your online patient account.
• St Petersburg. City hospitals and a federal trauma and orthopaedics centre both operate. Their queues differ, so ask at both.
• Regions without a large centre. Patients are sent to federal centres in other cities. Travel and companions’ accommodation are usually not paid, so budget for them.

We do not rank hospitals: advertising law forbids comparisons without evidence[7]7Федеральный закон № 38-ФЗ «О рекламе», ст. 24 — КонсультантПлюс, 2006To the list of sources →.

This is a typical list. The hospital or commission may ask for more.

The referral uses form 057/u, approved by Ministry of Health order No. 519n of 2 September 2025[9]9Приказ Минздрава России от 02.09.2025 № 519н: форма направления 057/у и порядок её ведения — Минздрав России, 2025To the list of sources →. You can track a VMP voucher by its number on the Ministry of Health portal[11]11Портал учёта ВМП (проверка статуса талона) — Минздрав России, 2026To the list of sources →. Consent to personal data processing is required by Law 152-FZ[8]8Федеральный закон № 152-ФЗ «О персональных данных» — КонсультантПлюс, 2006To the list of sources →.

Keep two copies of every document and photos on your phone.

First ask for a written decision with the reason. Common reasons are an incomplete package or an “insufficient” stage on the X-rays. Sometimes other conditions need to be brought under control first, such as high blood sugar or blood pressure.

Where to go next:

• Your doctor and the head of the clinic help complete the documents and resubmit them.
• Your OMS insurance company. The phone number is on the back of the policy. Insurance representatives must help with routing and handle complaints.
• The regional OMS fund and health ministry accept written requests via their website or Gosuslugi.
• Roszdravnadzor, the health watchdog, if deadlines or procedures were breached.

State the dates, document numbers and the reason for refusal. A written request works better than phone calls.