Fillings, tooth extraction, and X-rays - what dental services are available under MSHI

Dental care in Kazakhstan is not exclusively a paid service. A portion of dental treatments is funded by the state or through the Mandatory Social Health Insurance (MSHI) system. However, free assistance is not available to all patients and depends on whether the individual requires routine treatment or emergency intervention.
Tengrinews.kz submitted an official inquiry to the Ministry of Health to clarify who is eligible for free dental care, whether services such as fillings, extractions, or prosthetics are covered by MSHI, and whether clinics have the right to demand additional payments.
Who is eligible for free dental treatment
As explained by the Ministry of Health, routine dental care is provided free of charge to only two categories of citizens:

children under 18 years of age;pregnant women.

This refers to the treatment of diseases and conditions that do not threaten the patient's life and do not require urgent intervention. For example, a person may visit a dentist for cavity treatment or a tooth extraction if there is no acute pain or other signs of an emergency condition.
Routine care may include:

dental examinations;anesthesia;
X-rays of the tooth or jaw;treatment of damaged dental tissues;fillings;simple or complex tooth extractions.

Pulpitis treatment followed by a filling can also be free of charge. Such care is provided to children and pregnant women, and in cases of acute pulpitis or exacerbation of the disease, to other preferential categories entitled to emergency dental care. However, there must be medical indications, and the clinic must operate under a contract with the Social Health Insurance Fund (SHIF).
Meanwhile, adult patients who do not belong to these preferential categories cannot visit a clinic to have a cavity treated for free under MSHI. To reiterate, only children and pregnant women are entitled to do so.
Who is eligible for emergency dental care
The list of those eligible for free emergency dental care is significantly broader.
It is provided to:

children under 18 years of age;pregnant women;veterans of the Great Patriotic War;people with disabilities;pensioners by age;recipients of targeted social assistance;mothers of large families awarded the "Altyn Alka" and "Kumys Alka" pendants;patients with infectious and socially significant diseases (such as tuberculosis, HIV, hepatitis B and C, etc. — Ed. note).

Emergency care is provided for acute diseases, severe pain, trauma, and exacerbations of chronic diseases where the patient requires urgent treatment, even if there is no immediate threat to life.
Specifically, by law, one can seek such assistance for:

acute pulpitis or exacerbation of chronic pulpitis;acute periodontitis or its exacerbation;trauma to a tooth or the maxillofacial region;acute stomatitis;alveolitis — inflammation of the socket after tooth extraction;abscesses;phlegmon;furuncles or carbuncles;osteomyelitis;other inflammatory diseases of the maxillofacial region;conditions requiring surgery or inpatient treatment.

As part of emergency care, a patient may receive anesthesia, an X-ray, a tooth extraction, an abscess drainage, a filling, a tissue incision for pus drainage, as well as treatment for pulpitis, periodontitis, stomatitis, and alveolitis.
It is important to note that the presence of severe dental pain does not automatically mean that free care is available to everyone. The patient must belong to one of the categories specified in the Ministry of Health's order.
Is it possible to get a filling for free?
Yes, the placement of a filling can be included in free dental care.
During routine treatment, children and pregnant women may receive chemical-cure composite fillings. Filling procedures may also be performed during pulpitis treatment or as part of emergency care, provided there are appropriate medical indications.
Note:Chemical-cure composite is a dental filling material that hardens through a chemical reaction after two components are mixed, rather than through exposure to a curing light.
However, patients cannot always choose any material or specific type of filling under the Compulsory Social Health Insurance (CSHI) system. If a person wishes to receive a service or use a material not covered by the free benefit package, the clinic may offer treatment on a paid basis.
Does CSHI cover dental prosthetics?
Standard dental prosthetics are not included in free routine dental care..
As explained by the Ministry of Health, routine care does not cover orthopedic treatment, which includes the fabrication and installation of crowns, bridges, removable dentures, and other structures used to restore missing teeth.
Consequently, in most cases, adult patients requiring a crown or denture will have to pay for the treatment themselves.
Specific support measures may be available for certain social categories at the regional level; however, this does not mean that prosthetics are included in the general CSHI package for all insured individuals.
Is there a limit on free dental treatment?
The law does not establish a specific limit on the number of dental services a patient can receive per month or year.
This means there are no regulations stating that a patient can only receive one filling per year or visit a dentist a limited number of times.
Care must be provided based on medical indications and within the scope prescribed by legislation.
However, the absence of a formal limit does not mean patients can receive any dental service of their choosing. A doctor must confirm the necessity of the treatment, and the service itself must be included in the relevant free care package.
Are orthodontic services available?
As a rule, orthodontic treatment is also not covered by the CSHI system.
The installation of braces, aligners, and other methods of bite correction are typically provided on a paid basis.
Exceptions are made for specific categories of children:

children with congenital maxillofacial pathologies;children from low-income families—subject to established medical indications.

This means that a desire to correct a bite is not enough. The decision must be based on a diagnosis, medical indications, and the child's eligibility for the corresponding category.
Can patients be asked for additional payment?
If a dental service is included in the list of care covered by CSHI, the clinic has no right to demand additional payment from the patient.
The Social Health Insurance Fund (SHIF) reimburses the medical organization the full cost of treatment according to established tariffs.
Additional payment is possible only if the patient, of their own volition:

selects a service not included in the free package;chooses additional materials or procedures;opts out of CSHI-covered treatment and decides to receive care privately;enters into a contract with the clinic for the provision of paid medical services.

Before treatment begins, the patient must be informed which procedures will be free of charge and which must be paid for.
If a service is included in the CSHI package but the clinic still demands money, the patient may contact the Social Health Insurance Fund to verify the validity of the charges.
Can I go to a private dentist?
Free dental care can be obtained not only at state clinics but also at private dental offices.
The primary condition is that the medical organization must have a valid contract with the Social Health Insurance Fund specifically for the provision of dental services.
A patient may visit:

a dental office within a state clinic;a state dental clinic;a private dental practice that is a SHIF service provider.

However, not all private dental clinics accept patients under the Compulsory Social Health Insurance (CSHI) system. Even if a clinic partners with the Social Health Insurance Fund (SHIF) in other areas, it does not necessarily mean they provide free dental care.
The current list of service providers can be checked on the official SHIF website or by calling 1414.
Is a residence permit or clinic referral required?
The Ministry of Health has outlined the following procedure for receiving care:

Verify your status as "insured" in the CSHI system if the service is being provided specifically under the insurance package.
Find a medical organization that provides the required type of dental care and has a contract with the SHIF.
Contact the selected clinic or dental office.
Undergo an examination by a dentist.
Receive treatment if medically indicated.

Dental services are among the types of care where patients can independently choose their SHIF provider. However, before visiting, it is advisable to confirm with the clinic whether they operate under the CSHI system, accept the relevant category of patients, and provide the specific service needed.
Earlier, Otbasy Bank reported that Kazakhstani citizens may once again be allowed to use their pension savings for dental treatment. According to the bank's head, Lyazzat Ibragimova, work is currently underway to make the process as transparent as possible. To achieve this, the mechanism for receiving funds for treatment is planned to be transitioned to an online format by the end of 2026.