In 2026, MSHI deductions and contributions are classified as social payments and are paid in accordance with the Law of the RK “On Compulsory Social Health Insurance” (Article 4 of the Tax Code of the RK). The employer pays deductions at its own expense, while employees’ contributions are withheld and transferred by the employer. Individual entrepreneurs and other persons required to make payments independently pay contributions for themselves. Insured persons receive medical care under the MSHI package, while the guaranteed volume of free medical care is provided separately. The tax agent reports information on the income used to calculate the payments in the declaration under Form 200.00 in the “MSHI deductions and/or contributions” section.
MSHI in the RK in 2026: who pays and for what
Two types of payments apply under the MSHI system in the RK, and it is important to account for them separately:
- MSHI deductions — the employer pays them from its own funds, without withholding them from the employee’s income;
- MSHI contributions — the employer, acting as the payer, withholds them from the employee’s income and transfers them to the fund.
For payments to individuals under civil-law contracts, the accountant determines the obligation to calculate, withhold and transfer contributions in accordance with the MSHI Law. If this obligation is imposed on the income payer, the relevant amounts are included in the MSHI calculation and reporting.
MSHI forms part of social payments along with mandatory pension contributions, mandatory occupational pension contributions, mandatory employer pension contributions and social contributions (Article 4 of the Tax Code of the RK). Each type of payment is calculated and accounted for under the legislation governing it, so the accountant keeps the calculations separate.
MSHI for IEs in 2026
An individual entrepreneur may participate in MSHI calculations in two capacities at the same time:
- As an employer — if the IE has employees, the IE calculates and pays deductions at its own expense and also calculates, withholds and transfers contributions from employees’ income in accordance with the procedure prescribed by the MSHI Law.
- As an independent payer — the IE pays MSHI contributions for themselves in accordance with the procedure established by the MSHI Law.
If an IE pays income to employees or individuals under civil-law contracts and acts as an MSHI payer, information on such payments is reported in the designated lines of Form 200.00. The IE’s payments for themselves must be separated from payments calculated on the income of employees and other individuals: these are different obligations and have different grounds for recognition in accounting.
When calculating an IE’s contributions for themselves in 2026, the accountant applies the base and limits expressly established by the current version of the MSHI Law. The payment is made for the relevant period using the correct payer details so that the transferred amount is taken into account when determining insured status.
How to report MSHI in Form 200.00
The individual income tax and social tax declaration under Form 200.00 contains a separate “MSHI deductions and/or contributions” section for MSHI. When completing it, the indicators are allocated by month of the reporting quarter:
- lines 200.01.019 I, II, III — income used to calculate MSHI deductions, separately for each month of the reporting quarter;
- line 200.01.019 IV — the quarterly total of the indicators in lines 200.01.019 I, II and III;
- lines 200.01.020 I, II, III — income of employees and individuals under civil-law contracts from which the payer calculates, withholds and transfers MSHI contributions, separately for each month of the quarter;
- line 200.01.020 IV — the total contributions indicator for the reporting quarter.
Form 200.00 also contains separate sections for social tax and social contributions. MSHI indicators should not be transferred to them automatically: the purpose of the lines and the information reported in them differ. Before completing the form, the accountant allocates accruals by type of social payment and by month of the reporting quarter.
Practical tip: before submitting the form, reconcile the monthly indicators in lines 200.01.019 and 200.01.020 with payroll records and payment documents. Separately verify the individual identification numbers of income recipients, the payment period and the payment purpose. This reconciliation helps identify an omitted payment, an incorrect reporting month or an error in the details in a timely manner.
Free MSHI: what insured status provides
Medical care in Kazakhstan is provided under two packages prescribed by law:
- guaranteed volume of free medical care (GVFMC) — medical care provided from budget funds to persons entitled to receive it;
- MSHI package — medical care paid for from the fund’s assets and provided to persons with insured status.
For persons belonging to categories whose contributions are paid by the state, payments are made from the budget. Other participants obtain insured status on the basis of payments received on their behalf or independent payment in accordance with the procedure prescribed by law. The list of categories for which the state pays, as well as the scope of medical care, is determined by the MSHI Law and healthcare regulations.
MSHI online: how to check status and payments
MSHI participation status can be checked online through the e-government portal and the electronic services of the Social Health Insurance Fund. The check result shows the current insurance status. If insured status is absent, the accountant should compare the accrual periods with the payment documents and verify the employee’s individual identification number, the period and the purpose of the transfer.
IEs and other independent payers should also monitor their status after paying contributions for themselves. Particular attention should be paid to periods for which payments were not previously made: each payment must be allocated to the month specified in the payment document.
MSHI in 2025, 2026 and 2027: what to consider
MSHI is calculated under the rules applicable in the relevant period. The procedure used for 2025 cannot be automatically applied to 2026 or 2027: changes may affect payment calculations, payer categories, reporting and status determination rules. The accountant should:
- apply the version of the MSHI Law effective during the period in which the income is accrued and the payment is calculated;
- compare the calculation indicators used with those established for the relevant year;
- check the current rules and structure of Form 200.00 before preparing the declaration;
- after updating the accounting software, verify the MSHI calculation settings and accrual results for each type of income.
Frequently asked questions
How do MSHI deductions differ from contributions? — The employer pays deductions from its own funds. Employees’ contributions are calculated from their income, withheld and transferred by the employer in accordance with the established procedure.
Must MSHI be paid on civil-law contracts? — Contributions are calculated, withheld and transferred when the relevant obligation of the income payer is prescribed by the MSHI Law. Such income is reported in lines 200.01.020 of Form 200.00 designated for contributions.
Does an IE pay MSHI for themselves in 2026? — Yes, an IE pays MSHI contributions for themselves in accordance with the procedure prescribed by the MSHI Law. If the IE has employees, the IE also fulfils the employer’s obligations regarding deductions and contributions from their income.
Can medical care be obtained without MSHI insured status? — Medical care within the GVFMC is provided to persons entitled to receive it. Insured status is required to receive services under the MSHI package.
Where can MSHI status be checked online? — On the e-government portal and through the electronic services of the Social Health Insurance Fund.