Russia may have come a long way since its Communist days. However, it appears that the country's health system is still stuck in the past and woefully inadequate.

Those living in the countryside are particularly hard hit, with anything but the most basic of care practically unavailable. Those that can, tend to travel to Moscow or Leningrad, while expatriates living in the east of the country often head out of Russia altogether to receive treatment in Japan or China.

Just the need to travel for treatment makes medicine an expensive business in Russia. As a result, expats often see insurance as a necessity when living or working in Russia. As Karen Teasdale, Axa PPP's marketing operations manager, told the Telegraph: “Treatment in private and foreign operated facilities is good, but expensive. Those in Moscow and Leningrad are particularly to be relied on.”

She added that there is a public healthcare in place, and a reciprocal arrangement is in place between Russia and the UK. However, standards “vary greatly”, with particular problems found in rural regions.

Meanwhile, Bupa's medical director Dr Sneh Khemka told the paper that the clinical services in Russia are of a good standard. The main problems he has seen, however, tend to relate to levels of service, language difficulties and the cost. Indeed, establishments in Moscow are between 20 and 30 per cent more expensive than their counterparts in the west.

Clearly money is the key when it comes to healthcare in Russia. In addition to the standard outlay for treatments, there are widespread accusations of fraud within the sector, which could further push the price up for unprepared visitors. We would advise expatriates heading over to the region to do their research and look for an insurer that has a sound reputation both outside of Russia and within the country's own insurance and healthcare sectors. There is no point taking a risk with your health, especially when the financial costs are already so high.