Good emergency medical treatment is not cheap in Russia, so take out a policy that covers you for the worst possible scenario, such as an accident requiring an emergency flight home.
No vaccinations are required for travel to Russia, but the World Health Organization (WHO) recommends that all travellers should be covered for diphtheria, tetanus, measles, mumps, rubella and polio, regardless of their destination. Since most vaccines don’t produce immunity until at least two weeks after they’re given, visit a physician at least six weeks before departure.
While brushing your teeth with tap water is OK, assume that it isn’t safe to drink. Stick to bottled water, boil water for 10 minutes, or use water purification tablets or a filter.
Medical care is readily available across Russia but the quality can vary enormously. The biggest cities and towns have the widest choice of places, with Moscow and St Petersburg well served by sparkling international-style clinics that charge handsomely for their generally excellent and professional service: expect to pay around US$100 for an initial consultation.
In remote areas doctors won’t usually charge travellers, although it’s recommended to give them a present – such as chocolate, fancy alcohol or just money. In some cases, medical supplies required in a hospital may need to be bought from a pharmacy and nursing care may be limited. Informal payments to doctors and especially nurses is sadly often the only way to improve conditions and ensure adequate treatment in large hospitals.
Infectious diseases include rabies, tick-borne encephalitis (a serious risk in rural Russia from May to July), HIV and AIDS, typhoid and hepatitis A. Consider having vaccinations before departure.
It's unlikely you'll experience any environmental hazards, but if you do, it'll likely be to do with the climate or air pollution in the biggest cities only.
Watch out for altitude sickness in the high mountains of the Caucasus, the Altai and Kamchatka; heat exhaustion and heat stroke or hypothermia and frostbite, depending on the season; stings or bites from insects, leeches and snakes.