Universal Health Insurance: Results of the First Nine Months and Prospects for Expansion in 2027

During the first nine months of the Universal Health Insurance system's operation, both the number of insured persons and the number of beneficiaries who used healthcare services increased significantly. In an interview with Public Television of Armenia, Hayk Babayan, Acting Director General of the Universal Health Insurance Fund, discussed the system's performance, changes in demand for healthcare services, financial indicators, and the planned expansion in 2027.

According to the recorded data, from January to September 2026, the number of insured persons increased by 15.5%, from 1,574,219 to 1,818,771. The number of beneficiaries who used healthcare services also rose significantly, reaching 1,020,527 as of September. During the first nine months of the system's operation, 56.1% of insured persons had used at least one service included in the insurance package, compared with 42.4% in June. Total reimbursements from January to September amounted to AMD 163.7 billion.

According to Babayan, it is noteworthy that a significant proportion of beneficiaries are citizens who have accessed healthcare services for the first time in the past 5–10 years. This indicates that the introduction of the insurance system has made healthcare more accessible to citizens who had not sought medical care for years.

Babayan noted that demand for healthcare services from January to September was particularly high among older age groups. Citizens primarily sought care for cardiovascular, ophthalmological, and bone and joint conditions. Previously accumulated demand for treatment resulted in a particularly high number of costly surgical interventions. Specifically, 25,561 beneficiaries received cataract treatment services from January to September. According to the Fund's actuarial estimates, this may represent approximately 30% of the accumulated cataract cases, with the figure potentially reaching 40–50% by the end of the year. During the same period, 9,473 beneficiaries received cardiovascular surgical services.

Despite the high demand for costly services during the initial phase of implementation, the system's financial indicators remained within the forecast range. According to Babayan, the claims ratio stood at 93%, which he assessed as a positive result.

Pharmaceutical coverage continues to be one of the most widely used components of the insurance system. More than 4 million medication dispensing events were recorded during the first nine months. Medicines used to treat cardiovascular diseases and diabetes account for a significant share of the medications dispensed.

One of the key changes planned for next year is the expansion of insurance coverage to additional population groups. Starting January 1, 2027, approximately 340,000 employees earning monthly salaries of up to AMD 200,000 will also join the Universal Health Insurance system.

In addition, starting in 2027, the system will cover individuals receiving rental income, interest, dividends, and royalties; individuals working under civil law contracts; sole proprietors and notaries with annual gross income of up to AMD 2.4 million; individuals engaged in agricultural activities in communities designated as affected under the legislation; persons affiliated with insured individuals; and individuals providing passenger transportation services by taxi.

The expansion of insurance coverage and changes in the structure of demand for healthcare services will mark the next stage of the system's development, contributing to improved access to healthcare services and strengthening the system's long-term sustainability.