Universal Health Insurance: Answers to Important Questions on “Every Morning”

Tigran Hovhannisyan, Head of the Contracts, Methodology and Quality Management Division of the Universal Health Insurance Fund, was a guest on Radio Marshal’s “Every Morning” podcast, presenting the operating principles of the universal health insurance system, the terms of cooperation with medical organizations, and answers to the questions most frequently asked by insured citizens.

During the conversation, Hovhannisyan emphasized that the universal health insurance system is based on the principle of ensuring equal opportunities for access to medical care. The aim of the system is to provide citizens with opportunities to access medical services, regardless of their social status and financial means. For several social groups of the population, insurance contributions are fully subsidized by the state, ensuring their inclusion in the overall system.

Speaking about the further expansion of insurance coverage, he noted that, starting January 1, 2027, individuals earning salaries of up to AMD 200,000 are also expected to be included in the system, eliminating the currently applicable income threshold.

During the program, the criteria for selecting medical organizations and the terms of cooperation with the Fund were presented in detail. Hovhannisyan explained that cooperation is on a voluntary basis, while the requirements established for medical organizations are regulated by the relevant decision of the Government of the Republic of Armenia dated December 25. Depending on the type of services provided, medical organizations must meet the established criteria. These relate to technical facilities and the availability of necessary equipment, as well as the qualifications of specialists and compliance with medical protocols. However, signing a contract does not mark the end of the monitoring process. The Fund conducts training sessions, as well as regular scheduled and unscheduled inspections, to assess medical organizations’ compliance with established requirements, the conditions under which services are provided, and their quality.

Hovhannisyan also presented the structure of the insurance package, noting that it includes inpatient and outpatient medical care, laboratory and instrumental examinations, and the provision of medicines. Lists of services included in the package, reimbursable medicines, and medical organizations cooperating with the Fund are available on the Fund’s official website. Hovhannisyan added that, when navigating the list of reimbursable medicines, it is important to consider not only the trade name of a medicine but also its active ingredient. Therefore, if the medicine a citizen is looking for is not included in the list under that particular trade name, an alternative containing the same active ingredient may be available.

The program also addressed the procedures for accessing medical services, particularly the specific aspects of seeking medical care and accessing relevant services in cases of chronic diseases.

Hovhannisyan also addressed cooperation with private insurance companies. It was noted that the Fund has signed memoranda of cooperation with private insurers, aimed at ensuring the complementary operation of the public and private insurance systems.