In Ukraine, additional payments for medical services may be introduced

Government of Ukraine
The Association of Private Medical Institutions of Ukraine has submitted proposals for the introduction of mechanisms for additional payments for medical services to the consideration of the Committee of the Verkhovna Rada of Ukraine on Health, the Ministry of Health, and international partners.
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Government of Ukraine

According to the official TG channel of the Verkhovna Rada Committee on National Health, Mykhailo Radutsky, the meeting addressed a number of issues.

“The introduction of compulsory health insurance is a strategic goal we are moving towards. The Committee had a working group on the introduction of insurance medicine, which studied the issues of introducing co-payments and stimulating the development of voluntary health insurance (VHI). Currently, we are discussing these important issues on another platform – in the working group of the Ministry of Health to strengthen the role of private medicine,” commented Mykhailo Radutskyi.

The meeting heard reports on three issues.

– Presentation of the “roadmap” for the implementation of health insurance

On August 25, the Ministry of Health approved an order on a roadmap for the introduction of health insurance. The document proposes, among other things, the following steps: to stimulate the development of VHI, to define the list of medical services provided under the PMG and those for which the patient will have additional options, including a surcharge for medical services.

– Information on the implementation of the pilot project on pharmaceutical insurance

Pharmaceutical insurance is one of the tools to compensate citizens for the cost of medicines. In December 2021, a pilot project was launched: Ukrainians were offered to pay a monthly premium for an insurance policy, a family doctor prescribes the drugs, and the patient pays 20% of their cost at the pharmacy. Due to the war, the project was suspended and resumed in February 2023.

– Proposals of the Association of Private Medical Institutions of Ukraine on the introduction of mechanisms for additional payment for medical services

In May 2023, the Razumkov Center conducted a survey of citizens commissioned by the Association. The survey results include the following: 93% of respondents signed a declaration with a family doctor in public institutions, 6% – in private institutions, 80% of citizens faced informal payments, 61% of respondents would like to use a surcharge for medical services (for the state to pay part of the amount and the patient to pay the rest).

According to the association, the NHSU tariff covers 60-80% of the market tariff for medical services. The introduction of a co-payment for medical services would help to combat informal payments (patients would pay extra for the service officially) and compensate for the difference in tariffs. The EBA has developed a draft law that proposes to introduce a co-payment mechanism. It is about covering the difference between the NHSU tariff and the market tariff. For example, the state pays for a patient’s surgery. If the patient wants the surgery to be performed by a renowned professor rather than an ordinary doctor, the patient will pay extra for this service. It is also important that no additional payment is proposed for primary and emergency care.

The Committee, the Ministry of Health and international partners will analyze the proposed document before the next meeting of the working group and form a common position.





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