WB to support compulsory medical insurance in Armenia 

ArmInfo.The World Bank loan funds will be used to support the universal health insurance  implementation program in Armenia. The draft law of the Republic of Armenia "On Ratification of the Loan Agreement "Implementation of the Universal Health Insurance Program" between the Republic of Armenia  and the International Bank for Reconstruction and Development (IBRD) was approved by the Government of Armenia on September 12.

As stated in the background information to the document, the loan agreement was  signed between the Republic of Armenia and the IBRD on July 25, 2024. 

The objectives of the loan program worth 102 million euros ($110  million) are to support the Republic of Armenia, in particular the  Ministry of Health of the Republic of Armenia, in the implementation  of comprehensive health insurance, improve the quality and  implementation of primary health care, increase the efficiency of  healthcare spending and increase the availability of medical services  for the population.  This loan will support the implementation of the  Five-Year Action Plan (2021-2026) of the Government of Armenia and is  part of the national strategy for the development of the healthcare  system.

The credit program is results-oriented (the financing instrument  "Program for Results" - PforR will be used), i.e. the funds will be  spent (allocated) if previously agreed and defined goals/indicators  are achieved.  The preparation of the credit program package took  about a year, and the indicators were developed as a result of joint  work and coordination of the Ministry of Health, the Ministry of  Finance and the World Bank.

It is also important to note that the need for the program and the  achievement of the set indicators depend on the adoption of the law  , the document says.

The project completion date is September 30, 2029.

On February 2, 2023, the Armenian Cabinet approved the Concept on the  implementation of the Universal Health Insurance (UHI) proposed by  the Ministry of Health, according to which the implementation of the  system was planned for the next 4 years. 2023 was considered as a  year, and 2024-2026 were called the   with the full implementation of the UHI in 2027. According to the  plan, the implementation phase of the system should begin in July of  this year, in connection with which the state budget for 2024 has  planned allocations of about 18 billion drams. However, the  implementation was postponed until 2025.

As Samvel Kharazyan, co-author of the concept for the introduction of  the Universal Health Insurance (UHI) told an ArmInfo correspondent in  June of this year, the cost of compulsory medical insurance in  Armenia will be about 164,400 drams per year. Monthly payments to the  insured person will be 13,700 drams. At the same time, a system of  subsidies will be in effect for people with low incomes: the state is  ready to subsidize insurance premiums in the amount of up to 60% of  the cost of the policy for people with a monthly income of no more  than twice the minimum wage. The subsidy for people with a monthly  income in the range of 150-300 thousand drams (gross salary) will be  40%. And people with higher incomes will have to pay the premiums  themselves in full. A subsidy of 20% is also provided for each person  affiliated with the insured person (family members) in the event of  joining the system.

Medical insurance in Armenia will cover both citizens of the country  and residents of the RA (from the point of view of medical insurance,  these are persons who are actually in the country for at least 183  days during 12 consecutive months preceding the moment of insurance).  However, working citizens will not pay compulsory medical insurance  contributions for the unemployed. In particular, if a citizen does  not work - is not registered with the tax authority and has no  income, is not included in any social assistance group, then he is  entitled to a minimum package, which will include emergency services,  services for diseases that pose a danger to society and those that  are necessary in the event of infectious diseases: tuberculosis,  infectious services, the same maternity hospital, some outpatient  services. He will have to pay for the rest of the services out of his  own pocket.

In 2025, according to preliminary estimates by the Ministry of  Health, 130 billion drams will be required from the state treasury to  subsidize contributions for those under 18, beneficiaries of the  social package, people with disabilities (the latter may also include  pensioners) and persons included in the social assistance system  (about 1.2 million people). From 2026, another 600 thousand  beneficiaries are expected to join the insurance system - people aged  63 and older, as well as employees of budgetary organizations, and  budgetary allocations will amount to approximately 230-240 billion  drams. From 2027, when hired workers will also be included in the VMS  (plus 500-600 other people), the state will need about 260-270  billion drams to finance subsidies for insurance contributions of  about 2.4 million people.