ArmInfo. Our government has been working for the past 5-6 years to implement a COMPREHENSIVE health insurance system in the country (which is highly welcome), but since it turned out to be limited in coverage (not only in terms of coverage but also in terms of reimbursement of service costs), it was decided to change the title of the bill to "On Universal Health Insurance" (which is certainly more honest :)): (The author's style and punctuation have been preserved - ed.). Haykaz Fanyan, head of the ACSES analytical center, shared his assessment.
The expert posted a table on his Facebook page showing the systems of 15 EU countries, along with their key performance indicators. In countries with a similar system, which will be implemented in Armenia starting January 1, 2026 (Estonia, Lithuania, and Poland, ranked 8th, 12th, and 13th), beneficiary satisfaction is estimated at 63%, 51%, and 51%, respectively.
However, in the Netherlands, which has a mandatory universal healthcare system managed by the state and supplemented by private insurance companies, every resident is required to have basic health insurance (Zorgverzekeringswet). Long-term care is covered by separate insurance (Wet langdurige zorg). Here, the citizen satisfaction rate is estimated at 83%.
"Insurance in the Netherlands is also mandatory, provided through numerous private insurers, which, in my opinion, is the most optimal way to limit numerous and varied risks," Fanyan wrote.
Germany tops the ranking (with 85%), with a dual health insurance system: mandatory public insurance (GKV), which covers approximately 90% of the population, and private insurance (PKV). Mandatory insurance is financed by wage contributions (shared equally by both the employee and the employer), while private insurance is individualized. Regardless of the type of insurance, every resident is required to have health insurance.
"It is regrettable that since January 5, 1992, the establishment of a market economy in Armenia, such a massive step back to a model characteristic of an administrative-command economy has been taken, where the state [a quasi-state fund] would determine the price of any service that is not, by its nature, a natural monopoly," concludes Haykaz Fanyan, promising to present a policy brief on the topic in December.
As a reminder, on November 13, the Armenian government adopted a written resolution "On approving and recognizing as urgent the draft law "On Universal Health Insurance" and related laws." Thus, the first stage will begin in January 2026. The system will be implemented within three years. By 2028, the entire population of Armenia should become beneficiaries of this system. The state procurement system will gradually transition to compulsory health insurance. Until then, those who used the state procurement system will continue to do so.
In the first stage, the compulsory health insurance system will include children under 18, individuals aged 65 and older (even if employed), individuals with disabilities aged 18 to 65, and members of socially vulnerable families. The state will fully cover the health insurance coverage for these categories of citizens. Citizens with a monthly income of over 200,000 drams will pay for their own insurance. Overall, the first stage plans to reach 1.6 million beneficiaries (citizens of the Republic of Armenia who have resided in the Republic of Armenia for more than 183 days).
Able-bodied citizens who are unemployed and do not belong to special social groups will not yet receive insurance, but in the future, it is planned to require them to pay for their own insurance. "In the future, we intend to establish this procedure, requiring them to pay contributions even if they are unemployed." "This is consistent with our policy of stimulating employment," Health Minister Anahit Avanesyan stated at a cabinet meeting on November 14.
In 2026, the insurance will cover the most in-demand services, including outpatient services, clinic visits, family doctor visits, specialist consultations, and laboratory tests (a certain number per year). The list of services will be expanded and refined, covering certain surgical procedures, including ophthalmological (cataracts), cardiovascular, and others. Annual medical examinations will be mandatory under the system.
Compensation will apply to certain types of medications (based on the active ingredient, not the manufacturer). If citizens wish to purchase a more expensive medication, they will be required to pay extra. If an ambulance transports a patient to the hospital and they receive inpatient treatment or surgery, this will also be reimbursed up to a certain amount (if the compensation is insufficient, the patient will pay the difference). In the future, coefficients will be established that will reduce state payments for citizens who abuse tobacco and alcohol. If, after calling an ambulance and undergoing an examination, the patient is not referred for hospitalization but nevertheless decides to undergo treatment, they will be referred to a clinic for testing. The tests will be covered by insurance, but the patient will be responsible for paying for hospital treatment.
The system will automatically check people and automatically include beneficiaries. They will then receive an invitation to become beneficiaries of the system through the Armed eHealth e-health system (or through their local doctor).
The base cost of an insurance policy in 2026 will be 129,600 drams (10,800 drams per month), compared to 164,000 drams a year ago (naturally, the policy coverage has been reduced compared to the initial draft). Part of this amount will be offset by payments to the Zinapa Military Insurance Fund. These payments, increased in 2021, are now returning to their previous level of 1,000 drams, regardless of salary.
Specifically, individuals with salaries between 200,000 and 500,000 drams will be able to reduce their monthly Zinapa premium from 5,500 to 1,000 drams. The 4,500 drams saved can be used to pay for health insurance. Additionally, when filing their income tax return in 2026, they will be able to receive an additional 6,000 drams per month (as a tax deduction). For citizens with salaries between 500,000 and 1 million drams, the Zinapa contribution will also be reduced to 1,000 drams (from 7,500), allowing them to redirect 6,500 drams toward insurance (in 2027, they will be able to receive a 4,000 drams monthly refund). Individuals earning over 1 million drams will be able to file their income tax return in 2027 and receive a 4,000 drams monthly refund. The insurance payment will be made by a tax agent, meaning it will be deducted from wages in the same way as income tax, social security contributions, and other taxes.
A state fund will be created to manage the health insurance system. It will operate under temporary management for three months, after which a state selection committee will form its board of directors (which, as stated in the Concept for the Implementation of Compulsory Medical Insurance, will be chaired by the Minister of Health).
The 2026 budget allocates 127 billion drams for the implementation of the health insurance system.
