Voluntary Health Insurance Landscape in Ukraine

The health care landscape in the Ukraine is complex. Private insurance makes up only 2% of Ukraine’s healthcare spending, with the majority of spend comprised of out-of-pocket expenses and government spending. 

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January 09, 2020

The health care landscape in the Ukraine is complex. Private insurance makes up only 2% of Ukraine’s healthcare spending, with the majority of spend comprised of out-of-pocket expenses (52%) and government spending (43%). Voluntary Health Insurance (VHI) itself has many challenges. Care for those with VHI is often provided in state-run facilities. Managers of these facilities and doctors providing care in these facilities have different perspectives towards those seeking care through VHI. Reform, said to be in progress, is anxiously anticipated.

Table 1: Top 10 Voluntary Health Insurers in the Ukraine (as of 2019)

Rank Insurer Premiums Payments
1 UNIQUE 159, 757 91,296
2 ARX (AXA Insurance) 108,517 42,312
3 Alfa Insurance 82,289 62,752
4 INGO Ukraine 77,484 42,713
5 Neftegazstrakh 61,973 46,638
6 PZU Ukraine 36,631 19,939
7 Universal 34,666 10,839
8 TAS SG 24,874 17,333
9 Arsenal Insurance 18,509 6,630
10 VUSO 10,104 4,130

Source: https://forinsurer.com/

Voluntary Health Insurance Prevalence

  • 96% of participating companies provide a private medical plan.2
  • In professional/para-professional plans, eligibility can be for:2
    • Employees only – 58%
    • Employees and all dependents – 41%
    • Employee and spouse – 1%
  • Employee contributions vary2
  • Employees typically pay a co-payment2

Table 2: Employee Contributions

Employee Category General Professional Executives/Managers
Self 10% 18% 20%
Spouse 40% 100%7 100%
Children 42% 100% 75%

Health Care System Challenges

  • Funding for the public sector heath care system is inadequate.4
  • Underpaid doctors require informal payments for people to receive treatment.4
  • Most people cannot afford treatment, so they avoid care until they reach advanced stages of illness.4
  • Ukraine’s mortality rate has increased while its Eastern European counterparts have decreased.4
  • Ukraine has more than 2,000 hospitals, but they are out-of-date and cannot provide complex care.4
  • Unlike its Eastern European counterparts, the country has not invested in its health care system or developed a functional health insurance scheme outside of voluntary health insurance.4
Out of Pocket Spending Grows Compared to Government and Private Insurance 
Figure 1: Out of Pocket Spending Grows Compared to Government and Private Insurance
  • Healthcare staff are emigrating to Poland, the U.S. and the European Union leaving understaffed health care facilities.4
  • The “hybrid war” in the Eastern regions of the country and Russia’s annexation of Crimea are exacerbating the country’s social and economic situation.4

Managers of state facilities tend to prioritize treatment of people with VHI.3 However, doctors working in these facilities are not interested in treating people with VHI, who are less likely than others to make informal payments.


Valery Lekhan

Health Care System Financing

  • Private Insurance makes up 2% of Ukraine’s healthcare spending.5
  • Out-of-Pocket Expenses makes up 52% of Ukraine’s health care spending.5
  • Government Spending makes up 43% of Ukraine’s health care spending.5

2018 Health Care System Reform

Ukraine citizens are skeptical of health care reform as previous efforts have not shown progress.4 Changes in 2018 include:

  • A package of guaranteed benefits
  • International standards
  • A co-payment system
  • Family medicine
  • Money follows the patient4

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TABLE OF CONTENTS

  1. Voluntary Health Insurance Prevalence
  2. Health Care System Challenges
  3. Health Care System Financing
  4. 2018 Health Care System Reform