Health Minister explained procedure for receiving treatment under state health insurance

YEREVAN, December 25. /ARKA/. Armenian Health Minister Anahit Avanesyan detailed the process for accessing medical care under the universal health insurance system.

In a video shared on Facebook, the Minister highlighted three primary categories of requests for beneficiaries of the system:

1) Urgent and emergency cases

In these instances, citizens either reach out to the Ambulance Service or go directly to a medical center. The patient's condition is evaluated on-site, and if necessary, hospitalization is arranged or an emergency examination is conducted around the clock. If hospitalization is not required, the patient is directed to the primary healthcare system—a clinic or outpatient facility.

2) Preventive care and screenings.

To receive a preventive examination, it is essential to book an appointment via the ArMed system. Once the range of medical services is established, the patient is referred either straight to a medical center or an outpatient clinic.

3) Chronic diseases.

In this scenario, citizens need to schedule an appointment with a general practitioner or family doctor at a clinic or outpatient facility, while children should consult a pediatrician. At primary care, patients receive consultations and medical treatment, or an open referral to a medical center, which they can use to visit a suitable medical facility for examination, treatment, or surgery.

"This approach not only enhances cost-effectiveness for the healthcare system but also represents a more intelligent way to access medical services. Dear citizens, please remember that scheduled cases covered by compulsory health insurance also necessitate an appointment and may involve a wait of up to two weeks. However, emergency situations are addressed immediately," Avanesyan stressed.

General health insurance plans are set to launch on January 1, 2026, with payments due by January 20.

In the initial phase of the three-year compulsory health insurance reform (2026-2028), 1.7 million residents of Armenia will be enrolled in the program. The state will fully cover the costs for these individuals.

The program will consist of two categories: those whose insurance is funded by the state—minors under 18; seniors aged 65 and older; individuals aged 18-65 with disabilities (groups I, II, and III); and families with 28 or more social insecurity points.

Starting in 2027, the second phase will expand the system to include individuals earning up to 200,000 drams, and from 2028, it will also encompass other groups, such as agricultural workers and their families.

The annual cost of the health insurance package will be 129,600 drams, payable monthly. This insurance will cover essential services, including outpatient care, clinic visits, family doctor consultations, specialist appointments, and a limited number of laboratory tests each year. The range of services will be broadened and improved to incorporate specific surgical procedures, such as those for ophthalmological issues (like cataracts), cardiovascular conditions, and more.

For the implementation of the health insurance system, the 2026 budget has allocated 127 billion drams. ($1 = 381.76 drams).-0-