Medical insurance has become an important part of ensuring the health of Ukrainians, because it enables quick access to medical services without the need to pay for them out of one's own pocket. Insurance companies in Ukraine offer a variety of medical insurance programs that allow you to cover the costs of treatment, diagnostics, medications and other medical services. However, among the many options, it is important to correctly choose the optimal program that meets your needs and financial capabilities.
Medical insurance in 2024 is developing at a fairly active pace, and the National Bank of Ukraine provided information that net insurance premiums in January-September 2024 reached UAH 4.3 billion, which is 16.2% more compared to the same period in 2023. In Ukraine, such insurance is voluntary, therefore, everyone can choose a company and a policy for a certain insurance amount to receive medical consultations, medical assistance and treatment in both public and private medical institutions throughout the year. What are the advantages of voluntary health insurance and what services are available to owners of such insurance?
Services under the policy: what filling of health insurance is offered in 2024
In Ukraine, health insurance has become the most widespread in the corporate segment, when employer companies provide policies to employees within the framework of social security packages. This affects the spread of health insurance culture, experts say.
"Interest in health insurance products is growing, but mostly the corporate segment gets used to using these services. It is employers who bring the culture of health insurance and stimulate its development in Ukraine. Companies are increasingly trying to protect their employees in this way. It also allows them to increase their attractiveness on the labor market in conditions of growing personnel hunger ," says Maryna Zvarych, director of the sales department of personal types of insurance at SC INGO.
In general, not many companies offer voluntary health insurance (VHI) programs in Ukraine. Some insurance companies are focused on services only for the corporate segment, for example, SC "Universalna" and PZU, but there are also companies that offer health insurance to both companies and citizens - these are SC INGO, ARX, SC UNIKA, VUSO and some others.
Voluntary health insurance (VHI) policies in companies can differ significantly. There are so-called basic insurances, they cost 2-4 thousand UAH. per year, but there are few options in such a policy - two or three calls to the ambulance and several consultations with a therapist. Of course, there is no question of diagnosis, hospitalization or payment of medicines at all.
In order to have comprehensive medical care - consultations of various specialists, payment for diagnostics, medicines, and, if necessary, hospitalization - another policy is necessary, under which the insurance amount will be at least 100 thousand UAH, and better - 180-250 thousand. UAH "It is worth paying attention to the size of the insurance amount for which you can receive medical services. If a few years ago it was possible to limit yourself to 100-150 thousand hryvnias, then today we advise you to choose an insurance amount of at least 250,000 hryvnias. in order not to have complications in case of inpatient treatment in private clinics," says Maryna Zvarych.
Over the past year, the cost of health insurance has increased by approximately 20%. The rise in prices was facilitated by the increase in the cost of medical services and medicines and general inflationary processes
Insurance for a larger insurance amount will already have better content and will guarantee the client service in private clinics, payment of necessary research, tests, and coverage of the costs of medicines prescribed by a doctor. Such an annual policy will already cost 12-25 thousand. UAH or more expensive, it depends on the level of clinics specified in the contract, on the insurance amount and on the availability of limits. For example, the policy may specify a limit for dentistry - 3 thousand. UAH Everything above the limit is paid by the policy owner.
In recent years, insurance policies have become more expensive. This is influenced by general inflation, the increase in the cost of medicines and, in general, the increase in the price of medical care.
In order to have comprehensive medical care, you need a policy under which the insurance amount will be at least UAH 100,000
"During the last year, the cost of health insurance has increased by approximately 20%. The rise in prices was facilitated by the increase in the cost of medical services and medicines and general inflationary processes. The insured began to seek medical care more often, the nature and type of illnesses changed. People have shortened the waiting time for planned assistance as much as possible. If earlier they could plan to receive non-urgent aid within 3-6 months, now this period has been shortened to 1 month," said Maryna Zvarych. According to her, if previously among the insured, diseases such as SARS dominated, now cardio-diseases and neurological diseases come to the fore. Accordingly, this affected the growth of the average check for one disease.
What services does the insurance company pay for in the event of an insured event under the DMS policy
As Maryna Zvarych noted, in recent years, the classic structure of filling out the DMS policy has been formed, which is currently considered optimal: outpatient polyclinic care, inpatient and emergency care. The rest is already additional coverage that companies add to the policy at their discretion. It is about coverage of dental services and some additional services. For example, related to the treatment of certain critical diseases, such as diabetes and oncology. Or some preventive services, such as professional examinations, vaccinations, etc.
"It should also be noted a new type of insurance programs - co-branded. The main difference between such programs is that medical services are provided only in medical institutions of a certain brand. Such insurance allows you to combine all the advantages of insurance and private medicine," Maryna Zvarych said.
The main options of the voluntary health insurance policy:
- Ambulance
- Outpatient treatment
- Diagnostics
- Medicines
- Hospital
- 24/7 support
According to Maryna Zvarych, first of all, buyers of a DMS policy should pay attention to filling out the insurance program: ambulatory polyclinic care, inpatient and emergency care. Secondly, at the level of medical facilities in which you can be served, whether the program includes medication provision and to what extent, whether there is a deductible for this coverage and what exactly it is . In addition, the expert adds, it is worth checking whether there is such an option as calling a doctor at home, covering a day hospital, and if the hospital is provided, then in which clinics.
"Usually, the insurance policy will not cover health damage that a person received while under the influence of alcohol or drugs. Such behavior is considered as intentional exposure to risk. If you engage in extreme sports, separate insurance is provided for this. Damage to the health of military personnel due to military risks is not included in the standard coverage (there is no such exclusion for civilians). Certain groups of diseases are not covered, for example, congenital pathologies, HIV/AIDS, mental illnesses and addictions. Treatment of such conditions is difficult and long-term, and the cost can significantly exceed the limits of standard insurance coverage," said Maryna Zvarych.
Some insurance companies do not insure persons over the age of 60, as well as people with disabilities, under DMS programs. A contract will not be concluded if a person is suffering from drug addiction, alcoholism, or if he is being registered for tuberculosis, in a skin-venereal or psycho-neurological dispensary.
In the company's DMS policies, a number of exceptions are usually prescribed - when the insurance will not cover the treatment. This usually applies to diseases such as rheumatism, heart defects, chronic circulatory failure, hepatitis B or C, cirrhosis of the liver, insulin-dependent diabetes mellitus, chronic renal failure of the II degree and above, encephalitis, multiple sclerosis, epilepsy, parkinsonism, schizophrenia, Bekhterev's disease, malignant neoplasm.
It is important that now, when there is a war in the country and injuries due to shelling are not uncommon, companies indicate in their policies that war risks for civilians can be covered by insurance. But this does not apply to areas of active hostilities.
As for war risks, for example, in SC INGO today, such coverage is standard for civilians located in territories where active hostilities are not taking place. That is, the company covers the treatment of health damage due to the war, which is included in all INGO health insurance policies without additional payment. In general, says Maryna Zvarych, according to the insurance contract, the company organizes and pays for medical care in the entire territory of Ukraine, except temporarily occupied territories and zones of active hostilities. "That is, in all places where civilian medics can physically provide assistance. Telemedicine services are also available abroad, which are included in some insurance policies," says the expert.
Health insurance in 2025: what changes to expect
Most likely, in 2025, companies that offer health insurance policies to individuals will continue to provide health insurance services, and health insurance programs, like today, will differ in terms of services, the sum insured, and the price. According to Maryna Zvarych, the forecast of the Voluntary Health Insurance (VHI) market in Ukraine for 2025 depends on several key factors: economic stability, legislative and regulatory changes, and demand for medical services.
In general, the cost of health insurance policies will increase next year. trends of 2024, it is possible to predict a 10-15% increase in the volume of the DMS market. The increase in the number of insured persons will be thanks to employers. The number of corporate clients will probably increase by 20% ," says Maryna Zvarych.
At the same time, the popularity of health insurance may gradually increase, especially in large cities, where citizens often seek to protect their families from long queues at specialized doctors and to take care of policies for children who need regular medical examinations. In Ukraine, despite the shrinking population, there will still be a high demand for the services of clinics and diagnostic centers.
It is important that now, when the country is at war, companies indicate in the policies that war risks for civilians can be covered by insurance
"The war continues, so increased attention to health and medical protection will remain. People will continue to look for ways to compensate for certain limitations of public health care, which will stimulate demand for voluntary health insurance (VHI). At the same time, enterprises can more actively implement corporate insurance programs to support their employees. Insurers are increasingly adapting their products to new needs, offering coverage not only for traditional medical expenses, but also for telemedicine, psychological support, or rehabilitation services," said Maryna Zvarych, director of the sales department for personal insurance at SC INGO.
