In today's world, access to quality medical care is one of the key aspects of ensuring the health of the nation. Ukraine, like many other countries, has two main systems of providing medical services: public and private. If you previously used exclusively private medicine and now want to understand how the public system works and how to use its services, let's analyze the main aspects and steps.
Entering the medical system
The entry point for medical care with state funds is a declaration with a family doctor. Without it, a limited list of services will be available to you free of charge.
Therefore, step 1, if you haven't done it yet, is to choose a doctor and sign a declaration with him.
How to do it:
- Ask about good family members who still have places through word of mouth. That is, through acquaintances, social networks, neighbors, etc.
- If this option did not work, there is an official one.
Go to the NSHU dashboard, select the filters you need in the left menu: city, district, or even a specific medical facility. Or I want to be served only by private individuals at state expense. I will show on the example of Vyshgorod, where I live:
You can use filters to select doctors available in your city
There are places with these doctors, you can Google them. Then you call the institution, say that you want to make a declaration with such and such a doctor, make an appointment and get acquainted.
How to know that the doctor is of high quality and will not prescribe fuflomycin? Unfortunately, there is no clear system that will allow you to see the quality of a doctor online by rating.
At the start of the reform, it was advised to focus on the number of signed declarations. Like, a more popular doctor is more likely to be a good one.
You can Google whether the specialist you like has additional professional activities, participation in professional conferences, training, schools, etc.
If you want to change the family doctor, just sign the declaration with the new one - the system will automatically terminate the agreement with the previous one. You don't need to make any statements.
Doctor's visit to an elderly patient and vaccination against Covid-19 at home, Kyiv, April 20, 2021.
What does a family doctor do?
The basis of everything you need in the medical system. You can refer to it as many times as you like. There are no restrictions on the number of visits per month / year. But there is common sense.
If medical help is urgently needed at 10 p.m., it is already to the emergency room. The doctor does not have to run to you so late or be on the phone and leave all household chores. Do you have a personal agreement in a specific case or condition.
The responsibilities of a family doctor, according to the contract with the state, include, in addition to receptions and treatment of the most common conditions, examinations:
- General blood analysis with leukocyte formula;
- General analysis of urine;
- Glucose in whole blood;
- Total cholesterol;
- Rapid tests for pregnancy, troponin, HIV, viral hepatitis B and C;
- SARS-CoV-2 antigen test .
All this is free for the patient and paid to the doctors by the state. Similarly, the family doctor performs mandatory professional examinations and tests for risk groups.
Every year:
- Diabetes mellitus: 45 years and older, all with risk factors;
- HIV: 14 years and older;
- Tuberculosis: all in case of risk factors.
Once every two years:
- Breast cancer: 50-69 years, with 40 - in case of risk factors. Once every one or two years, depending on risk factors;
- Hypertensive disease and other cardiovascular diseases — women 50 years and older, men 40 years and older;
- Colorectal cancer: women and men older than 50 years;
- Prostate cancer: from the age of 40, depending on the degree of risk.
Also, the family doctor can perform electrocardiography, peakflowmetry, spirometry, otoscopy, ophthalmoscopy and visual acuity measurement.
If other studies are needed, he issues a referral for additional examinations or a consultation with a specialist doctor.
The doctor of the visiting team, Oleksiy Kokhan, conducts an ultrasound of the patient's thyroid gland.
For example, in institutions that have a contract for the "Instrumental and endoscopic studies for early diagnosis of neoplasms" package, upon referral, they do free of charge:
- mammography for people 40+ years old;
- hysteroscopy for people 50+ years old;
- esophagogastroduodenoscopy — also 50+;
- colonoscopy — 40+;
- cystoscopy — from 50+;
- bronchoscopy — from 50.
At the same time, local or general anesthesia for endoscopic examination should be provided free of charge. Such referrals can also be issued by the attending physician, the main thing is that he should be in the National Health Service system.
Also, the family doctor writes prescriptions under the "Affordable Medicines" program for cardiovascular diseases, bronchial asthma and chronic obstructive pulmonary diseases, diabetes, and also, based on the appointment of a specialist doctor, writes prescriptions for insulin, drugs for mental disorders, behavior and epilepsy, Parkinson's disease, a palliative state.
Medicines can be obtained from pharmacies that have signed an agreement with the National Health Service of Ukraine.
It is convenient to find them, you can call the contact center of NSZU at number 16-77.
Where you can get tests done free of charge, in particular at private individuals
In 2024, NSHU concluded contracts with four private medical laboratories: "Eskulab", CSD , "Smartlab" and "Sinevo". In order to get free tests there, you need a referral either from a family doctor or from a doctor who is in the NHSHU system.
Mostly, free analyzes in private laboratories are provided under the package of secondary medical care "Prevention, diagnosis, observation and treatment in outpatient conditions". For example, we are talking about detailed blood analysis, biochemical, tumor markers, vitamin D , liver tests, etc. The full list of analyzes is available on the NSZU website.
In Kyiv, 76 places have a package. Among the 11 private companies is Sinevo, for example. However, not everyone who is here does the analysis. So you should also check.
Both a family doctor and a specialized doctor can refer for additional tests. It is important that they are in the system of NSZU. If you just go to a private gynecologist who does not have a contract with the National Health Service, his referral will not give you free tests.
To get to a specialist doctor at state expense, a referral from a family doctor is required.
Do all narrow specialists need a referral from a family doctor?
No. You can apply without a referral to:
- obstetrician-gynecologist, child and adolescent gynecologist;
- a psychiatrist, particularly a child psychiatrist;
- narcologist;
- phthisiologist;
- to a doctor with whom a patient with chronic diseases is under medical supervision;
- in emergency condition.
An obstetrician-gynecologist performs ultrasound during the consultation
How to find a specialist doctor?
Unfortunately, there are no specialty filters on the NHSHU dashboards, as in family medicine. You can see which medical institutions have a contract under the package "Prevention, diagnosis, monitoring and treatment in outpatient settings", and then Google whether there is a specialty you need and which doctor.
In Kyiv, it is convenient to do this through Helsi . There is a filter system by which you can choose which of the doctors of the desired specialty can accept under the contract with the NHSHU, that is, free of charge for you. Obolonsky district is selected on the screen, with filters for working with the National Health Service and referral. There are seven doctors.
You can make an appointment by referral or self-referral to the listed doctors online, come to the appointment at the agreed time and avoid waiting in long queues.
During the appointment, the doctor will redeem the referral through the code. There is no need to pay extra or make charitable contributions. Used personally.
Again, if you want to consult a private doctor, you can choose an additional filter. For example, there is such a private ENT in Kyiv.
If you need to go to the hospital, to the inpatient unit
If the application is planned, a referral from the family or attending physician is necessary.
If it is urgent, nothing is needed. You come by yourself or by ambulance.
For example, when our daughter fell ill and we saw that we were unable to give advice on an outpatient basis with the help of pediatricians, we got into the car at 10 p.m. and drove ourselves to the infectious disease department. We were examined and hospitalized. Residence does not play a role here either.
The state pays hospitals for the number of services provided. Therefore, it is even beneficial for the hospital to have a better rating and to receive more patients.
A medical worker transports a patient with an oxygen bag in the infectious disease department of a Kyiv hospital.
Who pays for medicines and tests?
When you are hospitalized, the state pays for the treatment in full, from consumables to medicines.
When my daughter and I were in the state infectious disease hospital, everything was there, including a children's antibiotic in sweet syrup.
Therefore, if you are given kilometer-long lists of drugs that you allegedly need to buy because they are not available, do not be afraid to ask why they are not available? Don't be afraid to check availability.
- This can be done with the help of the Medical Procurement site or a chatbot — look through the filters to see if a specific drug is available in a specific hospital and how much of it.
- The list of medicines purchased by the Ministry of Health can be viewed here .
- List of drugs from the National List of Essential Medicines.
It is illegal for a hospital to require a patient to purchase something from this list at their own expense, and the patient has the right to file a complaint.
If you continue to be told that the official electronic information is a lie and there are no medicines, contact the chief doctor and the National Health Service hotline.
If you entered the system correctly - with a referral, then laboratory and instrumental research under the contract with the National Health Service is free of charge for you. As well as surgical operations.
Consumables for laboratory and instrumental research, for example, X-ray film, as well as for surgical operations in outpatient conditions should be free of charge within the package.
An important point: if someone close to you has suffered a stroke or heart attack, check whether the hospital where the person was hospitalized has a contract with the National Health Service.
If not, it means that the state does not cover the treatment of a stroke or heart attack there and you may be asked to pay for examinations, medicines, tests, etc.
For example, in Kyiv there are 17 places that treat strokes at state expense, and five that treat heart attacks. No private institution that provides such treatment free of charge under a contract with the state.
Services
Delivery by package can be obtained both by referral and by self-referral.
The obstetric team on duty accepts births free of charge, it must provide conditions for partner vaginal births. In case of complications, a planned or urgent caesarean section is performed.
If you want a specific doctor, the facility can offer it as an additional paid service.
During childbirth, epidural analgesia or anesthesia, laboratory and instrumental studies, monitoring of the state of labor and fetus, mother and newborn are also free of charge; if necessary, intensive therapy, vaccination.
Lutsk Clinical Maternity Hospital
Oncolic disease
Chemotherapy is free of charge in institutions that have appropriate contracts with the NHSHU. This also includes the necessary examinations and tests, in particular MRI and CT, as well as oxygen support, analgesia.
In case of radiological treatment, radiation therapy, medical products for it and consumables, accompanying medical therapy are free of charge for the patient.
If the medical institution has a linear accelerator, a gamma knife or a cyber knife, then radiation therapy with this equipment is also included in free care.
If the patient needs surgery, it is free of charge and covered by the package "Surgeries for adults and children in hospital conditions"
There are also private institutions for such cases. Choose the appropriate filters and see.
Are teeth treated free of charge?
There are medical institutions that have a contract for a package of dental care for adults and children. According to him, emergency dental care is free of charge as part of the package for both children and adults, and planned (except for orthodontic procedures and prosthetics) — only for children under 18 years of age.
Treatment of infertility, in particular, through in vitro fertilization
To use the service at state expense, you need a referral from a medical facility that has a special multidisciplinary board. It refers adults to infertility treatment with the help of assisted reproductive technologies under the Medical Guarantee Program.
There must be a diagnosis of female or male infertility. The age of the patient at the time of the start of the cycle should not exceed 40 years.
Infertility can be treated in any facility that has a contract with the National Health Service. And here, most of the medical facilities are private.
In Kyiv, for example, all six places for such treatment are private medicine.
The medical facility guarantees treatment confidentiality.
In all cases, you should use the public service contracts dashboard. And then choose a group of services and see what exactly suits you. You can read more about these and other services, from dialysis to psychiatric care, in the guide to the Medical Guarantee Program.
