68-year-old Samvel Karabekyan, who months ago paid nothing for rheumatology services under universal health insurance, scheduled an appointment for June 26 on June 22. At the hospital, he learned that co-payment was now in effect, and he would need to pay 25 percent of the service cost. However, on the day of the appointment, it turned out that the co-payment amount had already increased.
“They said, ‘It’s now 50 percent, but since you registered at the time when it was still 25, pay that amount,’” Karabekyan told Azatutyun.
He is puzzled as to why this co-payment did not exist before the elections. “It was a pre-election operation that allowed them to stay in power a little longer,” he wrote on his Facebook page.
The fund responded to Karabekyan's post from its official page. They first asked him to specify the name of the medical organization so they could investigate the issue. They then informed him that there had been no change in the co-payment procedure, which is applied according to the law, and that each medical center independently determines the cost of services but cannot exceed the established price by more than double. Co-payment is also provided for visits and consultations with rheumatologists.
“I didn’t see an answer there; I got the impression that it might be a chatbot that responds to any question with certain pre-written texts,” Karabekyan noted.
This is not the only issue. His doctor prescribed a medication included in the list of free or co-payment drugs, but he was able to find another drug with the same active ingredient, but “doctors prescribe it, but that medication simply isn’t available in pharmacies.”
Many citizens responding to a Facebook survey by Azatutyun expressed satisfaction with the quality of services received under the insurance:
“I have used it and am very satisfied. They show great care. There is only a co-payment during consultations, and I paid 1000-3000 drams. 99 percent of my tests - MRI, sonography, mammography, duplex - were all provided under this framework at state expense,” wrote one woman.
Quoting another respondent: - “This is the most humanitarian reform in Armenia since independence. My family members - my mother, aunt, wife - are beneficiaries. The state is with its citizen. The joy of grandmothers and grandfathers who undergo surgical and serious interventions is indescribable.”
Some parents were also displeased that they were told that part of the free services they received previously would now require payment starting in June. “Were the rumors true that after the elections, the insurance funds would start to be insufficient?” they asked.
Health Minister Anahit Avanesyan noted last week that these rumors were the reason for the artificially increased demand in May.
“In May, citizens exhibited a panic behavior to get services as quickly as possible, fearing that after June, the insurance reform might stop. Thanks to the measures taken, we were able to cope with this demand,” Avanesyan stated.
The Universal Health Insurance Fund did not give an interview to Azatutyun today as they had guests. However, they conveyed that the co-payment was not introduced after the elections; it was anticipated in the initial concept and later enshrined in law.
“Have the funds allocated for insurance been exhausted? If not, why did the government allocate 7.1 billion drams to the fund in one of its decisions last month?” - this question is being discussed both in the press and online.
The health minister also addressed this question last week: - “It’s not that our expenses exceeded the established limits and additional funds were needed, but the number of insured persons defined by law has increased due to the subsidized group, and the state has fulfilled its obligations.”
In January, the number of beneficiaries was 1.5 million, and a week ago the minister announced a new figure of 1.7 million. According to Avanesyan, the increase is due to the rise in the number of residents earning 200,000 drams or more and individual entrepreneurs.
As of June, out of 1.7 million insured citizens, 842,750 have already utilized medical services provided under the health insurance framework. In total, they have received more than 8.3 million services, meaning each beneficiary has utilized several services.
Despite these figures, complaints remain about why hospitals have started to apply co-payments more frequently, not only in rheumatology but also in several other services.
