Armenia’s parliament has adopted a repeatedly revised legislative package “On Universal Health Insurance,” approving a landmark reform that will introduce a nationwide mandatory health insurance system beginning January 1, 2026. Passed in its second and final reading with 64 votes in favor, two against, and five abstentions, the law establishes a three-year phased rollout through 2028, with insurance payments set to begin on January 20, 2026. The reform aims to ensure broad access to essential healthcare services, with the overwhelming majority of citizens expected to be covered by 2029.
The universal health insurance system will be introduced gradually over a three-year period from 2026 to 2028. In the first phase, coverage will extend to underage Armenians, pensioners aged 65 and older, persons with disabilities in groups I, II, and III, individuals with functional limitations, socially vulnerable citizens registered in the social support system, recipients of poverty benefits, families of fallen servicemen, and employed citizens earning at least 200,001 drams ($525) per month. Officials estimate that approximately 1.7 million residents, roughly half of Armenia’s population, will be covered during this initial stage.
In 2026, the state will fully cover insurance premiums for children under 18, seniors aged 65 and older, persons with disabilities or functional limitations, socially vulnerable individuals, families of fallen servicemen, and beneficiaries of the social support system. A special insurance fund, which is due to be established for this purpose, will collect no payments from these groups.
Financing, Subsidies, and Citizen Contributions
The state will also pay most of the insurance premiums for other citizens whose monthly wages range from 200,001 to 1 million drams. Much of that subsidy will be financed through another state fund that compensates the families of Armenian military personnel killed, wounded, or missing in action, including through the redirection of existing Zinapah contributions.
For citizens earning between 200,001 and 500,000 drams per month, the state will subsidize most of the insurance premium. From the 5,500 drams currently contributed to the Zinapah foundation, 4,500 drams will be redirected to health insurance, while the remainder will be covered through social credit refunds via the personal income tax return system. As a result, the final out-of-pocket cost will be just 300 drams (80 U.S. cents) per month.
For those earning between 500,001 and 1 million drams per month, 7,500 drams from the existing 8,500-dram Zinapah contribution will be redirected to health insurance. These citizens will pay 3,300 drams monthly, which will be refundable through the personal income tax return system. Initial monthly contributions for higher earners are estimated at around 4,000 drams before reimbursements.
Social package beneficiaries earning over 200,001 drams per month will also be included in the first phase and will receive the same reimbursement format. They may additionally use their monthly social package amount of 6,000 drams to cover any remaining insurance costs. Beneficiaries with salaries below 200,000 drams will continue receiving healthcare under the existing state program.
The annual insurance package cost is set at 129,600 drams, paid monthly, equivalent to approximately $27 per person per month. Citizens will be able to offset insurance contributions through social credits when filing their tax returns.
Scope of Coverage and Medical Services
In the second stage of the reform, beginning in 2027, individuals earning salaries of up to 200,000 drams will be included in the system. In the third stage, starting in 2028, coverage will be extended to additional groups, including those employed in agriculture and their families. By the end of the three-year rollout, all citizens and residents of Armenia are expected to have health insurance, though not all medical services will be included.
According to the Ministry of Health, the insurance will finance primary healthcare, emergency medical services, and inpatient treatment. Non-emergency medical services will begin at the primary healthcare level. The insurance package will cover the most in-demand services, including outpatient care, clinic visits, family doctor visits, specialist consultations, and a limited number of laboratory tests per year. The list of covered services will be expanded and refined over time and will include certain surgical procedures, particularly ophthalmological procedures such as cataract surgeries, as well as cardiovascular and other treatments.
The specific list of services, covered diseases, diagnostics, screenings, and medications will be approved by government decision and made publicly available through the Armed mobile application, as well as the websites of the Ministry of Health and the Insurance Foundation.
Minister of Health Anahit Avanesyan stated that November will be considered the first month for calculating insurance premiums, while December is excluded due to additional salary and bonus calculations. She emphasized that while the insurance system is universal and will include all citizens of Armenia, it will not cover the full range of medical needs of every individual, noting that it is aimed at mitigating conditions and illnesses that are the primary drivers of morbidity and mortality while ensuring the best possible treatment outcomes.
Opposition Response and Criticism
Opposition lawmakers rejected the government’s assurances, arguing that the new system lacks sufficient clarity and readiness ahead of its launch. Opposition deputies dismissed statements by government officials, describing the reform as a political maneuver aimed at boosting support for the ruling Civil Contract party ahead of next year’s general elections.
“There is uncertainty for citizens of Armenia because they do not know what type of services they will be able to receive [for free] from January 1,” said Anna Grigoryan, a deputy from the opposition Hayastan alliance. “There is also uncertainty for medical institutions, polyclinics and hospitals.”
Grigoryan and other opposition lawmakers challenged Minister Avanesyan to publish a detailed list of surgeries and medical services that will be covered under the insurance system. In response, the minister stated that the list is extensive and would require hours to read in full.
“Our insurance package doesn’t cover everything,” Avanesyan acknowledged in an interview with RFE/RL’s Armenian Service. She said that the list of free services will be specified on a government website.
Opposition critics also argued that with less than a month remaining before the system’s launch, the government has yet to establish the insurance fund and approve regulations governing its activities. Avanesyan responded that the government will promptly complete those steps following the passage of the bill.
Healthcare Spending and System Capacity
Public spending on healthcare in Armenia has historically been among the lowest in the region, at 1.4% of GDP, limiting access to quality medical services. In response, the Ministry of Health has been allocated 210.911 billion drams in 2026, an increase of 44.313 billion drams compared to 2025. Of that amount, 127 billion drams are allocated specifically for the implementation of the health insurance program. Minister Avanesyan described the allocation as a historic budget for the sector and said the initiative is in its final stages before submission to the government.
Capital expenditures for 2026 are set at 12.3 billion drams, supporting the construction and reconstruction of regional medical centers and outpatient clinics. More than 20 outpatient clinics are currently undergoing transformation, with plans to expand the number to 50 in the coming years. The Ministry of Health is also coordinating with Yerevan Municipality to upgrade polyclinics under its jurisdiction.
Additional Reforms and Government Messaging
The Ministry of Health is implementing additional reforms, including a review of pricing policies for pediatric care, surgical procedures, emergency medical services, and the full chain of resuscitation. Licensing reforms are also underway for residents and interns, who will receive individual limited-scope licenses to gain supervised practical experience and knowledge of ethical norms, with licensing for specialists set to begin next year. Additional changes include revisions to reimbursement mechanisms for primary care drugs, psychotropic medications, and rehabilitation services.
Minister Avanesyan noted that over three years, the state order for healthcare services will gradually transition to the insurance program, with some cases continuing to be reimbursed under minimum services. She emphasized that the volume, quality, and beneficiary coverage of services will be expanded and transformed before full adoption of the insurance system.
During a working discussion in November, Prime Minister Nikol Pashinyan highlighted the phased nature of the reform: “It’s not like we’re going to wake up the next day and see that our healthcare system, mentality, relationships, everything has changed. All of that has to change over time and through our work.”
He emphasized the importance of public communication to ensure citizens understand the system’s structure, priorities, and implementation process.
