What Is a Co-payment? | Universal Health Insurance in Armenia

Information for Visitors of Vardanants Medical Center

As of January 1, 2026, the Universal Health Insurance (UHI) system has entered into force in the Republic of Armenia pursuant to the Law of the Republic of Armenia on Universal Health Insurance, adopted by the National Assembly of the Republic of Armenia on December 17, 2025.

Under this Law and the Government of the Republic of Armenia decisions adopted for its implementation, insured persons are required to pay part of the cost of certain medical services and medicines included in the insurance package through a co-payment.

Below are official excerpts from the applicable legislation explaining what a co-payment is, the legal basis for its application, and how its amount is determined.

This English translation is provided for informational purposes only. In the event of any discrepancy, only the official Armenian text published on www.arlis.am shall have legal effect.

1. What Is a Co-payment?

"Co-payment means the amount that, in the cases provided for by this Law, must be paid by the insured person to a healthcare provider or a pharmacy. It is equal to the negative difference between the maximum reimbursement amount established for medical care and healthcare services or medicines provided within the insurance package and their actual price."

Law of the Republic of Armenia "On Universal Health Insurance"
(adopted on December 17, 2025),
Article 2, Clause 13

2. What Is the Legal Basis for Charging a Co-payment?

2.1. A co-payment applies only to those medical services and medicines that have been expressly included by the Government of the Republic of Armenia in the approved list of services and medicines subject to co-payment. A medical institution cannot independently determine whether a co-payment should be charged for a particular service.

"Medical care and healthcare services eligible for insurance reimbursement shall be provided to insured persons in accordance with the standards, protocols, and guidelines approved by the Authorized Body. The procedure for establishing the insurance package, introducing amendments and additions thereto, as well as the lists of reimbursable medical care and healthcare services (including those subject to co-payment) and medicines (by their International Nonproprietary Name), shall be approved by the Government."

Law of the Republic of Armenia "On Universal Health Insurance"
Article 7, Part 2

2.2. The purpose of applying a co-payment is expressly established by law.

"Partial reimbursement through the application of a co-payment shall be established for certain medical care and healthcare services included in the insurance package, as well as for the provision of certain medicines, diagnostic examinations, meals, and accommodation during the delivery of such services. The purpose of the co-payment is:

1. to cover the difference between the amount of the insurance reimbursement and the calculated cost of the respective medical care and healthcare service;

2. to prevent the unnecessary utilization of certain medical care and healthcare services."

Article 8, Part 2

2.3. For medicines, a co-payment applies when the price of the medicine exceeds the established maximum reimbursement amount.

"The portion exceeding the established maximum reimbursement amount, but not exceeding fifty percent (50%) of that maximum reimbursement amount, shall be paid by the insured person as a co-payment from their own or other available funds. A medicine whose reimbursement price exceeds twice the established maximum reimbursement amount shall not be included in the list of reimbursable medicines for reimbursement calculation purposes."

Article 10, Part 4

3. How Is the Amount of the Co-payment Determined?

"The procedure for insurance reimbursement of the costs of medical care and healthcare services shall be approved by the Government."

Article 8, Part 3

"The amounts of insurance reimbursement and co-payments for the costs of medical care and healthcare services shall be determined by the Board of Trustees of the Universal Health Insurance Fund (hereinafter referred to as the 'Board of Trustees') in accordance with the price of the respective service or the cost norm calculated based on the methodology approved by the Government."

Article 8, Part 4

"The co-payment amounts for medical care and healthcare services established pursuant to Part 4 of this Article shall not exceed twice the price of the respective medical care and healthcare service."

Article 8, Part 5 (Maximum Co-payment Limit)

"The amount of the co-payment and the costs subject to insurance reimbursement shall be published by the Fund on its official website at least one month before they become effective."

Article 8, Part 6 (Mandatory Publication of Applicable Amounts)

The reimbursement amounts and co-payments for medicines are determined in accordance with the same principles.

"The reimbursement prices of medicines and the maximum reimbursement amounts shall be determined by the Board of Trustees based on the methodology approved by the Government. Reimbursement for a medicine eligible for insurance reimbursement shall be provided in the amount of the reimbursement price calculated for that medicine, but not exceeding the maximum reimbursement amount established for the respective medicine in accordance with the Law of the Republic of Armenia 'On Medicines'."

Article 10, Parts 2–3

4. Official Texts of the Legal Acts

• Law of the Republic of Armenia "On Universal Health Insurance" (adopted on December 17, 2025)
  https://www.arlis.am/hy/acts/218650
• Government Decision of the Republic of Armenia on the Formation of the Insurance Package and the Lists of Medical Services and Medicines, Including Those Subject to Co-payment
  https://www.arlis.am/hy/acts/219067
• Government Decision of the Republic of Armenia on the Procedure for Insurance Reimbursement of Medical Care and Healthcare Service Costs
  https://www.arlis.am/hy/acts/219009
• Government Decision of the Republic of Armenia Approving the Methodology for Calculating Reimbursement Amounts and Co-payments
  https://www.arlis.am/hy/acts/219006
• Government Decision of the Republic of Armenia on the Procedure for Insurance Reimbursement of Medicine Costs
  https://www.arlis.am/hy/acts/219136

5. Where Can You Find the Exact Co-payment Amount for a Specific Service?

The specific co-payment amounts (determined separately for each medical service and medicine) are established by the Board of Trustees of the Universal Health Insurance Fund and published on the Fund's official website, together with the date from which they become effective.

• Universal Health Insurance Fund Service and Medicine Catalog
  (Search by the name of the medical service)
  https://www.uhif.am/am/services

You can also check the co-payment amount for a specific service through:

• the ARMED mobile application;
• the Universal Health Insurance Fund Contact Center by calling 8866;
• or by email at [email protected].

If you are asked to pay a co-payment exceeding the amount officially published by the Universal Health Insurance Fund, or if you are requested to pay for a medical service that is fully covered under the insurance package without a co-payment, please contact the Administration of Vardanants Medical Center or the Universal Health Insurance Fund of the Republic of Armenia.

Disclaimer

This material is provided for informational purposes only and does not replace the official text of the applicable legislation.

The official and legally binding version of the legislation is available at: www.arlis.am