Georgia’s Universal Healthcare (UHC) programme, introduced in April 2013, extended state-funded healthcare coverage to the entire Georgian population — transforming a targeted, means-tested social insurance system into a universal entitlement. It is administered by the Social Service Agency (SSA) of the Ministry of Health and is one of the largest single public policy reforms in modern Georgian history.
UHC benefit package
| Service category | Coverage | Co-payment / notes |
|---|---|---|
| Primary care / family doctor | Consultations, basic diagnostics, preventive services, referrals | Free at point of care for all residents |
| Emergency care | Emergency ambulance, A&E, emergency surgery and hospitalisation | Free (up to defined thresholds); life-threatening emergencies fully covered |
| Planned surgery | Wide range of elective surgical procedures | 50% state / 50% patient co-payment for many planned procedures; some fully covered |
| Chronic disease management | Diabetes, hypertension, heart failure, asthma, COPD, epilepsy — outpatient management including medicines | Partially subsidised; co-payments apply for medicines beyond defined formulary items |
| Cancer diagnosis and treatment | Oncology diagnosis, chemotherapy, radiotherapy (defined tumour types) | Significant state subsidy; specific cancer programmes (cervical, breast, colorectal screening) |
| Maternal and child health | Antenatal care (full ANC package), delivery, postnatal care, childhood immunisation, child preventive exams to age 5 | Fully covered under UHC; all deliveries in licensed maternity facilities |
| Immunisation | All vaccines on the national immunisation schedule | Free — no co-payment; see National Immunisation Schedule |
| Mental health inpatient | Acute psychiatric hospitalisation in licensed psychiatric facilities | Defined day-limits; long-term care requires separate funding streams |
| TB, HIV/AIDS, HCV treatment | Full treatment course for all three disease programmes | Fully covered — no co-payment; delivered through disease-specific programmes |
| Dialysis | Chronic haemodialysis for end-stage renal disease | Fully covered; patients registered in national renal registry |
Provider participation and contracting
Healthcare facilities participate in the UHC programme by contracting with the SSA. Contracts specify the services to be provided, quality requirements (including licensing by RAMA and, for higher-level services, accreditation requirements), reporting obligations and tariff rates. Tariffs are set by the SSA in negotiation with provider associations and Ministry of Health. Facilities must maintain electronic medical records compatible with the national e-Health system to participate. Payment is primarily fee-for-service, with capitation payments for registered family doctor practices.
Impact and reform trajectory
Before the reforms, out-of-pocket payments dominated health financing — as much as 80% of current health expenditure in 2005, falling to 47% by 2019–2020 (source: P4H, Georgia country profile). UHC dramatically reduced unmet need for emergency and primary care. However, coverage remains incomplete for outpatient medicines, dental care and long-term care. Subsequent policy work has focused on rationalising the benefit package, improving quality of care, strengthening primary care gate-keeping and reducing catastrophic health expenditure for chronic disease patients. The UHC programme is subject to annual revision through the government budget law and Ministry of Health normative acts.
In plain language
The Universal Healthcare Programme, launched in 2013, gives most residents of Georgia state-funded coverage for a defined package of primary, emergency, outpatient and inpatient care. It greatly widened entitlement, but out-of-pocket payments — especially for medicines — remain high.
What it means in practice
| Who | What changes |
|---|---|
| Patients | Entitlement depends on the programme rules and benefit package; co-payments and exclusions apply. |
| Clinicians and providers | Providers contract with the state purchaser to deliver covered services under set tariffs and rules. |
| Facility managers | Participation brings contractual, reporting and — for state-funded hospitals — accreditation obligations. |
International frame of reference
Questions and answers
How much do people still pay out of pocket?
Out-of-pocket payments were 48% of health spending in 2018, and 1 in 6 households faced catastrophic health spending (source: WHO/Europe, 2021).
What drives catastrophic spending?
Mainly out-of-pocket payments for outpatient medicines, according to the same WHO/Europe study.
Related pages
Government Decree No.36 on Universal Healthcare — Matsne Legal Herald
Open Georgian source →Additional reference →Full text in Georgian on Matsne. SSA (Social Service Agency) website contains current programme documentation.
Published by the Public Health Institute of Georgia (PHIG) · Regulations Hub · Contact PHIG