If a foreigner gets sick in Ukraine he or she may run into problems with medical care and paying for it.
Foreign patients that know nothing about the standard medical services market in Ukraine and the pricing policy of medical institutions will face difficulties
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| PHÎÒÎ: SHUTTERSTOCK |
Such patients are wheedled out of their money first and only after that our doctors examine and treat them. Medical insurance policies, which could cover expenses, are asked about only in private clinics
A sales manager named Maksud knew from his personal experience that it is much better to pay a doctor immediately without even waiting for any hints. Then the attitude towards patients will not resemble a mere formality. “A friend of mine had a heart attack while he was visiting me in Kyiv and we had to call an ambulance. The doctor who examined him was in no hurry to take any action. We had to pay him UAH 100 to do at least something as my friend was in severe pain. After we paid the doctor he immediately found the necessary medicine and gave him an injection,” complained Maksud. Nobody was interested in an insurance policy and the patient himself forgot about it in a bustle.
Andriy Nikolayev, First Vice President of European Tourist Insurance, said all foreigners on the territory of Ukraine should have medical insurance policies, as this document is the first thing you need to receive medical assistance.
“The standard policy for foreigners is needed to cover expenses in cases of emergency,” says Viktoria Raspopova, a director of the insurance division for citizens going abroad at the TAS Insurance Group. For example, if a foreigner has an acute exacerbation of a disease our physicians are obligated based on a medical insurance policy to render first medical aid to stabilize a patient’s state of health. Following that they should transport the patient to a medical institution or to a doctor’s surgery. Standard policies do not apply to the treatment of chronic diseases.
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| PHÎÒÎ: AP |
Unfortunately, there are no regulated institutions for a foreigner to get insurance. Such a situation creates what seems to be the main problem: if a foreign insurance company has no accredited assistance centers on the territory of Ukraine its insurance policies are basically useless. Non-residents have to pay for all services out of their own pockets when they turn in for medical care. Some foreign companies reimburse expenses for medical care only after the patient presents receipts and certificates.
No wonder foreigners that have lived in Ukraine for many years understand that it is senseless to go to a doctor or hospital with an empty wallet even if they have a medical insurance policy.
They complain of…
Accidental traumas are the first reason why foreigners turn to Ukrainian hospitals for medical assistance. Among them are injuries, displacements, fractures, etc. Raspopova said foreigners most often ail from acute respiratory diseases, like flu or common colds often caused by climate changes and which are typical for the winter period. They often complain of food poisoning, because changes in common diet often cause unpredictable reactions. Elder foreigners over 40 – 50 often have complications of the heart and blood vessel diseases, such as hypertension, for example.
Raspopova said the minimum cost of first aid per individual for foreigners are around UAH 500 on average. At the moment, this fee is almost half that of an emergency call in a private clinic, which costs UAH 800 – 900.
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| PHÎÒÎ: AP |
In cases where expenses for the treatment of a disease or a trauma exceed the insurance policy limit, foreigners will have to pay the difference out of their own pockets. “Foreigners will pay twice or three times more for services that Ukrainians pay 50 hryvnia for,” complained Witek Dartek from Poland.
In 2009 over 20.3 mn foreigners visited Ukraine, according to the Ministry of Culture and Tourism. 71% of them were from CIS countries, 27% – from the EU and 2% from other countries. Nikolayev said Turks, Europeans and Russians use Ukrainian medical insurance policies most often.
Choice of hospital
Patients have no choice after they buy a medical insurance policy as the insurance companies determine the medical institutions they can turn to for assistance. When foreigners pay for medicare out of their own pocket, they prefer to ask for the assistance of proven physicians recommended by friends or acquaintances.
Employees in private hospitals in Kyiv such as Boris, Eurolab and Medicom say they do not refuse to render medical assistance to foreigners and do not deliberately charge higher prices for this group of patients. What is most important for such clinics is that foreign patients have insurance policies for the proper sums. In case they do not have such a policy, they simply have to make a pre-payment for medical treatment. Taking into account that the prices of these private companies are comparable to those in EU countries, for example a primary doctor’s advice will cost EUR 45 – 150, employees of foreign consulates and embassies are the main contingent in such commercial hospitals. Many foreigners simply cannot afford services in Kyiv private clinics.
“Not all state hospitals can render paid medical services officially, because medical treatment is free for Ukrainian citizens according to our legislation. For this reason, many hospitals have no precise tariff and price lists and they collect payment for treatment as “charity donations”, which is very inconvenient for insurance companies and often perplexes foreign citizens,” explained Nikolayev. Such a practice is widely used in the most popular tourist destinations – Kyiv, the Carpathians and Crimea.
A year ago Kyiv authorities decided to tackle the problem with foreigners, emphasizing the need to create a municipal operator that would render foreign citizens high-quality services and the full set of medical services. There were plans to establish the Kyiv Municipal Medical Agency that would specialize in medical treatment for non-residents at prices twice higher than in ordinary city hospitals and polyclinics on the base of the Assessment and Certification Engineering Center. Such a center would free medioprophylactic institutions in Kyiv from having to render additional services for foreigners. Unfortunately, nothing was done to bring these plans to fruition.
Insurance treatment
Raspopova said the choices of medical aid for foreigners on the terms of insurance policies depend on the purposes of their visits to Ukraine. The first category consists of foreign tourists that visit Ukraine for up to a month. A short-term tourist insurance policy for 14 days with a minimum insurance premium of UAH 2,000 costs UAH 10-15 in our insurance companies. The latter do not mention the number of foreign tourists that sign up and pay for such policies.
Foreigners that come to Ukraine for work constitute the second group. Many Russian, Belarusian, Moldovan and Turkish citizens live and work in Ukraine. The range of their professions varies from top managers and experts to ordinary workers. Their employment is officially registered by the State Department of the Ministry of Internal Affairs of Ukraine on Issues of Citizenship, Immigration and Registration of Foreign Citizens.
A medical insurance policy with a Ukrainian insurance company (bought from insurance companies accredited by the ministry) is one of the compulsory conditions for being issued a visa on an employment basis.
The third category consists of foreign students studying in Ukrainian universities. Currently, there are more than 40,000 students from the Middle East, Asia and Africa studying in Ukraine. A medical insurance policy is a mandatory requirement to receive permission to get an education for them. Foreigners are not admitted to our universities without medical insurance. “The insurance premium for first aid in a 12-month policy, which is the optimum variant for students and working foreigners, is UAH 5,000. Such a policy costs on average UAH 400 – 500,” said Raspopova.
Moreover, most foreigners traveling to work in Ukraine have an insurance policy from their native countries or take out a policy with a Ukrainian insurance company. Raspopova says foreigners insure themselves only when they are obligated to do so by their employers, universities, etc. Many of them have no insurance at all. In the meantime, foreigners say many physicians are absolutely not interested in their policies. Moreover, the duration of medical insurance policy for foreign entrepreneurs expires even before their visa expiry dates.
International barrier
Foreigners often have difficulties in communication with Ukrainian doctors. The absence of registration is one of the most common problems. Many foreigners staying in Kyiv are in fact registered in other cities. Moreover, there is a category of expat entrepreneurs with business visas (i.e. Russians, Belarusians, Georgians, etc.) that are not required to register in Ukraine for a 3-month term. Physicians deal with such patients very reluctantly.
Misunderstandings occur when people have no idea of what medical institution they should turn to in cases when medical assistance is based on an insurance policy. “If a foreigner goes to any hospital or private clinic, insurance companies can easily refuse to reimburse expenses, arguing that the hospital or clinic was not on the list of accredited healthcare institutions,” said Raspopova. One must know the procedure like the back of one’s hand: if you get sick, immediately call the number of the company specified in the contract.
The language barrier also poses a problem. There are only a handful of doctors at state-run polyclinics that can speak English. It is often even difficult for foreigners that speak Russian or Ukrainian fluently to describe their symptoms to a doctor, let alone those that are newcomers to Ukraine and have not mastered the local lingo yet. One of the alternative solutions in such cases is using the vocabulary of all foreign languages you know or having a friend help translate. At the same time, doctors can send such patients to some other hospitals in a snap.
Healthcare institutions also have their nuances. For example, non-resident women can only give birth to a child in the No. 6 state maternity hospital in the Borshchahivka District. The rest of the maternity hospitals in Kyiv do not render birthing services to foreigners. Private maternity hospitals are an exception to this rule. Accordingly, the service fees are much higher than in state hospitals.
Foreign patients also have certain peculiarities. For example, a woman from a Muslim country will definitely reject an examination of a male physician. Definitely, Muslims would not trust Ukrainian physicians with such a simple operation as circumcision. They prefer to invite experts from Muslim countries. Foreign surgeons come to Ukraine once a year especially to perform such an specific operation.
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