What is mandatory health insurance?

Mandatory health insurance is a form of social protection of population. It is as a system of juridical, economic and institutional measures established by the government mainly focused on provision of primary health care, first aid and emergency medical assistance to population (insured) at the expense of resources of mandatory health insurance in case of insurance claim and in provision of the medical services to insured within the specified conditions of benefit package. The goal of the system is to ensure access to medical services and reduce the financial burden of healthcare costs for the population.

Who's entitled to mandatory health insurance?

Citizens of the Republic of Azerbaijan with an identity document.

The foreigners, and stateless persons who have obtained refugee status in the Republic of Azerbaijan and are under the protection of the United Nations High Commissioner for Refugees in Azerbaijan. To benefit from mandatory health insurance, they are required to present the relevant document.

The foreigners and stateless persons who are temporarily or permanently residing in the Republic of Azerbaijan and paying mandatory health insurance premiums. They are required to present the relevant permit for temporary or permanent residence issued by State Migration Service.

Where to receive medical service through mandatory health Insurance?

Insured persons seeking healthcare services may visit any state healthcare facility affiliated with TABIB, as well as medical institutions under the Ministry of Health of the Republic of Azerbaijan. All patients must present a valid identity card when accessing services at these facilities.

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How to receive medical service through mandatory health insurance?

To receive elective outpatient medical care, it is necessary to visit a family doctor or a qualified physician.

Visiting a family doctor

Family doctor services are provided only at primary healthcare facilities (Polyclinic, Family Health Center, doctor’s office, medical station and women's counseling center) within the area where you are registered.

After examining the patient, the family doctor refers the patient to an appropriately qualified doctor if necessary.

You can choose and change your family doctor without any restrictions.

Visiting a qualified doctor

Citizens may visit specialized doctors directly, regardless of their registration address.

A qualified physician may refer a patient to inpatient (therapeutic or surgical services) treatment if necessary.

Patients may choose doctors and medical institutions.

Laboratory and instrumental examinations, radiological services, and other procedures performed upon the doctor`s order are covered free of charge under mandatory health insurance. Copayments apply to outpatient Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans. For these examinations, the patient is required to pay 20% of the tariff specified in the Benefits Package.

Emergency and urgent medical services

Citizens may receive medical care at home or be transported to a medical facility via the ambulance service (103). In emergency cases, a citizen will receive immediate medical care at healthcare facility. Ambulance services, emergency and urgent medical care in both outpatient and inpatient settings, as well as medicines and medical disposables used during emergencies, are free of charge under the Benefits Package of mandatory health insurance.

In case of emergency and urgent medical care, a citizen may directly visit one of the nearby private or affiliated healthcare facilities. In this case, the medical facility submits an application to the State Agency on Mandatory Health Insurance, and the Agency reimburses the hospital for the medical services provided, in accordance with the tariffs outlined in the Benefits Package of mandatory health insurance.

Use of mandatory health Insurance at private healthcare facilities

If a necessary medical service included in the Benefits Package cannot be provided at medical facilities overseen by the Administration of Regional Medical Divisions (TABIB) or the nine scientific research institutes under the Ministry of Health, a referral will be issued to private or affiliated state healthcare facilities contracted by the State Agency on Mandatory Health Insurance. The referral form and the medical services provided with the referral are free of charge.

The referral form is valid for 10 days

You may visit Educational-Therapeutic and Educational-Surgical Clinics of the Azerbaijan Medical University, as well as the Baku Health Center, without a referral, to access inpatient therapeutic and surgical services included in the Benefits Package, at the expense of mandatory health insurance. To receive the services under mandatory health insurance, examination results confirming the need for inpatient treatment are required.

Private healthcare facilities

Citizen may choose both private and affiliated state healthcare facilities. Choice can also be made through the “e-Tabib” mobile application.

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If you visit a private or affiliated healthcare facility without a referral, except in emergency or urgent cases, medical services will be provided at your own expense.

What healthcare services are covered under mandatory health insurance?

The Benefits Package is a set of medical services provided to insured persons and funded by mandatory health insurance. These services are offered according to specified types, volumes, and conditions. The Benefits Package covers 3,315 medical services.

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The Benefits Package does not cover medical services for the examination and treatment of conditions included in state programs and laws, nor does it cover cosmetic procedures, plastic surgeries, dental services, in vitro fertilization, or other similar services.

Didn’t find an answer to your question?

If you have any questions, please contact our Call Center by phone at 1542 or via our online chat service. Both services operate 24/7, and all calls to Call Center are free of charge. You may also submit an electronic application to the Agency.

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