💊 Healthcare Coverage (%) in Georgia

Healthcare Coverage in Georgia

Approximately 80% of Georgia's population is covered by the Universal Healthcare Program (UHCP) — a considerable achievement compared to the situation before 2013, when large segments of the population had no insurance coverage. The UHCP covers basic outpatient care, emergency medicine, and a portion of inpatient treatments. The remaining 20% — predominantly employed individuals with private insurance or informally employed workers who fall through the cracks — represent the gaps of a system that was built quickly but still has substantial room for improvement in quality and depth.

The Universal Healthcare Program: Structure and Benefits

The UHCP was introduced in 2013 under the government of Bidzina Ivanishvili and is administered by the Social Service Agency (SSA). It targets all Georgian citizens who do not have private health insurance. The benefits package includes: outpatient doctor visits (general practitioner, specialists with referral), emergency room and inpatient emergency treatment, basic oncology care (chemotherapy, radiation), prenatal care and delivery, planned surgical procedures (with waiting times of 3–12 months), and basic psychiatric care.

The reality behind the 80% coverage figure is more nuanced: many benefits are capped. For inpatient treatment, the UHCP pays a maximum of 15,000 GEL per case (approximately 5,250 USD) — insufficient for complex surgeries or intensive care. Medications are only partially covered: the state medication program subsidizes approximately 200 essential active ingredients; patients with chronic conditions must pay fully out of pocket for many medications.

Out-of-Pocket: The Hidden Burden

The most severe problem in the Georgian healthcare system is the high level of patient co-payments. According to WHO data, out-of-pocket payments amount to approximately 47% of total health expenditure — one of the highest rates in Europe. For comparison: in the United States, out-of-pocket spending is approximately 11%; in the United Kingdom about 15%; in Canada around 14%; and in Australia roughly 17%. These co-payments arise from: inpatient treatment co-pays (30% self-contribution for planned procedures), medication costs (50–300 GEL monthly for chronic conditions), dental treatment (not included in the UHCP), diagnostic procedures (MRI: 200–400 GEL, CT: 150–300 GEL), and elective services (private room: 100–200 GEL/day).

For low-income families, this means: despite formal 80% coverage, medical care is often unaffordable. Geostat reports that 15% of the population forgone needed medical treatment in the past year due to costs. In rural regions, this share reaches 22%.

Regional Care: Concentration in Tbilisi

Medical infrastructure is heavily concentrated in the capital. Tbilisi houses approximately 60% of all specialists, all university hospitals (Tbilisi State Medical University Hospital, Todua Clinic, National Center of Surgery), and the only specialized centers for cardiology, oncology, and neurosurgery. The major private hospital groups — Evex Medical Corporation (New Hospitals), GPC (Georgian Polyclinic Center), and MediClub Georgia — operate regional clinics, but with a more limited scope of services.

In the regions of Mtskheta-Mtianeti, Racha-Lechkhumi, and Upper Svaneti, hospitals exist only in regional centers (Mtskheta, Ambrolauri, Mestia). Travel time to the nearest specialized clinic can be 3–5 hours. The emergency medical service (Gadaudzvelebis Samsakhuri) operates 120 ambulance stations nationwide, but response times in remote areas often reach 45–60 minutes instead of the targeted 15 minutes.

Private Health Insurance

The private insurance market is growing dynamically: GPI Holding, Aldagi, and ARDI are the largest providers. Premiums for an individual run 100–300 GEL/month (35–105 USD) for a comprehensive package covering doctor visits, hospitalization, medications, and dental care. Family policies cost 250–700 GEL/month. For comparison: in the US, average employer-sponsored health insurance premiums are approximately 700 USD/month for family coverage (employee share); in the UK, private medical insurance averages 1,500–2,000 GBP/year; in Canada, supplementary health insurance runs 100–300 CAD/month; and in Australia, private hospital cover averages 150–300 AUD/month.

For expats and newcomers, private supplementary insurance or international policies are recommended. Georgian UHCP-level coverage suffices for routine care but not for complex or planned procedures. Some employers in Tbilisi — particularly international companies and NGOs — offer corporate health insurance as a salary component.

Reform Outlook

The WHO and the EU Commission jointly recommended UHCP reform in 2024: reducing out-of-pocket shares below 30%, expanding medication coverage, and strengthening primary care in rural areas. The Georgian government announced in its 2025–2030 Health Strategy Plan an increase of public health spending from 2% to 3% of GDP. This would improve care but would remain far from the levels maintained by the US (approximately 17% of GDP), the UK (10%), Canada (11%), or Australia (10%).

The 80% coverage rate is a significant achievement since 2013, but the quality and depth of coverage remain below Western standards. High co-payments, regional care gaps, and the absence of specialized medicine in rural areas limit practical utility. Newcomers should plan for supplementary private insurance.

This article was created on April 19, 2026