How Ukraine’s New Medical Referral System Works in 2025
What changed, why it matters, and how not to get stuck without care
Starting in 2025, Ukraine has introduced new rules for accessing medical examinations under the National Health Service (NHSU). While it may sound like just another bureaucratic reform, it directly affects your ability to get free diagnostics, consultations, and even life-saving procedures.
We explain, in simple terms, what’s changed — and how to act smart to protect your health and your rights.
The Family Doctor is Now Your Gatekeeper
Under the new system, everything begins with your primary care physician (family doctor). They are now responsible for:
- deciding whether you need advanced diagnostics;
- determining which specialist you should see;
- and initiating the referral process.
If you bypass this step — for example, by trying to schedule an MRI or surgery consultation on your own — you may be refused or charged full price.
Even if you pay taxes, that alone doesn’t grant you automatic access to all services anymore.
Your Patient Journey: Step by Step
Here’s how the new process works:
1️⃣ You make an appointment with your family doctor — at any public or private clinic with an NHSU contract.
2️⃣ If needed, your doctor refers you to a narrow specialist (e.g., neurologist, cardiologist, endocrinologist).
3️⃣ That specialist, after examining you, can issue an electronic referral for complex diagnostics — like an MRI, CT, or endoscopy.
4️⃣ Only then are you eligible to receive these services free of charge under the national health guarantee.
Without proper referrals in the system, the NHSU won’t cover the service — and hospitals have the legal right to charge you or deny care.
What Can Family Doctors Refer You For Directly?
There’s still a long list of basic services your GP can refer you for, without involving a specialist. These include:
- general blood and urine tests;
- glucose and cholesterol screenings;
- rapid tests (COVID-19, HIV, hepatitis, pregnancy);
- chest X-rays;
- electrocardiograms (ECG);
- basic ultrasounds;
- mental health screenings;
- initial consultations with a psychiatrist, therapist, or gynecologist.
These are fully covered by the government and require no additional approvals.
What Requires a Specialist’s Approval?
There are services your GP cannot refer you for directly. These include:
- MRI and CT scans;
- endoscopy or biopsy;
- hormone panels, antibody tests, cancer markers;
- spirometry and other invasive diagnostics.
These require a visit to a narrow specialist — and that specialist must initiate the e-referral. Otherwise, you’ll have to pay out of pocket.
Why Was This System Introduced?
The NHSU cites three key reasons:
- Patient flow control: To prevent misuse of costly diagnostics (e.g., requesting a CT scan instead of a basic X-ray).
- Reducing duplication: Avoiding repeat exams across different facilities.
- Budget optimization: Public healthcare funds are limited and must be used wisely.
This model reflects what’s used across much of Europe, where structured referral pathways are the norm — not the exception.
Revelant
What If You Urgently Need an Exam?
You still have options:
- Explain the urgency clearly to your family doctor;
- Pay out-of-pocket to see a specialist faster, if delays are too long;
- Visit a private diagnostic center without a referral, if you’re ready to pay;
- In life-threatening cases, go directly to emergency care — no referral needed.
How to Know If a Service Is Free or Not?
It all comes down to the eHealth system. If your referral is correctly registered in the system, your service is covered.
If not — you pay.
This reform isn’t about making things harder — it’s about bringing order to a fragmented system. But for it to work in your favor, you need to understand your role in it.
It starts with one step: talking to your family doctor. If you do it right and on time, you’ll save both money and time — and receive legal, guaranteed care.
Health is too important to rely on guesswork. Ask questions. Know your rights. Choose consciously.
About the Author
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