Expat insurance and health insurance in Ukraine

Since the reform launched in 2017-2018 (the "law on public financial guarantees for medical care"), Ukraine has had a State Medical Guarantees Programme (PGM) managed by the National Health Service of Ukraine (NSZU), which acts as the sole buyer of health services from contracted facilities, both public and private. Unlike a contribution-based system, rights do not depend on individual payments: the care package is tax-funded and open to Ukrainian citizens and residents who have signed a declaration with a family doctor; a foreign national passing through has no access to it and remains covered, where applicable, only by insurance taken out before departure.

Since February 2022, the Ukrainian health system has been operating in a wartime context: according to the World Health Organization, verified attacks on health facilities and staff rose by around 20% in 2025 compared with 2024, and over 2,500 medical facilities have been damaged or destroyed since the start of the conflict, some of which have since been restored. Access to medicines and rehabilitation care remains documented as particularly difficult in regions near the front line. In parallel, a private sector remains active in Kyiv and Lviv, with facilities working with international insurers and appearing on the list of doctors kept up to date by the French embassy.

• Travel formally advised against by France Diplomatie, whatever the purpose, across the entire Ukrainian territory, due to the armed conflict ongoing since February 2022: a state of emergency declared on 23 February 2022 and renewed quarterly, a nightly curfew (midnight-5am in Kyiv) and frequent air raid alerts.
• Visa: French nationals are exempt from a visa for a stay not exceeding 90 days in a 180-day period; beyond that, a visa must be obtained before departure, with no possibility of issuance on the ground. Passport valid at least 3 months after the planned return date, with at least two blank pages.
• Health and repatriation insurance strongly recommended before any departure: France Diplomatie recommends having an assistance contract covering medical costs (including surgery and hospitalisation) and medical repatriation, as these costs can never be covered by the French embassy on the ground.
• Access to the State Medical Guarantees Programme: reserved for Ukrainian citizens and residents who have signed a declaration with a family doctor; a visitor or foreign resident without equivalent status has no automatic access.
• No France-Ukraine coordination: absent a bilateral social security agreement, no European Health Insurance Card nor any form allows a French insured person to claim their rights on the ground.
• Seconded employee : absent an agreement, remaining affiliated to the French scheme relies solely on French law (unilateral secondment), for a period of 3 years renewable once.
• Dual French-Ukrainian nationals: France Diplomatie notes particular risks regarding leaving the country for people who also hold Ukrainian nationality, notably linked to the mobilisation rules in force in Ukraine.

Ukrainian civil airspace has been closed since February 2022: commercial flights to and from Ukraine remain suspended, which means that a medical evacuation, even one organised by private insurance, is carried out overland to a neighbouring country (notably Poland), with variable waiting times at border crossings.

France and Ukraine are not linked by any bilateral social security agreement (CLEISS): there is no applicable European Health Insurance Card, no A1 or S1 form enforceable with the Ukrainian authorities, and no direct reimbursement mechanism between the two systems.

• Temporary stay: no European or bilateral coordination applies; only health/travel insurance taken out before departure covers costs on the ground, provided the policy does actually cover Ukrainian territory.
• Secondment from France: absent an agreement, French law provides for a unilateral secondment of 3 years renewable once. The employee remains affiliated to the French scheme, with contributions paid in France; care received on the ground is reimbursed afterwards by the French fund, within the limit of French rates, on presentation of receipts and form S3125.
• Long-term move: access to the State Medical Guarantees Programme requires resident status and a declaration with a family doctor; no transfer of rights from France is provided for, including for retirees.
• Since February 2022, most standard Western travel and health insurers exclude armed conflict zones or countries formally advised against by the authorities from their policies, which covers the entire Ukrainian territory; specialised "war risk" policies exist, generally reserved for professional or humanitarian travel rather than tourism. Unlike other conflict zones, the Ukrainian banking system remains connected to international networks: Visa and Mastercard cards issued abroad remain widely accepted, which makes it easier to pay directly for costs on the ground where care is accessible.

1. Before departure: check France Diplomatie's "Security" page on Ukraine, as travel is formally advised against there whatever the purpose.
2. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
3. Before departure: take out health/repatriation insurance and explicitly check with the insurer that Ukrainian territory is covered by the policy.
4. Seconded employee: arrange unilateral secondment with the employer through the French fund before departure (maximum duration 3 years renewable once).
5. On arrival: register on Ariane and with the roll of French nationals living abroad at the French embassy in Kyiv or the consular office in Lviv.
6. Resident: apply for access to the State Medical Guarantees Programme by signing a declaration with a family doctor.
7. Keep care receipts and form S3125 for any subsequent reimbursement request with the French fund (secondment case).
8. For any medical need, consult the list of doctors and facilities kept up to date by the French embassy, which takes no responsibility for quality or rates.