Medical Insurance: Essence, Types and Development Trends

Abstract

The transformation of the healthcare system and the increasing economic instability determine the growing importance of medical insurance as a key instrument of financial protection of the population and an additional source of healthcare financing. These processes are particularly relevant in the context of limited public resources and increasing demand for accessible and high-quality medical services. For the national economy, the issue of effective functioning and development of the medical insurance market becomes strategically important. Purpose. The purpose of the article is to investigate the essence of medical insurance, generalize its main types, analyze the mechanisms of its implementation and assess the current state and development trends of the medical insurance market in Ukraine. Methods. The methodological basis of the study includes general scientific and special research methods, in particular analysis and synthesis, comparison, statistical analysis, graphical method, and generalization of scientific approaches. Results. The study reveals the economic nature of medical insurance as a component of the healthcare financing system that combines social and market mechanisms of risk redistribution. The main types of voluntary medical insurance are systematized, including continuous health insurance, health insurance in case of illness, and medical expenses insurance for persons traveling abroad. It is substantiated that the current model of healthcare financing in Ukraine is characterized by the dominance of public funding within the framework of the Medical Guarantees Program, while insurance mechanisms play a complementary role. Based on statistical data analysis, a positive trend in the growth of gross insurance premiums in 2024–2025 is identified, indicating the expansion of the voluntary medical insurance market. A high level of market concentration is revealed, with leading positions occupied by a limited number of large insurance companies. Significant variability in claims ratios is also identified, reflecting differences in insurance programs, portfolio structure and claims settlement policies. Conclusions. The study proves that the development of medical insurance in Ukraine is constrained by insufficient integration of insurers into the healthcare system, limited access to medical information, and low public trust. It is substantiated that further development of the market is associated with the expansion of insurance products, improvement of service quality, digitalization of processes and strengthening cooperation between the state and insurance institutions.