Martial law and why dates matter

Ukraine declared martial law and general mobilisation on 24 February 2022. Media reports from July 2026 describe the 20th extension, which runs to 31 October 2026; check whether it has been extended again before you rely on anything below. Labour, tax, currency and insurance rules all have wartime changes, and the martial-law changes end when martial law does.

Read this page as a picture of the position as of October 2026, not a permanent rule set. This page gives no guidance on mobilisation, military registration or the reservation of employees.

The programme of medical guarantees

Public health care in Ukraine runs through the Programme of Medical Guarantees (PMG). It is paid for from the state budget, and the national health service of Ukraine (NHSU) uses that money to buy care from public and private providers. The government approved the 2026 programme in Cabinet Resolution No. 1808 of 31 December 2025, with 46 service packages.

The programme covers citizens, foreigners and stateless people who live in Ukraine permanently, along with recognised refugees and people granted additional protection. It funds emergency care, primary care, specialist and hospital packages, and the Affordable Medicines programme. For 2026 the government raised spending on severe injuries, trauma rehabilitation and inpatient psychiatric care, and media reports describe free mental health services in NHSU-contracted primary care from the 2025 programme.

Reaching care: the declaration with a family doctor

A resident does not enrol through an employer. Instead, they sign a free declaration with a primary-care doctor, a family doctor, therapist or paediatrician, at any facility contracted with the NHSU. The NHSU then pays that facility a set amount for each declared patient, and the doctor issues electronic referrals to specialists. Emergency care is provided with or without a declaration.

To sign, the person brings an identity document, such as a passport or a permanent residence permit, and their tax number; children under 14 are declared with a birth certificate. Government figures from December 2025 put the number of people with family-doctor declarations at nearly 29.8 million. People displaced by the war can sign a new declaration where they now live, and a doctor with room on their list may not turn them away.

Payroll in 2026: levies, but no health contribution

Because the PMG is budget-funded, a Ukrainian employer pays no health insurance contribution. Tax-office explainers for 2026 describe three main payroll items instead: the unified social contribution (ESV) at 22% of the base, paid by the employer with a monthly ceiling, which funds social insurance rather than health care; personal income tax at 18%, withheld from pay; and the military levy, withheld from employees at 5% after a wartime increase from 1 December 2024. Those are 2026 figures, so check the current figure for each.

No law requires a Ukrainian employer to buy private medical insurance for staff, and the list of compulsory insurance classes does not include employee health cover, according to law-firm guidance from February 2026.

Voluntary medical insurance and international plans

Voluntary medical insurance, known as DMS, is an established employee benefit in Ukraine, and the tax service has published explainers on employer-paid premiums. Do not assume employer-paid premiums are free of income tax, the military levy or ESV.

There is no health insurance mandate for an international plan to replace. For a resident employee it can only add to PMG access. Who can provide it is the harder part. Law-firm guidance describes the National Bank of Ukraine (NBU) as the insurance regulator from July 2020, with a new Law on Insurance in effect from 1 January 2024. The same guidance describes non-resident insurers as generally able to write business in Ukraine only through an NBU-authorised branch, with branch-free exceptions for aviation, marine and cargo risks rather than health. The NBU has also published wartime currency restrictions for insurance, so payments to a non-resident insurer may be limited. Whether a plan can cover someone in Ukraine, and how premiums can be paid, is for the insurer to confirm.

Hiring through an EOR, an entity or a FOP contractor

Law-firm briefings describe employment as following the Labour Code with a martial-law overlay, Law No. 2136-IX of March 2022 as amended, and a later law, No. 4412-IX, in effect from June 2025, with parts applying from March 2026. Mobilisation and reservation rules also apply to Ukrainian employers. Check how these rules, and any tax on a benefit, apply to your setup with a local adviser or tax professional before engaging anyone.

EOR providers describe a US company without a Ukrainian entity as usually either hiring through an employer of record or engaging the person as a contractor. Many Ukrainian IT professionals work as registered private entrepreneurs, known as FOPs, rather than as employees. Under any of these routes, a resident keeps access to the PMG through their family-doctor declaration, whoever pays them. The employer’s part, if it employs, is the payroll levies plus any voluntary medical insurance it chooses to add. Our page on health coverage for EOR employees and contractors abroad sets out who arranges cover in each case.

Requesting an introduction for your Ukraine team

Mithril1 does not sell, quote or recommend any health plan. If you want international cover to sit alongside the PMG for people working with you in Ukraine, we can introduce you to a benefits partner focused on health coverage for international and remote teams. Fill in the quote form on this page with the region where each person lives, how many people you have there, whether they are employees, EOR staff or FOP contractors, and whether family members should be included, and we will send it to the partner. From there, the partner and the insurer make the calls on who is eligible, which plans are available and what they cost.

For neighbouring countries, see Poland and Romania, or compare the region on the Europe page. The international health insurance overview and the employee benefits hub cover the wider picture.

A few useful answers

Common questions

Is there a health insurance contribution on salary in Ukraine?

No. As of 2026 the Programme of Medical Guarantees is paid from the state budget. Employers pay the unified social contribution, which funds social insurance, and withhold income tax and the military levy.

How does someone in Ukraine access public health care?

By signing a free declaration with a family doctor, therapist or paediatrician at an NHSU-contracted facility. Emergency care is given without one.

Does an international plan replace anything in Ukraine?

No. There is no employee health insurance mandate, so an international plan adds to a resident’s access to the public programme.

Can a foreign insurer cover an employee in Ukraine?

Law-firm guidance describes non-resident insurers as generally needing an NBU-authorised branch, and wartime currency rules can affect premium payments. The insurer has to confirm what is possible.

Does martial law affect hiring in Ukraine?

Yes. As of October 2026, wartime changes apply to labour, tax, currency and insurance rules, so confirm the current position before you hire.

International Health Insurance for Remote Employees in Ukraine