Referral Services Programme: who decides, what it funds and how to apply to the commission

What are referral services in 2026?

"Referral Services" is one of the annexes to the annual state healthcare programmes. In 2026 it is approved by Annex 19 to Government Resolution No. 655 of 31 December 2025, under programme code 27 03 03 08. The programme's total budget is GEL 70,000.0 thousand, of which GEL 68,000.0 thousand goes to the individual medical assistance component. The rest funds three small, narrowly targeted components.

Within the individual component there are also several separate strands: treatment for victims of sexual violence, treatment of cancer patients under 18 at the Fund's partner clinics abroad (this route is described in the guide to children's treatment) and cardiac surgery abroad for children under 18 under the terms of the "Paediatric Cardiac Surgery Convention". Most families, however, apply to the commission under the general rule: asking for funding for the cost of a specific operation, treatment or test.

An important clarification: the commission is set up at the Solidarity Fund, and the Fund is an organisation founded by the state. Solidaroba.ge does not represent this Fund and has no influence on the commission's decisions. What the Fund is and how not to be deceived in its name is covered in our guide to the Solidarity Fund.

Who can apply to the commission?

The commission's rules of procedure describe a wide range of beneficiaries. The most important provision says that a beneficiary is a person who, by an appropriate application, requests funding for costs related to medical services or assistance. Age, diagnosis or social status are not conditions for applying; they only affect the state's share.

In addition, the rules separately name people affected by natural disasters, catastrophes or emergencies, people living in the occupied territories, law enforcement and military personnel, victims of sexual violence, and people insured from the budget whose inpatient care is not covered by their insurance terms. For the last group, treatment is funded on Universal Healthcare principles: with the same package, co-payment share and cost.

Commission assistance is not available to state political officials and their spouses, children and parents, except in cases provided for by law. However, the rules allow the commission, by its own decision, to make exceptions both to the range of beneficiaries and to the funding rules. In serious and rare cases this provision becomes the main argument of an application, so if you do not fit the standard framework, ask for an exception directly in your application and give your reasons.

Because the commission assesses whether funding is justified, attach to your application whatever shows that you have already used other sources: the Universal Healthcare reply, the municipality's decision, the insurer's letter. What Universal Healthcare covers and what remains as a co-payment is in the Universal Healthcare guide, and the rules of local programmes are in the guide to municipal assistance.

How does the commission decide what share the state will fund?

The commission first assigns the application a "funding status". The status is set by category, and if the applicant has no category, their income is checked. The higher the status, the larger the share the state takes on.

The commission's rules set the categories but do not name a specific percentage for each status; additional conditions may be regulated by an act of the Fund's executive director in agreement with the Ministry. So check the exact share with the Fund before you apply.

Income is calculated by a formal rule. A salaried employee is assessed on taxable income for the last 12 consecutive months before the reporting month, without deducting tax reliefs. Someone who files a tax return is assessed on taxable income for the previous reporting year, and an entrepreneur with small business status on 25% of income taxed under the special regime plus their other taxable income. If the family is in the database of socially vulnerable families, attach an extract from the database to the application, so that the category is confirmed by a document rather than clarified later. We explain what the score means and how to go through the assessment in the guide to social status.

Which documents does an application to the commission need?

The rules require three mandatory attachments to an application addressed to the commission. All three are equally important: a defect in any one of them is enough for the Fund not to pass the file on to the commission.

• A copy of the ID document of the applicant or their representative. If a family member is acting, bring a power of attorney or a document proving the relationship.
• Form No. IV-100/a, with every item filled in clearly and in detail using ICD-10 or NCSP codes: the full diagnosis (main, concomitant, complications), past illnesses, medical history, tests and consultations carried out, and the course of the disease. You will find a sample of a correctly completed certificate in the Form 100 guide.
• An invoice with a cost estimate, that is, the costs broken down into items rather than a single final figure.

Additional requirements if treatment is planned abroad

In Form IV-100/a the doctor must also record a recommendation that treatment or diagnostics are needed outside Georgia, again with ICD-10 and NCSP codes. The foreign invoice and cost estimate must be translated into Georgian and notarised, and the costs must be divided as follows: non-medical costs (transfer, hotel, accompanying person) and medical costs broken down by surgery, conservative treatment, diagnostics, chemotherapy and radiotherapy.

This is where cases often stall: the foreign clinic's invoice contains a single total or is in English. First ask the clinic for an itemised invoice, then have it translated; we prepare translation of financial documents together with notarisation, and the translation calculator will show you an indicative price.

How does an application go from submission to treatment?

1. The Fund receives and checks the file

   The Fund organises the commission's sessions: it explains to the applicant what to submit, receives and logs the documents and checks that they meet the requirements. Only a complete file is passed to the commission, so be sure to write down the registration number and the date of submission.

2. Expert review for requests abroad

   If treatment is planned abroad, the documents are sent to the Ministry's specialist expert for an opinion. For requests for a laboratory test abroad, the documents go to laboratories in Georgia, and since 1 May 2026 the same rule applies to ophthalmology services: local providers must confirm whether they can provide the same service.

3. The commission's session

   A session is quorate if more than half of the members attend. Decisions are taken by a majority of those present, the chair has the casting vote in a tie, and the outcome is recorded in minutes.

4. Notification and informing the clinic

   You are notified of the decision by text message and, on request, as a paper guarantee letter. You pass the funding information to the clinic yourself. The clinic may not make you pay the amount allocated by the commission in advance or place it on deposit.

5. Starting treatment on time

   From the day the minutes are adopted, the service must start within one month in Georgia and within two months abroad. The period can be extended only once by decision of the commission, for the same length of time; otherwise the decision is deemed cancelled.

The commission's rules set no special review period. In that case Article 100 of the General Administrative Code applies: unless the law provides otherwise, a decision is made within one month of the application being submitted (for an act that does not affect third parties' interests the Code names 15 days), and where more time is needed to establish the circumstances, the period is set by a separate decision when the proceedings begin and must not exceed three months in total. If the operation date does not fit within this period, justify the urgency in the application with the doctor's opinion.

What changes when treatment takes place abroad?

Treatment abroad is funded in two ways, each with its own reporting. With advance funding, the beneficiary or their authorised representative undertakes in writing, in the prescribed form, to submit to the Fund a report on the work performed and a document confirming the costs no later than 30 calendar days after receiving the service. If the treatment has already taken place, the Fund settles on the basis of completion documents issued by the clinic, which the beneficiary can also submit.

For cancer and certain other diagnoses (for example, ICD-10 codes C00-C97 and D00-D09), the patient must be registered in the population-based cancer registry. If treatment is abroad and the patient is not in the registry, the Fund arranges the registration, but this is an extra step that takes time.

A practical tip: along with the invoice, ask the foreign clinic for a sample of the completion documents it issues after treatment. Handing in the discharge summary, the final invoice and proof of payment within the 30-day period is much easier if you know in advance what form they will take and in which language. The clinic search service can help with choosing a clinic and with logistics, and we compare all the funding channels for treatment abroad in a separate guide.

Why does the commission refuse and how can you avoid it?

The reasons for refusal are often formal and can be avoided in advance. The situations listed below follow directly from the commission's rules:

1. Form IV-100/a is incomplete. Without codes, medical history or the tests carried out, the certificate does not meet the rules, and for a request abroad, without the doctor's recommendation, the application lacks a basis.
2. The invoice is not itemised. A foreign document without a breakdown of costs, a translation or notarisation does not count as a complete file.
3. The service is available in Georgia too. The specialist expert's opinion, or confirmation from a local laboratory or ophthalmology clinic, may rule out the need for treatment abroad.
4. The deadline has passed. Failing to start treatment within one or two months, without requesting an extension, cancels the decision. In that case you can apply to the commission again, and it will use the documents already submitted.
5. The information is inaccurate. Submitting false information to the commission entails liability, and the documents are sent to the investigative authorities. Never overstate or understate your income or circumstances.

If you are refused anyway, first request the refusal in writing, with reasons and the minutes number. We explain the deadline and structure of a complaint in the guide to appealing a refusal.

How we can help

No one can speed up or guarantee the commission's decision, but a great deal depends on the shape in which your case reaches the session. Advocat.Ge lawyers check Form 100 against the requirements of the rules, draft the application with arguments on funding status, income and exceptions, and write the complaint if you are refused. All of this is part of the funding search service. We carry out translation and notarisation as described on the medical translation page.

Frequently asked questions about the referral programme