Medical care in Ukraine is limited. The U.S. Embassy maintains a short list of English-speaking physicians and a list of pharmacies that offer American and Western European supplies and medicines. The availability of basic medical supplies, including disposable needles, anesthetics and antibiotics, still does not meet expectations. Elderly travelers and those with existing health problems may be at risk due to inadequate medical facilities. Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars or more. Doctors and hospitals often expect immediate cash payment for health services.