Bulgaria

Healthcare system

The Bulgarian health system is based on an insurance model consisting of compulsory social health insurance and voluntary health insurance. The public health insurance is performed by the National Health Insurance Fund (NHIF). NHIF is a public institution, which provides obligatory health insurance in the country. It is divided into 28 subdivisions in the regional central cities – regional health insurance funds (RHIF). The benefit package and prices of services are negotiated between the NHIF and the professional associations of physicians and dentists in Bulgaria. The negotiation takes place every year.

Healthcare providers are autonomous self-governing organisations. The private sector encompasses all primary medical and dental care and the pharmaceutical sector, most of the specialised outpatient care and some hospitals.

Accessing care

You can obtain medically necessary treatment by presenting the European Health Insurance Card (EHIC), when you are temporarily staying in Bulgaria. Medically necessary treatment refers to treatment that cannot wait for your return home. You may need such treatment in case of acute illness or accident. You can also receive treatment related to pregnancy and childbirth or to a chronic illness. The need for treatment must emerge during the course of your stay. If your illness requires regular treatment while you are temporarily staying abroad, agree with the treatment provider beforehand on the arrangement of treatment. Treatments that need to be arranged in advance include, for example, dialysis, oxygen therapy, specialised care of asthma and chemotherapy as well as echocardiography in chronic autoimmune diseases.

You will receive treatment on the same terms and at the same price as the locals. It is advisable to carry copies of your European Health Insurance Card with you, along with the card itself. If you didn’t have your EHIC with you or it was not accepted, and you were required to pay all the costs of treatment yourself, you might be able to apply for reimbursement from Kela retrospectively.

Before accessing care, you should make sure that the service provider (doctor/hospital/medical laboratory/pharmacy) is contracted by the Bulgarian National Health Insurance Fund (NHIF). Private medical services are also available in Bulgaria and if you receive treatment there, you have to pay all costs yourself.

The availability of public healthcare in Bulgaria varies. In rural areas, the availability of doctor and hospital services is more limited than in the larger towns. Be aware, that rescue services in the mountain resorts of Bulgaria are not covered by the statutory health insurance. To have coverage while in the mountains, you should obtain mountain accident insurance. Otherwise, you are liable for all costs by yourself.

Sudden illness

Doctor

In need of a doctor, you should look up a general practitioner who is contracted by the NHIF. Most doctors have such a contract. You can request the contact information of doctors from NHIF or one of the regional health insurance funds (RHIF). Show your European Health Insurance Card and ID at the appointment. In this way, you will pay only the consumer tax charge.

You can see a specialist if you have a general practitioner’s referral. You pay the consumer tax charge for the treatment. If you see a specialist without a referral, you will have to pay the full price of the treatment.

Dentist

You can see dentist without a referral. If the dentist is contracted by the NHIF you will receive treatment at the co-payment rate when presenting your European Health Insurance Card and ID. The amount of co-payment depends on the procedure. However, the scope of dental care covered by NHIF is extremely limited.

Medication

If you get medication prescribed with form No. 5, you should collect the medicines from a pharmacy that has a contract with the NHIF. With your European Health Insurance Card, you will receive the medicines either free of charge or at a partially reduced rate. If you receive a prescription form other than No. 5, you will not receive any reimbursement and so you can collect the medicines from any pharmacy.

Hospital treatment

For hospital treatment you will need a doctor’s referral unless it’s an emergency. Go to a hospital that has a contract with the NHIF and present the referral alongside your European Health Insurance Card and ID. You will be asked to fill in a declaration that the purpose of your stay in Bulgaria is not to receive treatment. You should only have to pay for the consumer tax charge per day and any separate costs for medical supplies not covered by NHIF. Consumer tax for hospitalization for more than 10 days/year is not collected. After being discharged, you are entitled to two free check-ups. Ambulance transport in emergencies is free.

If your illness requires you to use special transport when returning to Finland, you will be liable for the travel costs in their entirety. You are recommended to take out a travel insurance that covers these costs.

Information about reimbursements of the costs of medical care can be obtained from Bulgaria´s National Health Insurance Fund (NHIF). The contact information of the Fund´s regional units (28 RHIFs) are available on the NHIF website.

Read more about suddenly falling ill in Europe.

Read more about reimbursement of costs of treatment abroad.

Useful websites

If you wish to travel to Bulgaria for the purpose of using healthcare services, you can find general information on our site concerning seeking treatment abroad. For more specific information concerning Bulgaria, you should contact the National Contact Point of Bulgaria.

Quality and safety of treatment

In the event of treatment injuries, the legislation and patient insurance of the country providing the treatment is always applied. In case you are unhappy with the treatment you received, you should primarily try to sort the matter out with the treatment provider. The national contact point can help you with finding the right authority if you wish to make a complaint.