Asylum seekers have their health insurance covered by the state. Once granted a refugee or humanitarian status, you are obliged and personally responsible to pay your monthly health insurance installments.
Transfer of health insurance coverage after receiving international protection
- Upon the submission of a copy of your new identity card of a refugee or humanitarian status holder, the State Agency for Refugees issues a document that your health insurance has been paid during the asylum procedure when you had a Personal Number of a Foreigner. The Agency sends this document to the National Revenue Agency office, serving your area of residence in accordance with your permanent address which then transfers the health insurance payments from the Personal Number of a Foreigner to your new Personal Identification Number (which you receive upon your registration in the municipality of your permanent residence).
NB: It is important to proceed with this transfer as soon as possible, once you have your Bulgarian ID documents issued, as otherwise if you are in need of medical services, you might be requested to pay back the health insurance installments due for the period of the asylum procedure.
NB: In case you do not pay your health insurance installments regularly, you cannot benefit from the Bulgarian health care system (except for emergency assistance, see point 2.3.). You could still receive medical services but at much higher prices.
Monthly health insurance installments:
- If you are employed and have a labour or a civil contract signed, monthly health insurance installments are obligatory. The monthly installment equals 8% of the monthly salary. It is covered partly by the employer – 60%, while the remaining 40% are automatically deducted from your remuneration.
- If you are self-employed or unemployed, you need to personally cover the health insurance installments monthly. As of 2019, the monthly fee is 22,40 leva. In order to cover this amount, you need to fill a special declaration and submit it in the regional office of the National Revenue Agency serving your area of residence in accordance with your permanent or current address.
- If you are registered as unemployed in the Labour Bureau and you receive unemployment compensation, the health insurance is covered by the state for the period of the compensation.
- If you receive monthly social assistance or are accommodated in a specialized institution for social services, the health insurance is covered by the state for the period of the assistance or accommodation.
- If you are below 18; you are above 18 and full-time pupil (until the age of 22); you are full-time student in state universities (enrolled as Bulgarian student until the age of 26); or you are pensioner, the health insurance is covered from the state budget.
NB: You lose your rights under the health insurance system, if you do not cover the installments for a period longer than three months. Those rights are restored upon the payment of the lacking installments for the respective past periods of time. You can check at any time your health insurance status and the amount of the due health insurance installments at www.nap.bg
Medical services
- General Practitioner (GP)
A person with paid health insurance has the right to choose a personal General Practitioner. This is the doctor who follows your general medical condition, does regular check-ups, obligatory vaccinations, treats minor diseases (such as flu and other respiratory conditions), provides necessary medical documentation, keeps digital record of illnesses and issues referrals to specialist doctors, if needed.
If you choose a GP for the first time, you can do it any time of the year by visiting the office of the GP of your choice and submitting an application to the Regional Health Insurance Fund. You can find the application form on the spot or at the website of the National Health Insurance Fund: https://www.nhif.bg/page/1499.
The choice for minor or juvenile children is made by their parents or guardians.
When you choose a GP for the first time, you have to have a Health Insurance Book issued. It certifies your registration with a GP or a dentist. The Health Insurance Book is issued by the office of the Regional Health Insurance Fund.
If you are already subscribed with a GP during the asylum procedure, you can keep the same GP or choose a new one. In case of change, you need to fill in and submit an application form with the GP of your choice in the periods 1-30 June or 1-31 December of each year.
Registration with a GP can be done electronically via a special platform of the National Health Insurance Fund with a Personal Identification Code provided by the National Revenue Agency and a Qualified Electronic Signature. The platform is available here: https://pis.nhif.bg/main/.
Usually, patients choose a GP close to the address of their residence.
As of 2019, a visit to the GP costs 2,90 leva. GP visits are free of charge for children, pregnant women and women within the first 45 days subsequent to giving birth, persons who receive social assistance or unemployment compensation, persons suffering from cancerous diseases and others. Pensioners pay a reduced fee of 1 lev.
- Specialist Doctors and Hospitalization
In case you need the service of a specialist doctor, you have to first visit your GP who issues a medical referral form to the specialist of your choice. In that case, check-ups with the latter cost a minimum fee (equalling the visit to a GP). If you choose to go to a specialist without a referral letter, you will need to pay between 30-70 leva for examination only depending on the type of service needed. In order to pay a reduced fee with the referral, the specialist of your choice needs to work with the National Health Insurance Fund.
When needed, a GP could refer a person to inpatient treatment in hospitals. Hospitalization in facilities which have a contract with the National Health Insurance Fund is free of charge, with the exception of some optional additional services.
NB: Pregnant women have the right to a number of pre-natal tests and medical services during childbirth, even if their health insurance installments are not covered.
Refugees and humanitarian status holders who are not health insured can use a limited number of hospital services to be covered by the Directorate for Social Assistance in accordance with their current address. In order to benefit from this possibility, you need to fill an application form which is then submitted to the respective Directorate for Social Assistance via the director of the hospital. The application form can be found here: http://www.asp.government.bg/web/guest/services.
- Emergency Assistance
You have the right to free of charge emergency medical assistance in life-threatening situations no matter whether you have paid your health insurance or not.
Call number 112 for emergency situations related to medical assistance, road traffic accidents, fires, etc. It is free of charge and Europe-wide. It is available also in English language.
- Medicines
Medicines are to be bought in pharmacies and official drug stores. Some mild medicines can be obtained without a doctor’s prescription (paracetamol, nurofen, aspirin, analgin, etc.). The majority of medications can be obtained only with a prescription (such as antibiotics, for example).
Medicines are paid by the patients. In cases of some chronical diseases and continuous treatment, a doctor could prescribe medication to health insured individuals which is to be fully or partially covered by the state budget. For that purpose, you GP needs to issue a Prescription Booklet for Patients with Chronic Disease.
The National Health Insurance Fund shall not pay for medications and medical products prescribed to uninsured persons and persons whose health insurance rights have been suspended.
- Dental care
Health insured persons can choose to use the services of dentists of their own choice. They are due a limited number of dental services for free per year. These include an overall examination and three dental services, among which fillings or tooth extraction. All other dental services and accompanying treatment need to be covered by the patient. At each visit, the patient pays the same patient’s fee as that owed at each visit to the GP or to a specialist.