Healthcare and Health Services

Emergency healthcare

Beneficiaries of international protection, and all the individuals who are on the territory of the Republic of Bulgaria receive emergency healthcare free-of-charge and irrespective of health insurance on the grounds of Art. 4 of the Ordinance No 25 of 4 November 1999 on the Provision of Emergency Healthcare.

Emergency healthcare includes all the medical activities with the aim to treat any emerging acute life-threatening disorders and to maintain the vital functions of the body on the grounds of Art. 2 of the Ordinance No 25 of 4 November 1999 on the Provision of Emergency Healthcare.

All healthcare establishments provide the necessary scope of emergency healthcare to any person in need of such care, regardless of their nationality, residence and health insurance status on the grounds of Art. 3 of the Ordinance No 25 of 4 November 1999 on the Provision of Emergency Healthcare.

The costs for the provision of emergency healthcare before the patient’s hospitalization are ensured by the state on the grounds of Art. 7 of the Ordinance No 25 of 4 November 1999 on the Provision of Emergency Healthcare.

Health insurance

According to Art. 33, para. 1 (4) of the Health Insurance Act, health insurance is mandatory for persons granted refugee or humanitarian status.

Transfer of accounts for health insurance from personal number of foreigner (PNF) to the personal identification number (PIN)

Person who are in the procedure for granting refugee or humanitarian status is issued identity card with personal number of foreigner (PNF).

Personс who obtain refugee or humanitarian status аре issued identity card with personal identification number (PIN).

The obligation of covering health insurance arises from the date of initiation of a procedure for granting refugee or humanitarian status. The payment of health insurance for persons in a procedure for granting refugee status or humanitarian status is done by the State Agency for Refugees with funds from the State Budget.

The transfer of accounts for health insurance and paid health insurance is done by the National Revenue Agency. Persons with granted refugee or humanitarian status have to file a request to the National Revenue Agency, and to provide  a Certificate from the State Agency for Refugees for which it is necessary to file a request with the State Agency for Refugees.

The health insurance for beneficiaries of international protection is subject to the terms and the procedure for Bulgarian nationals – on the grounds of Art. 34 (2), item 2 of the Health Insurance Act.

  1. If the beneficiary of international protection has a job under an employment contract or management contract, the health insurance contributions are made at the National Revenue Agency (NRA) by the employer or the employment institution (40% of the amount of the health insurance contribution is at the expense of the insured person).
  2. If a person with a refugee or humanitarian status is a sole trader or person registered as a self-employed person and/or craftsman, he/she must be insured on a monthly income that cannot be less than the minimum amount of the insurance income for these self-employed persons. The obligation to pay the health insurance contribution is to the insured person.
  3. If the person with a refugee or humanitarian status does not have a job, he/she makes the health insurance contributions at his/her expense at the branch of NRA with jurisdiction over his/her residence/address registration in Bulgaria.
  4. If the person with a refugee or humanitarian status is retired and receives a pension, health insurance contributions are paid by the state budget.
  5. If the person with refugee or humanitarian status is registered as unemployed and receives unemployment benefit, the health insurance contribution is paid by the Unemployment Fund.
  6. If a person with a refugee  or a humanitarian status qualifies for receiving monthly social benefits and targeted heating allowances under the Social Assistance Act, if he/she is not insured on another basis and if he/she is accommodated in specialized institutions for social services, the health insurance contribution is at the expense of the State Budget.
  7. The health insurance for minor and underage beneficiaries of international protection is paid from the state budged under the terms and following the procedure for Bulgarian nationals – on the grounds of Art. 40 of the Health Insurance Act.

Pursuant to Article 52 of the Health Insurance Act, persons granted refugee or humanitarian status who are not insured under this law shall pay the medical care they receive at the prices determined by the medical institutions.

The health insurance rights of a person granted refugee or humanitarian status are discontinued under the terms and conditions for Bulgarian citizens – if no three-month health insurance contributions have been made for a period of 36 months.

Restoring the discontinued health insurance rights of persons granted refugee status or humanitarian status is subject to the terms and conditions for Bulgarian citizens – all health insurance obligations for the last 60 months must be paid.

Consumer fee

Beneficiaries of international protection are charged a consumer fee for their visit to the general practitioner, specialist doctor, dentist, and laboratory under the terms and following the procedure for Bulgarian nationals.

List of persons exempt from a consumer fee, according the National Health Insurance Fund.

Access to a general practitioner

Beneficiaries of international protection have the right to register with a general practitioner (GP) under the terms and following the procedure for Bulgarian nationals. Initial registration with a GP can be done at any time. Persons with health insurance are entitled to change their GP with another one chosen by them every year in the months of June and December.

Register of General Practitioners who have a contract with NHIF.

Access to specialist doctors

Beneficiaries of international protection have the right to see specialist doctors under the terms and following the procedure for Bulgarian nationals. The access to a specialist is ensured by means of a referral issued by the GP. The consultation with a specialist doctor is covered by the health insurance fund; the patient pays only a consumer fee.

Register of Specialist Doctors  who have a contract with NHIF.

Access to dental medical services

Beneficiaries of international protection have access to dental medical services under the terms and following the procedure for Bulgarian nationals.

When the patient sees a dentist, he/she must have with him/her his/her health insurance booklet where the actions performed are entered.

Register of Dental Medical Doctors who have a contract with NHIF.

Access to inpatient medical care

The access to inpatient medical care (hospitalization) for beneficiaries of international protection is ensured under the terms and following the procedure for Bulgarian nationals laid down in Section III of the Ordinance on the Right of Access to Medical Care.  

The health-insured person is entitled to choose a healthcare establishment which has a contract with NHIF on the territory of the whole country by presenting a referral issued by the GP or the specialist doctor.

Register of Hospitals which have a contract with NHIF.

Fee  for hospitalization

The payment of a fee for hospitalization  shall be made under the terms and conditions for the Bulgarian citizens on the basis of Art. 37 (1) of the Health Insurance Act.

Fees are due for every day of hospitalization for up to 10 days a year. Mandatory health insured persons pay for each day of hospitalization the amount of 5.80 BGN per day. The fee is defined as 2% of the minimum wage.

If the patient has to stay in a hospital for more than 10 days within one year, he/she does not pay a consumer fee for his/her stay after the 10th day.

The right to targeted funds for diagnosis and treatment in inpatient healthcare facilities

The right to receive targeted funds for diagnosis and treatment in inpatient healthcare establishments is enjoyed by persons who do not have an income or personal property allowing them to participate in the health insurance process in conformity with a Decree of the Council of Ministers 17/2007. The scope of the cases which meet the conditions laid down in Art. 1 (3) of the Decree encompasses also beneficiaries of international protection.

For more information, see the website of the Social Assistance Agency.

Access to medication

Beneficiaries of international protection have access to medication under the terms and following the procedure for Bulgarian nationals laid down in Ordinance No 4 of 4 March 2009 on the Terms and the Procedure for Prescribing and Providing Medication.

Register of Pharmacies which have a contract with NHIF.

Access to laboratory analyses

The access to laboratory analyses covered by NHIF is ensured under the terms and following the procedure for Bulgarian nationals in conformity with the NHIF’s Framework Contracts for medical and dental care (concluded with the Bulgarian Medical Association or the Bulgarian Dental Association).

Patients are referred to laboratories by means of a “Medical Referral for a Medical Diagnostic Activity”. Health-insured persons are charged a consumer fee for laboratory analyses.

Register of Healthcare Establishments for Laboratory Analysis which have a contract with NHIF.

Certification for permanent work incapacity and for disability type and degree

Expert examinations for permanently reduced work capacity are carried out by Territorial Expert Medical Committees (TEMC) and a National Expert Medical Committee (NEMC).

Beneficiaries of international protection have access to TEMC and NEMC under the terms and following the procedure for Bulgarian nationals laid down in the Ordinance on Medical Expert Examinations.

The preparatory actions for the presentation of persons with disabilities before TEMC are carried out by their general practitioner. The GP determines the medical documents, examinations, consultations and analyses needed for the relevant persons, and issues a medical referral for TEMC on the grounds of Ordinance No 2 of Ministry of Health of 25 March 2016 on Determining the Basic Healthcare Package covered by the Budget of the National Health Insurance Fund.

HIV testing

Persons with refugee or humanitarian status have the right to laboratory tests for AIDS in the Laboratories for anonymous and free counseling and testing for HIV / AIDS under the terms and conditions for Bulgarian citizens.

The test is free and does not depend on the availability of health insurance.

National Program for Prevention and Control of Tuberculosis in the Republic of Bulgaria for the period 2017-2020

Persons with refugee or humanitarian status are a key target group / beneficiary under the National Program for Prevention and Control of Tuberculosis in the Republic of Bulgaria for the period 2017-2020.

The inclusion in the program of persons with refugee  оr  humanitarian status is under the rules and conditions for the Bulgarian citizens – diagnosis, hospitalization, post-hospital treatment and medicines are free of charge.

25.06.2017