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Using The Healthcare System In Bulgaria – A Short Guide For Expats

The Ministry of Health in Bulgaria takes care of the execution and supervision of the National Health Service and policy in the country. Healthcare in each of the administrative districts of Bulgaria is taken care of by Regional Health Centers. All residents are eligible to receive some amount of health insurance coverage. In addition, one can also opt for private healthcare for an extra cost. The working population in Bulgaria is legally required to make health insurance contributions. It is advisable for both visitors and residents to have health insurance, as without it medical bills can be quite high.Visitors
Visitors who come to Bulgaria for a period of less than 90 days at a time and less than 183 days in a year, need to ascertain if they are eligible for free or subsidized healthcare as part of a reciprocal health agreement. If there is no such agreement, visitors can choose between private health insurance and travel insurance.

Some individuals, such as UK citizens, are entitled to free health treatment in Bulgaria based on a reciprocal healthcare agreement between Bulgaria and their home country. EU citizens who intend to stay in Bulgaria temporarily are eligible for free or subsidized medical treatments under Bulgarian social insurance. This requires a European Health Insurance Card (EHIC). Since many expats feel that Bulgarian healthcare is not on par with the standards of healthcare in European countries, they also opt for private medical insurance.

Residents
Individuals, who intend to take up residence in Bulgaria and will be working in the country, are entitled to free or reduced cost medical and dental treatment from the state. The families of these individuals are also entitled for such healthcare. Those with a residence permit are required to pay health contributions through Bulgarian social security (NOI). This allows them to avail of free medical treatment from a GP, free specialist referrals and free or subsidized medicines. Again, even residents prefer to have private health insurance because it is of a superior quality as compared to the national healthcare. Those who plan to become residents in Bulgaria should make it a point to take out full health insurance for themselves and their family during the period between leaving their home country and taking out health insurance in Bulgaria.

Those who don’t pay social security, such as retirees, and are not eligible for healthcare under a reciprocal agreement, need to take out their own private international health insurance cover.

Private healthcare
Bulgarian private healthcare is of a higher standard and hence the cost of such healthcare is also much higher, although it is more affordable in comparison to that of Western European countries. As a result, many foreigners come to the country to avail of the private healthcare system.

Doctors, hospitals and polyclinics
Doctors are available in most of the small towns in Bulgaria and patients can register with any doctor they choose, in any town. The doctors have the responsibility of referring patients to hospitals or specialists depending on the requirement. If you visit a doctor without a referral, you are required to pay for the services.


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Some companies make it a point to have their own clinic and GP. This makes things a convenient for the employees of these companies.

Hospitals are present in all major cities and towns. There are also about 30 specialist hospitals in the country such as those for acute diseases, cosmetic operations and obstetrics. Once a doctor gives a referral, the patient is admitted to a hospital. If there is no referral, the patient may only be admitted after the hospital has evaluated if they really require hospital care.

Polyclinics were part of the old healthcare system in Bulgaria.

The name still remains, but they currently serve as specialist diagnostic and consultation centers for outpatient treatment.

Emergencies
In case of medical emergencies, patients are admitted to the nearest medical facility and are treated there until the condition is stabilized or until they are transferred to another facility.

Pharmacies
In previous years, a range of drugs, including antibiotics, could easily be bought over the counter. Today, a system is in place and only qualified pharmacists can run pharmacies. However, some medicines that are available only by prescription in other countries, can still be acquired in Bulgaria from pharmacies.