Basic concepts, registration and guidelines for Compulsory Health Insurance of Foreign Nationals in Bulgaria

The circle of persons subject to compulsory health insurance in Bulgaria is determined by the National Revenue Agency (NRA) in accordance with the Health Insurance Act (HIA). These include foreign nationals and stateless persons who have a long-term or permanent residence permit in the country.

Am I subject to compulsory health insurance in Bulgaria if I have a long-term residence permit?

All foreign nationals with long-term or permanent residence in Bulgaria are obliged to pay health insurance contributions. This provides them with access to state-funded medical care. The obligation to take out health insurance arises from the date of obtaining the residence permit. Health insurance contributions are collected by the National Revenue Agency (NRA).

How does the healthcare system in Bulgaria function?

Unlike many other countries in the European Union, Bulgaria does not issue health cards to its insured. Instead, each insured person has the right to freely choose their own personal doctor (general practitioner) who works with the National Health Insurance Fund (NHIF). The choice can be made at a primary outpatient care facility throughout the country.

The GP has a key role in the health system - he carries out basic medical check-ups and issues referrals to specialists if necessary.

What are the conditions for obtaining health insurance rights in Bulgaria?

To get full health insurance rights in Bulgaria, you must meet the following conditions:

• you have been insured in an EU country for the last 60 months (5 years) and
• have no more than three months of unpaid health insurance contributions.

How can I prove that I have health insurance in another EU country and qualify for health insurance in Bulgaria?

For foreign nationals coming from another EU member state, the NHIF requires confirmation of the previous health insurance period. This is done via the official European form S041 (electronic equivalent of form E104). This document certifies completed periods of health insurance in the country from which you are moving.

The process of obtaining the S041 form is carried out ex officio through the EESSI (Electronic Exchange of Social Security Information) system - RINA. You are only required to initiate the procedure by submitting an application to the Bulgarian Health Insurance Fund with information about the EU member states where you have been insured, as well as information about your insurance numbers in these countries. The NHIF will contact the foreign health insurance funds and request the necessary information entirely ex officio. The information includes your health insurance periods in EU member states for the last 60 months, which is necessary to be eligible for health insurance rights in Bulgaria.