Health Insurance in Bulgaria

The system for health insurance in Bulgaria aims at improvement of the Bulgarian citizens’ life through regulation and enhancing of the social, health and economic efficiency of health expenses.

The improvement of the service quality and the equality of their usage; introducing of the mechanisms for fair payment to the medical specialists; the positive change in doctor – patient relations are the main priorities which should be the leading principles during the implementation of health insurance policy in Bulgaria.

What is the health insurance?

The health insurance is a process of collecting of the so called health insurance installments; their management and spending for services, products and others in favor of the insured persons in case of need or in case of definite conditions.

Generally, the health insurance means that installments are collected monthly by each Bulgarian citizen. The collected money are kept and managed by the National Health Insurance Fund.

The health insurance is two types – obligatory and voluntary.

The obligatory health insurance guarantees to everybody access to a basic package of medical services. All Bulgarian citizens who are not citizens of any other country are obliged to pay health insurance installments.

The voluntary health insurance is at people’s choice. Everybody who wants can pay additionally in order to receive extra health services. In Bulgaria there are companies licensed under the Health Insurance Law which regulates the collected funds.

Why shall we pay for health insurance?

According to Bulgarian legislation, every Bulgarian citizen, permanent resident, or foreign students (citizens who are not insured in another country) are subject to obligatory health insurance.

In case of need for medical services, every insured person can use his rights. The National Health Insurance Fund pays for the services partially or entirely.

How much shall we pay for health insurance?

In case you work under labor contract

The amount of the health insurance is calculated as 8 % of your gross salary. The employer is obliged to pay 4,8 % of this amount and you as a worker shall pay the rest 3,2 %, which are normally taken from the salary.

In case of self-insured persons (including foreigners):

The health insurance is also 8 % of your insurable earnings. The only difference is that you shall completely pay for it yourself.

Health insurance for students and pupils:

If you are a regular student / pupil you should be health insured by your university / school. In case you study by correspondence you should pay on your account.

Health insurance in case of unemployment:

The unemployed are also subject to obligatory health insurance, which they have to pay on their account. The amount they have to pay monthly is BGN 16.80.

Important:
The amount for health insurance has a dynamic value which is defined by the Bulgarian law.

When the insurance rights are terminated?
In case of non-payment of the health insurance for more than three months, you automatically lose your health insurance rights. So you have to pay completely all the health services and products you might need. In some cases it could be too hard. Over all non-paid installments, you owe a high interest rate which is stored each month over the amount you have to pay. At the moment, it is defined on the basis of the basic interest rate (BIR) + 20 points:

BIR + 20% = 0.17 % + 20 % = 20,17% – yearly penalty interest for non-paid installments.

The non-paid health insurance is due forever.

Consequences of the terminated insurance rights
You lose your rights of using free medical services defined by the National Health Insurance Fund. You will be obliged to pay completely of every type of medical help you might need.

What shall we do in case of terminated insurance rights?
Your health insurance rights will automatically be restored as soon as you pay the amounts due (installments and interest).

Changes for 2012
Art. 40а, par. 1 of Law of Health Insurance (LHI) – the words „including those people with double citizenship” are erased in order to make the decree more precise. Based on the art. 33, par. 1, p. 2 of LHI, Bulgarian citizens, who are citizens to another country and do not live permanently in Bulgaria, are not a subject to obligatory health insurance in Bulgaria and it is not necessary to be released of the payment of health insurance installments according to art. 40a of the law.

Art. 40, par. 1, p. 3, letter „в” of LHI – the decree is changed. As a result of that, the deadline for payment of the health insurance installments, due by people who work without a labor contract, becomes equal to the deadline for payment of the health insurance for State Social Security. Installments must be paid till 10^th of every month, following the month when the remuneration had been paid;

Art. 40, par. 3, p. 10 of LHI – precision of the regulation for synchronization with the relative regulations of the Legislation for Home Land Defense and Armed Forces of the Republic of Bulgaria;

Art. 40, par. 1, p. 2а of LHI – the regulation is changed. As a result, the seamen are insured not on the basis of pre-determined average insurable earnings (between the minimum and maximum amount of the insurable earnings) of the self-insured people, fixed by the Law for the Budget of the State Social Security for the respective year. They are insured on the basis of chosen monthly insurable earnings on the ground of Art. 4 A, par.1 of the Social Insurance Code. In other words, the insurable earnings of the seamen for health insurance are equal to the same insurable earnings, on which they insure themselves for State Social Security.