Guidance

Healthcare in Bulgaria

Healthcare information for UK nationals visiting, living in or moving to Bulgaria.

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This content was originally published on the NHS website.

Healthcare in Bulgaria after Brexit

You should prepare for possible changes to your access to healthcare if there is a no-deal Brexit and you are a UK national travelling to or living in Bulgaria.

You should review your access to healthcare now. There may be a gap or permanent change in how you access healthcare if there is no deal and no agreements with Bulgaria in place.

For example, if you are a current S1 form holder, or a posted worker or student using a European Health Insurance Card (EHIC) you will not be able to rely on these to access your healthcare as you do now.

If you live in Bulgaria

You need to make the best decisions for your circumstances and consider:

  • registering to live in Bulgaria
  • registering for healthcare under the local rules and legislation of Bulgaria. The UK is working with the Bulgarian authorities to clarify access to state-funded healthcare for UK nationals residing in Bulgaria after Brexit. Any policy developments will be published as soon as they become available
  • buying comprehensive health insurance while you are applying for residency, or if you are not eligible for local schemes

Make sure you have all the right documentation and it is up to date.

S1 certificate holders

Your S1 certificate may not be valid after the UK leaves the EU. This will depend on whether the UK has an arrangement with Bulgaria and may mean you have to pay in full for treatment.

Studying in Bulgaria after Brexit

Your EHIC may not be valid if there is a no-deal Brexit. This will depend on whether the UK has an arrangement with Bulgaria and might mean you need to pay in full for treatment.

If you’re already studying in Bulgaria before the UK leaves the EU, the UK will cover your healthcare costs for the duration of your course.

Students starting courses after the UK leaves the EU should ensure they have comprehensive healthcare cover in place.

Get help paying for medical treatment after Brexit

During the first 6 months after Brexit, if you need medical treatment and you’re being asked to pay for it, the UK can help.

This may be through arrangements with the country you live in, or by paying your healthcare provider directly. To organise a payment, you’ll need to give your healthcare provider’s details to the NHS Business Services Authority’s Overseas Healthcare Services.

Call the NHS Business Services Authority on +44 (0)191 218 1999 for more information. Lines are open Monday to Friday 8am to 6pm and Saturday 9am to 3pm (UK time).

Using NHS services when visiting the UK

You should not expect to be able to use NHS services for free if you are living in Bulgaria and are not currently eligible for a UK-issued S1 form or EHIC.

You should take out appropriate travel insurance when visiting the UK, as you would when visiting any other country.

If you are living in Bulgaria before Brexit, you can use NHS services in England, Scotland and Wales without charge after exit day if you:

  • have a UK-issued S1 form
  • have a UK-issued EHIC
  • would have been eligible for the UK to fund your healthcare access, if exit day had not occurred

Returning to the UK permanently

If you return to the UK permanently and meet the ordinarily resident test you will be able to access NHS care without charge.

European Health Insurance Cards (EHIC)

Your EHIC may not be valid after exit day if there is a no-deal Brexit. This will depend on whether the UK has an arrangement with Bulgaria and might mean you need to pay in full for treatment.

You should prepare for possible changes to your access to healthcare if there is a no-deal Brexit and you are a UK national travelling to Bulgaria.

Make sure you have comprehensive travel insurance if you’re planning to visit Bulgaria.

Check your insurance has the necessary healthcare cover to ensure you can get any treatment you might need.

If you have any pre-existing health conditions, talk to your insurer about how to get the right cover, and how this affects your travel.

UK-issued EHICs will still be valid until the UK leaves the EU. Your EHIC can also be used to access UK-funded treatment if your visit or treatment started before exit day until you return to the UK.

To organise a payment, you’ll need to give your healthcare provider’s details to the NHS Business Services Authority’s Overseas Healthcare Services.

Call the NHS Business Services Authority on +44 (0)191 218 1999 for more information. Lines are open Monday to Friday 8am to 6pm and Saturday 9am to 3pm (UK time).

Living in Bulgaria

This information is for healthcare in Bulgaria until the UK leaves the EU. Read this section on healthcare for UK nationals living in Bulgaria after Brexit.

Registering for the Bulgarian healthcare system

To enrol in the Bulgarian healthcare system, you must first be lawfully registered with the Ministry of Interior (MoI). You will be eligible to access state-funded healthcare based on your residency status.

Healthcare in Bulgaria is universal and funded by mandatory health insurance through the National Health Insurance Fund (NHIF). Contributions to the NHIF are around 3.55% of your salary for workers, 7.35% for people self-employed. If you have a work contract, your employer will register you and transfer your monthly contributions to the authorities on your behalf.

If you are self-employed, you will need to pay monthly healthcare contributions to the National Revenue Agency (NRA). In 2019, the minimum healthcare contribution is BGN 22.40.

You must register with the NHIF to get your Bulgarian National Health Insurance Card. You will have to present the card every time you see a doctor or dentist.

Once you are registered with the relevant authorities, you are entitled to state-funded healthcare. You will only have to pay the same patient contributions as a permanent resident of Bulgaria when you visit doctors and dentists who have a contract with the NHIF.

For more information, contact the Bulgarian NHIF:

National Health Insurance Fund
1 Krichim Str.
Sofia 1407

Telephone: 00359 2 965 9116

Website: www.nhif.bg

Or visit the Ministry of Health website (information in Bulgarian only).

S1 certificate

This information is for healthcare in Bulgaria until the UK leaves the EU. Read this section on S1 certificates for UK nationals in Bulgaria after Brexit.

You may be entitled to state healthcare paid for by the UK if you live in Bulgaria and receive:

  • an exportable UK State Pension
  • a contribution-based Employment Support Allowance
  • another exportable benefit

You will need to apply for a certificate of entitlement known as an S1 certificate.

An S1 certificate helps you and your dependants to access healthcare in Bulgaria. If you have an S1 certificate, it will be valid until the UK leaves the EU.

It is possible to apply for an S1 certificate until the UK leaves the EU. It is important to have all the right documentation and that it is up to date.

You may be eligible for an S1 certificate if you:

  • receive certain UK benefits, such as a UK State Pension
  • are employed by a UK body or firm (you are a posted or frontier worker)
  • are a dependant of someone who has an S1 certificate

You can apply for an S1 certificate through the Business Services Authority.

If you receive a UK State Pension, you can apply for your certificate via the Overseas Healthcare Service on +44 (0) 191 218 1999 (option 5).

For other exportable benefits, you may need to contact a different team depending on the exportable benefit.

You can find more information under claiming benefits if you live, move or travel abroad. Different exportable benefits can have different rules in terms of healthcare cover.

Working in Bulgaria

This information is for healthcare in Bulgaria until the UK leaves the EU. Read this section on healthcare for UK nationals working in Bulgaria after Brexit.

UK posted workers

If you are a worker posted by a UK company to Bulgaria, you may be entitled to health cover funded by the UK in the country you are posted to.

You can find out more from HM Revenue and Customs (HMRC):

Studying in Bulgaria

This information is for healthcare in Bulgaria until the UK leaves the EU. Read this section on healthcare for UK nationals studying in Bulgaria after Brexit.

The government always advises UK nationals to take out comprehensive insurance when going overseas.

Your EHIC is not an alternative to insurance and you should have both when you travel abroad. If you are a UK resident studying in Bulgaria, your EHIC will be valid until the UK leaves the EU.

Read more about healthcare when studying abroad.

For more information about healthcare when living abroad, read the NHS guide on planning your healthcare when moving abroad.

Visiting Bulgaria

This information is for healthcare in Bulgaria until the UK leaves the EU. Read this section on healthcare for UK nationals visiting Bulgaria after Brexit.

Make sure you have comprehensive travel insurance if you’re planning to visit Bulgaria. The government always advises UK nationals to take out comprehensive travel insurance when going overseas.

Your EHIC is not an alternative to travel insurance and you should have both when you travel abroad.

Emergency medical care is provided to anyone requiring urgent attention. You can expect to be charged in full for any care provided without an EHIC.

Your EHIC enables you to access necessary state-provided healthcare in Bulgaria at a reduced cost, or sometimes for free, if you are staying there temporarily.

Make sure you are treated by a healthcare provider that has a contract with the Bulgarian National Health Insurance Fund (NHIF). An EHIC will not cover you for private healthcare.

Remember to keep all receipts and any paperwork.

Contact NHIF for more advice before you travel. You can call 00359 2 965 9116 from the UK.

Pre-existing health conditions

You should buy medical travel insurance before you visit Bulgaria if you have a pre-existing health condition.

You must tell the insurance company about any pre-existing health conditions you have, so that you can get the cover you need.

The Money and Pensions Advice Service has information about buying travel insurance for people with pre-existing medical conditions.

If you have a pre-existing condition that will need treatment while abroad, ask your doctor in the UK for advice before you travel. Take any documents about your health condition or medicine with you.

If you are travelling to have planned medical treatment, read the NHS guide on seeking medical treatment in Europe.

Healthcare services in Bulgaria

Finding help in an emergency

Call 112 if you have a serious or life-threatening emergency or you need an ambulance. This number is free of charge.

Using an ambulance in an emergency is free. Be aware that if you request an ambulance from a hotel, a private ambulance service may be called, for which you will be charged in full.

Hospitals

Inpatient treatment is provided by state and private hospitals. You should ask to be referred to a hospital that has a contract with the NHIF, as they will cover most of the cost of treatment.

The minimum daily charge for hospital stays in medical facilities which have a contract with the NHIF is BGN 5.80 for up to 10 days of your hospital stay.

You should be told about any additional costs you may have to cover yourself. Additionally, you can request a specific medical team, a private room or personal assistance upon additional charge.

After being discharged from hospital, you are entitled to a maximum of 2 free examinations as part of your inpatient care.

Dentists

You should consult a dentist who has a contract with the NHIF. However, you may be charged a patient contribution.

You will be charged the full cost of the treatment if the dentist does not have a contract with the NHIF. These charges are not refundable.

Prescriptions

You can visit any pharmacy in Bulgaria with a prescription, but you will have to pay the full cost. This is non-refundable.

Bringing your own medicines to Bulgaria

Some prescribed medicines contain drugs that are controlled under the Misuse of Drugs legislation in the UK. This means that extra legal controls apply to these medicines.

You may need a personal licence to take controlled medicines abroad.

Specific requirements also apply to:

  • the information that you must take with you
  • how you carry your controlled medicines

Read more information about travelling with controlled medicines.

Published 23 September 2019