Those who hold a temporary residence permit in Bulgaria buy compulsory medical insurance for foreigners. Once permanent status is obtained, it becomes possible to use the state health insurance system in Bulgaria. What does that require?
Immediately after receiving your ID card, you need to register with the tax office at your place of residence. This requires:
With these documents you need to register with NAP in the nearest regional city. You will also have to pay the arrears on your осигуровки – since the obligation to pay arises at the moment permanent status is granted, a small debt has already accumulated by the time the card is issued. As soon as the arrears are settled, the foreigner becomes a person with «непрекъснати здравоосигурителни права». This means they can use the Bulgarian healthcare system in the same way as Bulgarian citizens.
Those who do not have a job in Bulgaria also fill in a declaration at NAP stating that they will pay the осигуровки themselves. If they do have a job, this is not necessary – the employer will pay the taxes.
Being able to use the health insurance system does not yet mean you can turn up for an appointment with any doctor at a convenient time. Such a visit requires a referral issued by a general practitioner. This is the personal doctor the patient is registered with, and the first person to approach with any health problem (except dental treatment, which is discussed below). You can register with a doctor at any time, but you can only change doctors in December or June.
How do you choose a doctor? Any general practitioner with a contract with the «Здравна каса» (the health insurance system in Bulgaria) will do. When choosing a doctor you can go by the recommendations of acquaintances, or you can simply go to the nearest clinic and choose a suitable doctor.
The following documents are required for registration:
The registration form («регистрационна форма за първоначален избор на общопрактикуващ лекар») can be downloaded from the НЗОК website (the «За граждани» section) or bought at a stationery shop.
In rare cases it happens that a general practitioner is already heavily loaded and cannot take on a new patient. In that case you will have to keep looking. More often the doctor agrees and registers the new patient. From then on, with any health problem you should turn to your personal doctor – he has no right to refuse help. Each appointment with the personal doctor costs 2.9 leva, pensioners pay 1 lev, and children under 18 pay nothing.
The general practitioner issues certificates, orders tests and, if necessary, refers you to specialists. Important: if you go to an appointment with an ophthalmologist, cardiologist or another specialist on your own, you will have to pay for the visit out of your own pocket, even if all осигуровки have been paid on time. A free appointment is only available with a referral from the general practitioner. There are two exceptions to this rule: emergency care, which can be used without going through the personal doctor, and dental treatment. In the latter case a «Здравноосигурителна книжка» is required.
This document used to be obtained directly from the personal doctor at registration. Since 2017 the medical booklets have been issued at РЗОК offices. So after registering with a personal doctor you need to go to the district «Здравна каса» office with an identity document (the ID card). No other documents are required: the staff will take all the data from the database. The procedure takes about 5 minutes and is completely free.
After receiving the booklet you need to visit your personal doctor again so that he fills in the page with his details and puts a stamp on it. After that the booklet can be used. It will be required for visits to the dentist or when changing your personal doctor.
A visit to any specialist for those insured under the НЗОК system (i.e. those who pay their осигуровки regularly) costs 2.9 leva. However, a visit to the dentist will cost more. The point is that the «Здравна каса» covers the cost of dental care only partially, and not more than a certain amount per year. Exact figures for the cost of particular dental procedures can be obtained directly at the doctor’s appointment.
Even so, those who pay осигуровки are in a better position than those who do not use the health insurance system. For example, treating caries can be dozens of leva cheaper. All procedures paid for by НЗОК are recorded in the medical booklet. At the same time, some procedures remain fully paid – for example, prosthetics, whitening and professional teeth cleaning.
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