Obtaining permanent status is an important event in the life of any immigrant in Bulgaria. However, in this situation a foreigner acquires not only rights but also obligations. One of them is paying «здравни осигуровки».
Healthcare in Bulgaria is insurance-based. All adult citizens, as well as holders of EU long-term resident status and permanent residence permits, pay a special tax («здравни осигуровки»), and in case of illness their treatment is paid for by the «Здравна каса» (НЗОК). The person paying the osigurovki is left with only symbolic costs – 2,9 leva for a doctor’s appointment, 5 leva per day in hospital. When tests are taken, only the blood draw is paid for – the analyses themselves are covered by the «Здравна каса».
Insurance-based medicine does not cover all types of treatment. As a rule, the НЗОК pays for the cheapest options, while expensive ones have to be paid for out of your own pocket. Nevertheless, using the health insurance system is convenient and advantageous. Whereas the ordinary insurance for foreigners taken out when obtaining a residence permit covers only emergencies, the «здравна каса» allows you to treat chronic conditions and have planned operations.
Insurance-based medicine also covers dentistry, but not in full. In most cases the «Здравна каса» pays only part of the cost of dental treatment, at the basic rate, and the remaining amount has to be paid out of your own pocket. The НЗОК does not pay for professional teeth cleaning, prosthetics or implants – dentists perform such procedures for cash only.
All that is required for this is to pay the «osigurovki» every month. For employed citizens and foreigners with a permanent residence permit or EU long-term resident status, the employer does this. Everyone else (including pensioners) must pay a fixed amount themselves, as unemployed persons. This obligation does not apply only to minors and students (including those in higher education). At the same time, in the period between finishing school and starting university, young people with permanent status (a permanent residence permit or EU long-term resident status) must make payments – either themselves or through an employer.
Important: the obligation to pay osigurovki arises from the moment the long-term or permanent residence permit is obtained.
In that case you cannot use the possibilities of insurance-based medicine. This means that with any ailment you will have to be treated at your own expense – at least until the debt is settled. The maximum period for which payment will be required is 5 years. In addition, the interest accrued over that time must be paid.
Paying osigurovki is mandatory for everyone. An exception is made only for Bulgarian citizens who have lived outside the country for a long time and have submitted a special declaration. As for foreigners, the law makes no mention of them. It therefore turns out that foreign nationals who have obtained a permanent residence permit or EU long-term resident status in Bulgaria are obliged to pay osigurovki even if they are outside the country.
Immediately after receiving the personal card showing the ЕГН, you must register with the National Revenue Agency (NAP) (the tax authority). You should take with you a copy of the notification letter stating the date on which the permanent or long-term residence permit was granted – the osigurovki will be calculated from that day. If you do not have this document, you can obtain the relevant certificate from the migration service for 30 leva. If no documents are provided at all, you will have to pay the «debt» in osigurovki for 5 years.
After the application is filled in, an NAP officer registers the new payer of osigurovki and calculates the amount to be paid for the period from the decision granting EU long-term resident status or a permanent residence permit up to the moment of registration. Once payment is made, the foreigner gains access to the compulsory health insurance system in Bulgaria – choosing a personal doctor, visiting specialists, receiving hospital treatment.
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