Chronic disease monitoring in Bulgaria (диспансеризация)
NZOK pays for regular check-ups and tests for health-insured people with chronic diseases under 'dispensary follow-up' (диспансеризация). It starts with an examination in which the doctor establishes the diagnosis; for the patient it is voluntary and based on consent.
Healthcare · Last reviewed: 2026-10-08
This is not legal or financial advice
Scope: what does NZOK pay for?
According to the NZOK page, the fund pays for medical activities and tests (by type, periodicity and frequency) under dispensary follow-up of health-insured persons (ЗОЛ) with chronic diseases that need monitoring and/or treatment. Which diseases fall in scope is set in Ordinance No. 8 of 2016 (Наредба № 8 от 2016 г.) and in the annexes to the National Framework Contract (separate annexes for GPs and for specialists).
How follow-up starts
Examination and diagnosis
Follow-up starts with an examination by the GP (ОПЛ) that finds a diagnosis subject to dispensary follow-up.Registration
The GP enters the insured person in the register of persons under dispensary care and starts the algorithm set in the Ordinance. The number of examinations varies by disease; at them the activities, tests and specialist consultations written in the Ordinance are carried out.If a specialist is needed
If the disease is followed by a specialist, the GP issues a 'referral for consultation or joint treatment' (МЗ-НЗОК form No. 3); the specialist takes over the follow-up.First year
On first follow-up for a disease, the total number of examinations, tests and consultations for that calendar year is set in proportion to the months left in the year.
Rules and limits
- You cannot be followed for the same disease in more than one facility and/or by more than one doctor in the same period.
- Under 18, if several codes fall in one disease class, all are followed by a specialist; over 18, the page gives the GP as the general rule and lists exceptions.
- Follow-up is voluntary, except where it is part of compulsory or forced treatment ordered by a court.
- The doctor who finds the disease must give detailed oral information on its type and severity, possible complications, the way of follow-up and treatment, and the possible risks of refusing follow-up.
This page is neither legal nor medical advice
Frequently asked questions
Who follows up my chronic disease?
According to the NZOK page, every GP and specialist under contract with NZOK carries out examinations and tests of the type and frequency in the Ordinance; who follows which disease is set by the Ordinance and its annexes.
Can I refuse follow-up?
The page says follow-up is voluntary and based on the patient's consent (except court-ordered compulsory or forced treatment). The doctor must explain the possible risks of refusing.
Sources
The information on this page is based on the official sources listed below. Legislation changes — open the links and verify the current position.
- НЗОК — Диспансерно наблюдение за хронично болните (НЗОК за теб · Полезно е да знаете) — https://www.nhif.bg/bg/nzok-za-teb/useful/710 · 2026-10-08
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