Bulgaria's compulsory health insurance: who is covered
Access to public healthcare in Bulgaria runs entirely through compulsory health insurance. This page is not a treatment guide: it explains who owes contributions, when the obligation begins and which authority confirms your status.
Healthcare · Last reviewed: 2026-08-16
Where the obligation sits
The obligation is personal, not the employer's. For an employee the contribution is calculated and transferred by the employer, but the insured person remains the one who owes it. Self-insured persons, company partners and freelancers pay on their own declaration. For students, pensioners, unemployment-benefit recipients and certain social groups the state covers the contribution. Anyone who fits none of those categories is self-insured and pays personally.
The fund is the National Health Insurance Fund (НЗОК), but contributions are collected by the revenue administration (НАП). The split matters in practice: questions about care go to НЗОК and its regional office, questions about contributions and arrears go to НАП. Turning up at the wrong counter is the most commonly wasted hour in Bulgarian administration.
When the obligation starts for a foreign resident
- A holder of a long-term residence permit, or an EU citizen with a residence certificate, is as a rule brought into the compulsory scheme.
- A short tourist stay creates no obligation; cover then comes from travel insurance or a European Health Insurance Card issued elsewhere in the EU.
- Someone insured in another EU country is not insured twice here; cross-border forms decide which state is responsible.
- Starting work triggers the obligation from the beginning of the employment relationship, whatever the type of residence permit.
- There can be a lag between the month the obligation starts and the month the first contribution lands, during which the status may still not read as active.
What the "basic package" actually means
НЗОК does not pay for everything, only for a scope defined by a Ministry of Health instrument that is revised from time to time. Listing individual procedures is not this page's job. The rule worth carrying is different: anything outside the scope — a private clinic visit, imaging the fund does not cover, most dental work — is paid out of pocket. So the useful question before a procedure is not "is it expensive" but "is this inside the НЗОК scope, and does it need a referral".
Verifying your status
Have your identifier ready
Bulgarians use their ЕГН; foreign residents use the ЛНЧ or the personal number printed on the residence document.Open the revenue administration's online service
The health insurance status check sits among НАП's e-services and returns either an active status or a break in cover.Note the months with gaps
The check shows exactly which months lack a contribution; any correction is made against those periods.Send care questions to НЗОК
Lists of contracted doctors, the referral system and the covered scope belong to the regional fund office (РЗОК).
This page gives no medical advice
Why there are no figures
This is not legal or financial advice
Frequently asked questions
I work remotely for a company abroad while living in Bulgaria. Where am I insured?
Residence and the place where the work is actually carried out drive the answer far more than the employer's address. Within the EU the applicable-legislation rules decide a single competent state; outside the EU the question is settled by the residence and social security rules that apply to you. Confirm your case with НАП before assuming either side covers you.
Does my private international policy replace the compulsory scheme?
No. Private cover sits on top of the statutory system and does not remove the obligation to contribute. If contributions are missing, your public status still shows a gap however good the private policy is.
How do I prove I am insured?
The status check and a contribution statement from НАП are accepted in most administrative procedures. Some procedures additionally ask for the health insurance booklet.
Sources
The information on this page is based on the official sources listed below. Legislation changes — open the links and verify the current position.
- Национална здравноосигурителна каса (НЗОК) — https://www.nhif.bg/ · 2026-08-16
- Национална агенция за приходите (НАП) — https://nra.bg/ · 2026-08-16
- Министерство на здравеопазването — https://www.mh.government.bg/ · 2026-08-16
- Your Europe — Health care in the EU — https://europa.eu/youreurope/citizens/health/index_en.htm · 2026-08-16
Related topics
How health insurance contributions are paid in Bulgaria
The mechanics for employees, the self-insured and those paying on their own account: who declares, where the money goes, what a gap causes and how the abroad exemption works.
Registering with a GP in Bulgaria
How to find a contracted doctor, what the registration form contains, which documents to bring and when a change of GP is possible — the administrative process step by step.