Updated 18.03.2025
Who is entitled to health insurance in Bulgaria?
In Bulgaria, the following categories of persons are subject to mandatory health insurance:
• Foreigners or stateless persons granted the right to long-term or permanent residence in Bulgaria. The obligation to provide insurance arises from the date of receipt of the relevant permit;
• Persons granted refugee or humanitarian status, or the right to asylum, as well as persons who are in the process of international protection;
• Persons with temporary protection;
• Foreign students and doctoral candidates admitted to higher education institutions and scientific organizations in Bulgaria under the Decree of the Council of Ministers No. 103 of 1993 on the implementation of educational activities among Bulgarians abroad and Decree of the Council of Ministers No. 228 of 1997 on the admission of citizens of the Republic of Macedonia as students in state higher education institutions of the Republic of Bulgaria.
Important! For foreign citizens who are staying in the country for a short or continous term, no health insurance contribution is due. They pay the cost of the medical care provided to them, unless an international treaty to which the Republic of Bulgaria is a party is in force for them.
Persons with refugee or humanitarian status, asylum seekers and Ukrainian citizens with temporary protection in Bulgaria, as well as persons with long-term or permanent residence have equal rights to healthcare with Bulgarian citizens and are subject to mandatory health insurance.
Ukrainian refugees who are registered for temporary protection who entered the territory of Bulgaria before 26.04.2022 are considered as health insured as of 26.04.2022.
If you have refugee or humanitarian status
Once you have been granted refugee or humanitarian status, you are obliged and personally responsible to pay your monthly health insurance contributions if you are unemployed or self-employed. If you are employed, then your employer will deduct the health insurance contributions from your monthly salary.
If you are an asylum seeker with ongoing proceedings
As an asylum seeker, your health insurance is covered by the State Agency for Refugees (SAR) while your procedure for international protection is pending and you have not received a final decision.
If you are a Ukrainian refugee with temporary protection over the age of 18 or under 63 for women and under 65 for men
Your health insurance is covered by the state for 90 days from the date of registering for temporary protection, or from 26 April 2022 if the temporary protection was granted before that date.
After those 90 days, you must pay for your own health insurance. If you are employed, your employer will deduct the health insurance contributions from your salary.
If you are a Ukrainian refugee with temporary protection under the age of 18 or over 63 for women and over 65 for men
Your health insurance contributions will be paid by the State for the entire period of your temporary protection.
Other persons whose health insurance is paid by the state
There are other groups of people whose health insurance is paid by the state. These are:
- Unemployed persons who receive unemployment compensation;
- Persons with disabilities who have been injured in natural disasters and accidents;
- Persons who are under the age of 18, and older than 18, if they are studying full-time, until the completion of high school, but no later than the age of 22;
- students enrolled in work-based learning (dual system of education) for the duration of their studies in accordance with the relevant curriculum.
- University students who are in full-time education up until the age of 26 and doctoral students in full-time education under a state funded program.
- People who receive monthly social benefits and heating allowances if they are not insured on other grounds.
- Beneficiaries of state-funded social or integrated health and social services for residential care and shelter.
- Parents, adoptive parents, spouses, grandparents who care for a person with a 50% or more disability and who need someone else's help.
Procedure for establishing disability
- Persons who have retired in Bulgaria, regardless of the type of pension they receive (retirement pension, disability pension, inheritance pension, etc.). In this case, you will need to pay health insurance contributions only if you are both retired and continue to work.
Amount of health insurance
The amount of compulsory health insurance contributions for persons who are not registered as self-insured people and who are not insured under an employment or civil contract is 37,32 BGN per month.
If you are working, then your health insurance is charged as a percentage of the income you earn – 8% for 2025.
How can I pay for my health insurance?
Before you start paying your health insurance contributions, you must submit a Form 7 declaration to the territorial branch of the National Revenue Agency in accordance with the address where you are registered. You can find the addresses of these offices at this link. You can also file this declaration online through the NRA website with a Personal Identification Code (PIC).
You can then pay your health insurance on the spot at the territorial branches of the NRA with debit and credit cards at POS terminals, by bank transfer, by postal order or online through the NRA portal.
To pay your health insurance online, you need a Personal Identification Code (PIC). You can find out how to get one in this article:
HOW TO GET A PERSONAL IDENTIFICATION CODE (PIC)
Deadline to pay your health insuarance contributions
These contributions are due by the 25th day of the month following the month for which you owe health insurance contributions. If you pay later than this date, you will need to pay an interest for each day of delay. For example, the health insuarance contribution for January 2025 must be paid by 25 February 2025 at the latest.
Do I have to pay health insurance even when I am absent from Bulgaria for a long time?
Yes, you are obliged to pay your health insurance every month, even if you were absent from Bulgaria during that time and resided in another country.
The Foundation for Access to Rights made an official inquiry to the National Revenue Agency (NRA) regarding this obligation for persons with temporary protection as well. According to the NRA’s response, if you are registered with temporary protection in Bulgaria, you are obliged to pay your health insurance for the entire period during which you resided outside Bulgaria, for example, if you returned to Ukraine or were in another country. You are obliged to pay these insurance until the final termination of the temporary protection in Bulgaria by decision of the Bulgarian government.
According to the NRA’s official response, only persons with Bulgarian citizenship or dual citizenship are entitled to submit a declaration that they will be absent from the country for a certain period during which they will not owe health insurance. If you have international or temporary protection, you are obliged to pay your health insurance contributions during this time.
The NRA's response with erased personal data can be found at the end of this article.
What if I don't pay health insurance?
Your health insurance rights are interrupted if more than 3 monthly contributions are not paid. This means that if you need to go to the doctor you will have to pay a much higher fee for a check-up. Interrupted health insurance rights can be restored provided you pay all your outstanding health insurance contributions. Entitlements are restored from the date all outstanding health insurance contributions for that period are paid.
You can check your health insurance status, as well as check the periods for which you have not paid health insurance contributions, through the NRA's electronic service, which has free access: https://portal.nra.bg/health-status
Where your employer or another person is liable for your contributions, failure to pay will not disqualify you from health insurance system.
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