Health insurance in Bulgaria for foreigners and residents (2026)
Bulgaria has public health insurance run by the National Health Insurance Fund (NHIF/NZOK). If contributions are paid, your family doctor, referred specialist care and planned hospital treatment are largely free. Without contributions you pay, except for emergency care.
In short: the contribution is 8% of income (employee 3.2%, employer 4.8%). If you are not working and pay yourself, it is €24.81 a month from 1 August 2026. Children are covered by the state. Register with a family doctor first; specialists need a referral. The visit fee is €1.48.
Who is insured
- Employees — the employer pays (part is deducted from salary).
- Self-employed — pay themselves, at least €49.62 a month from 1 August 2026.
- Children, pensioners, full-time students under 26 and unemployed people on benefit — covered by the state.
- Everyone else living in Bulgaria long-term — pays €24.81 a month.
What applies to you
| Your situation | Who pays | What to do |
| Employee in Bulgaria | Employer and you (4.8% + 3.2% of gross) | Choose a GP; check your status in the NRA service |
| Self-employed | You, at least €49.62 a month | Pay by the 25th of the next month |
| Not working, living in Bulgaria long-term | You, €24.81 a month | Pay by the 25th; choose a GP |
| Child, pensioner, full-time student under 26 | The state | Register with a GP |
| Type D visa or residence without work (non-EU) | Private insurance (you) | Buy a policy with at least €30,000 of cover before applying |
Amounts as of 1 August 2026; details for each case are below. Check the rules for your own permit with the consulate or the NHIF.
What it costs
Pay each month's contribution by the 25th of the following month. If more than three contributions in the last 36 months are unpaid, your rights are suspended and treatment becomes chargeable; restoring them means paying all arrears for the last 5 years with interest.
Visit fee: €1.48 (pensioners €0.51), children free. Specialists need a referral from your GP. Emergencies: 112, free for everyone. Private specialists usually charge €30–60.
Choosing a family doctor
- Find a GP with an NHIF contract near you (NHIF/regional fund lists or local groups).
- Fill in the permanent choice registration form and hand it to the doctor with your ID.
- Your previous doctor's consent is not needed.
A first choice can be made any time. Changing is possible from 1 to 30 June and 1 to 31 December, or outside those windows if you move. Popular doctors' lists fill up — register soon after arriving.
How treatment works
- Visit fee for a GP or specialist: €1.48 (pensioners €0.51). Children are exempt.
- Specialists need a referral from your GP; without one you pay.
- Prescriptions are electronic; the NHIF pays fully or partly for some medicines for chronic conditions.
- Emergency care: call 112, free for everyone, even without insurance.
EU and non-EU nationals
- EU citizens can use their EHIC at first; once you live and work in Bulgaria you join the Bulgarian system.
- EU pensioners usually stay insured by the country paying the pension and register an S1 form in Bulgaria.
- Non-EU nationals are insured in the NHIF by law once they hold an EU Blue Card, a single residence and work permit, a seasonal work permit, temporary protection, or long-term (EU) or permanent residence (Health Insurance Act, art. 33). Others — for example on a type D visa or with a residence permit without work, as pensioners often have — need private insurance (see below).
Insurance for the type D visa
According to the Bulgarian Ministry of Foreign Affairs checklist, the type D visa needs a policy from an insurer licensed in the EU that covers the whole stay with at least €30,000 of cover, including emergency care, hospital treatment and repatriation. Consulates sometimes add their own details, so check with the consulate where you apply before you buy.
How to check that your insurance is active
Health insurance status is kept by the National Revenue Agency (NRA, НАП). You can check it for free:
- Online: the “health insurance status” service (Здравноосигурителен статус) on the NRA e-services portal, open to everyone. It shows the months with no contributions.
- At an NRA office: after an ID check you get a statement.
- By phone: NRA information centre, 0700 18 700.
Check before a doctor’s appointment or planned surgery, especially if you pay contributions yourself: it is easier to pay missing months before your rights are suspended.
Private healthcare
Every large city has plenty of private clinics. A specialist visit usually costs €30–60; tests and ultrasound are inexpensive by EU standards. Many employers offer extra private insurance, so ask at the interview. Our city guides list the main hospitals.
FAQ
How much is health insurance in Bulgaria in 2026?
Employees pay 3.2% of gross and employers 4.8%. People not working who pay themselves pay €24.81 a month from 1 August 2026; the self-employed at least €49.62.
How do I choose a family doctor in Bulgaria?
Find a GP contracted with NHIF, fill in the permanent choice registration form and give it to the doctor with your ID. Changes are allowed in June and December or after moving.
How much does a doctor's visit cost with insurance?
The visit fee is €1.48 (pensioners €0.51); children are exempt.
Are children insured in Bulgaria?
Yes, children are insured by the state and do not pay the visit fee.
What health insurance do foreigners need for a Bulgarian type D visa?
According to the Bulgarian Ministry of Foreign Affairs checklist: a policy from an EU-licensed insurer for the whole stay with at least €30,000 of cover, including emergency care, hospital treatment and repatriation. Check the details with your consulate.
Is health insurance mandatory for foreigners in Bulgaria?
Yes for foreigners with an EU Blue Card, a single residence and work permit, a seasonal work permit, temporary protection, or long-term or permanent residence: they are insured in the NHIF by law. Employers pay part of it; people not working pay €24.81 a month themselves. Others, for example on a type D visa, need private insurance.
What happens if I do not pay contributions?
If more than three contributions in the last 36 months are unpaid, your rights are suspended and treatment becomes chargeable, except emergency care. Restoring them means paying the arrears for the last 5 years with interest.
How do I check if my health insurance in Bulgaria is active?
For free: the health insurance status service on the NRA (НАП) website, at an NRA office or through the NRA information centre on 0700 18 700. The statement shows the months without contributions.
Is health insurance free in Bulgaria?
Not for adults: the contribution is 8%, and anyone paying it themselves pays €24.81 a month. Children are covered free of charge.
📚 Sources: 8
For information only; not legal advice.
