Quick Answer: Health Insurance in Bulgaria
Health insurance in Bulgaria is mandatory for employees, self-employed individuals, and certain uninsured residents. Contributions are collected by the National Revenue Agency (NRA) and managed by the National Health Insurance Fund (NHIF). The standard contribution rate is 8% of income, granting access to public healthcare services. Private health insurance may be used as a supplementary option but does not replace mandatory coverage.
Introduction
Health insurance in Bulgaria plays a central role in accessing medical care and maintaining legal compliance. Whether you are an employee, self-employed professional, business owner, or foreign resident, understanding how the system works is essential.
The Bulgarian health insurance system is based on mandatory public contributions, which provide access to state healthcare services through the NHIF. In addition, many individuals and employers choose to supplement public coverage with private health insurance for faster access and extended services.
This guide explains how health insurance in Bulgaria works, who must contribute, what is covered, how contributions are calculated, and when private insurance may be appropriate.
Mandatory Health Insurance Contributions in Bulgaria
Health insurance contributions are mandatory and calculated as a percentage of income. The rules depend on your employment status.
If you are employed
- Total contribution: 8% of gross salary
- Employer pays: 4.8%
- Employee pays: 3.2%
Contributions are calculated up to the maximum monthly insurance base of €2111,64 (BGN 4,130).
If you are self-employed or a freelancer
- You pay the full 8% contribution yourself
Current contribution bases:
- Minimum base: €550,66 (BGN 1,077) → minimum monthly contribution: €44.05 (BGN 86.16)
- Maximum base: €2111,64 (BGN 4,130) → maximum monthly contribution: €168.96 (BGN 330.40)
If you are a student
- Full-time students are generally insured by the state or their educational institution
- Part-time or distance students must insure themselves unless covered under another legal basis
If you are unemployed and not covered by social support
Monthly self-insurance contributions:
- January–March: €19.07 (BGN 37.32)
- From April onward: €22.03 (BGN 43.08)
These contributions must be declared via Form 7 (Obrazets 7) and submitted to the NRA.
Special notes
- Bulgarian citizens permanently residing abroad and holding dual citizenship are not required to pay health insurance contributions in Bulgaria (Article 33 of the Health Insurance Act).
- EU citizens working or managing companies in Bulgaria obtain full healthcare rights after 60 months of continuous health insurance contributions.
What Medical Services Are Covered by NHIF?
If your health insurance is active, the NHIF provides access to public healthcare services, including:
- General Practitioner (GP) consultations
- Specialist consultations (with referral)
- Hospital treatment
- Maternity care
- Partially or fully subsidised medications
Some services may require co-payments, depending on treatment and provider.
Accessing Healthcare in Bulgaria
To use the public healthcare system:
- Your health insurance must be active
- You must register with a General Practitioner (GP)
- GP referrals are required for most specialist visits
- Emergency care is available to everyone, regardless of insurance status
EU visitors or temporary residents may access public healthcare using a valid European Health Insurance Card (EHIC).
When Are Health Insurance Rights Suspended?
Health insurance rights are suspended if contributions are unpaid for three or more consecutive months.
To restore coverage:
- All outstanding contributions must be paid
- Statutory interest applies (currently approx. 20% annually)
- Coverage is reinstated once payments are processed by the NRA
Private Health Insurance in Bulgaria
Private health insurance is commonly used as a supplement to NHIF coverage.
Benefits of private insurance
- Faster access to diagnostics and specialists
- Access to private hospitals and clinics
- Broader coverage (e.g. dental care, extended hospital stays)
- Shorter waiting times
For employers
- Improves employee retention and satisfaction
- Recognised as a business expense up to €31 (BGN 60) per employee per month
- Amounts above this threshold may be treated as a taxable benefit
Private plans typically range from €10–50+ per month, depending on coverage.
Key Considerations
- Ensure contributions are paid correctly and on time
- Understand what NHIF does and does not cover
- Monitor annual changes to thresholds and contribution bases
- Seek professional advice when dealing with complex or cross-border situations
How Aidos Can Help
Aidos supports businesses and individuals with:
- Accurate calculation of health insurance contributions
- NHIF registration and compliance
- Payroll coordination for employees and managers
- Guidance on private health insurance options
👉 Contact us to discuss your specific health insurance or payroll situation.
For a broader employment cost overview, see:
Payroll in Bulgaria: An Essential Guide for Business Owners
Frequently Asked Questions (FAQ)
Who must pay health insurance in Bulgaria?
Employees, self-employed individuals, and uninsured residents who are subject to Bulgarian health insurance rules.
What is the standard health insurance rate?
8% of income, split between employer and employee for salaried workers.
What happens if contributions are not paid?
Health insurance rights are suspended after three unpaid months.
Is private health insurance mandatory?
No. It is optional and used to supplement public coverage.
Can employers provide private insurance?
Yes, and it is commonly offered as an employee benefit.
Does NHIF cover emergency care?
Yes, emergency medical care is provided regardless of insurance status.
Can EHIC be used in Bulgaria?
Yes, for temporary stays, under the same conditions as local residents.
📌 Disclaimer
This article is provided for general informational purposes only and does not constitute legal, tax, medical, or insurance advice. Health insurance regulations and contribution thresholds in Bulgaria may change. Always consult the National Health Insurance Fund (NHIF), the National Revenue Agency (NRA), or a qualified professional for advice specific to your situation.
Last reviewed and updated: January 2026