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This guidance will be updated if anything changes to how you get state healthcare in Bulgaria.
This information is about living in Bulgaria. Theres different guidance if youre visiting Bulgaria.
State healthcare in Bulgaria is not completely free. You may need to pay something for most treatments and services. How much you pay depends on how your healthcare is funded.
UK nationals usually access the Bulgarian healthcare system in one of these ways:
- paying state health insurance contributions through their Bulgarian employer
- paying state health insurance contributions independently if youre self-employed or financially independent
- taking out private health insurance
- using a European Health Insurance Card (EHIC) or UK Global Health Insurance Card (GHIC) for temporary stays
- registering a UK-issued S1 form with Bulgarias National Health Insurance Fund (NHIF)
Healthcare if you live and work in Bulgaria
You must register as a resident if you intend to stay in Bulgaria for more than 3 months.
When you apply for residency, youll be asked to show a proof of health insurance.
As a resident, you can pay national health insurance contributions. This will entitle you to cheaper state healthcare, so youll only pay a small patient fee rather than the full amount.
If youre employed or self-employed, youll pay monthly national health insurance contributions to the National Revenue Agency (NRA, website in Bulgarian)
If youre not working, you can either:
- pay your contributions to the NRA by registering as a self-insured person
- get private health insurance
You may be entitled to a Bulgarian EHIC for travel, including visits to the UK.
You may also have the right to apply for a UK S1 if you start drawing a UK State Pension.
How to register
You must register as a resident to pay healthcare contributions in Bulgaria.
If youre working for a Bulgarian employer, theyll arrange for monthly national health insurance payments to the NRA to come out of your salary before youre paid.
Youll need to register at your local NRA office (website in Bulgarian) if youre:
- registering as a self-insured person
Check with your local NRA office what documents youll need to provide when you register.
Once youre making contributions, you can register with a local GP. Make sure theyre registered with the National Health Insurance Fund (NHIF).
Your GP will help you get a National Health Insurance Card. Show this whenever you see a doctor.
Youll need a referral from your GP to see a specialist. If you dont have a referral, youll have to pay the full price of the visit or treatment.
How much youll pay
If youre employed, your monthly national health insurance contributions are 8% of your salary before tax, split between your employer and you. Your employer pays 4.8% and you pay 3.2%. Your contribution will be taken out of your salary before youre paid.
If youre self-employed, your national insurance contributions will be 8% of your taxable income.
If you do not have a taxable income for example, you receive a pension youll pay a small health insurance contribution. This is set from the national minimum wage.
Emergency healthcare is free in Bulgaria.
Youll have to pay a small amount for most other medical services, for example:
- from 2.90 Bulgarian leva for a visit to your GP
- from 5.80 Bulgarian leva per day for the first 10 days youre in hospital
Some people may be exempt from paying healthcare costs, for example if youve just given birth or are having cancer treatment. Youll need an exemption certificate from your doctor.
There are no set costs for dental treatment.
Youll have to pay for all prescribed medicine. How much youll pay depends on the medicine.
If your UK employer has sent you to Bulgaria temporarily (posted workers)
A posted worker, also known as a detached worker, is someone employed or self-employed in the UK, but temporarily sent to a European Economic Area (EEA) country.
UK posted workers can access healthcare in Bulgaria using an EHIC, GHIC or S1 form.
HMRC has a helpline for National Insurance enquiries from non-UK residents. They can answer questions about posted worker status and explain which documents you will need to get healthcare while posted.
UK-funded healthcare: using an S1 form in Bulgaria
Theres different guidance if you have an S1 as a posted worker.
You may be entitled to state healthcare paid for by the UK if youre a Bulgarian resident and receive a UK State Pension.
You may also be entitled to an S1 form if youre a frontier worker (someone who works in one state and lives in another). You must contact HMRC National Insurance enquiries to find out if youre eligible.
If you started living in Bulgaria before 1 January 2021, you may also be entitled to an S1 if you receive some other exportable benefits.
Once you have an S1 form, you must register it with the Bulgarian National Health Insurance Fund (NHIF).
This will mean you and your dependants will be entitled to healthcare in Bulgaria on the same basis as a Bulgarian citizen.
Youll also get:
Dependants and family members may be classified differently in Bulgaria than the UK.
Check with the local authorities when you register your S1 form.
How to get an S1 form
If you have a UK State Pension, you must request an application form by phone from NHS Overseas Healthcare Services.
NHS Overseas Healthcare Services
Telephone: +44 (0)191 218 1999
Monday to Friday, 8am to 6pm
Saturday, 9am to 3pm
How to use an S1 form in Bulgaria
Once you have an S1 form, you must register it with your local NHIF office.
Youll get a certificate to show that youve registered your S1 form. Bring this with you whenever you visit a doctor or get medical treatment.
This will show youre entitled to healthcare on the same basis as a Bulgarian citizen.
Studying in Bulgaria
You can use an EHIC or GHIC to get medically necessary healthcare until the end of your study period. You can use your card in Bulgaria and when you travel to other EU countries.
Getting treatment in the UK
Some former UK residents do not have to pay for NHS treatment when visiting England. This includes UK nationals who started living in the EU before 1 January 2021.
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