Available Healthcare in Bulgaria

The rise in popularity of Bulgaria among holiday makers, holiday home seekers and even those looking for an attractive and affordable retirement location or a new country to live in abroad means that greater numbers of international citizens are spending increased amounts of time in Bulgaria.

If you fall into any of these categories you really should be appraised of the situation relating to available healthcare in Bulgaria before you go just in case you fall ill, fall over or find yourself in need of a doctor! This is a guide to the available healthcare in Bulgaria and it contains the recommendations of the British Department of Health regarding health insurance requirements for foreigners travelling to or living in Bulgaria.

The state health care system in Bulgaria has been severely under funded for many years and although things are slowly changing now that Bulgaria has joined the EU, is in receipt of financial assistance and is actually improving its own economy, changes such as these take significant amounts of time. As a visitor to Bulgaria or a foreign citizen living in Bulgaria a great deal will depend on your home country’s reciprocal agreement with Bulgaria for the provision of healthcare as to whether you will receive any treatment free or whether you will have to pay for all treatment.

British citizens are the main ones currently moving to Bulgaria and taking holidays there and fortunately for them, Britain has a reciprocal agreement in place whereby any Bulgarian in the UK who requires emergency medical or dental assistance will receive it, so any Brit in Bulgaria who needs urgent attention will receive it free of charge as well.

When it comes to the availability of doctors, medical clinics and hospitals it all depends on where you’re headed. In the main towns, cities and resorts there is a far greater availability of general services – both private and state funded – but as soon as you venture into the more rural areas of Bulgaria and away from the madding crowd you’ll find it harder to find any form of medical assistance (this is certainly worth bearing in mind if you’re thinking about living in Bulgaria and you prefer a rural retreat). You may have to travel long distances just to see a GP or to buy basic medical supplies.

According to the UK’s Department of Health website “recent changes suggest that the state healthcare sector is very limited. Private medical insurance cover is strongly recommended.” We would agree with this statement – if you’re going to be spending any amount of time in Bulgaria you’d be very wise to take out a medical insurance policy and probably one that covers not just emergency treatment but all forms of treatment and even repatriation to your home country in the event that medical services in Bulgaria cannot treat you.

For those Britons who are happy to risk it and just rely on the reciprocal arrangement for the receipt of emergency treatment, they will need their passport and NHS medical card whenever they go to a doctor or to hospital, they will currently receive medical, hospital and dental treatment free and have to pay for medicines, certain specialist treatment and most laboratory tests.

The NHS is a residence-based healthcare system. Therefore, once you have moved permanently away from the UK you are no longer entitled to medical treatment under normal NHS rules.

You must notify your former GP when you move so that you and your family are removed from the NHS register.

You will also no longer be entitled to use your UK-issued European Health Insurance Card (EHIC) to access healthcare abroad.

The National Health Insurance Fund administers the health insurance system in Bulgaria and is carried out by its territorial divisions – the 28 regional Health Insurance Funds.

The availability of state provided healthcare varies in Bulgaria. Although bigger cities and towns provide access to clinics, doctors and hospitals, provision in the more rural areas is restricted.

Short-term stay: According to the new requirements, Bulgarian doctors are obliged to charge all EU-members at the standard prices, defined by the National Health Insurance Fund (NHIF). This means that you can go to any doctor who works with NHIF, bringing only your EHIC (European Health Insurance Card) with you. Then the NHIF will contact your own health care fund to receive the money for your treatment. Only if you would require some specific medical services, you could make a health insurance as it covers bigger costs.

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Doctors
About 90% of doctors in Bulgaria are registered with the National Insurance Fund, however, you should always check before making an appointment. There is a small charge for seeing a doctor. This is non-refundable in Bulgaria but you may be able to seek reimbursement when you are back in the UK (limited to the equivalent cost on the NHS).

If you require medication, a doctor will usually issue you a receipt form (for non-chronic diseases) or a prescription (chronic illnesses).

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Hospital treatment
Inpatient treatment is provided by public and private hospitals. However, you should ask to be referred to a hospital that has a contract with the National Health Insurance Fund, as they will cover the cost of treatment. After being discharged from hospital, you are entitled to maximum two examinations as part of your in-patient care.

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Prescriptions
If you have been issued a receipt form you are able to get you medication for either free or at a reduced cost. However, ensure you take the receipt form to a pharmacy that is registered with the National Health Insurance Fund otherwise, you will have to pay the full price.

If you have been issued a prescription you can visit any pharmacy in Bulgaria but you will have to pay the full cost. This is non-refundable in Bulgaria but in case your stay is temporary you may be able to seek reimbursement when you are back in the UK (limited to the equivalent cost on the NHS).

A final note worth adding is that while many doctors have at least rudimentary English language skills, the majority of nursing staff do not. Therefore if you can, take someone who can translate with you when you go to seek medical assistance! Additionally, the numbers of nursing staff available per patient is very low in Bulgaria and so general nursing duties such as changing sheets and administering meals in hospitals are expected to be done by the family members of the sick person.

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Compare the cost of elective surgery abroad

The information provided here on the cost of elective surgery abroad is obtained from the Treatment Abroad PriceWatch Survey 2008, an independent survey of medical tourism prices.

The price comparisons take into account hospital and doctor charges, but do not include the costs of flights and hotel bills for the expected length of stay.

Bear in mind that these are average costs based on a survey of a large number of clinics and hospitals abroad. Also note that the pound sterling prices calculated below, were based on a Euro conversion rate of €1.08 = £1, and a dollar conversion rate of US$1.39 = £1.

Coronary bypass surgery

Country UK sterling price including hospital and doctors’ fees € equivalent US dollar equivalent
UK £14,025 €15,147 $19,495
Bulgaria £10,024 €10,826 $13,933

Arthroscopy

Country UK sterling price including hospital and doctors’ fees € equivalent US dollar equivalent
UK £2,400 €2,592 $3,336
Bulgaria £1,273 €1,375 $1,769
Germany £1,500 €1,620 $2,085
Spain £1,875 €2,025 $2,606
Thailand £1,865 €2,014 $2,593

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