Health Care for UK Citizens living in Bulgaria

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This guide is for UK citizens living, working or studying in Bulgaria; guidance is different for those visiting the country.

For those legally resident in Bulgaria up to and including December 31 2020, access to healthcare in the country will stay as is for the entire duration of residency.

Healthcare provision in Bulgaria is not totally funded by the state. Anyone in need of medical attention is required to make a contribution to costs; exactly how much depends on how the care is funded.

UK nationals usually access the Bulgarian healthcare system in one of the following ways:

  • state health insurance contributions paid by their Bulgarian employer
  • state health insurance contributions paid independently (for self-employed or those financially independent)
  • through private health insurance
  • via a UK-issued European Health Insurance Card (EHIC) for temporary stays
  • registering a UK-issued S1 with Bulgaria’s National Health Insurance Fund (NHIF).

 

The S1 system gives access to state healthcare for UK citizens on the same basis as to Bulgarian nationals. Recipients of UK state pensions and some other British benefits are eligible for S1 status.

Healthcare for British Bulgarian residents

Employed residents are liable to pay 8% of salary for healthcare. This is divided into 4.8% paid by the employer, and 3.2% by the employee. Contributions are deducted directly from salary.

Self-employed Bulgarian residents must pay 8% of their taxable income to the NRA / NHIF

For those without a taxable income, healthcare contributions are levied based on 8% of the national minimum wage; as of 2020, this equates to 24.40 Bulgarian leva per month.

All emergency healthcare is free in Bulgaria.

Other medical treatments and visits incur a small cost, including:

  •  approx. 2.90 Bulgarian leva per GP visit
  • approx. 5.40 Bulgarian leva per day for the first 10 days in hospital

There are exemptions from the above costs in certain circumstances, e.g. for new mothers and cancer patients. The GP must issue an exemption certificate.

There are no set costs for dental treatment in Bulgaria.

Payment is required for prescribed medicine; prices vary according to the medicine.

Posted workers

Posted workers are UK residents who are usually employed (including self-employed) in the UK, but have been ‘posted’ abroad to work in another country within the European Economic Area (EEA) for a specific period of time. Bulgaria is in the EEA.

Up until 31 December 2020, posted UK workers can access healthcare in Bulgaria via the EHIC system.

Non-UK residents posted in Bulgaria will require healthcare using a different route; HMRC has help advice for workers in this situation.

Both the EHIC and S1 healthcare provision systems remain in place for the duration of 2020.

S1 healthcare for UK citizens resident in Bulgaria

UK nationals registered as Bulgarian residents are eligible for state-funded healthcare, provided they receive:

  • a UK state pension
  • one or other ‘exportable benefits’.

(Note: Not all UK benefits claimable abroad entitle the claimant to UK-funded healthcare.)

Posted workers and frontier workers (those working in a different country to that of their registered residence) may be able to claim healthcare cover via the S1 system. Contact HMRC National Insurance for details.

Once registered with the Bulgarian National Health Insurance Fund (NHIF), the S1 healthcare form covers the applicant and any dependents.

Obtaining an S1 form

Recipients of UK state pensions or other exportable benefits should apply for an S1 form from the following:

NHS Overseas Healthcare Services
Telephone: +44 (0)191 218 1999
Monday to Friday, 8am to 6pm
Saturday, 9am to 3pm.

Using the S1 form in Bulgaria

Once the S1 form is completed, it should be registered with a health insurance fund.

After registration with the fund, the residency card will be updated with its details. Healthcare is then available on the same basis as for Bulgarian citizens.

UK S1 healthcare in Bulgaria from 1 January 2021

UK citizens registered as Bulgarian residents as at 31 December 2020 will continue to receive the same level of healthcare via the S1 system after that date, providing they:

  • receive a UK State Pension;
  • receive another ‘exportable benefit’; or
  • are a frontier worker (someone who works in one country while resident in another).

This coverage also ensures:

  • continued access to healthcare in Bulgaria with the UK-issued S1 form;
  • a UK-issued EHIC for travel;
  • planned treatments in other EU countries via the S2 system;
  • access to the NHS in England, Scotland and Wales when in the UK.

UK students living in Bulgaria

Students studying in Bulgaria should apply for a Student European Health Insurance Card (EHIC). This version of the EHIC gives access to healthcare for a longer period.

EHIC does not replace health insurance; this should be taken out by the individual student before travelling abroad, and cover the length of the course of study.

Students can also apply for healthcare cover via the S1 system; this requires registration as an Bulgarian resident.

Students registered with the EHIC system before 1 January 2021 will continue to receive healthcare cover in Bulgaria for the duration of their course.

Returning to live in the UK

Any UK citizen returning to the country to live permanently is entitled to full access to the National Health Service (NHS).