How does healthcare work in Bulgaria, and what travel insurance, health insurance or expat insurance do you need?

What is the quality of healthcare in Bulgaria?

• In Bulgaria you will find an interesting combination of well-trained healthcare workers and outdated facilities. The latter mainly due to a lack of funding from the government (or the National Health Insurance Fund - NHIF).
• For everyone who works and lives in Bulgaria, it is mandatory to contribute to the national health insurance under the Health Insurance Act of 1998.
• For this reason, there is also a large supply of private institutions.
• There are hospitals in every big city and there are also many specialist centres.
• Outside the big cities such as Sofia and Plovdiv, it can be difficult to find English-speaking doctors.
• Only qualified pharmacists can dispense medicines, this is different from a few years ago when you could easily buy antibiotics and other medicines without a prescription.
• The government is working on improving emergency care. To get help you can call 112, but sometimes it is still difficult to communicate.

How does the public healthcare system work in Bulgaria?

• Public healthcare is run by regional health centres. Public healthcare is quite limited due to a lack of funding. As a result, there are often too few staff and the facilities leave much to be desired. Nevertheless, there are incredibly well-trained people working there who are working hard with the oars they have.
• EU residents can use their European Health Insurance Card to access free healthcare in public hospitals.
• Everyone who goes to live and work in Bulgaria is entitled to free or cheaper public healthcare (both medical and dental).
• It is mandatory for working emigrants with a residence permit to contribute to the public healthcare system.

How does the private healthcare system work in Bulgaria?

• Private healthcare is much better in Bulgaria. Private healthcare focuses on specialist care, primary medical care, pharmaceutical care and dental care. Many expats go for private healthcare.
• Many well-trained doctors from the public sector switch to the private sector. Furthermore, healthcare is generally cheaper than in surrounding Western countries.
• The private sector in Bulgaria itself attracts medical tourism for, for example, dental care and cosmetic surgery.

How is the family doctor or general practitioner arranged in Bulgaria?

• If you contribute to the national health care system, you can choose your own GP. Their offices can be found throughout the country. 
• The GP is the first point of contact and will treat you as much as possible. The GP can also refer you to a specialist.

How is the dental care and dentist arranged in Bulgaria?

• There are both public and private dental clinics. Appointments can be made for public institutions via the National Health Insurance Fund (NHIF). However, many emigrants choose a private clinic because of the shorter waiting times and the greater range of care available.
• Part of the public dental care is covered via the public system.
• Private dental care can be paid for via private insurance or out of your own pocket. To find a private clinic, you can look at the Bulgarian Dental Association (BDA), which offers a list of recognised dentists.
• Bulgaria is a popular destination for medical tourism in the field of dental care.

How is pregnancy and maternity care arranged in Bulgaria?

• Maternity care in Bulgaria is highly medicalised. Midwives play a small or no role in maternity care.
• The quality of pregnancy and maternity care also varies greatly by area. In cities, care is generally better than in rural areas.
• Through the national health care system, you will receive a check-up once a month for the first 7 months, then once every two weeks until the birth.
• As soon as you give birth, you will be admitted to the hospital in a 2-4 person room. You can also arrange a private room in advance, but then you often have to pay extra.
• After a normal birth, mothers usually stay in the hospital for three days, after a caesarean section for 5 days. You may be separated from your baby for a relatively long time.
• Most births take place in the hospital. Home births are almost non-existent, and midwives are not trained for home births.

How safe or unsafe is a trip or stay in Bulgaria?

What should you pay attention to in terms of safety in Bulgaria?

• Life in Bulgaria is generally great and safe, although there are some minor things to keep in mind.
• Bulgaria is a hub for a number of problems such as smuggling and illegal immigration, but as an expat you will not encounter these quickly.
• As a foreigner, there is a greater chance that you will encounter minor crime. For example, there are many pickpockets active in city centers, stations and tourist areas. Robbery from hotel rooms also occurs.
• Conflicts occur more in the poorer suburbs of cities. These places are best avoided, especially in the evening and certainly as a woman alone. Drunken fights can also occur around nightclubs and bars.
• Another problem in Bulgaria are problems surrounding ATMs and credit cards. Bulgaria unfortunately experiences major organized crime aimed at stealing card details.

What should you look out for in terms of diseases in Bulgaria?

• There are not many health risks in Bulgaria. Watch out for ticks when walking in natural areas and beware of the sun, which can be quite hot! 
• Tap water is drinkable and food hygiene is generally good.
• There are many stray dogs. Make sure you act quickly when you get bitten or licked on an open wound by a dog. 

What should you pay attention to when it comes to traffic in Bulgaria?

• People drive on the right in Bulgaria. The roads are generally not of the best quality (although there are also good motorways) and locals can drive quite recklessly. So be conservative in your own driving style.
• For the major roads outside the cities you usually need a vignette. You can get these at petrol stations.
• In the countryside there are sometimes animals on the road, especially during the harvest season.
• In winter the road conditions can be quite rough, so make sure you have winter tyres. It is also required by law to have snow chains in the car from November to March.
• Bus and train transport are good and popular.

What are the best insurance options for backpacking, traveling, doing an internship, studying, volunteering, or working in Bulgaria?

• Is the trip to Bulgaria and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity?
• Insurance for backpacking and traveling in Bulgaria
• Insurance for studying in Bulgaria
• Insurance for internships in Bulgaria
• Insurance for volunteering in Bulgaria
• Insurance for digital nomads or paid work in Bulgaria

What types of insurance should you get if you're planning to emigrate, work as an expat, or live in Bulgaria?

• It is mandatory to have local insurance for long stays in Bulgaria. The local insurance is insufficient, when you want access to better and faster care. You need your own international insurance, when you want to be reimbursed for emergency treatment abroad or medical repatriation.
• Make sure your insurance covers medical evacuation as well as coverage in neighboring countries.
• International health insurance for Bulgaria
• International travel insurance for Bulgaria
• International life insurance for Bulgaria
• International income protection insurance for Bulgaria