Healthcare in Bulgaria

Although the quality of healthcare in Bulgaria does not meet the standards of most Western European countries, the country provides universal healthcare and low hospital fees. While Bulgaria has made some improvements in healthcare infrastructure, recent reports indicate the system faces significant challenges, with Bulgaria recording some of the highest mortality rates and largest negative population growth in the EU.

Bulgarian doctors and medical staff are highly trained, but the country’s health infrastructure has funding challenges. The state spends the lowest percentage of its GDP on healthcare among EU countries. Many hospital facilities are overcrowded and in poor condition, particularly in rural areas.

A public health insurance scheme primarily funds healthcare in Bulgaria and provides access to medical care through public hospitals and clinics. Bulgaria has implemented mandatory electronic health records (EHR) for all medical activities, so all health-related information for Bulgarian citizens is now centralised and easily accessible to healthcare providers.

Public healthcare in Bulgaria

Public healthcare is managed by the Ministry of Health. Although medical staff in Bulgaria are highly trained, new arrivals may find that the facilities in public hospitals vary widely. Expats will also find that English is not widely spoken in public hospitals.

Medical facilities in urban centres like Sofia and Plovdiv tend to be better equipped than those in rural areas, where access to doctors and hospital services is significantly more limited. Many healthcare establishments in smaller towns and rural areas face potential closure due to staff shortages. 

EU and EEA citizens can use their European Health Insurance Cards (EHIC) at Bulgarian public hospitals until they become residents of Bulgaria. British expats can also use their GHIC – or, for pensioners, their S1 forms. Once officially registered as citizens, foreign residents will have their healthcare provided for under Bulgaria’s compulsory healthcare insurance scheme.

Private healthcare in Bulgaria

Many new arrivals choose to use private healthcare in Bulgaria. The private sector’s general healthcare standards and facilities are typically superior to public healthcare services and should provide a familiar standard for EU expats.

While private healthcare in Bulgaria remains comparatively cheaper than in Western Europe, Bulgarians actually have to pay the highest private healthcare costs in the EU relative to their income, and significant private co-payments are required due to limited public funding.

Most private doctors are bilingual, which limits language barrier issues for expats. Bulgaria has also grown as a destination for medical tourism, as people travel to the country for cosmetic and dental procedures.

Health insurance in Bulgaria

Expats living and working in Bulgaria are given access to free or subsidised healthcare through the Bulgarian public health insurance system. Contributing to this system is compulsory for all residents in Bulgaria. When granted a residence permit, foreigners contribute to their health insurance through their Bulgarian social security number.

Workers in the country are enrolled in Bulgaria’s public healthcare system by their employers, with healthcare fees deducted from employees’ salaries. The total social security contribution rate is about 33 percent, which includes health insurance contributions.

Many expat retirees are not covered by compulsory health insurance plans and must secure private insurance to ensure healthcare coverage.

Polyclinics in Bulgaria

Polyclinics have a long history in Bulgaria, tracing their roots back to the socialist era, when they served as primary healthcare centres that provided an extensive range of services to the population. To this day, they serve as an essential component of the country’s healthcare system, acting as an intermediate level of care between general practitioners and hospitals.

These medical establishments have traditionally focused on providing outpatient services, including diagnostics, consultations and minor procedures. Over the years, polyclinics have evolved to cater to the diverse medical needs of the local population, often offering specialised care in fields such as paediatrics, gynaecology and cardiology.

Pharmacies in Bulgaria

Expats can easily find pharmacies in Bulgaria’s urban centres, and some hospitals also have a pharmacy attached. There are some 24-hour pharmacies in the largest cities like Sofia and Plovdiv.

Expats can buy many prescription medicines over the counter, and Bulgaria has been digitising its prescription system to improve medication access and reduce antibiotic misuse. Expats can have their prescriptions from other EU countries filled in a Bulgarian pharmacy. Pharmaceuticals in Bulgaria are relatively cheaper compared to the prices in other European countries. As brand names vary from country to country, expats should take note of the generic names of their medications.

Health risks in Bulgaria

New arrivals will experience few health risks when living in Bulgaria. If you’re going out in the countryside, be careful of tick-borne diseases such as Lyme disease and encephalitis. You can avoid tick bites using insect repellent and wearing long trousers.

Vaccinations for Bulgaria

Before they travel to Bulgaria, it is recommended that expats and tourists ensure they have received the appropriate vaccinations to safeguard their health. The following vaccinations are recommended:

• Routine vaccinations – such as measles, mumps and rubella (MMR); diphtheria, tetanus, and pertussis (DTP); polio; and varicella (chickenpox)
• Hepatitis A
• Hepatitis B

Emergency services in Bulgaria

Emergency care in life-threatening situations is free of charge in Bulgaria. Emergency rooms are required to treat every patient regardless of health insurance status, nationality or ability to pay.

Public ambulance services are free if urgent care is required, but patients must pay if their condition isn’t serious. Bulgaria has been actively improving its emergency services, including the introduction of medical helicopters.

Foreign residents should inquire about ambulance response times in their area, as it might be quicker for expats to make their own way to a hospital in an emergency. Some private hospitals operate their own ambulance services, which foreigners with private insurance should consider investigating.

Emergency numbers

• EU emergency line: 112
• Ambulance: 150
• Fire department: 160
• Police: 166