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Update on Medical Insurance - Page Two

With regard to the EU citizens permanently residing in Bulgaria, the issue with changing their place of medical insurance is easily addressed – as soon as they stop paying their medical insurance elsewhere – they will (and are obliged to) start paying medical insurances in Bulgaria. Another question, important to us, which got the “We do not know” answer in both institutions quoted above, was: If you have income in another country, in which you are medically insured, but you also have income in Bulgaria, will you still be obliged to pay medical and all other insurances on that income? Two established legal principles conflict in this case – the principle for avoidance of being medically insured in two different EU countries, and the principle that all income is subjected to medical insurance and social security charges. We would rather suggest that you will have to pay medical insurance in as many EU countries, in which you have income, but neither the law nor the established practice of the competent authorities has provided the real answer yet.

A similar approach we would suggest also in respect of EU citizens, who are shareholders or directors in Bulgarian limited liability companies. If the company is “non-active” (dormant) and the shareholders and/or directors do not derive any income from it, they are not obliged to pay medical insurance. Medical insurance is definitely due by the shareholders and/or directors of Bulgarian limited liability companies, if the company provides income for them, if the shareholders and/or directors are permanently resident in the country. If they are only long-term residents, the question still remains in the ‘grey’ area of the law.

In respect of pensioners it is much more straightforward. All that a retired EU citizen, living in Bulgaria, has to do, is to get Form E-121 from their country of medical insurance, which will provide them full medical care, identical to the one provided to Bulgarians.

Finally, some hints on the level of medical treatment in Bulgaria may help you choose whether to bother trying to get free medical care in Bulgaria at all, or just make sure you pay when you are obliged to and observe the law:

  • Even if your country of medical insurance is Bulgaria, in order to obtain the right for free examination by a medical expert or for some more specific tests (in fact almost everything that cannot be provided by your GP), you need to prove to your GP that you really need it. GPs get a very limited number of the so-called “directions” for their registered patients and will not give you one, unless it is not really necessary. Otherwise, you have to go to the relevant specialist of your own will and pay for that.
  • Being medically insured in Bulgaria does not mean that all your medicines will be provided for free. There is a certain list of free medicines, determined by the Ministry of Health every year, but they relate to serious medical conditions only. In the most common case you are required to pay for your medicines.
  • The free dental care covers only the taking out of one tooth (as if you need it every year!) and two fillings (metal ones!) per year. In practice, these three free procedures are totally useless, so you normally always go to a private dentist – no one wants iron in his teeth in the 21st century.
  • To get to your GP for examination or for a free “direction”, most times you need to queue together with at least 10 pensioners, which may be quite annoying for an active and busy person.


Roumen V. Petrov
Asya Mandjukova
GPNG Law Firm