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Finding your Way through the Health System - short term visitors

The Bulgarian Health System has been grossly underfunded during the Communist and post Communist era and the buildings lack any aesthetic surroundings although they do now contains much in the way of modern technology, which in city hospitals is on a par with that offered in the West. The standard of nursing and ancillary care varies between institutions and in some cases relatives are expected to provide food for the sick family member as well as spending long periods in the hospital arranging bedding. All medication must be paid for and in some instances you will be asked to collect a prescription for you relative from a nearby pharmacy.

There are also 30 specialist hospitals located across the country – some specialise in the treatment of particular diseases whilst others cater for patients in need of rehabilitation – the thing to remember is that such hospitals may be located hundreds of miles from your home town, but they are well equipped to deal with ease with their areas of speciality.

Each hospital has an Accident and Emergency department, which treats all emergency cases in one area. Emergencies are admitted without a doctor’s referral to the closest hospital until their condition is stabilised or until they can be transferred to a hospital that caters for their injury or illness. Foreign visitors and expats can attend the A&E using their EHIC cards in conjunction with their passports. If you need to call an ambulance dial 112, the EU emergency number.  Bear in mind that sometimes it may be faster to take a taxi.

It is worth noting that Bulgarian pharmacies are often the first point of call for those with minor ailments and injuries. It is only recently that pharmacies known as Apteka became regulated by the government. Prior to 2007 they were often manned by non-qualified personnel, however today all pharmacists must be qualified to prescribe drugs. Pharmacies can sell many drugs over the counter, which are not permitted for sale without a prescription in the West, medicines like antibiotics without a prescription.

Healthcare for Short Term Foreign Visitors

All states within the European Union have a reciprocal health agreement with Bulgaria and this also includes those non-EU members who are part of the European Economic Area, namely Norway, Switzerland, Iceland and Liechtenstein. Some of Bulgaria’s neighbouring countries and former CIS country members also have reciprocal medical agreements. Those citizens who do not hold a passport from a country in these groups must ensure that they have private medical insurance to cover their stay in Bulgaria.

If you are an EU citizen, you should ensure that you apply for a European Health Insurance Card (EHIC). This allows you to receive free medical treatment for any injury or illness that occurs during your stay here. This treatment can only be given in state institutions and any treatment within a private clinic must be paid for accordingly. The card also provides treatment for ongoing chronic disease and illness as well as routine maternity examinations. If you need treatment like oxygen therapy or kidney dialysis whilst you are visiting the country, you have to arrange this in advance.

You must be sure that your illness or injury is deemed significant and has happened during your stay, otherwise you will be asked to pay private medical fees. Backache or a sprained wrist is not considered a medical emergency no matter how painful, unless it turns out to be broken or part of a larger life threatening problem.

The World Health Organisation does not recommend any vaccinations for visitors to Bulgaria, but some medics recommend that those staying outside of the tourist resorts ensure that they are vaccinated against tetanus, typhoid and hepatitis A, hepatitis B, tick-borne encephalitis and rabies.

The decision to immunise against these is an individual one and most people do not bother.

Bulgaria’s abundance of mineral springs mean that its tap water is safe to drink although the water is chlorinated and some visitors experience mild stomach upset because of this.


Health Care Within the Resorts

Within Bulgaria’s many holiday resorts there is a wide range of medical care on offer – everything from physiotherapy to dental care. Visitors should be aware that these facilities are all private practices and are limited in the injuries and illnesses they can treat – they also charge extremely high fees and do not accept the EHIC card. Fees in excess of 100 lv. are charged for treating a bout of ‘flu, when the local chemist could have provided medicine to cure the common cold at a fraction of the price. Visitors who run to their hotel reception desk for help with an ailment or injury are likely to find themselves transported by ambulance to the nearest private clinic. It is wise to refuse an ambulance if you can make your own way there as the cost is in the region of 200 lv. for journeys as short as two minutes!