Access to healthcare for people seeking and receiving international protection

  1. People seeking international protection

    People who are still in procedure are entitled to health insurance, accessible medical care and free use of medical services such as Bulgarian citizens (under the Asylum and Refugees Act and the Health Insurance Act).

    Primary care is the responsibility of the State Agency for Refugees (SAR) and is implemented with the support of international and local NGOs.

  2. People who have been granted international protection (refugee status, humanitarian status, temporary protection)

    In order to be entitled to health services, the person granted international protection must have an identity card issued.

    When an ID card is issued, people receiving international protection must refer to the SAR (and in particular the Ovcha Kupel REA). A copy of the ID card must be sent to SAR to the National Revenue Agency (NRA), which transfers the health insurance to the person from the personal number of an alien (NSA) to a single civilian number (PIN).

    Then, the recipient of international protection completes Declaration No. 7 in the relevant NRA regional unit under address registration.

    Important! If this procedure is not done, the NRA system may consider that there are non-existent obligations to pay health insurance contributions for previous years.

  3. Health insurance

    Following the procedure above, the health insurance of people receiving international protection must be paid in order to preserve the right of all healthcare services.

    If the beneficiary of international protection works on a labor or employment contract, the health insurance is paid by the employer at 60% and 40% is paid by the employee’s salary.

    A person who has been granted international protection, who is unemployed or self-employed (for example, with a free profession as a doctor, craftsman, trader, farmer, etc.), pays his own health insurance, which in August 2017 is 18, per month. They are deposited at the counters of the bank, which is located in the respective NRA regional office, after filling in a blank copy in two copies, which is received at the place.

    Important! The form must be filled in exactly to pay the money deposited into the correct bank account.

    In case of unpaid health insurance for more than 3 months, the person in the NRA system already has “discontinued health entitlements” which are reimbursed after payment of the unpaid amounts.

    If a person has a “disconnected health entitlement”, he/she must take the amount of healthcare he/she wants. If he wants to re-establish his/her health entitlements and immediately benefit from a health service, besides paying the sum, the person must also take a “note of due sums” to the doctor with whom he/she wants to review because the doctor can not check the restored health rights immediately in the system. A check for unpaid health insurance can be done on the NRA’s website after entering an EGN.

    Important! The payment of health insurance benefits in principle relieves the person benefiting from health services from payment for them. However, there are certain minimum fees, such as a stay in a hospital per day (in 2017 it is BGN 5.80) and a check with a GP or dentist (in 2017 it is BGN 2.90), with copayment for the services not covered by the National Health Insurance Fund (NHIF). The children do not have to pay a medical examination fee, and for pensioners the examination fee is BGN 1.

    A person with continuous health insurance can use emergency medical and dental care while in another EU country if a European Health Insurance Card (EHIC) has been issued. Card issuance is free of charge.

  4. Choosing a general practitioner (GP)

    Every health-insured person with paid health insurance must choose a GP. This may be done during the procedure for obtaining international protection or as soon as possible afterwards. The personal doctor conducts prophylactic examinations, issues directions for specialist doctors, issues a medical certificate for starting work, etc. If a person already has a GP and wants to choose a new one, he or she should visit the new doctor only in the period June 01-30 or December01-31.

  5. Access to health care and conclusion of an agreement for integration with the municipality

    According to the Ordinance on the terms and conditions and procedure for concluding, implementing and terminating the agreement on the integration of aliens with granted asylum or international protection (Ordinance on Integration Agreements) of July 19, 2017, when signing such an agreement between the person who received international protection and the mayor of the municipality where he/she wants to live, support is provided by:

    • informing of the options of choosing a GP on the territory of the municipality;
    • informing the relevant Regional Health Inspectorate and the Health Insurance Fund about the concluded integration agreements.

    The Ministry of Health of the Republic of Bulgaria – through the Regional Health Inspections, provides the person who has concluded an agreement on integration:

    • information on how to carry out compulsory immunizations and re-immunizations (or a plan to carry them out with regard to age) – this is true while the person does not yet have a GP;
    • information on preventive examinations and studies and the preparation of a plan for their implementation;
    • information on the right of access to health services under national and regional health programs;
    • information on the health requirements for admission to kindergartens and schools;
    • to perform anti-epidemic measures, if necessary.