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 National Health Service Bulgaria

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PostSubject: National Health Service Bulgaria   Wed Nov 10, 2010 11:22 pm

Sorry about the translation g

How can I receive medical help within the scope of the public health insurance in case of a temporary stay on the territory of Bulgaria

I WILL TRAVEL TO THE REPUBLIC OF BULGARIA. I WILL STAY IN THE COUNTRY TEMPORARILY

In the Republic of Bulgaria the public health insurance is performed by one health insurance fund – The National Health Insurance Fund (NHIF). It is a public institution, which provides obligatory health insurance in the country and has 28 subdivisions in the regional central cities – regional health insurance fund (RHIF).

If I want to use the rights for obligatory health insurance, I have to use medical and dental care only in health establishments for outpatient care, health establishments for hospital care and independent medical and diagnostic laboratories, which have concluded agreements with the National Health Insurance Fund.

I don’t pay for the health services, provided to me from the package of the National Health Insurance Fund, except for the consumer tax.

I HAVE TO SUBMIT A CERTIFICATE of entitlement to benefits in kind for temporary stay in Bulgaria. This may be a European health insurance card (ЕHIC) or a certificate provisionally replacing the EHIC.This documents grant me entitlement to immediately necessary and necessary health care– i.e. each type of help, for which the doctor decides that depending on the health condition and the length of stay cannot be delayed until my planned return in the country where I live. If I don’t possess any of the two documents, this does not deprive me of medical care In case of necessity they may be additionally acquired from my health insurer.

It is recommendable to have copies of EHIC (or the Certificate provisionally replacing the EHIC), which I shall provide to the treating doctors.

I NEED EMERGENCY MEDICAL CARE

I call the center for emergency medical care (telephone 150) or turn for help to the health institution. I am examined and provided with medical help and in case of necessity I am transported to a hospital.

I HAVE A HEALTH PROBLEM OF WHICH IMMEDIATELY REQUIRES MEDICAL CARE

I turn for help to a general practitioner (GP) from a health institution for first outpatient medical care.
I have a proven health problem and plan to stay in Bulgaria for a period longer than 1 month, it is recommendable to temporarily select a GP from a health institution for first outpatient medical care, who has concluded a contract with the National Health Insurance Fund. For that purpose I shall fill in a registration form and present it to the doctor, selected by me.
Information on the addresses of the health institutions for first outpatient medical care, which have concluded contracts with the National Health Insurance Fund where I can select a GP, I shall receive in the relevant Regional Health Insurance Fund.
The general practitioner examines me and in case of necessity prescribes me a certain treatment. If he/she so decides the GP may:
• Prescribe medicines for home treatment, fully or partially paid by the National Health Insurance Fund;

• Issue a “Referral for Consultation or for Conducting of a Cooperative Treatment” to a relevant specialist;

• Appoint conducting of additional medical and diagnostic examinations with a “Referral for Conducting of Medical and Diagnostic Activities”;

• Issue a “Referral for hospitalizing” – in case that the treatment cannot be performed in the conditions of an outpatient medical care.

I NEED CONSULTATION WITH A SPECIALIST

I turn to a health institution for first outpatient medical care. A general practitioner examines me and in case of necessity directs me for additional consultation with a specialist. For that purpose the GP issues me a medical referral for consultation and conducting of cooperative treatment. The referral may be used for up to 30 calendar days following its issuing.
With the referral I go to a health institution for a specialized medical aid for outpatient care, which I have selected. The specialist examines me and determines the further treatment. If he/she so decides he/she may:
• Prescribe medicines for home treatment, fully or partially paid by the National Health Insurance Fund;

• Issue a “Referral for Consultation or for Conducting of a Cooperative Treatment” to a another specialized doctor;

• Appoint conducting of additional medical and diagnostic examinations with a “Referral for Conducting of Medical and Diagnostic Activities”;

• Issue a “Referral for hospitalizing” – in case that the treatment cannot be performed in the conditions of a medical aid for out patients

If the consultation with the specialist is not appointed by the GP or another specialist in compliance with the procedure described above and I wanted it done for me, I have to pay for the medical help provided to me under the prices of the health institution.

I NEED MEDICINES FOR HOME TREATMENT

In case that medicines for home treatment are prescribed to me, which are fully or partially paid by the National Health Insurance Fund, if the diagnosis determined concerns a non-chronic disease, the doctor issues me a receipt form – sample MH-NHIF No 5. I may get my medicines only from a pharmacy, which has concluded a contract with the National Health Insurance. If the medicine is not subject to full reimbursement, I shall pay some additional amount for the part of its price, which is also paid by the Bulgarian citizens that possess health insurance.
If the medicines for the diagnosis determined are not paid by the NHIF, the doctor issues me a prescription form – sample of the Ministry of Health (МH) and I can buy them in each pharmacy.
If I have a chronic disease, my planned stay in Bulgaria is longer than one month and I need medicines for home treatment, paid by the NHIF for the relevant diagnosis I have to select a general practitioner. He/she shall prepare a “Prescription book of the chronically ill person”, which I have to verify at the RHIF. I may receive the medicines, prescribed to me from each pharmacy, which has concluded a contract with the National Health Insurance Fund, which is situated on the territory of the region from which I have selected a general practitioner. The master-pharmacist from the pharmacy must be provided with the two copies of the prescription form, the prescription book, my identity document and a copy of the protocol for prescription of medicines – sample MH-NHIF (in the cases when a protocol is required). If the medicine is not fully reimbursed, I pay in addition the part of the amount, which shall be paid by the Bulgarian health insured persons.

From the general practitioner selected by me I can receive information for the medicines, which the NHIF pays fully or partially and also for the amount, which I have to pay to the pharmacy in addition.

If for the paid diagnosis the medicines are not paid by the NHIF, the doctor shall issue me a prescription book – sample МH and I may buy them in each pharmacy. The expenses made may be reimbursed by my health insurer.

I NEED SOME MEDICAL AND DIAGNOSTIC EXAMINATIONS PERFORMED TO ME

I turn to a health institution for outpatient care. A general practitioner examines me and makes me the required examinations with a referral for medical and diagnostic examinations. With the referral I go to a medical and diagnostic laboratory. The referral may be used for up to 30 calendar days after its issue.
If I don’t have a referral for medical and diagnostic examinations, issued by the general practitioner or a specialist in compliance with the procedure described above and I want them made to me, I shall pay for the examinations in accordance with the prices determined by the health institution.

I NEED DENTAL HELP

I may visit each doctor specialized in dental medicine who has signed a contract with the National Health Insurance Fund. For the activities, which are not fully paid by the National Health Insurance Fund I shall pay the required amount, in the same way in which the Bulgarian health insured persons pay for it.

I NEED HOSPITAL TREATMENT

The general practitioner, the specialized doctor, the doctor for dental medicine or the doctor from the center for emergency medical aid shall issue a referral for hospitalization to me. With this referral I may be admitted to a health institution for hospital care, which has concluded a contract with the National Health Insurance Fund for Treatment of the relevant disease.
The National Health Insurance Fund shall pay for my treatment and diagnosis under a clinical path.
Upon admission to the hospital I shall be informed about my disease, about the steps, which should be undertaken in the process of my treatment and also about the necessity to pay additionally for certain consumables, if required. I sign a declaration for informed assent.
My treatment under a clinical path includes no more than two control examinations after the release from the hospital.

OXYGEN THERAPY AND HEMODIALYSIS

In order to get access to those types of medical care I have to do the following in advance - either me or my health insurance fund shall contact a health institution in Bulgaria, which provides them. After my admission to such a health institution is agreed and confirmed, I may receive oxygen therapy and hemodialysis during my stay in Bulgaria.

CONSUMER TAX FOR MEDICAL AND DENTAL HELP

For each visit at the GP, a doctor specialized for treating out patients and a doctor specialized in dental medicine I shall pay a consumer tax amounting to 1% of the minimum wage for Bulgaria.
When I make tests, prescribed by my GP, a specialized doctor or a doctor specialized in dental medicine, in the laboratory I pay:
• A price for taking of biological material (the amount may not be higher than BGN 2 for one visit to the laboratory, in spite of the number of tests)
OR
• A consumer tax, amounting to 1% of the minimum wage for Bulgaria.

For each day of hospital treatment I pay a consumer tax, amounting to 2% of the minimum wage for Bulgaria. If I am treated in a hospital for more than 10 days within one year, I don’t pay a consumer tax for my stay there after the tenth day.

For each paid consumer tax or medical service I shall require a financial document (a cash receipt or invoice) for the payment made.

ADDITIONAL INFORMATION FOR THE VISITOR OF MOUNTAIN RESORTS

If I visit the mountain resorts in Bulgaria it is recommendable to make a medical insurance for rendering first aid and transport according to the medical indicators in a case of accident. This insurance is not included in the package for the obligatory health insurance.
IF I STAY IN BULGARIA FOR A LONG PERIOD OF TIME, I need to have a certificate for registration of the Bulgarian health insurance fund – NHIF, namely:
♦ Е 101 – for the applicable legislation, concerning people working under labor contracts or self-employed persons, residing in Bulgaria. The form shall be presented to the National Social Security Institute (NSSI) for registration and starting of an insurance process according to the work place in Bulgaria.
♦ Е 106 – for entitlement to sickness and maternity insurance benefits in kind for person residing in a country other than the competent for employed and self-employed persons and members of their families, which accompany him/her.
♦ Е 109 – for registration at the NHIF of members of the family that live in Bulgaria, separately from the member of the family, employed by another member state.
♦ Е 121 – for registration in the NHIF of pensioners and members of their families.

How to Register with Bulgaria's Health System

Bulgaria's national health system is administered by the National Health Service. It has offices in each regional centre of the country.

"
If you wish to take up long-term residency in Bulgaria it is likely that you will need to register with the health system in order to receive medical services, unless you have taken up private medical insurance,"
explains Mr. Stephane Lambert, the director of Stara Planina Properties.

If you have an employment contract:

* Your employer will be obliged to submit your documents to the National Social Service and, through them, to the National Health Service. The health cover installments will then be set and paid every month by your employer.

If you are the owner of a company:

* The health insurance installments will be arranged by your accountant on a monthly basis as part of all your compulsory social payments.

If you are not working:

* You will need to submit your documents and the documents for family members directly to the regional office of the National Health Service.

Step 1

The first step will be to visit the regional office of National Revenue Agency where you will receive information about the amount you need to pay (currently 10.40 Bulgarian Levs per month) and bank details of the account where you will have to transfer the health payments in order to join the National Health Service and maintain your membership.

You will have to pay for some time before you can register with a doctor, although you do have the option of making a back-payment which will give you immediate access to the health system.

Step 2

You pay the amount, as instructed, from any bank, through a bank transfer. The payment document should contain your personal number, which is given to you, together with your residency card. It is called 'Personal Number of a Foreigner' (or 'Lichen Nomer na Chuzdenets').

Step 3

Once the necessary payments have been made you can visit the regional office of the National Health Service with your identification documents. (On some occasions, it may be a good idea to take the payment slips with you detailing the installments made.)

At the regional office you will fill in a form in order to choose a general practitioner. It would be good to have met the doctor and gained his/her agreement prior to this as some doctors have too many patients and would not want to register new ones.

If you are a citizen of the EU and have retired, you will need to bring your official documents with you as you are entitled to join the national health system free of charge.

Children are insured as dependent on their parents, and you will have to inform the National Revenue Agency and NHS of your children during your initial visit.

Step 4

The forth step is to visit your GP with the documents from the NHS who will register you on their list and prepare your patient file. After completing the above procedure, you will be able to use the same medical services as Bulgarian citizens.


Simplified below

Medical assistance

If you experience health problems you will have to visit your GP. He/she will examine you and prescribe treatment. If your condition requires it, then your GP will send you for medical tests or to a specialist for further examination. You will be required to pay a 'consumer fee' for the visit (currently 2.20 Bulgarian Levs).

If you are sent to a specialist, you will have to visit him/her within 30 days and present the document given to you by your GP. The same 'consumer fee' will be charged by the specialist doctor.

If you wish to visit a specialist doctor without visiting your GP, you will have to pay the full price of the examination. Some specialists only have a private practice.

Hospital treatment

If your condition requires hospital treatment, you will be given the necessary documents by your GP. There is a small daily charge payable in the state hospitals but all medical tests and medicines should be free.

In Bulgaria, most medicines are paid for by the patient but if you have a chronic disease it is likely you to be entitled to free or partly paid medicines. Prescriptions for such medicines are given by the GP.

Emergency medical care

If you need emergency medical care, you have to telephone 112, or visit an emergency centre at the nearest hospital. Even if you are not registered with the National Health System, you are entitled to free emergency care if you possess an EU health card from the country of your permanent residence.



After the registration at the National Health Insurance Fund/ the Regional Health Insurance Fund by virtue of one of the certificates mentioned above, I have to select my general practitioner (GP), in order to be included in the patient list of the National Health Insurance Fund. After that I may receive medical care like each Bulgarian health insured person.
Detailed information may be obtained at the following addresses:

National Health Insurance Fund
[You must be registered and logged in to see this link.]

Central Management
[You must be registered and logged in to see this link.]
++ 359 (2) 965 93 87;


Sofia Health Insurance Fund (SHIF):
e-mail: [You must be registered and logged in to see this link.]
++ 359 (2) 965 67 76

Regional Health Insurance Fund – Blagoevgrad:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (73) 88 300 475

Regional Health Insurance Fund – Bourgas:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (56) 80 66 66

Regional Health Insurance Fund – Varna:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (52) 68 90 11

Regional Health Insurance Fund – Veliko Tarnovo
e-mail: [You must be registered and logged in to see this link.]
++ 359 (62) 61 12 52

Regional Health Insurance Fund – Vidin:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (94) 609 824

Regional Health Insurance Fund – Vratsa:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (92) 686 124


Regional Health Insurance Fund – Gabrovo:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (66) 81 95 26

Regional Health Insurance Fund – Dobrich:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (58) 65 45 00

Regional Health Insurance Fund – Kardjali:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (361) 63 514

Regional Health Insurance Fund – Кjustendil:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (78) 55 97 05

Regional Health Insurance Fund – Lovetch:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (68) 68 81 15

Regional Health Insurance Fund – Montana:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (96) 39 61 51

Regional Health Insurance Fund – Pazardzik:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (34) 40 21 05

Regional Health Insurance Fund – Pernik:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (76) 64 92 85

Regional Health Insurance Fund – Pleven:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (64) 88 25 77

Regional Health Insurance Fund – Plovdiv;

e-mail: [You must be registered and logged in to see this link.]
++ 359 (32) 60 30 60

Regional Health Insurance Fund – Razgrad:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (84) 61 15 67

Regional Health Insurance Fund – Ruse:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (82) 88 61 73

Regional Health Insurance Fund – Silistra:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (86) 81 21 44


Regional Health Insurance Fund – Sliven:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (44) 61 52 05

Regional Health Insurance Fund – Smoljan:
e-mail: [You must be registered and logged in to see this link.]
++ 359 (301) 670 44

Regional Health Insurance Fund – Sofia-district:
E-mail: [You must be registered and logged in to see this link.]
++ 359 (2) 96 56 943

Regional Health Insurance Fund – Stara Zagora:
e-mail: [You must be registered and logged in to see this link.]
++ 359 42 610 977

Regional Health Insurance Fund – Targovishte:
E-mail: [You must be registered and logged in to see this link.]
++ 359 (601) 61 104


Regional Health Insurance Fund – Haskovo:
E-mail: [You must be registered and logged in to see this link.]
++ 359 (38) 60 73 11

Regional Health Insurance Fund – Shumen:
E-mail: [You must be registered and logged in to see this link.]
++ 359 (54) 85 00 70

Regional Health Insurance Fund – Jambol:
E-mail: [You must be registered and logged in to see this link.]
++ 359 (46) 68 50 68

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Zuzi
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PostSubject: Re: National Health Service Bulgaria   Tue Jan 04, 2011 5:37 pm

you can avoid too much hassle and some poor service ( depends where you are in BG) by getting medical insurance with EU coverage, in case you need to see doctor, you can go to any doctor you want and then get your money back, if you deal with NHIF you'll see the health care in hard way. There are even certified BUPA agents in BG, like MediHelp, may have others too, try to google and see for yourself.
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PostSubject: Re: National Health Service Bulgaria   Wed Jan 26, 2011 2:34 pm

From Novinite

500 Bulgarian Doctors Found Jobs Abroad in 2010

More than 500 Bulgarian doctors left the country to go work abroad in 2010, according to the Secretary General of the Bulgarian Doctors Union, Dimitar Lenkov.

On Wednesday, he announced the data, established by the union on the basis of issued certificates for good medical practice, required for working abroad.

Mostly anesthesiologists and surgeons left Bulgaria in 2010, followed by urologists, orthopedists, traumatologists, obstetrician-gynecologists, pediatricians, and pathoanatomy specialists.

According to Lenkov, the number of doctors who left Bulgaria in 2009 was 400, while the number in 2008 was 380. He noted that most of the doctors head to Germany, France, England, North Ireland, Denmark and Sweden.

Data from the Society of Anesthesiologists in Bulgaria showed that for several years, the number of specialists in the country dropped from 1500 to 600. The monthly salary of an anesthesiologists in Bulgaria is about BGN 700-800, while in France is it about EUR 6,000.

The pathoanatomy specialists in Bulgaria are below the minimum – only 70-80 in the whole country. The lab specialists are also few - only 280.

A strong drop was seen in 2010 in the number of virologists, rheumatologists, infectious diseases specialists, allergy specialists and even general practitioners, Lenkov said.

He has explained that some regions of Bulgaria, mostly mountain areas that are difficult to reach, some areas in Northwestern Bulgaria and the Rhodope Mountains, lack general practitioners.

The data from the Bulgarian Doctors Union showed that the number of nurses is also below the minimum. At present, they are about 30,000.

"
According to the world standards for quality of medical service, one doctor should work with two nurses. In Bulgaria, one doctor works with one nurse and some doctors even work without nurses,"
Lenkov said.

A huge number of specialists in internal diseases also left Bulgaria because the National Health Insurance Fund (HNIF) does not sign contracts with them, but rather with doctors on narrow specialties.

In comparison, Germany looks for specialists in internal diseases and it pays them EUR 6000 per month, Lenkov said.

"
How can we keep doctors if they receive EUR 6000 in Europe,"
Lenkov rhetorically asked.
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PostSubject: Re: National Health Service Bulgaria   Wed Jan 26, 2011 4:36 pm

If you reside in Bulgaria you will be kicked out of the NHS and will have to join the BG state scheme. Well that is until you are caught or someone shops you.

We have used the BG Medical Service and in some ways it is much better than the NHS. Example. Someone we know had a Cariology examination, the Cariologist thought that she had detected something on a Video scan, so the patient was refered to a specialist. The appointment happened the same day. Yes the same day. In the UK that would have taken months, even in Bupa or some other scheme it would not have been that quick. The down side is the buildings, some are very old.

Ok you may have to pay but at 2.40nb I think most people can afford the fee. g

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PostSubject: Re: National Health Service Bulgaria   Wed Jan 26, 2011 5:00 pm

agree with you Tony
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PostSubject: Re: National Health Service Bulgaria   Wed Jan 26, 2011 6:06 pm

[You must be registered and logged in to see this link.] wrote:
If you reside in Bulgaria you will be kicked out of the NHS and will have to join the BG state scheme. Well that is until you are caught or someone shops you.

We have used the BG Medical Service and in some ways it is much better than the NHS. Example. Someone we know had a Cariology examination, the Cariologist thought that she had detected something on a Video scan, so the patient was refered to a specialist. The appointment happened the same day. Yes the same day. In the UK that would have taken months, even in Bupa or some other scheme it would not have been that quick. The down side is the buildings, some are very old.

Ok you may have to pay but at 2.40nb I think most people can afford the fee. g


It sounds pretty good tony.


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PostSubject: Re: National Health Service Bulgaria   Tue Feb 01, 2011 10:27 pm

[You must be registered and logged in to see this link.] wrote:
If you reside in Bulgaria you will be kicked out of the NHS and will have to join the BG state scheme. Well that is until you are caught or someone shops you.

We have used the BG Medical Service and in some ways it is much better than the NHS. Example. Someone we know had a Cariology examination, the Cariologist thought that she had detected something on a Video scan, so the patient was refered to a specialist. The appointment happened the same day. Yes the same day. In the UK that would have taken months, even in Bupa or some other scheme it would not have been that quick. The down side is the buildings, some are very old.

Ok you may have to pay but at 2.40nb I think most people can afford the fee. g


Agree with you Tony this is exactly what we do and I can understand you saying in some ways it is much better than the NHS I have found that there isn't any long waits either with the Gp or the hospitals and no matter what some may say from my experience they do know what they are doing
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PostSubject: Re: National Health Service Bulgaria   Thu Feb 03, 2011 5:09 pm

Got to agree wit Tony in the UK i paid 30 pounds a week 120 pounds a month over 1 year over 1000 pounds a year over 30 years over 30000 pounds thats over 60000 lev that would give me a lot of medical cover in BG



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PostSubject: Re: National Health Service Bulgaria   Thu Nov 17, 2011 10:13 am

We have got our residency cards and want to join the BG NHS scheme.
How do we actually go about this? Do we need to find a local GP first, there is one in our village,
or do we apply to somewhere else?
This has probably been answered elsewhere but I couldn't find it - sorry! :Please:
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PostSubject: Re: National Health Service Bulgaria   Thu Nov 17, 2011 10:46 am

We registered with a Doctor first and he guided us through. He also gave us the initial forms and told us where to go g

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PostSubject: Re: National Health Service Bulgaria   Thu Nov 17, 2011 11:36 am

T
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PostSubject: Re: National Health Service Bulgaria   Thu Nov 17, 2011 3:36 pm

The way Tony says it is how we did it and it was quite smooth for Bulgaria. Good luck
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PostSubject: Re: National Health Service Bulgaria   Thu Nov 17, 2011 3:55 pm

[You must be registered and logged in to see this link.] wrote:
The way Tony says it is how we did it and it was quite smooth for Bulgaria. Good luck

Yep too true

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