Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, focusing on clear, neutral information to help people find health coverage abroad.
Last updated: January 29, 2026
Quick Summary: Health Insurance in Bulgaria
- Health insurance required for Type D visa—minimum €30,000 coverage for Schengen compliance.
- NHIF public system costs 8% of income (employer/employee split)—EU citizens can use EHIC for temporary stays.
- Private consultations are remarkably affordable: BGN 50-100 (€25-50) at Acibadem City Clinic or Tokuda.
- International plans cost €60-150/month; local private insurers (Bulstrad, DZI) offer plans from €30/month.
- Sofia has excellent private hospitals; Black Sea coast and rural areas have limited specialist care.
Do You Need Private Health Insurance in Bulgaria?
Non-EU citizens need health insurance for Bulgaria's Type D (long-stay) visa—minimum €30,000 coverage with no deductible for medical emergencies and repatriation. EU citizens can use their EHIC for temporary stays or register in NHIF if working/residing long-term. The Freelancer visa and Digital Nomad-style arrangements also require proof of insurance. After obtaining residence, you can enroll in NHIF (8% of income) or maintain private coverage.
Insurance is required for:
- Non-EU citizens applying for Type D visa or residence permit—mandatory requirement
- EU citizens not yet registered in Bulgarian NHIF—EHIC only covers emergencies
- Digital nomads and freelancers on self-employed visas
- Retirees wanting faster access than public system wait times
- Anyone living outside Sofia who may need evacuation for specialist care
Public vs Private Healthcare in Bulgaria
Public Healthcare
NHIF (National Health Insurance Fund)
- Access: Bulgarian citizens, residents paying 8% contribution, EU citizens via EHIC
- Cost: 8% of income (split employer/employee); ~BGN 30 (€15) minimum for self-employed
Sofia has good public hospitals including Pirogov (emergency) and Alexandrovska University Hospital. Outside major cities, public facilities are often underfunded with older equipment. Wait times for specialists can be weeks. Most public doctors speak limited English. EU citizens can access NHIF services with EHIC for temporary stays, but long-term residents should register locally.
Private Healthcare
International or Local Private
- Access: Open to anyone
- Cost: BGN 50-100 (€25-50)/consultation; BGN 500-1,500 (€250-750)/night hospitalization
Sofia has modern private hospitals: Acibadem City Clinic (Turkish chain, excellent facilities), Tokuda Hospital, and Heart and Brain Centre. Varna and Burgas have decent private options on the Black Sea coast. Private care is remarkably affordable by Western European standards—dental tourism is popular. Many private doctors in Sofia speak excellent English.
Plan Options to Compare
Here are the most popular insurance options for expats in Bulgaria. Each has trade-offs depending on your situation.
Cigna Global
Best for: Worldwide coverage and strong customer service
Not ideal for: Budget-focused expats staying only in Bulgaria
Allianz Care
Best for: High-deductible savings and EU-based service
Not ideal for: Those wanting minimal out-of-pocket costs
BUPA Global
Best for: Pre-existing conditions and mental health coverage
Not ideal for: Those seeking the lowest premiums
IMG Global
Best for: Budget international coverage
Not ideal for: Those wanting premium service levels
Comparison Table: Top Expat Health Plans for Bulgaria
Compare the leading options side by side. Click "Details" to learn more about each provider.
| Provider | Best For | Coverage Style | Includes U.S.? | Notable Limits | Learn More |
|---|---|---|---|---|---|
| Cigna Global | Worldwide coverage and strong | International comprehensive | Higher cost than local options | Details → | |
| Allianz Care | High-deductible savings and EU-based | International comprehensive | Deductibles apply to savings | Details → | |
| BUPA Global | Pre-existing conditions and mental | International premium | Premium pricing | Details → | |
| IMG Global | Budget international coverage | International standard | 12-month pre-existing exclusion | Details → |
Common Watch-outs for Bulgaria
Keep these points in mind when choosing coverage:
- Black Sea resorts (Sunny Beach, Golden Sands) have limited healthcare—serious cases go to Varna or Burgas.
- Rural and mountain areas have basic clinics only—evacuation to Sofia may be needed.
- NHIF covers basics but has significant co-pays and limited specialist access—private supplement recommended.
- Winter ski resorts (Bansko, Borovets) have small medical facilities—ensure mountain evacuation coverage.
- Non-EU citizens must maintain valid insurance throughout residence—lapsed coverage can affect permit renewal.
Frequently Asked Questions
Can EU citizens use public healthcare in Bulgaria?
Yes. EU citizens can use their European Health Insurance Card (EHIC) for necessary medical care during temporary stays. For long-term residence, you should register with NHIF—either as an employed person (employer pays contributions) or voluntarily (8% of declared income, minimum BGN 30/month). EHIC covers emergencies but not routine care or pre-existing conditions.
What's the best private hospital in Bulgaria?
Acibadem City Clinic in Sofia is generally considered the best—it's part of a Turkish hospital chain with modern equipment and English-speaking staff. Tokuda Hospital (now also Acibadem-affiliated) and Heart and Brain Centre are also excellent. For emergencies, Pirogov Hospital in Sofia is the main trauma center. Outside Sofia, options are more limited—Varna and Plovdiv have decent private facilities.
How much does health insurance cost in Bulgaria?
Very affordable compared to Western Europe. Local insurers like Bulstrad, DZI, and Euroins offer plans from €30-60/month covering private hospital access. International plans (Cigna, Allianz) cost €60-150/month but include worldwide coverage and repatriation. The NHIF public option costs 8% of income—around €50-100/month for typical expat salaries.
Is Bulgaria good for dental tourism?
Yes, Bulgaria is a popular dental tourism destination. Dental work costs 50-70% less than Western Europe—a crown might cost €150-250 vs €500-800 in Germany. Sofia and Varna have modern dental clinics with English-speaking staff. Many European expats combine vacation with dental work. Travel insurance doesn't cover elective dental, so budget separately.
Do I need evacuation coverage in Bulgaria?
Recommended if living outside Sofia. While Sofia's private hospitals are good, smaller cities and resort areas have limited facilities. Ski resorts (Bansko, Borovets, Pamporovo) have basic medical posts—serious injuries require helicopter evacuation. For non-EU citizens, repatriation coverage is required for the visa anyway. EU citizens should consider it for peace of mind.
Related: Comparisons and Next Steps
Disclaimer: This guide is for informational purposes only. Healthcare policies, insurance requirements, and visa rules change. We are not insurance brokers, immigration consultants, or licensed advisors. Verify all information with official sources and insurance providers before making decisions.