Healthcare is one of the first things people want to understand when moving to a new country. Bulgaria has a national health insurance system, a growing private sector, and costs that are a fraction of what you'd pay in the UK or Western Europe.

Here's what you need to know.

The National Health Insurance System

Bulgaria has a compulsory national health insurance system (Национална здравноосигурителна каса — НЗОК). Most employed people and pensioners contribute automatically. Self-employed people and those without employment need to make their own contributions.

EU citizens arriving in Bulgaria can access the national system, but the route depends on your situation:

• If you're working in Bulgaria and paying Bulgarian social insurance, you're automatically covered
• If you're retired and receiving a pension from another EU country, you may be entitled to healthcare via the S1 form from your home country
• If you're not working and not receiving a pension, you'll need to either register as a self-insured person (paying monthly contributions) or rely on private insurance

The national system covers GP visits, specialist referrals, hospital treatment, and some medications. There are co-payments for some services, but they're modest.

Registering with a GP

The first step is registering with a personal doctor (личен лекар) — the Bulgarian equivalent of a GP. You can choose any GP who is accepting patients in your area.

To register, you'll need:

• Your health insurance card (здравноосигурителна книжка) or proof of insurance status
• Your ID or passport
• Your address registration certificate

Once registered, your GP is your gateway to the rest of the system. Specialist consultations typically require a referral from your GP.

Practical tip: Finding a GP who speaks English can be challenging outside Sofia and the larger cities. This is one area where having a local contact or support service makes a real difference.

Private Healthcare

Private healthcare in Bulgaria is excellent value and widely available. Many expats use a combination of the national system for routine care and private clinics for specialist consultations or when they want English-speaking doctors.

What things cost privately:

• GP consultation: €15–€30
• Specialist consultation: €20–€60
• Blood tests: €10–€40 depending on what's tested
• X-ray: €15–€30
• MRI scan: €80–€150 (compared to €500+ in the UK privately)
• Dental check-up and clean: €20–€35

Private hospitals in Sofia (such as Tokuda, Acibadem, and others) offer high-quality care with English-speaking staff. Standards are generally good, though they vary.

Dentistry

Bulgarian dentistry deserves a special mention. It's excellent, affordable, and many dentists speak English — particularly in the cities. People regularly travel to Bulgaria specifically for dental treatment.

A full check-up, clean, and X-rays might cost €30–€50. Fillings, crowns, and implants are a fraction of UK or Western European prices. Quality is generally very good.

Pharmacies

Pharmacies (аптека) are widespread and well-stocked. Many common medications are available over the counter that would require a prescription elsewhere. Pharmacists are generally helpful and some speak English.

Prescription medications are available at subsidised prices through the national system. Private prescriptions are also available and still very affordable.

Mental Health

Mental health services are less developed in Bulgaria than in Western Europe, and finding English-speaking therapists or counsellors can be challenging. Private psychologists and therapists are available in Sofia and the larger cities, but options are more limited elsewhere.

Online therapy with English-speaking therapists (based anywhere) is an option many expats use.

Health Insurance

If you're not covered by the national system, private health insurance is worth considering. International health insurance policies (from providers like Cigna, Allianz, or AXA) give you access to private care in Bulgaria and coverage when travelling elsewhere.

Costs vary significantly depending on age, coverage level, and provider, but a basic policy for a healthy adult might cost €50–€150 per month.

Emergency Care

In an emergency, call 112 (the European emergency number). Ambulance services are available, and hospital emergency departments (спешно отделение) are required to treat anyone regardless of insurance status.

The quality of emergency care varies between hospitals. In Sofia and the larger cities, standards are generally acceptable. In rural areas, you may be better off getting to a larger hospital if the situation allows.

Practical Tips

Learn the basics in Bulgarian. Being able to describe symptoms, say where it hurts, and understand basic instructions makes a huge difference. Even a few key phrases help.

Keep your medical records. Bring copies of any important medical history, current prescriptions, and vaccination records. Having these in both English and Bulgarian (translated) is ideal.

Find a good pharmacist. A local pharmacist who knows you and speaks some English is invaluable for minor ailments and medication queries.

Don't delay getting registered. Sorting your healthcare registration early means you're covered when you need it, not scrambling to sort it out when you're already unwell.

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Healthcare in Bulgaria is genuinely good value and, in many respects, very good quality — particularly for specialist and dental care. The main challenges are the language barrier and navigating the administrative side of the system. If you need help getting registered or finding the right doctor, we're happy to assist.