Can I be insured abroad and in Bulgaria at the same time?

I work abroad on an official employment contract and I have health insurance in the country of employment. Can I voluntarily insure myself in Bulgaria, in case it becomes necessary to use medical care during visits and short-term stays in our country? If there is such a possibility, what monthly amount should I contribute – as an unemployed person, with a monthly contribution of BGN 24.40 or the maximum, in view of my high salary abroad?

Plamen Mihailov, city of Varna

In this case, we can only provide you with indicative information, as you do not specify whether you are insured in another EU/EEA/Switzerland member state. Regarding health insurance, you are probably referring to compulsory health insurance, which provides a package of health activities guaranteed by the NHIF budget.

According to Article 33, Paragraph 2 of the Health Insurance Act (HII), people who, according to the rules for coordination of social security systems, are subject to health insurance in another member state are not necessarily insured in the NHIF. On this basis, during the period during which the insurance legislation of another country from the EU/EEA/Switzerland is applied to the patient, he is not subject to compulsory health insurance in the NHIF. For these periods in Bulgaria, it is not a matter of obligations, but of months, without data on health insurance.

In addition, dual social and health insurance is not allowed in the EU/EEA/Switzerland. A basic principle of European law in the field of social security states that citizens are insured only in one country – the one in which they exercise legal work.

When the insurance of the person in the other member state of the EU/EEA/Switzerland has ended, in order to be included in the Bulgarian health insurance system, in case of upcoming insurance in it, then it is necessary to request a certification document from the foreign insurance institution – form E104/S041.

In Bulgaria, the certification document E104/S041 is submitted to the territorial directorate/office of the National Revenue Agency (NAA) at the place of residence in Bulgaria. Based on the data specified in the document, the months without health insurance data in Bulgaria will be covered and the person’s health insurance status will be corrected.

Regarding medical assistance during a temporary stay in Bulgaria (or in another EU country), you have the right to urgent and urgent medical assistance (until the end of the temporary stay), within the package of the mandatory health insurance – upon presentation of a valid European Health Insurance card (EHIC) issued by the insurance state.

The EHIC facilitates the access of patients for emergency and/or urgently needed medical care to doctors/medical facilities in other EU countries, when there is a sudden acute medical condition or an aggravated chronic illness, and when the patient cannot return to his own country of health insurance without violating the pre-planned period of temporary stay in the other country.

The condition is determined whether it is urgent or urgently needed by the treating doctor in the other country (in this case Bulgaria), not by the patient. The doctor determines the type, scope and volume of the necessary emergency medical services that can be provided to the patient against a valid EHIC.

In Bulgaria, it is necessary for him to apply only to the medical facilities that have signed a contract with the NHIF.

The EHIC is not intended for carrying out planned treatment, diagnostics and/or examinations outside the competent country of insurance.

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