Relations under the compulsory and voluntary health insurance shall be regulated by the Health Insurance Act (BG).
Health insurance shall be implemented via collection and spending the monetary funds – insured persons and contributors participate in the health insurance system with social security contributions, and in case of an insurance event the insured persons shall obtain medical aid as prestation.
Compulsory health insurance is an activity related to managing and spending the funds from compulsory health insurance contributions for payment of health related activities, which is carried out by the National Health Insurance Fund (NHIF) and its territorial divisions - regional health insurance funds. The compulsory health insurance provides for a basic package of health related activities guaranteed by the budget of NHIF.
The body, which carried out and manages the compulsory health insurance, is NHIF – it organizes the collection, management and distribution of the funds for compulsory health insurance. The compulsory health insurance contributions are collected by the National Revenue Agency (§ 20 of the Transitional and Final Provisions of the Health Insurance Act).
..... compulsory participation in the collection of the contributions;
..... participation of the state, the insured persons and the employers in the management of NHIF;
..... solidarity of insured persons in the use of the collected funds…….
The health insurance contributions shall be paid:
..... through a bank transfer – the social insurance contributions under the Health Insurance Act (BG) shall be paid into the relevant account of NRA. See the bank accounts and the codes for types of payment
..... by postal order.
- All Bulgarian citizens who are not simultaneously citizens of another country;
- Bulgarian citizens who are also citizens of another country and live permanently on the territory of the Republic of Bulgaria.
- Foreign citizens or stateless persons who have obtained permission for permanent residence in the Republic of Bulgaria, unless stipulated otherwise in an international contract to which the Republic of Bulgaria is a party.
- Individuals who have been granted statute of a refugee, humanitarian statute, or right of asylum.
- Foreign students and PhD students admitted for training in higher schools and scientific organizations in Bulgaria pursuant to the procedure established by Decree of the Council of Ministers No 103 of 1993 on the Implementation of Educational Activities amongst Bulgarians Abroad, and Decree of the Council of Ministers No 228 of 1997 on the Admission of Citizens of the Republic of Macedonia as Students in the State Higher Schools of the Republic of Bulgaria
- Persons beyond those indicated in items 1 – 5, to whom the legislation of the Republic of Bulgaria is applicable pursuant to the rules for coordination of the social security systems of the EU Member States..
The persons who, pursuant to the rules for coordination of the social security systems, are liable to health insurance in another Member State shall not be compulsorily insured in NHIF.
Amount of the health insurance contribution – it shall be fixed every year by the NHIF Budget Act (BG) – 8 per cent for the year 2014.
For the year 2014 the distribution of the health insurance contributions between the contributor and the insured person shall be in a 60:40 ratio, as follows:
- 3.2 per cent at the expense of the insured person;
- 4.8 per cent at the expense of the contributor;
The health insurance contribution of the self-insured persons shall be completely at their expense and shall amount to 8 per cent for the year 2014.
The insurable earnings for the purposes of the compulsory health insurance are fixed in the Act or shall be determined depending on the accrued/paid or non-accrued remunerations, indemnifications or the income chosen by the self-insured person, which may not be smaller than the minimal monthly insurable earnings pursuant to the State Social Insurance Budget Act /SSIBA/ for the respective year.
The following amounts of monthly insurable earnings have been determined for the year 2014 by Art. 8 of the SSIBA:
- minimal monthly amount of the insurable earnings during the calendar year according to basic economic activities and qualification groups of professions in accordance with Annex No 1 to Art. 8, Item 1 of the SSIBA for the year 2014;
- minimal monthly amount of the insurable earnings for self-insured persons in conformity with their insurable earnings for 2012 as self-insured persons:
- up to BGN 5400 - BGN 420;
- from BGN 5400,01 up to BGN 6500 – BGN 450;
- from BGN 6500,01 up to BGN 7500 - BGN 500;
- over BGN 7500 - BGN 550;
- minimal monthly amount of the insurable earnings for registered agricultural manufacturers and tobacco growers – BGN 240;
The maximal amount of the monthly earnings, on the basis of which the health insurance contribution shall be calculated, shall be the maximal income determined by the SSIBA (Art. 40, Para. 7 of the Health Insurance Act) – BGN 2 400 for the year 2014.
The insurable earnings, on the basis of which the contribution shall be calculated, shall be established according to payrolls and other documents for paid or accrued but unpaid remunerations, according to pension records, paid medical certificates, paid indemnifications for unemployed persons, and according to the tax declaration under the Personal Income Tax Act (Art. 42 of the Health Insurance Act).
The income, terms and method for payment of the health insurance contributions for insured persons are stipulated in Art. 40 of the Health Insurance Act.
The health insurance rights of the persons, who are obligated to pay contributions at their expense, shall be interrupted in case that the persons have not paid more than three months for a period of 36 months up to the beginning of the month preceding the month of the medical aid rendered. The persons with interrupted health insurance rights shall pay for the medical aid rendered to them.
Persons, who have not paid more than three months for a period of 36 months up to the beginning of the month preceding the medical aid rendered, shall restore their health insurance rights provided that they pay all the health insurance contributions due for the last 36 months. The health insurance rights shall be restored as of the date of the payment of all health insurance contributions due for this period /Art. 109 of the Health Insurance Act/.
The Health Insurance Act stipulates a special procedure for Bulgarian citizens who reside abroad for a long time. Under certain conditions, these persons are provided with the opportunity to be exempted from the obligation to pay health insurance contributions – from the date of leaving the country.
Pursuant to Art. 40а of the Health Insurance Act, Bulgarian citizens who shall be obligated to secure themselves and reside abroad for more than 183 days during one calendar year, may choose not to pay health insurance contributions until the end of the respective calendar year counted from the date of leaving the country and for each following calendar year, after a filed application to the National Revenue Agency.
The health insurance rights of the abovementioned persons shall be restored after their return to the country after the expiration of 6 consecutive months, during which the person has been covered by health insurance in accordance with Art. 40.
Beyond these cases, the health insurance rights of the persons may be restored after their return to the country after a lump sum payment amounting to 12 health insurance contributions on the basis of the minimal monthly amount of the insurable earnings for self- insured persons stipulated by the State Social Insurance Budget Act as of the time of payment of the contributions.
On the grounds of § 19i, Para. 1 of the Transitional and Final Provisions of the Health Insurance Act, Bulgarian citizens who resided out of the country for more than 183 days during one calendar year for the period 1 July 1999 - 31 December 2007 and owe health insurance contributions at their expense for the period they were abroad, shall be exempted from the obligation to pay these contributions if they did not use medical aid paid for by NHIF. In these events the individuals shall submit to the competent territorial directorate of NRA a declaration following a template ratified by an order issued by the Minister of Finance - in person or via an authorized person. The declaration may also be submitted by a licensed mail operator or by electronic means through use of a universal electronic signature of the sender.