As much as we don't like to confront the possibility, during a holiday or a trip there may be times when we have to use hospital services. This can incur unforeseen costs, but there is a way to avoid them in certain situations.
The European Health Insurance Card (EHIC) is a document that allows EU citizens to be treated abroad free of charge in emergencies and urgent cases. It is valid for stays in all EU countries, as well as in other countries in the European Economic Area (Norway, Iceland and Liechtenstein), Switzerland and the UK. Those issued in Bulgaria are also valid for North Macedonia and Serbia. When using the EHIC, the patient's home country is obliged to pay for the treatment at the prices of the respective clinic or doctor admitting them.
Everyone with active health insurance rights is entitled to such a card, including foreign holders of a Bulgarian ID card who work and pay their healthcare contributions here. According to the National Health Insurance Fund (NHIF), the last seven years have seen around 160-170,000 EHICs issued per year in Bulgaria. It is important to clarify that the EHIC is only valid for one year. After that, a new one must be issued or extended for another year before it expires.
How is an EHIC issued?
The Health Insurance Fund justifies the short validity of the EHIC by its attempts to curb its misuse, and even in 2016 an attempt was made to halve its validity to 6 months. This didn't happen, but the current deadline doesn't help people who want to get a health card either. Obtaining it can involve time and effort, even though the document itself is completely free. Unfortunately, the issuance is mainly done over the counter - more precisely in about 120 branches of First Investment Bank (FIB) around the country. You must submit an application form, and 15 days later, the card is available to pick up at the same branch.
Visiting a specific bank twice during business hours could deter those who would say "I am unlikely to use the card." Thus, issuing the EHIC electronically would attract many Bulgarians. There is now such a process, which we all owe largely to blogger Boyan Yurukov, who back in 2022 "forced" the NHIF to issue him the document after filling in the application electronically, even though the NHIF claimed they had no procedure for this. Back then, the only receipt happened physically, but to date, not only is there a procedure, but it is also possible to receive the card by courier without having to visit any branch.
Going full electronic
Since the end of 2024, the procedure has been completely simplified as no application is printed and scanned. Everything happens in a few clicks. The Ministry of Electronic Government (MEU) website is used for this purpose, and if you do not have an account, you need to create one using an e-signature (KEP), a B-trust or Evrotrust mobile KEP (which are completely free if used for MEU platforms), as well as a personal identification code (PIC) from the National Revenue Agency or National Social Security Institute (NSSI)
After registration, you select "National Health Insurance Fund" from "Other administrations established by law" from the "Service providers" menu. Then under "Services" select "Issue of European Health Insurance Card." After clicking on "Request service," the system asks you to identify yourself in one of the ways listed above. An electronic form is then opened via eForms, which asks to select a district administrative unit of the NHIF according to the district where the applicant lives. The claimant then chooses whether they are submitting the claim as a holder or legal representative. On the next screen, personal details such as Cyrillic and Latin names are filled in, as well as a contact telephone number and email. The SSN is automatically filled in by the system. If an EHIC is being requested for another person, their details are also entered here, as well as whether the representation is from a parent, guardian or custodian.
The applicant must then vouch for the correctness of the data provided, and the last step is choosing how to obtain the card. If "in person" is selected, this happens at the district cashier's office that issues the card. The other two options are by domestic or international mail, where the delivery address is also indicated. It is important to note here that the issuance itself is free, but the courier service is paid by the applicant. Thus, after about two weeks, the card is received without visiting a physical branch.
Free, but some exceptions apply
Experience shows that in certain instances the EHIC card does not work - for example, in some Greek islands, emergency care for injuries and fractures that require surgery is mainly provided by private hospitals, which may not recognize the card. The alternative is waiting in public health facilities.
"If you have paid cash for medical care in another EU member state, you can present the original payment documents (invoices) to the regional health insurance fund of your place of residence when you return to Bulgaria. There, you will be informed whether (and how much) you can be reimbursed," the health insurance fund told Capital Weekly.
As much as we don't like to confront the possibility, during a holiday or a trip there may be times when we have to use hospital services. This can incur unforeseen costs, but there is a way to avoid them in certain situations.
The European Health Insurance Card (EHIC) is a document that allows EU citizens to be treated abroad free of charge in emergencies and urgent cases. It is valid for stays in all EU countries, as well as in other countries in the European Economic Area (Norway, Iceland and Liechtenstein), Switzerland and the UK. Those issued in Bulgaria are also valid for North Macedonia and Serbia. When using the EHIC, the patient's home country is obliged to pay for the treatment at the prices of the respective clinic or doctor admitting them.
