How To Do a Health Insurance Claim For Foreigners In Bulgaria

Today topic is more technical than the usual ones, but at the same time is particularly important for the foreigners that during they stay in Bulgaria (doesn’t matter if is on vacation or with residence) have a health emergency and need medical attention in Bulgaria.

Every foreigner from outside the European Union in a temporary residence or during a stay with visa, need to have valid mandatory health insurance for the period of his/her stay in Bulgaria.

The mandatory health insurance in Bulgaria must have a Coverage of minimum 30 000 Euro, roughly 60000 leva, and that’s the limit that the health insurance provider will cover of your expenses in case of a medical emergency during your stay in Bulgaria.

According to resolution on compulsory medical insurance for foreigners in Bulgaria health insurances sold in Bulgaria to foreigners allow the insured person to apply to any medical institution in Bulgaria and the possibility of subsequent payment of expenses by the insurance company. This is convenient. You can apply to a proper clinic, pay and receive the insurance payment.

Claims payment

The insurance compensation is defined within the insurance limit and the insurance amount.

The payments are settled within 15 working days after presenting medical case histories, invoices, prescriptions, resolutions of the Labour Expert Medical Committee, deeds, and other required documents.

Covered risks

– Medical expenses due to an accident or acute illness;

– Emergent dental treatment;

– Transport expenses for accommodation or transfer of the insured person in a medical institution.

Uncovered risks

– Chronic diseases of any nature and the consequences of it; available illnesses before the starting date of the insurance policy; repeated illnesses;

– Deliberate actions of the insured with the purpose of self-injury and causing loss of working capacity, as well as in cases of exceptionally gross negligence, which has led to health damage;

– Suicide or suicide attempt;

– Use of opiates, stimulants and doping, alcohol, alcohol poisoning, self-treatment and abuse of medicines;

– Sunstroke and heatstroke, radioactive poisoning;

– AIDS, venereal and other illnesses, transferred by blood flow;

– Expenses that are paid or covered by medical schemes, other insurers, governmental or private medical program;

– Treatment of mental and mental-neurological disorders or states, as well as in the case of psychoanalytical or psychotherapeutic methods;

– Expenses for hemodialysis and hemotransfusion

– Transplant of organs, tissues, and cells;

– Claims in cases the insured person is with a fatal diagnosis;

– Claims in cases the insured person is traveling for medical treatment in Bulgaria;

– Claims by the insured due to participation in races or preparation for races;

– Plastic cosmetic operations and other cosmetic medical services.

What to do if you have a European Health Insurance Card (EHIC)

If you need medical treatment while you’re in another EU country, presenting your European Health Insurance card (EHIC) can simplify payment and reimbursement procedures.

With your EHIC you can get healthcare – and claim reimbursement for the costs you incur – on the same terms as nationals of the country you are in. If the treatment you need is free for local residents, you won’t have to pay. If you have to pay for your treatment, you can either ask for reimbursement from the national institution whilst still in the country and get reimbursement directly there, or ask for reimbursement from your health insurer when you get home.

Your expenses will be reimbursed according to the rules and rates of the country where the treatment was received. So you will either be reimbursed for the full cost of the treatment, or you will have to pay the patient’s fee according to the rules of the country where you were treated. Alternatively, your insurer may decide to reimburse the full cost according to its own rules.

This post was possible because of the technical help of euromedins.com