Healthcare in Bulgaria for retirees
Healthcare in Bulgaria runs through the National Health Insurance Fund; a foreign retiree needs medical insurance for the D visa and compulsory insurance for the residence permit.
The hospitals retirees use, what insurance does and does not cover. Checked against official and hospital sources on Oct 8, 2026.
- Life expectancy
- 75.8 years US 78.9. World Bank, 2024
- Doctors
- 4.3 per 1,000 US 3.7. World Bank, 2022
- Health spending
- $1,258/person Per year; US $13,473. World Bank, 2023
- Paid out of pocket
- 35.5% Of all health spending; US 10.9%. World Bank, 2023
Hospitals retirees use in Bulgaria
Sofia
University Hospital Lozenetz
- Emergency department
- Clinics including cardiology, general surgery, nephrology, orthopaedics and internal medicine
Lozenetz Hospital. Checked Oct 8, 2026.
Plovdiv
University Hospital Kaspela
- More than 20 clinics and departments
- Contract with the public health fund: insured patients are treated free
- Rooms with two or three beds and their own bathroom
Kaspela Hospital. Checked Oct 8, 2026.
Varna
University Hospital St. Marina
- University hospital for active treatment
St. Marina Hospital. Checked Oct 8, 2026.
Burgas
University Hospital Burgas
- Emergency admission
- Ward for long-term care and recovery
UMBAL Burgas. Checked Oct 8, 2026.
Public care in Bulgaria runs through compulsory health insurance managed by the National Health Insurance Fund (NHIF) and paid for by contributions. Insured patients pay a small fixed user fee for each visit to a doctor or dentist and for each day in hospital, for up to 10 days a year. Every long-term residence permit requires compulsory health insurance: a foreigner who is not insured under Bulgaria's Health Insurance Act shows medical insurance valid in Bulgaria.
Paying for care in Bulgaria
35.5% of health spending in Bulgaria is paid directly by patients, about 3 times the US share, so plan how you will pay before you move.
Retirees use either an international health plan, which can also cover care at home and in other countries, or a local plan from an insurer in Bulgaria, which costs less but covers care there only. Prices depend on age and on the insurer's terms for existing conditions; compare written quotes.
If you are on Medicare
Medicare usually does not pay for care outside the United States; the exceptions are narrow, such as a foreign hospital closer to your US home than the nearest US hospital.
Medicare.gov. Checked Oct 7, 2026.
Healthcare questions
Does Medicare cover me in Bulgaria?
Medicare usually does not pay for care outside the United States; the exceptions are narrow, such as a foreign hospital closer to your US home than the nearest US hospital. Plan on private insurance or paying directly for care in Bulgaria.
Do I need health insurance for the Pensioner residence visa?
The D visa needs medical insurance covering repatriation, urgent medical aid and emergency hospital treatment for the stay. The residence permit then needs compulsory medical insurance valid in Bulgaria if you are not insured under the Health Insurance Act.
How much of the bill do people pay themselves?
In Bulgaria, 35.5% of all health spending is paid out of pocket, against 10.9% in the US (World Bank, 2023).
Do retirees need health insurance in Bulgaria?
Yes. The D visa needs medical insurance covering repatriation and emergency treatment, and the residence permit needs compulsory medical insurance valid in Bulgaria if you are not insured under the Health Insurance Act.
Is public healthcare free in Bulgaria?
Not entirely. Patients insured with the National Health Insurance Fund pay a small fixed user fee per doctor visit and per hospital day, up to 10 days a year. Hospitals with a fund contract, such as Kaspela in Plovdiv, treat insured patients free.
Where are the main hospitals for retirees in Bulgaria?
University Hospital Lozenetz in Sofia, Kaspela in Plovdiv, St. Marina in Varna and University Hospital Burgas on the Black Sea coast.
