19. Health Legislation in Bulgaria. Health Insurance Law

Question 1

What is a Health

Insurance ?

Answer 1

• Health Insurance is a process of collecting health insurance
  fees, the management of resources and spending for
  healthcare activities and services

Question 2

What are the types
of Health Insurance
in Bulgaria ?

Answer 2

Health insurance can be;
A. Obligatory – is carried out by the National health
insurance fund
B. Voluntary – is additional and is carried out by
shareholder companies registered according to the
commercial law and who have obtained licence under
the conditions and by the order of this law.

Question 3

What principles is
obligatory health
insurance carried
out on ?

Answer 3

Art.5
1. Collecting fees
2. The participation of employers, employees and the
state in the management of the resources of the
(NHIF)
3. Solidarity in using the resources
4. Negotiation between the NHIF and executors of
medical care
5. A guarantee by NHIF a basic package of health
activities
6. Free choice of a physician

Question 4

What does the
obligatory health
insurance
guarantee?

Answer 4

Art. 4.
(1) The obligatory health insurance guarantees to the
insured persons accessible medical care through a
definite type, range and volume of package of health
activities, as well as a free choice of a provider who
has concluded a contract with a regional health
insurance fund.
(2) The right of choice shall be valid for the whole
territory of the country and it cannot be restricted on
geographic and/or administrative grounds.

Question 5

What is the
financial structure
of Health
Insurance?

Answer 5

Art. 23
(1) The revenue of NHIF shall be raised from:
1. insurance instalments;
2. interest and receipts from the management of the property
of the fund;
3. revenue stipulated by other laws in favour of the health
insurance;
4. reimbursement of insurance expenses in the cases
stipulated by normative acts;
5. fines and penalty interest;
6. taxes determined by a tariff of the Council of Ministers;
7. liquidation shares of trade companies - debtors, declared
for liquidation;
8. donations and inheritance;
9. other sources.
(2) In cases of shortage of resources can be used short-term
interest free loans from the
republican budget or credits from other institutions.

Question 6

Who is obligated to
have health
insurance?

Answer 6

Art. 34. (1) The obligation for insurance occurs:
1. for all Bulgarian citizens - from the enactment of the law
and for the newly born - from the date of birth;
2. from the date of obtaining permit for permanent
residence;
3. from the date of opening procedures for granting status of
refugee or right of asylum.
(2) The rights of the insured under Art. 33 shall occur:
1. for the newly born - from the date of birth;
2. the date of opening of the procedures for conceding statute
of refugee or right to asylum;
3. for all the others from the date of payment of the health
insurance instalment.
(3) The rights of the insured shall be personal and cannot be
ceded (transferred).

Question 7

. What are the rights

of the insured?

Answer 7

Art. 35. The obligatory insured shall have the right:
1. to medical care within the range of the basic package of
health care activities guaranteed by the budget of NHIF;
2. to choose one medical care executive who has concluded
contract with RHIF;
3. to emergency medical care wherever it is needed;
4. to receive information from RHIF about the contracts
concluded by it with the medical care executives;
5. to participate in the management of NHIF through their
representatives;
6. to file appeals to the director of the respective RHIF for
violations of the law and the
contracts.

Question 8

How will the
insurance
instalments be
taken from the
employed?

Answer 8

Art. 40.
(1) The health insurance instalment of the insured person,
determined by the order of Art. 29, para 3 shall be calculated
over an income and shall be paid as follows:
1. for persons receiving income from legal terms of
employment, official legal terms of employment or terms of
employment occurred on the basis of special laws, persons
employed under contracts for management and control of
trade companies and the members of cooperations receiving
remuneration from the cooperation - the income on which
instalments are made for the state public insurance
determined by the Code for the obligatory public insurance;
the instalment shall be made by the employer or by the
administrative body and by the insured person in the
following proportion:
- 2000 - 2001 - 80:20;
- 2002 - 2004 - 75:25;
- 2005 - 70:30;
- 2006 - 65:35;
- 2007 - 60:40;
- 2008 - 55:45;
- 2009 and the following years - 50:50;