Bulgaria Introduces Mandatory Health Insurance for Single Work and Residence Permit Holders in 2025

Starting July 1, 2025, Bulgaria has enacted a significant policy update, making it mandatory for holders of Single Work and Residence Permits to enroll in the State Statutory Health Insurance System. This change brings their requirements in line with those for EU Blue Card holders, expanding healthcare access for foreign workers while introducing new compliance duties for employers.

Understanding the Single Work and Residence Permit in Bulgaria

The Single Work and Residence Permit serves as the key authorization document for third-country nationals engaged in employment within Bulgaria. It combines work and residency rights into one permit, typically valid for one year and renewable for up to three years, provided employment conditions remain unchanged.

Previously, only EU Blue Card holders (highly skilled workers earning at least 1.5 times Bulgaria’s average wage) were required to contribute to the National Health Insurance Fund (NHIF). Now, this mandate extends to all Single Work and Residence Permit holders, integrating them into Bulgaria’s social security framework.

New Health Insurance Requirements for 2025

Starting July 1, 2025, employers hiring non-EU workers under the Single Work and Residence Permit must:

• Deduct employee contributions (3.2%) from salaries.

• Pay employer contributions (4.8%) to the NHIF.

• Report contributions to the National Revenue Agency (NRA) and NHIF.

The total health insurance contribution remains 8% of the employee’s insurable income, split between employer (4.8%) and employee (3.2%). The insurable income is capped between BGN 933 (minimum) and BGN 3,750 (maximum) per month (subject to 2025 adjustments).

Implications for Employers

• Increased Costs: Employers must now cover an additional 4.8% in health insurance contributions.

• Compliance Risks: Failure to report or pay contributions may lead to fines or permit renewal issues.

• Administrative Burden: Employers must register employees with the NHIF and manage monthly filings.

Companies using an Employer of Record (EOR) may find compliance easier, as EORs handle payroll and tax obligations.

Implications for Employees

• Access to Public Healthcare: Permit holders can now use NHIF-contracted hospitals and clinics for free or low-cost care.

• Salary Deductions: Employees will see a 3.2% deduction from gross wages.

• Dental & Prescription Exclusions: Most dental care and medications remain out-of-pocket expenses, prompting some to seek private health insurance.

Bulgaria’s Health Insurance System in 2025

Bulgaria’s public healthcare system is managed by the NHIF, covering:

• In-patient hospital care (free).

• Outpatient visits (small co-payment, e.g., BGN 2.90 for GP visits).

• Emergency services (covered under NHIF).

However, long waiting times and underfunded facilities mean many expats supplement with private insurance.

Key Deadlines & Compliance Steps

1. Employers must register employees with the NHIF upon hiring.

2. Monthly contributions must be filed with the NRA.

3. Employees should verify deductions on payslips to ensure NHIF access.

For more details, visit the National Health Insurance Fund (NHIF) official website.

Conclusion

Bulgaria’s new mandatory health insurance rule for Single Work and Residence Permit holders ensures fairer access to healthcare while standardizing employer obligations. Companies must adjust payroll processes, while employees gain public healthcare rights.

For the latest updates on Bulgaria work permits, visit VisasUpdate.com.