Articles - Is it possible to be granted funds from the Health Insurance Fund for treatment abroad?
12th July 2023

Is it possible to be granted funds from the Health Insurance Fund for treatment abroad?

There is a fund for the treatment of children under the Council of Ministers. It provides organizational and financial support to Bulgarian children up to the age of 18 in cases of need of treatment abroad.

Take a look at our Children's Treatment Abroad Fund to see more examples of how certain donation amounts can help.

But people over the age of 18 may also need urgent treatment. Often they find themselves in a situation where they simply don't know where to turn. There are diseases that are considered incurable in Bulgaria, but for which successful treatment is available abroad. The amount needed is sometimes too high. Costs are further increased by the fact that patients also need a companion. People then try to seek help from the state, and if this is unsuccessful, they set up a fundraising campaign to raise money for treatment abroad.

Paying for treatment abroad

Payment for treatment abroad is made in accordance with the procedure laid down by the Minister of Health. This is done for medical services that fall outside the scope of compulsory health insurance. These are:

  • medical care for emergency conditions;
  • in-patient psychiatric care;
  • preventive check-ups and examinations and obstetric care for all uninsured women;
  • organ, tissue and cell transplants;
  • provision of blood and blood products;
  • expertise on the type and degree of disability and permanent incapacity for work;
  • compulsory treatment and/or compulsory isolation;
  • assisted reproduction;
  • medical transport in accordance with the procedure laid down by the Minister of Health;
  • payment for treatment for diseases in accordance with the procedure laid down by the Minister of Health.

Conditions for payment of expenses by the State

The Ministry of Health could cover all or part of the costs if a patient needs treatment abroad but the method of treatment is not applicable in Bulgaria. The chosen method must be proven to be effective abroad and be known and accepted in world medical practice. Treatment abroad cannot be implemented by the NHS if you choose to undergo an experimental transplant or treatment method. Another thing that is important to be aware of is that the purchase of medications and medical devices are at the patient's expense, as well as user fees, transportation, lodging and attendant care. That is, even if you receive assistance from the government, you will also need a considerable amount of money that you have to secure yourself. If you do not have the necessary funds, you can always easily start your online donation campaign on PavelAndreev.ORG.

Donate for treatment abroad

A commission for treatment abroad has been established to provide medical services outside the scope of compulsory health insurance for Bulgarian citizens. They are related to payment for treatment of diseases abroad. For this purpose, an application form must be submitted. This can be found on the website of the Ministry of Health. Other documents are also needed to give a full picture of the illness and the need for treatment abroad. Additional documents required are:

  • A copy of the patient's identity document;
  • A copy of documents certifying the legal representative's capacity, if any;
  • A declaration on a form by the applicant that he/she is not under a legal disability;
  • Medical documentation issued no more than 6 months ago and certifying the relevant diagnosis, treatment to date, epicrises, etc;
  • A declaration on a form that the patient is not currently benefiting for the same treatment since the application from a payment mechanism under Article 3, items 4-7;
  • Price quotation and expected results from the clinic where you plan to have the treatment abroad;
  • If the clinic has not yet been contacted you will need a declaration on a template that the applicant is giving the funding institution the opportunity to identify the treatment facility abroad;
  • A declaration on a form stating whether or not there is a donor account;
  • A declaration stating whether you are able to contribute to the treatment with your own funds;
  • A declaration of willingness to assist with any necessary information regarding the treatment;
  • A declaration on the processing and provision of personal data in a form;
  • Declaration on the use of social benefits;

Additional documents may be requested at the discretion of the committee depending on the treatment.

Time limit for responding to the application

Once the application has been received, it is checked within three days whether all the necessary documents are available. If anything is missing, the patient will be notified in writing and given 14 days to rectify the deficiencies. If the application is in order, the file will be sent to an expert. Within 14 days from that point forward, he prepares a report. If necessary, the time limit may be extended. After receiving the opinions from the CHR, a draft is prepared under the order of the Minister of Health. Within three days of the meeting, the Minister or other authorised person shall issue an order authorising or refusing the relevant payment for treatment abroad.

Conditions for receiving financial assistance from the State for transplantation abroad

Transplantation of organs and cells in such a medical institution, which is located on the territory of countries with which Bulgaria has concluded an agreement for this, shall be paid for with funds from the budget of the Ministry of Health. This is subject to the following conditions:

  • the transplantation of the organs concerned cannot be carried out in Bulgaria or could not be carried out in time.
  • the treatment method for the relevant disease must be established in world medical practice;
  • the patient must first be registered in the official register of the Executive Transplant Agency of persons waiting for organ transplantation.

If the conditions are met, the state will pay the cost of the transplant from the time of hospitalisation until de-hospitalisation. The funding covers a period not exceeding 60 days.

What obligations does the patient have when receiving a cash payment for treatment or transplant abroad?

After authorisation for treatment or transplantation abroad, a contract must be concluded with the Minister of Health. Next, the approved funds are transferred according to rules approved by the Minister of Health. The patient must provide the Ministry of Health with the necessary documentation and information on the procedures carried out in connection with the treatment or transplantation and the results thereof. All costs must be proven. Within one month after discharge, the patient must provide the Ministry of Health with his/her epicrisis and all financial records. In the event of failure to fulfil the responsibilities assumed, penalties follow, as described in the contract which the patient signs in advance.

Check out our blog with tips on how to run a successful campaign,what you need to know when getting treatment in Turkey and other useful information.

Check out all our charity campaigns or start yours now.

Fundraising for treatment abroad with the help of the Pavel Andreev Foundation

Fundraising for treatment abroad can be done through the Pavel Andreev platform. You can use our website to donate to fully fund treatment abroad, as well as when funding treatment abroad NHIF, however, when you will also need funds for transport, accommodation, companionship, supplies... If you are in need, feel free to set up a charity campaign to fund your treatment.

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