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We used a Broker and she found us Health Insurance that fitted all the requirements for the D visa. She is very patient and understanding and answered all our questions - and believe me, we had many. She's also helped us get car insurance etc. Her name is Galya Zlatanova, company is 2M Broker and email is  office@2mbroker.com
If you decide to contact her, feel free to say that I recommended her. She likes to help people.

There's a standard insurance for immigration purposes (D visa, residence) called something like "Medical Insurance for Foreigners", so any broker can do a policy for you in  a few minutes, and shouldn't charge more than 100 euros.

It's not a typical "private health insurance" so please don't assume it covers you for much! Once you've sorted out your immigration paperwork, and living in Bulgaria, then it would be advisable to either make your social security contributions and enroll in the health system, and/or purchase a true private health insurance.

You can get a USA or EU policy that provides similar cover, but it will probably be significantly more expensive than the Bulgarian version. Plus, officially, you should get the policy/certificate translated into Bulgarian. For example, AXA does a Schengen Policy (with optional extra non-Schengen countries, such as Bulgaria), but last time I checked it was around 250 euros.

24ins.bg is an online broker, so they definitely could sell you a policy, if you don't want to (or can't) go to an office.

Dzi.bg has a good explanation of the policy and what it covers under "Mandatory medical insurance for foreigners". But I think you have to go to office to get a policy.

Bg.euromedins.com has policy info, and you can buy online.

If you go into an office, you will get official paperwork. If you order online, you could pay extra to send the documents abroad (if necessary). But the Bulgarian Embassy will, most likely, also accept the email (and PDF certificate), if the broker will do that.

Hi GWYNJ,

thanks for detailed answer- will get the insurance for foreigners for the D visa.
My wife is Bulgarian so can I get eventually the Bulgarian government insurance just in case? I  plan to be paying out pocket as well if needed for private/expedited care( the fees are ridiculously low compared to the US)
Our US insurance  currently  covers the whole world but it is too expensive and we are switching to one  that  covers  only the US. This way we have insurance in America if any advanced future care is needed.

Yes, indeed, I have found that Bulgarian private treatment is very inexpensive. I go to Pulmed in Plovdiv which is very new, clean, and always helpful (and rarely busy).

If you're working you will pay social security as either employed or self-employed. If you're just hangin' out in Bulgaria, you can register as unemployed and that's 25 leva/month.

This is a very cost-effective way to have coverage in case of emergencies. My understanding is that most/all private hospitals will accept the state coverage for whatever the "official" treatment rate is,  and you can pay the difference for the VIP treatment option. And I believe a private health insurance policiy will, if you choose to get one, also be cheaper if you're covered in the state system.

USA health insurance is astronomically expensive, and gets even more so as you get older, and as you get any illnesses. So while retiring in Bulgaria will substantially reduce your cost of living... keeping medical insurance because you'll be spending x months a year in the USA will be quite a bump in your expenses!

Not in our case- my wife has unbelievable benefits from work- the retirement insurance rate for 2021 is $55 /month for 2 people including Dental.

this will be our new health plan( rates may be up 1-2 dollars for next year, not even worth mentioning)

Retiree & 1 or more dependents on Basic Plan A
2021 TOTAL       $2,517.84
MONTHLY
PREMIUM

2021 EMPLOYER     
MONTHLY SHARE   $2,467.49

2021 RETIREE
MONTHLY SHARE     $50.35  !!!!!!!!!!!!!

Totally comprehensive plan, no co-pay for visits; no co-pay for MEDS!!!!!

Lucky boy. Just make sure she never stops working. :-)

@gwynj  So this 100 euro is 100 / month or 100euro to get thru Visa d then purchase other health insurance? I ah from US, retired,  and have basic medicare would I still need this and what is the above insurance you have?

see above