海角乱伦

My experience with the BG health service, both public and private, is very much a curate's egg. Even the private sector has gaping holes, a squadron of self-important Lancelot Spratt-wannabes, squabbling "specialists", a lack of nursing auxiliaries to do the "dirty work" - and a too-frequent desire to order expensive scans despite recent results already being available. At my time of life, I'm pretty phlegmatic about the future and prepared to go whenever my number comes up - but in my view, and from my extensive and ongoing experience of it, most of the medical system here has a long way to go before it even reaches Carry On, Doctor levels.... 馃��

@JimJ

Thank you ! Thats really helpful - it is the one thing stopping us from pulling the trigger. Hmm may look at going home as that is Carry on Nursing standard

As for your comment about ordering scans etc. Its almost impossible to see a doctor in Luxembourg that doesnt send you for test after test !

@adrianwray

If your lawyer is helping you with your D visa application, then my guess he's simply referring to the private insurance most folks buy as part of their application. This is the Medical Insurance for Foreigners in Bulgaria. This is a policy to keep immigration happy, and it's merely an emergency/repatriation insurance. It pays out, but only in very narrow circumstances... and it's a completely different animal from either the public health system (NHIF) or proper private medical insurance. It would be completely unwarranted to draw negative conclusions about Bulgaria's health system (or its private healthcare insurances) based on a throwaway comment on a worthless immigration policy. It usually costs less than 100 euros, nobody expects it to do much for that price). :-)

I've been here for nearly 8 years and I'm a Bulgarian PR. We all have different experiences, but I've certainly found a great life here. There are many positive aspects to life in Bulgaria, and it's one of the best decisions I've made. It's been such a positive one that I moved my father over last year, and I'm caring for him here (he's 97, and has his S1). Even if your healthcare experiences were nowhere near as good as mine, there's no way it's sufficiently bad to be a deal-breaker! :-) Personally, I find it works very well.

You can access the public system by making monthly contributions (as employed, self-employed, or unemployed) or by having an S1 from the UK/other EU country. I pay 20 euros per month, as unemployed, for full public coverage. (My dad's has his S1, so he pays no regular contribution at all.) Public hospitals will provide you with free, or nearly-free, treatment/operations. Like the UK, it works via your GP who refers you to the appropriate specialist or orders the necessary scans/tests.

Most of the private hospitals are affiliated with NHIF, and also reimbursed by it. But, naturally, they're more expensive and there's a private surcharge. If they're not affiliated with NHIF, or you don't have public coverage, then you pay full price.

You can pay for private treatment out-of-pocket, or you can have a (proper) health insurance that covers it. There are several very reputable companies and I'm very confident that they pay out. Like everywhere, these policies get more expensive based on age and prior medical history, and often have deductibles/exclusions. As you'll have your S1 (and public coverage) then an unfortunate exclusion would not be a huge drama for you. My guess is that a policy would be less than 1,000 euros, but you can check with a couple of providers/brokers.

If someone is covered in the public system (as I am because of my contributions), then a private policy is substantially less expensive, because the public system will cover most of the cost.

I'm actually still a legal resident of both Spain and Cyprus, and they are both delightful countries with beautiful Mediterranean beaches. And they're deservedly popular with tourists and expats, and especially retirees. If I were a wealthier man, I would be living in a beachfront villa in one of those two countries! I can't claim that Bulgaria is in the same class, and the Black Sea is very much the Med's poorer, dirtier cousin. :-) However, I appreciate Bulgaria's charms and positives... and find it compares extremely well when you start to factor in the cost of living and cost of property. The reality is that we live FAR better here than we do/could in either Cyprus or Spain, and hence I spend most of my time here.

The public healthcare in Spain is very good, but the Cyprus system is relatively recent and I don't know how good it is. BUT the public/private cooperation discussed above is not present in either country. They, just like the UK, give you the choice between free, slow (but good), public treatment... or full-price VIP private treatment whenever you want it. Whereas, in Bulgaria, I can get the latter at a ludicrously small private surcharge because of my 240 euros a year NHIF contributions (or my father's S1).

Medical stuff is not enjoyable per se, but I find that I really enjoy this luxury option. And, indeed, I compare it with the alternative of standing in line for public treatment in Cyprus or Spain, and conclude that I don't want to be sick... but if I am, I'd rather be sick here. :-)

@adrianwray

As mentioned, we all have different experiences, so I'm not sure how useful my specific examples are. Especially as they concern my dad, who, at 97, seems to get more consideration here. But...

Last month, I had a cardiologist (private, via SuperDoc) appointment for my father. It was 50 lv (full price) for examination, BP, EKG, echocardiogram. Even in Bulgaria that's a ludicrously low price.

A couple of weeks ago, I took him to see his GP because of a growth on his face (which I suspected to be cancerous). Our GP saw him immediately... and then summoned the skin surgeon. The surgeon decided he should operate. Immediately (after some tests and a drip). He took a biopsy too and confirmed it was a basal cell carcinoma. We spent 4 hours in Medline, and they accepted his S1 and charged us an extra 50 lv. The surgeon then, very kindly, made several house calls due to my father's age. I paid him 150 lv per visit as I was so grateful (but I think the official rate is 50 lv). In my simplistic view, a home-visit by a surgeon (not a GP) is pretty much unheard of, and I'm 100% certain this would not have played out the same way on the NHS back in the UK.

Yesterday, we had a bit of adventure. My dad was knackered after a morning out in the park, and we put him down for a nap. He decided to get up on his own, tripped and fell head first. He'd bashed his arm and his head, and had a big gash on his forehead with blood all over the floor (face injuries can bleed like billy-oh, even if minor). To be honest, when I heard, I was in a bit of a panic. I knew Medline would take care of him, but our surgeon was at home (not surprising on a Sunday)... and I didn't think I could get him that far (2 miles) on Sunday afternoon buses, especially in his condition. Note to self: I need to figure out ambulances for any future episodes. :-)

I decided to try Pulmed (shiny new private hospital) across the road from us as it would take a more manageable wheelchair ride of 5 minutes. They wouldn't accept his S1 for emergency treatment (I didn't think they would) so we paid full whack from private treatment. I asked the emergency room doc about the cost, and he kindly gave me some ballpark costs for each element, so I could see it would be 100s, rather than 1,000s. :-)

They did, as @JimJ says, ask for multiple scans. So we did an x-ray of his arm (to check for fractures) and a CT-scan of his head (to check for fractures and brain bleeds/swelling). Even as a non-doc I suspected it was just bad bruising, but better safe than sorry, eh? We had an emergency room visit (no waiting), followed by 2 scans, and a consult with the facial surgeon. The surgeon cleaned the wound and had to put in 15 stitches (op is charged separately). We finished off with a tetanus booster (in the emergency room) and a prescription for pain-killers and antibiotics. If I'd got him to Medline, all this would have been nearly free (or completely free if I'd managed to get him to Sveti Georgi the big public hospital nearby). In Pulmed, it cost us 700 lv. Not cheap... until you compare it with private hospitals outside Bulgaria.

@gwynj

Hi and thank you for taking the time to give such a detailed and personal response. We will be flying out in聽 a few weeks to look at property now !

Its much appreciated

@gwynj

Very helpful