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Health Insurance: What You Need to Know?

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Earlier this year, some important changes in health insurance were adopted. It is good to be familiar with the law and to follow the changes in it, so that you are aware of your rights and obligations at all times.

For starters, you can always check your health insurance status on the NRA website (National Revenue Agency) or by phone, in both cases by entering your PIN.

And now let’s see the changes from 2020 and the answers to the most important questions about health insurance.

Changes in health insurance 2020
At the beginning of 2020, the amounts due for health insurance changed. This is due to the changes made in the regulatory framework and the increased amount of the minimum insurance income, which is already BGN 610.

The amount of the obligatory health insurance contribution is determined by Art. 2 of the State Social Insurance Budget Act.

For 2020, health insurance remains 8% of income. Most of it is borne by the employer, and less by the employee – the ratio is 60:40.

The exact obligation for each person depends on his income, whether he works, whether he is self-insured and whether he has the status of unemployed with or without the right to benefits.

Health insurance for persons who in 2020 are not on employment or equivalent contracts, are paid on insurance income not less than half of its minimum amount and not more than the amount of the maximum insurance income (which is 3000 BGN per month).

This year for self-insured persons half of the minimum insurance income is equal to BGN 305. It follows that the amount due for health insurance for the unemployed is a minimum of BGN 24.40 per month.
How are health insurances paid and by whom?
Those people who are subject to compulsory insurance with the National Health Insurance Fund, but are not insured on any of the grounds of the Health Insurance Act (for example, the permanently unemployed without the right to unemployment benefits), pay health insurance at their own expense and submit a one-time declaration – declaration form № 7 under Ordinance H-13 of 17 December 2019 of the Minister of Finance on the occurrence of the obligation to pay health insurance contributions on this basis. In it they indicate their chosen health insurance income.

The monthly as well as the final health insurance contributions are paid through the PIN to the bank account of the respective territorial directorate of the NRA (at your permanent address) for the collection of revenues for the NHIF.

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Unemployed people who receive unemployment benefits are exempt from health insurance contributions. They are covered by the state budget.

Graduates often forget the fact that they have to be self-sufficient for the period from graduating from school to starting university. They must then present a document from the relevant university certifying that they are students.

How to submit a declaration № 7?
You can submit the declaration at the office of the Revenue Agency, by mail with a return receipt or electronically via a personal identification code (PIC) – this is received free of charge on the spot.

What is the deadline for payment of health insurance?
Unemployed persons in 2020 must pay their health contributions by the 25th of the month following the month for which they are due. For example, if you have a debt for the month of September, you can pay it until October 25.

Those persons who provided health insurance themselves in the previous year should also make an annual equalization and pay final health contributions. This happens when the income under the tax return for the previous year exceeds the insurance income on which health insurance contributions have been paid monthly for the year. This applies to rental income, royalties and the like.

The annual adjustment for these persons is made through Table 2, an appendix to the annual tax return. The deadline for paying the final health contributions for the respective year is usually April 30 of the following year.

What happens when health insurance is not paid?
According to Art. 109, para. 1 of the Health Insurance Act, if you have not paid health insurance for more than 3 months within the previous 36 months, you will be deprived of health insurance rights. In order to restore your health status, you must pay all due contributions for the last 5 years.

It is important to know that in this case, your medical expenses are not reimbursed.

Do people on unpaid leave owe health contributions?
If you are on unpaid leave of your choice and you are not insured on other grounds, you owe health contributions at your own expense. Then you are a self-employed person and you have to pay the due health contributions to your employer. If you do not, your employer is not obliged to contribute them from its own funds.

It is important to know that insurers (employers) are obliged by law to submit data with a declaration form № 1 and form № 6, including for persons who are on unpaid leave, regardless of its duration.

Conclusion
Now you know what are your basic rights and obligations towards health insurance in Bulgaria, as well as the latest significant changes in the law.

We will add that for the days of employees and workers in temporary incapacity for work due to illness, pregnancy, childbirth and raising a small child, health insurance is due by the employer over BGN 610.

It is important to monitor your insurance, not only to avoid unnecessary headaches and sanctions, but also not to compromise your health and not to risk finding yourself in an unfavorable situation.

If you need consultation and assistance from a good lawyer, contact the law firm “Danailova, Todorov and Partners”. We will be happy to help.

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