Whether your healthcare expenses are covered by the National Health Insurance Fund, an insurance fund, or a supplementary health insurance policy, accurate documentation is essential for the reimbursement process. Here’s everything you need to know to make it easier:
When Can You Claim Reimbursement?
You can submit a reimbursement claim in the following cases:
- Treatment at private medical centers – if you haven’t used a referral from your general practitioner (GP). These costs are usually covered by supplementary health insurance.
- Treatment abroad – if the necessary therapy can’t be provided domestically (special conditions apply for policies such as "Treatment Without Borders").
- Medication costs – when the drugs are approved by the Bulgarian Drug Agency.
- Supplementary health insurance – this may cover consultations, tests, expensive medical materials, choice of physician/team, faster diagnostics, medications, eyeglasses, and dental services.
- Special cases – if the facility isn’t partnered with the insurer, you’ll pay upfront and later submit documents for reimbursement.
What Documents Are Required?
To request a reimbursement, you need to provide:
- Application form – filled out per the insurer's or institution’s template.
- Original medical invoices – with detailed service descriptions and issued in the insured person’s name.
- Discharge summary or medical documents – proving the treatment.
- Proof of payment – such as receipts and invoices.
- Outpatient sheet and prescription – if applicable.
- Steps to Submit a Reimbursement Claim
- Check your policy’s coverage – to understand what's included.
- Gather all required documents – ensure nothing is missing.
- Fill out the form correctly – mistakes can cause delays.
- Submit the documents – to your health fund, insurer, or via an online portal.
- Wait for approval – processing usually takes around 15 business days with supplementary health insurance.
How to Avoid Issues?
- Ensure invoices are in the insured person’s name, not the employer or insurer.
- Keep all receipts and documents – for proof of expenses.
- Check what’s covered in your insurance – before treatment.
- If your request is denied, find out why, gather any missing documents, and reapply.
Supplementary health insurance can greatly ease the burden of covering medical expenses and helps ensure faster reimbursements. If you use healthcare services often, consider such a policy for greater peace of mind and financial security. In many cases, you won’t need a GP referral and can book directly with a specialist. If the facility partners with your insurer, you may not even have to pay upfront. If not, pay and submit your claim—standard processing time is 15 working days.
