Bulgaria Mandates Health Insurance for Single Work and Residence Permit Holders

Bulgaria has introduced a major change to its immigration and labor policies that will affect thousands of foreign workers and their employers starting July 1, 2025. The country now requires all holders of The Single Work and Residence Permit to enroll in the national health insurance system, a rule that previously applied only to EU Blue Card holders. This update brings new responsibilities for employers, new rights and protections for foreign workers, and new procedures that everyone involved must follow to stay compliant with Bulgarian law.

This update explains the new health insurance requirement in detail, outlines what employers and workers must do, and discusses the broader impact of this change on Bulgaria’s labor market and immigration system. It also provides practical steps, official resources, and real-world examples to help readers understand what these changes mean for them.

Summary of the Changes

Starting July 1, 2025, every foreign worker in Bulgaria who holds a Single Work and Residence Permit must have health insurance through Bulgaria’s public system. Employers are now responsible for enrolling these workers, deducting health insurance contributions from their salaries, making additional employer contributions, and reporting everything to the National Revenue Agency (NRA) and the National Health Insurance Fund (NHIF). This requirement aligns the treatment of Single Work and Residence Permit holders with that of EU Blue Card holders and Bulgarian citizens, making the system more fair and consistent.

Background: What Is the Single Work and Residence Permit?

The Single Work and Residence Permit is the main document that allows people from outside the European Union to live and work in Bulgaria. It is usually valid for one year and can be renewed for up to three years if the worker’s job situation does not change. Before this new rule, only highly skilled workers with EU Blue Cards—who must earn at least 1.5 times the average wage in Bulgaria—were required to pay into the national health insurance system. Other foreign workers could often rely on private insurance or different arrangements.

What Has Changed?

As of July 1, 2025, all non-EU workers with a Single Work and Residence Permit must be enrolled in Bulgaria’s State Statutory Health Insurance System. This means:

• Employers must deduct 3.2% of the worker’s salary for health insurance.
• Employers must pay an additional 4.8% of the worker’s salary as their own contribution.
• Both contributions go to the National Health Insurance Fund (NHIF).
• Employers must report these payments to both the NHIF and the National Revenue Agency (NRA).
• Health insurance must cover the entire period of employment in Bulgaria.
• Workers with private health insurance must prove their coverage is valid and meets Bulgarian standards.
• Permit renewals may be denied if the worker cannot show proof of valid health insurance.
• Penalties for non-compliance include fines for employers, delays in permit processing, and possible deportation for workers.

Why Did Bulgaria Make This Change?

The Bulgarian government wants to treat foreign workers more like Bulgarian citizens and EU Blue Card holders. By making health insurance mandatory for all Single Work and Residence Permit holders, Bulgaria is:

• Improving social protection for foreign workers, giving them access to the same public healthcare as locals.
• Making the labor market more attractive to skilled workers from outside the EU.
• Aligning its rules with European Union standards, especially after joining the Schengen Area on January 1, 2025.
• Ensuring fairness by having all workers contribute to the public health system.

Who Is Affected?

This change affects:

• All non-EU nationals working in Bulgaria with a Single Work and Residence Permit.
• Employers who hire foreign workers under this permit.
• Legal and HR professionals who manage immigration and payroll for international staff.

What Are the New Employer Responsibilities?

Employers now have several important tasks:

1. Enroll foreign employees in the State Statutory Health Insurance System.
2. Deduct 3.2% of each worker’s salary for health insurance.
3. Pay an additional 4.8% as the employer’s share.
4. Report all contributions to the National Revenue Agency and the National Health Insurance Fund.
5. Keep records of health insurance enrollment for each foreign worker.
6. Ensure coverage is continuous for the entire period of employment.
7. Provide proof of insurance when renewing work and residence permits.

How Does This Affect Foreign Workers?

Foreign workers with a Single Work and Residence Permit will now:

• Gain access to Bulgaria’s public healthcare system, which covers doctor visits, hospital care, and other medical needs.
• Have their health insurance contributions automatically deducted from their paychecks.
• Need to provide proof of valid health insurance when renewing their permits.
• Face possible deportation if they do not have valid health insurance.

Workers who already have private health insurance must show that their coverage is valid in Bulgaria and meets all legal requirements. If it does not, they must enroll in the public system.

Step-by-Step Guide for Employers

To help employers follow the new rules, here is a simple step-by-step process:

1. Check the Worker’s Status: Make sure the employee has a valid Single Work and Residence Permit.
2. Register with the NHIF: Enroll the worker in the State Statutory Health Insurance System.
3. Adjust Payroll: Deduct 3.2% from the worker’s salary for health insurance.
4. Pay Employer’s Share: Add 4.8% of the worker’s salary as the employer’s contribution.
5. Report Monthly: Send monthly reports and payments to the National Revenue Agency and the NHIF.
6. Keep Documentation: Store proof of health insurance enrollment for each worker.
7. Monitor Coverage: Make sure the worker’s health insurance stays active for the entire time they are employed.

Employers who do not follow these steps risk fines, delays in permit processing, and other legal problems.

What Happens If Employers or Workers Do Not Comply?

Non-compliance can have serious consequences:

• Employers may face financial penalties for failing to enroll workers or pay contributions.
• Permit renewals may be delayed or denied if health insurance is not in place.
• Workers may be deported if they do not have valid health insurance.
• Legal and administrative problems can arise, affecting both the company and the worker.

It is important for both employers and workers to keep good records and make sure all payments and reports are up to date.

How Does This Compare to the Old System?

Before July 1, 2025, only EU Blue Card holders—who are highly skilled and earn higher salaries—had to pay into the national health insurance system. Other foreign workers could often use private insurance or different arrangements. Now, all non-EU workers with a Single Work and Residence Permit must be part of the public system, just like Bulgarian citizens and EU Blue Card holders.

This change means more workers are protected by the public health system, but it also means more paperwork and costs for employers.

What About Private Health Insurance?

Some foreign workers may have private health insurance. Under the new rules:

• Private insurance is allowed if it meets Bulgarian standards and covers the full period of employment.
• Workers must provide proof that their private insurance is valid and comprehensive.
• If private insurance is not accepted, the worker must enroll in the public system.

Employers should check all private insurance policies carefully to make sure they meet the legal requirements.

Broader Impact and Future Outlook

This reform is part of a larger effort by Bulgaria to modernize its immigration and labor systems. By aligning its rules with those of the European Union, Bulgaria hopes to:

• Attract more skilled workers from outside the EU.
• Create a fairer labor market where all workers have the same rights and protections.
• Improve its reputation as a destination for international talent.
• Prepare for future changes, such as new permits for digital nomads and updates to other residence permit categories.

According to analysis by VisaVerge.com, these changes are likely to make Bulgaria more appealing to foreign professionals and their families, while also ensuring that the country’s social security and healthcare systems remain strong and sustainable.

Practical Example: How the New Rule Works

Let’s look at a real-world example:

Maria is a software developer from India who works in Sofia, Bulgaria, with a Single Work and Residence Permit. Her monthly salary is 4,000 Bulgarian leva.

• Her employer must deduct 3.2% of her salary (128 leva) each month for health insurance.
• The employer must also pay 4.8% (192 leva) as their own contribution.
• Both amounts are paid to the NHIF and reported to the National Revenue Agency.
• Maria is now covered by Bulgaria’s public healthcare system and can access medical care like any Bulgarian citizen.
• When Maria renews her permit, she must show proof that her health insurance is active and paid up.

If Maria’s employer forgets to enroll her or misses a payment, Maria could have trouble renewing her permit, and the employer could face fines.

Tips for Employers and Workers

• Employers should update employment contracts to include the new health insurance requirements.
• Payroll systems must be adjusted to handle the new deductions and payments.
• Workers should keep copies of all health insurance documents and check that their coverage is always active.
• Legal and HR teams should stay informed about any further changes to Bulgaria’s immigration and labor laws.

Where to Find Official Information

For more details about the new health insurance requirements, employers and workers can visit the National Revenue Agency’s official website for up-to-date information on tax and social security contributions. The National Health Insurance Fund (NHIF) also provides resources on health insurance enrollment and benefits. The Bulgarian Ministry of Labor and Social Policy oversees labor regulations and foreign worker policies.

Conclusion and Next Steps

The new health insurance requirement for Single Work and Residence Permit holders in Bulgaria is a significant change that affects both employers and foreign workers. By making health insurance mandatory, Bulgaria is providing better protection for workers and creating a more attractive and fair labor market.

Employers must act quickly to update their systems, enroll workers, and ensure all payments and reports are made on time. Workers should check their insurance status and keep all necessary documents ready for permit renewals.

Staying informed and compliant is the best way to avoid problems and make the most of the opportunities Bulgaria offers. For those needing extra help, legal advisory firms with experience in Bulgarian immigration and labor law can provide guidance tailored to specific situations.

As Bulgaria continues to modernize its immigration system, more changes may come in the future. For now, understanding and following the new health insurance rules is essential for anyone working or hiring in Bulgaria under the Single Work and Residence Permit.

Learn Today

Single Work and Residence Permit → Legal document allowing non-EU nationals to live and work in Bulgaria for up to one year, renewable.
National Health Insurance Fund (NHIF) → Bulgaria’s public body managing health insurance contributions and coverage for workers and citizens.
National Revenue Agency (NRA) → Bulgarian government agency responsible for collecting taxes and social security contributions.
EU Blue Card → A permit for highly skilled non-EU workers with higher salary requirements and special labor rights.
Health Insurance Contributions → Mandatory payments deducted from salaries and paid by employers to fund public healthcare services.

This Article in a Nutshell

Bulgaria mandates public health insurance for all Single Work and Residence Permit holders from July 2025. Employers must contribute financially and report payments, aligning foreign workers’ protections with EU Blue Card holders to ensure fairness and improve the labor market for international talent in Bulgaria.
— By VisaVerge.com