Bulgaria’s doctors’ union is asking for a 25% increase in the prices paid for all medical activities under the public healthcare system, but the rise has not been approved and remains tied to the still-unresolved 2026 National Health Insurance Fund budget.

That was the message from Dr Nikolay Branzalov, chairman of the Bulgarian Medical Union (BLS), speaking alongside Assoc Prof Petko Stefanovski, manager of the National Health Insurance Fund (NHIF), in comments reported by Moreto.net.

What has been proposed

According to Dr Branzalov, the BLS wants tariffs for all medical activities to rise by 25%.

He said the BLS and NHIF have been in regular negotiations since last summer and have resolved many issues in the text of the national framework agreement. But he said the financial part remains unsettled, and argued that the wider system faces a real risk of destabilisation because of chronic underfunding.

Branzalov said:

  • sector costs have risen by 85% in recent years
  • prices for clinical pathways have not been changed since 2024
  • the current funding model is pushing the system to its limits

He also said that without a proper budget, all hospitals are at risk, not only municipal ones.

How much extra money officials say is needed

The sum most likely to decide the argument is €462 million.

That figure was given by Assoc Prof Stefanovski, who said that is the additional amount needed for the full 25% increase.

He broke it down as:

  • €42 million for primary outpatient care
  • €41 million for specialised outpatient care
  • €27 million for medical diagnostic activities
  • €351 million for hospital care

Stefanovski said that once the money is provided, an annex can be signed. He added that the funds would go towards treatment, prevention and medical services.

Why the 2026 budget matters

Both men tied any progress to the unresolved 2026 NHIF budget.

Dr Branzalov said parliament needs to take an immediate decision on the NHIF budget, warning that without a regular budget the system remains in a stalemate. He also argued that health insurance revenues collected since 2024 have increased significantly, but said there is no clarity over where those funds are and how they are being used.

He further said the NHIF reserve had been redirected in previous years and should be returned to the Fund.

Those points are important, but they remain claims attributed to Dr Branzalov. No official NHIF financial tables, government budget documents, or independent expert analysis have been published to confirm those wider financial assertions.

For his part, Stefanovski said the present situation stems from the non-adoption of the NHIF budget for 2026. According to him, the sums now being discussed had been included in the draft budget law, but that law was not passed by the previous parliament.

What is clear, and what is not

There is a straightforward news line here, and it is worth keeping it tidy.

What is clear from the source:

  • the 25% rise is a demand, not a decision
  • the €462 million estimate is attributed to Assoc Prof Stefanovski
  • the 85% cost increase is attributed to Dr Branzalov
  • both officials linked any deal to the missing 2026 NHIF budget

What is not independently evidenced at this stage:

  • exactly where recent health insurance revenues have gone
  • whether the NHIF can realistically cover the extra funding
  • whether a 25% increase would be enough, or affordable, in longer-term budget terms

Asked whether the NHIF could collect more than €460 million in health contributions this year, both officials said that answer would have to come from the National Revenue Agency.

A simple guide to the acronyms

For readers who do not spend their mornings swimming through Bulgarian administrative initials:

  • NHIF is Bulgaria’s National Health Insurance Fund, which finances much of state-covered care
  • BLS is the Bulgarian Medical Union, which represents doctors in these negotiations
  • clinical pathways are standard payment routes used for hospital treatment under the public system

For a British reader, the nearest practical comparison is not exact, but think of it as a dispute over what the public system pays providers for consultations, tests and treatment. Different machinery, familiar headache.

What this means for British residents in Bulgaria

For now, there is no immediate rule change for patients.

This report does not say that entitlement has changed, that new charges are coming in tomorrow, or that the 25% rise is already in force. But if the budget deadlock drags on, the effects may show up in more ordinary ways:

  • longer waits for specialist appointments
  • slower access to diagnostic tests
  • more pressure on regional and municipal hospitals
  • greater use of private care by people who want speed or certainty

That matters particularly if you:

  • rely on a Bulgarian GP for referrals
  • need ongoing specialist follow-up
  • combine public cover with private insurance
  • live outside the biggest cities and depend on local hospital services

Practical steps for Brit expats

There is no need for panic, but there is a case for being organised, which is not the same thing as cheerful.

If you depend on Bulgarian healthcare, it is sensible to check that you have:

  • up-to-date health insurance status
  • copies of your GP registration and referral paperwork
  • a clear understanding of what is covered publicly and what you may need to pay for privately
  • a back-up plan if a scan, specialist visit or hospital appointment is delayed

It is also worth:

  • confirming repeat prescription arrangements with your GP
  • asking whether tests or consultations can be done privately if waiting times grow
  • keeping digital and paper copies of key medical documents

In Bulgaria, paperwork has a habit of becoming urgent exactly when you hoped it might remain theoretical.

A brief UK and EU perspective

The source material does not provide comparative UK or EU data, so it would be a stretch to claim Bulgaria is uniquely troubled or unusually severe in this regard.

What can safely be said is that the argument itself will feel familiar to British readers: providers say their costs have risen, officials say more funding is needed, and the budget process moves with all the briskness of a wet overcoat.

That does not prove Bulgaria’s situation is the same as the NHS or other European systems. It simply places the dispute in a recognisable pattern of healthcare financing pressure.

What happens next

For the moment, the position is plain enough:

  • the BLS wants 25% more for all medical activities
  • Stefanovski says this needs €462 million in extra funding
  • the increase is not approved
  • both sides say progress depends on the unresolved 2026 NHIF budget

So this is not yet a policy change. It is a funding dispute with potentially practical consequences if it drags on.