Guide
How reimbursement by the NHIF (НЗОК) works
Prepared by the LekCheck team · Last reviewed: 2026-07-25 · How we create our content
Some medicines in Bulgaria are covered fully or partly by the National Health Insurance Fund (NHIF, НЗОК). This means that for certain prescription medicines the patient pays only the difference (co-payment) rather than the full price. Below we explain the main concepts — reimbursement, reference price and co-payment — to help you read what the fund covers. For specific medicines, check the current list and consult a doctor or pharmacist.
This guide was prepared by the LekCheck team and has not been reviewed by a doctor or pharmacist. This article is for general information only and is not medical advice, diagnosis, or treatment. Do not start, stop, or change any treatment without consulting a doctor or pharmacist.
What reimbursement means
Reimbursement is the (partial or full) payment of a medicine by the NHIF for insured people with a prescription. The fund maintains a list of reimbursed medicines by international name (INN), condition and level of coverage. Whether a medicine is covered depends on the diagnosis, the active ingredient and whether it is on the list.
Reference (ceiling) price and co-payment
For reimbursed medicines the NHIF sets a reference value — the amount up to which it covers a group of medicines with the same active ingredient and strength. If you choose a product more expensive than the reference, you pay the difference (co-payment). That is why the price under insurance for the same medicine can differ between products with the same ingredient.
How to check what is covered
Coverage is determined by the current NHIF list and the doctor's prescription. The treating doctor judges whether the condition meets the conditions for reimbursement and issues a prescription. At the pharmacy, the pharmacist can tell you the exact co-payment for a specific product. LekCheck shows which products are marked as NHIF-covered, but the final decision and exact amount are confirmed by the doctor and pharmacy.
Important to know
Reimbursement mainly applies to prescription medicines for certain conditions, not to ordinary over-the-counter products. The conditions and lists are updated periodically, so the information can change. For your specific case — whether the medicine is covered and what the co-payment is — always check with your doctor and pharmacy.
Frequently asked questions
Which medicines does the NHIF cover?
The NHIF covers certain prescription medicines for specific conditions included in its list by international name. Ordinary over-the-counter products are usually not reimbursed. Whether a medicine is covered depends on the diagnosis and the current list — this is judged by the treating doctor.
What is a co-payment?
The co-payment is the amount the patient pays above what the NHIF covers. If you choose a product more expensive than the reference value for the group, you pay the difference. For some medicines the co-payment is zero, and for others significant, depending on the chosen product and the level of reimbursement.
Why does the insured price differ between pharmacies and products?
The NHIF covers up to a reference value for a group of medicines with the same ingredient and strength. Different commercial products in the group have different final prices, so the co-payment varies. Pharmacies may also have different final prices. That is why comparing specific products matters.
How do I find out if my medicine is reimbursed?
Ask the treating doctor, who issues the prescription and knows whether your condition meets the conditions, and the pharmacist for the exact co-payment. You can also browse the products marked as NHIF-covered on LekCheck, but the final confirmation comes from the doctor and pharmacy.
Are over-the-counter medicines reimbursed?
As a rule, no — reimbursement applies to prescription medicines for certain conditions. Over-the-counter products are usually paid in full by the patient. Exceptions and specific conditions are set by the current NHIF rules.