Voluntary health insurance in Bulgaria continues to expand at a steady pace, with stable double-digit growth of around 15–20% in recent years. This was highlighted by Ivana Dimova, Member of the Management Board of ABZ (the Association of Bulgarian Insurers) and CEO of UNIQA Insurance, in an interview for Bulgarian National Television (BNT).
Interest has become particularly visible since the COVID-19 pandemic. With high out-of-pocket healthcare spending, more people are looking for predictability and financial protection in case medical treatment is needed, and are choosing voluntary health insurance as a proactive step.
The market is growing mainly through employer-sponsored programmes. Companies are most active in sectors where competition for skilled professionals is strong, including IT, financial services and high-tech industries. Sofia and other major cities account for a large share of employers offering health insurance as an employee benefit to attract and retain talent.
Smaller businesses are also showing interest when products are affordable and easy to manage. In such cases, employers typically start with basic packages and gradually expand coverage over time.
The most sought-after packages focus on outpatient care and prevention, including specialist consultations, laboratory tests, diagnostic imaging, medicines and medical devices. Services such as remote consultations and telemedicine are also developing. Increasingly, packages include psychological support, online consultations, access to sports activities and medical assistance abroad.
Voluntary health insurance is not standardised—each insurer offers different packages, coverages, limits and sub-limits, as well as specific exclusions. Two packages may appear similar but can differ significantly in terms of limits and conditions. For dental expenses, which tend to be frequent and predictable, setting limits is important to keep products affordable.
Voluntary health insurance cannot replace public healthcare financing, but it can complement the system through cooperation between the state and the insurance sector, including in prevention and early detection.
Over the longer term, more structured development of supplementary health coverage may become part of broader reform discussions, although such ideas are still at an early stage.
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