03.09.2024
HOW PEOPLE WITH DISABILITIES CAN RECEIVE ASSISTANCE FROM THE NATIONAL HEALTH INSURANCE FUND
Who is entitled to receive assistance from the National Health Insurance Fund? The Health Insurance Fund provides answers to this question.
People with disabilities are entitled to such funds, with a valid protocol from the Medical Advisory Commission/Territorial Expert Medical Commission/National Expert Medical Commission.
What are the steps if you are a person with a disability and need an aid, device, facility or medical device:
To visit a Medical Advisory Commission/Territorial Expert Medical Commission/National Expert Medical Commission, from where you will be issued an electronic protocol/decision to prescribe an aid, device, facility or medical device;
Expert committees of the National Health Insurance Fund/Regional Health Insurance Fund will review your electronic application and issue an approval or reasoned refusal to grant your pre-approved aid, device, facility or medical device; the deadline is 7 days from the receipt of the application. Each approval will contain details of you and, where applicable, of your authorized person (where the application is submitted by them). The approval will have a registration number and date of issue. It will include aids, devices, equipment or medical devices with the corresponding codes in the National Health Insurance Fund;
You or the person authorized by you will be informed about the approval or the reasoned refusal by a written message to the e-mail indicated by you and/or by telephone. You do not need to visit an office of the Regional Health Insurance Fund;
You can get your aid, device, facility or medical device from any retailer that has a contract with the Regional Health Insurance Fund, without territorial limitation - that is, wherever it is convenient for you in the territory of the country. For this purpose, you must identify yourself to the trader you have chosen by means of an identifier - PIN, names, number and date of approval for the provision of an aid, device, facility or medical device.
What should you do if your aid, device, facility or medical device needs repair?
You or a person authorized by you must submit an application for repair work (according to the model) to the director of the Regional Health Insurance Fund. You can also send the application by certified mail (return receipt requested) via a licensed postal operator;
An expert committee at the Regional Health Insurance Fund examines and approves the applications;
The Director of the Regional Health Insurance Fund issues an approval for the repair of an aid, device, facility or medical device or a reasoned refusal. A reasoned refusal is issued in case of non-compliance with the conditions specified in the list-specification of aids, devices, equipment or medical devices and is sent with a cover letter to the specified address of the applicant;
All retailers who have a contract with the Regional Health Insurance Fund are obliged to provide repair work for aids, devices, equipment or medical devices. For this purpose, you or a person authorized by you, must identify yourself to the merchant of your choice by means of an identifier - PIN, names, number and date of approval for granting an aid, device, facility or medical device. According to set criteria, the merchant notes the provided repair activity in the specialized software product.
You should also know:
Applications for the grant of an aid, device, facility or medical device with a total value of up to BGN 1,000 are considered by the relevant Regional Health Insurance Fund at a permanent or current address.
Applications for the granting of an aid, device, facility or medical device with a total value equal to or greater than BGN 1,000 are considered by the Central Office of the National Health Insurance Fund.
The prescription of an aid, device, facility or medical device is carried out according to the specification of the National Health Insurance Fund with a code, without specifying specific trade names or companies.
It is possible to submit applications for the grant of an aid, device, facility or medical device on paper to the Regional Health Insurance Fund only when the application cannot be submitted electronically by the Medical Advisory Commission/Territorial Expert Medical Commission/National Expert Medical Commission due to technical reasons.
Who to contact if you need information:
The list of experts from the Regional Health Insurance Fund, who are contact persons and submit information to the National Health Insurance Fund about problems or cases that have arisen, can be found on the website of the National Health Insurance Fund www.nhif.bg, under the heading "Resources".
The National Health Insurance Fund, together with "Information Service" JSC, is working on the implementation of a technological possibility that will allow people with disabilities who have applied for the granting of aids, devices, equipment and medical devices to be notified of the decision made via SMS and Viber messages.
