The limits insupplementary health insurance(DZO) determine how many and what health services you can use within the insurance package.They are a key element of any policy and directly affect access to medical care, quality of service and your personal costs.
What are the limits in DZO?
Limits are predetermined limits for coverage of medical expenses.They can be expressed in value (e.g. BGN 1,000 per year), in number of visits (e.g. up to 6 examinations) or in percentages (e.g. 80% of the cost of treatment).
Types of limits in supplementary health insurance
Different packages include different types of limits.The most common are:
| Тип лимит | Описание |
| Годишен лимит по полицата | Общата сума, до която дружеството поема разходи (напр. до 2 000 лв. годишно). |
| Лимит на медицински услуга | Например: до 5 специализирани прегледа годишно. |
| Лимит на стойност на услуга | До 80 лв. за един преглед или 150 лв. за изследване. |
| Процентов лимит | ДЗО покрива 70% от стойността, останалите 30% се доплащат от клиента. |
| Лимит по подкатегория | Отделни лимити за дентална помощ, профилактика, изследвания. |
Why are limits important?
The limits show the actual scope of the insurance.They determine how much you can rely on DZO when you need treatment.Without knowing them, you risk:
- Go over the limit and pay out of pocket;
- To be denied funding for treatment;
- Not to usethemfull package due to lack of information.
How to check your limits?
You can check the limits in the following ways:
- In the individual contract with the company;
- Through a customer online portal or mobile application;
- Through a written reference from the insurer;
- Every time you use a service, the limit is automatically marked.
What happens when the limit is used up?
When the limit is reached, usually:
- The insurer stops covering the costs of this service;
- The patient starts paying entirely out of pocket;
- Some companies offer an additional package or upgrade.
Example: If the annual limit for laboratory tests is BGN 300, and BGN 280 has already been used, the next test may have to be partially or fully paid for.
Can the limits be customized?
Yes.Most companies offerdifferent insurance planswith different limits, depending on:
- Contribution amount;
- Package Type (Basic, Advanced, Premium);
- Occupation, age, health status;
- Agreement with the employer (for group insurance).
More information on international health insurance can be found herelink!
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The limits insupplementary health insurance(DZO) determine how many and what health services you can use within the insurance package.They are a key element of any policy and directly affect access to medical care, quality of service and your personal costs.
What are the limits in DZO?
Limits are predetermined limits for coverage of medical expenses.They can be expressed in value (e.g. BGN 1,000 per year), in number of visits (e.g. up to 6 examinations) or in percentages (e.g. 80% of the cost of treatment).
Types of limits in supplementary health insurance
Different packages include different types of limits.The most common are:
| Тип лимит | Описание |
| Годишен лимит по полицата | Общата сума, до която дружеството поема разходи (напр. до 2 000 лв. годишно). |
| Лимит на медицински услуга | Например: до 5 специализирани прегледа годишно. |
| Лимит на стойност на услуга | До 80 лв. за един преглед или 150 лв. за изследване. |
| Процентов лимит | ДЗО покрива 70% от стойността, останалите 30% се доплащат от клиента. |
| Лимит по подкатегория | Отделни лимити за дентална помощ, профилактика, изследвания. |
Why are limits important?
The limits show the actual scope of the insurance.They determine how much you can rely on DZO when you need treatment.Without knowing them, you risk:
- Go over the limit and pay out of pocket;
- To be denied funding for treatment;
- Not to usethemfull package due to lack of information.
How to check your limits?
You can check the limits in the following ways:
- In the individual contract with the company;
- Through a customer online portal or mobile application;
- Through a written reference from the insurer;
- Every time you use a service, the limit is automatically marked.
What happens when the limit is used up?
When the limit is reached, usually:
- The insurer stops covering the costs of this service;
- The patient starts paying entirely out of pocket;
- Some companies offer an additional package or upgrade.
Example: If the annual limit for laboratory tests is BGN 300, and BGN 280 has already been used, the next test may have to be partially or fully paid for.
Can the limits be customized?
Yes.Most companies offerdifferent insurance planswith different limits, depending on:
- Contribution amount;
- Package Type (Basic, Advanced, Premium);
- Occupation, age, health status;
- Agreement with the employer (for group insurance).
More information on international health insurance can be found herelink!