What are the most commonly covered illnesses and medical services?

Health insurance (whether mandatory oradditionally) usually covers diseases and medical services of high social importance and frequency.These services are selected according to the needs of the population and the financial capabilities of the system or the insurer.

Which diseases are most often covered by health insurance?

The most commonly covered illnesses are related to mass morbidity, chronic conditions and emergency needs.Health insurance includes:

• Hypertension and cardiovascular diseases
  Diagnosis, drug therapy and monitoring are covered.
• Type 1 and type 2 diabetes
  Insulin, glucometers, consumables and preventive examinations are provided.
• Bronchial asthma and COPD
  Treatment, lung tests, and inhalation therapy are included.
• Cancers
  The health insurance fund and private insurers often cover chemotherapy, radiotherapy and consultations with specialists.
• Infectious diseases (flu, COVID-19, hepatitis)
  These are covered especially in epidemic situations and include tests, treatment and hospitalization.
• Children's diseases (angina, otitis, bronchitis)
  In children, most of the common acute and chronic conditions are covered.

Which medical services are most often covered?

Services are divided into preventive, diagnostic, therapeutic and rehabilitation.The most common are:

1. Examinations with a personal doctor and specialists
   The mandatory package includes unlimited access to a personal physician and to specialists upon referral.
2. Laboratory and imaging studies
   Blood, urine, hormone tests, ultrasound, X-ray, scanner - according to the disease and age.
3. Hospital treatment
   Hospitalization for emergency and chronic conditions, surgical interventions, post-operative care.
4. Medicines on a positive list
   The health fund partially or fully covers drugs for more than 100 diseases.
5. Physiotherapy and rehabilitation
   It is included in neurological, orthopedic and cardiovascular diseases.
6. Preventive examinations and immunizations
   Annual preventive examinations, examinations and a mandatory vaccination calendar are covered.

What services are added with supplementary health insurance?

Private health funds extend basic coverage with:

• Second medical opinion;
• Research without waiting;
• Psychological help;
• Highly specialized examinations (MRI, PET scanner);
• International travel;
• Dental services.

Table summarizing the most frequently covered services and diseases:

Категория	Примери за покритие	Типично за:
Хронични заболявания	Диабет, хипертония, астма	Задължително и допълнително покритие
Инфекции	COVID-19, грип, хепатит	Спешна и епидемична нужда
Диагностика	ЕКГ, кръвни изследвания, скенер	Включено в НЗОК и частни пакети
Медикаменти	Инсулин, антихипертензивни, антибиотици	По позитивен списък
Превенция	Прегледи, имунизации, профилактични програми	Основна и допълнителна осигуровка