What does the health fund cover at the dentist in 2026?
In 2026 the Bulgarian health fund (НЗОК, the NHIF) covers one thorough dental examination a year and, for adults, up to three treatments a year (a filling with chemical composite or extraction of a permanent tooth), while children under 18 get up to four, including up to two nerve treatments of a permanent tooth. Cosmetic procedures, root canal treatment for adults, tartar removal, crowns and implants are not in the НЗОК package and are paid for.
In short:
- Entitlements are set by the National Framework Agreement (NFA) for dental activities 2026–2028, signed on 16 September 2026.
- You need continuous health-insurance rights; check them in the НАП (National Revenue Agency) e-services.
- For most НЗОК activities adults pay a small amount, and children are exempt from the user fee.
This article is for anyone who wants to know what they can get without paying or with a small co-payment under the health fund, and what is paid in full. See how we work with НЗОК at SF Dent on the Dentist under the NHIF page. All figures below are from the official НЗОК documents published on nhif.bg.
What does the health fund cover at the dentist for adults?
Under Article 104 of the NFA 2026–2028, every insured person over 18 is entitled to:
- one thorough examination with a record of the oral status once per calendar year (pregnant women are also entitled to one additional examination);
- up to three treatments per calendar year.
The adult treatments in the primary dental care package are two: a filling with chemical composite and extraction of a permanent tooth with anaesthesia. This means that, for example, two fillings and one extraction in a year can be under the health fund, if your dentist has a contract with НЗОК and the activities have not been used up with another dentist.
What are children entitled to under the health fund?
For children under 18 the package is wider:
- one thorough examination a year;
- up to four treatments a year, including up to two treatments of pulpitis or periodontitis (nerve treatment) of a permanent tooth;
- the treatments include fillings, extraction of a baby or permanent tooth, and treatment of pulpitis or periodontitis of a baby or permanent tooth.
Children do not pay the user fee (НЗОК – User fee). There is also a separate package for specialised care by a specialist in paediatric dentistry.
How much do you pay at an НЗОК dentist in 2026?
The NFA sets, for each activity, how much НЗОК pays and how much the patient pays. The prices in the table are agreed for 1 September to 31 December 2026 (Article 105 of the NFA) and are in euro.
| НЗОК activity | Patient pays | НЗОК pays |
|---|---|---|
| Thorough examination (over 18) | €0.00 | €22.00 |
| Filling with chemical composite (over 18) | €2.05 | €43.63 |
| Extraction of a permanent tooth with anaesthesia (over 18) | €2.05 | €43.63 |
| Thorough examination (under 18) | €0.00 | €22.00 |
| Treatment of pulpitis/periodontitis of a baby tooth (under 18) | €2.40 | per the NFA |
| Treatment of pulpitis/periodontitis of a permanent tooth (under 18) | €3.07 | per the NFA |
Some other groups listed by НЗОК are also exempt from the user fee, for example pregnant women and people with certain conditions. Whether you are in such a group and how much you will pay with us, we will confirm when you book.
Are dentures covered by the health fund?
Yes, but only for a completely toothless jaw. Under the NFA, for patients with no teeth at all in the upper and/or lower jaw, НЗОК pays for a complete plate denture for that jaw, regardless of age, for a period of 4 years, including check-ups up to two months after fitting. Partial dentures, bridges and crowns are not in the package.
What does the health fund not cover?
The adult НЗОК package does not include:
- root canal treatment: nerve treatment is in the package only up to 18; for adults see "Root canal treatment: does it hurt and how long does it take?";
- tartar removal: more in "Tartar: why it forms and how often to have it cleaned";
- whitening, bonding and veneers;
- crowns, bridges and partial dentures;
- implants and aligners.
These procedures are paid according to the clinic's price list. If a treatment includes both an НЗОК activity and one outside the package, the dentist will tell you in advance which part is covered and which is paid.
Do you need a referral for an НЗОК dentist?
For primary dental care (the examination, fillings and extractions at a general dentist) no referral is needed. A referral ("Направление за консултация", form МЗ 119А) is needed for specialised surgical dental care. Under the NFA, a patient referred with such a form is entitled to the specialised surgical activities with no limit on volume.
What happens if the year's activities are used up?
The annual limits apply per calendar year and in total, not per dentist. If you have already used your three treatments with another dentist, the next ones are paid according to the price list. So it is worth saying when you book what you have had treated under the health fund this year.
The NFA has one more rule: a reported activity (for example a filling on a given tooth) covers a period of 12 consecutive months from the date it was done.
How do you see a dentist under the health fund at SF Dent?
- Check your health-insurance status in the НАП e-services. If your rights are interrupted, treatment is paid.
- Call us on +359 87 666 2785 and say you want an НЗОК visit. We will tell you which dentist sees patients under НЗОК and what can be done in your case.
- Come to the examination. The dentist examines your teeth and discusses with you which treatment is covered and which is paid, before starting.
SF Dent works with НЗОК. The clinic is at 22 Elemag St in Izgrev, Sofia, and is open Monday to Friday, 09:00 to 18:00.
What should you remember?
Under the health fund in 2026, adults are entitled to one examination and up to three fillings or extractions a year for a small co-payment, and children to one examination and up to four treatments, including nerve treatment. Anything cosmetic, prosthetic (except a complete denture) and root canal treatment for adults is paid for. The terms are set by the NFA and can change; the current documents are on nhif.bg. For questions about your case see the Dentist under the NHIF page or call us.
Frequently asked questions
How many fillings does the health fund cover per year?
For adults НЗОК covers up to three treatments per calendar year: fillings with chemical composite or extraction of a permanent tooth, in any combination. For children under 18 the limit is up to four treatments, which can include up to two nerve treatments of a permanent tooth.
Do you pay for the НЗОК dental examination?
Under the NFA prices for 2026 the patient pays nothing for the thorough examination; НЗОК covers the amount. The covered examination is once per calendar year, and pregnant women are entitled to one additional one. You need continuous health-insurance rights.
Does НЗОК cover tartar removal?
No. Tartar removal is not among the activities in the НЗОК package under the NFA 2026–2028 and is paid according to the clinic's price list. The same applies to whitening, bonding, veneers, crowns, bridges, implants and root canal treatment for adults.
Do children pay at an НЗОК dentist?
Children under 18 are exempt from the user fee and pay nothing for the examination, fillings and extractions under НЗОК. Under the NFA prices for 2026, nerve treatment carries a small co-payment of €2.40 for a baby tooth and €3.07 for a permanent tooth.
How do I check whether I am health-insured?
You can check your health-insurance status in the НАП (National Revenue Agency) e-services. If your rights are interrupted, treatment cannot be done under the health fund and is paid according to the clinic's price list until your rights are restored.
