Health Insurance Contributions in 2026: Who Pays How Much and By When

The health insurance contribution for an employee is 3.2% of gross remuneration and is withheld by the employer together with the other social security contributions – a total of 13.78% on the employee's side. The employer additionally pays 18.52%, plus the "Occupational Accident and Disease" (TZPB) contribution of between 0.4% and 1.1%, depending on the company's economic activity. These percentages include both pension and health contributions – they are paid as a single total amount into the NRA's unified account, not separately.

Who pays health insurance contributions

• Employees under an employment contract – the contribution is withheld by the employer from the gross salary.
• Self-insured individuals – sole traders, partners in an LLC, freelance professionals – pay their own contributions based on a chosen insurance income.
• Individuals without income and without another basis for insurance owe the health contribution themselves, under the terms of the Health Insurance Act (ZZO).

Minimum and maximum insurance income in 2026

From January 1, 2026, insurance income thresholds will be calculated in euro due to the introduction of the single currency (1 EUR = 1.95583 BGN).

• Minimum insurance income for self-insured individuals: 550.66 EUR until July 31, 2026 and 620.20 EUR from August 1, 2026.
• Maximum insurance income (the ceiling above which no contributions are due): 2,111.64 EUR until July 31, 2026 and 2,300 EUR from August 1, 2026.

This means that an owner of a sole-owner LLC (EOOD) who is self-insured cannot declare an insurance income below the minimum threshold, even if their actual income is lower. Above the ceiling, no health or pension contributions are due, regardless of how much higher the income is.

Deadlines for payment

Employers pay the contributions – including the health portion – by the 25th of the month following the month for which they are due. For example, contributions for January are paid by February 25. Self-insured individuals follow the same deadline – by the 25th of the following month, based on the insurance income they have chosen.

What happens if health insurance contributions are not paid regularly

Health insurance rights are suspended when a certain number of unpaid monthly contributions accumulate over the last three years. Suspension of rights means that when visiting a doctor or receiving hospital treatment, payment of the missed contributions is required in order to restore the rights. It is possible to check health insurance status through the NRA website using a PIC or a qualified electronic signature.

Self-insured individuals – what they need to decide

An owner of an EOOD or OOD who works in their own company must choose:

1. Whether to be insured only for disability due to general illness, old age, and death, or to also add insurance for general illness and maternity.
2. The amount of insurance income – between the minimum and maximum thresholds mentioned above.
3. The advance and annual equalization regime of contributions – the final amount of insurance income for the year is reconciled with the annual tax return under the Personal Income Taxes Act (ZDDFL).

Changing the chosen insurance income during the year is possible, but it must be declared to the NRA within the specified deadlines.

When to seek an accountant

If you own a company and determine your own insurance income, or if you have employees with varying salary amounts, it's a good idea to have an accountant check whether contributions are being calculated correctly against the current 2026 thresholds. The same applies in case of an interruption in insurance – for example, during sick leave, unpaid leave, or suspension of the company's activity – because the rules for paying health contributions in these cases have their own specifics under the ZZO.

If you have questions about your specific case – self-insurance, suspension of health rights, or transfer of a company – call +359 899 115 149 during business hours (Monday–Friday, 09:00–18:00) or leave an inquiry through the Fiscala website.