Treatment abroad: Bulgaria 

Bulgaria, a rising destination for medical tourism, offers high-quality and affordable healthcare services, with notable expertise in fields such as dentistry, fertility treatments, and cosmetic surgery.

Bulgaria is a country at a crossroads both in terms of its physical position and its social and economic development. Geographically, Bulgaria lies across the main routes from Europe to Asia and the Middle East, bordering Turkey and Greece to the south, Romania to the North, Serbia and Macedonia to the West and the Black Sea to the East, with Russia and the former Russian republics beyond.

This strategically important position has left this beautiful country with a rich history and heritage, including fascinating Roman and Greek ruins. Bulgaria has the most ancient monuments and historical sites of any country outside Italy and Greece.

Why consider Bulgaria?

Choosing Bulgaria as a destination for health tourism is a matter of weighing the pros and cons. Although the country does lag behind the rest of Europe in areas such as transport and other services, this lack of development does not extend to healthcare. Coming here for private treatment means considerable savings on your treatment, and your living expenses will be cheaper too. One good tip is to stick to the better developed resorts aimed at foreign visitors. Here you can enjoy the best of both worlds high quality facilities at surprisingly low prices.

Alternatively, you can head out into the countryside and discover a proud, patriotic people who offer a warm welcome and strive to make a good impression. This should be done with care however, as very few Bulgarians speak anything other than their native tongue and the national Cyrillic alphabet can be very hard to decipher on road signs. To add to this confusion, locals will shake their heads for yes and nod for no.

A tasty legacy of Bulgaria’s oft conquered past is its food, with elements of Greek, Turkish and Balkan cuisine fusing to create memorable meals of mouth-watering spiced lamb, for little more than a few pounds a head.

One of the biggest attractions that bring medical tourists to Bulgaria is the thousand or more natural spas across the country. These have been attracting visitors since Roman times, with warm, mineral rich waters and muds laying claim to all manner of healing and rejuvenating properties. The most famous of these spas have been fully developed into major tourist centres, with high quality hotels and facilities for the most discerning guests.

Bulgaria’s major claim to fame as a healthcare tourism destination is the proliferation of high quality, low cost private clinics for medical treatments, cosmetic surgery and dentistry. Forced to keep prices low for poorly paid locals and competitive for foreign healthcare tourists in a crowded market, these clinics offer a significant saving compared to the more affluent European member states.

Combine this with the stunning scenery and relaxed pace of life along the Black Sea Coast resorts, or the breathtaking vistas and fresh air of the mountain retreats, and you have a very special package for your overseas healthcare trip.

Reasons to choose Bulgaria

Strong and highly competitive private healthcare market

Sofia offers a typically European mix of cafes and culture

High quality facilities aimed at healthcare tourists

Low cost medical treatments, cosmetic surgery and dentistry

$5.4billion has been invested across the sector in the last five years

Bulgaria has over a thousand natural spas across the country

The healthcare system in Bulgaria

General healthcare in Bulgaria varies depending on where you are. In the cities, major hospitals boast plentiful, professional, qualified staff, clean modern wards and the latest technology, achieving standards that will be familiar to European visitors. In more rural areas, however, you may have to travel a considerable distance for the privilege of staying in a grim, Soviet era clinic, where your friends and family will be expected to make your bed and prepare your food.

Bulgarian healthcare is universal and state funded through the National Health Insurance Fund. Bulgaria spends around 4.2% of its GDP on healthcare and has around 1.8 doctors per 1,000 people, which is above the EU average. However, a legacy of poor healthcare funding over decades in the Eastern Bloc means that life expectancy is well below the EU average, at just 76 for women and under 70 for men.

The private healthcare sector however, sits in stark contrast to the overall picture. Many doctors and dentists turned private with the introduction of the free market following the fall of communism, leading to a glut of private practices. This meant that clinics had to invest in better technology and provide better staff training and service in order to gain a competitive edge in a crowded market. At the same time, a low wage economy forced them to keep their prices down.

The result is a very well equipped private sector for medical work, cosmetic surgery and cosmetic dental surgery, with incredibly low prices. For example breast enhancement surgery will cost no more than €2,500 and a face lift just €1,200. Bulgarian dental prices represent even greater savings, with initial treatment starting as low as €10. And with almost 8,000 well equipped Bulgarian dental clinics to choose from, you could negotiate an even better deal.

There is a wide choice of healthcare tourism options in Bulgaria, with many quality dental clinics springing up around the major tourist centres and medical and cosmetic surgery clinics appearing at many of the country’s famous spa sites. And the industry is growing and improving all the time, with the Bulgarian Union for Spa Tourism estimating that no less than $5.4billion has been invested across the sector in recent years.

Travel and accommodation in Bulgaria

There are three international airports in Bulgaria. The main airport is theSofia International Airportwhich is located 10km east from the city centre. Getting to and from the airport is straightforward. Airport buses run approximately every 10 minutes to the centre during the day and every 20 minutes between 9pm and 12.30am, with a journey time of around 20 minutes. There are also plenty of taxis available and vying for tourists’ custom outside Arrivals, but it is advisable to take one of the meter run ‘OK SUPERTRANS’ taxis from the line in front of Arrivals as some drivers try to get away with not using their meters, in which case the fare should be agreed in advance. As a guideline the average taxi fare from Sofia Airport to the city centre is 6 leva or €3.

There is also a regular public bus from Sofia Airport to the city centre (Bus No 84 to Sofia University) and the bus stop is just outside Arrivals. The line operates between 5am and 11pm all year round and a single ticket costs 0.50 leva or €0.25. Hotel shuttles and scheduled coach services also depart to the city centre and coaches are available through tour operators.

The international airport atVarnais located 7.5 km from the centre and charter airlines and some scheduled airlines use this airport during the summer months. It also serves regular internal flights to and from Sofia, with a journey time of less than an hour (compared to six hours by car!). Most tourists going on holiday on the south-east coast of the Black Sea arrive atBourgas Airportwhich serves only charter flights. Passengers arriving in and departing from Bourgas Airport are transferred mainly via bus by their tour operator but there is a bus (Number 15) departing into the centre and there are also taxis parked in front of the Departure Terminal.

Arriving by road or rail

The main European railway routes pass through Bulgaria and international trains link Sofia with many European capital cities. Travelling to Bulgaria from London by train is possible, contactRail Europeregarding information on train journeys and prices. If you arrive via international train you’ll go through passport control and customs at the border and the relevant officials will board the train and wake passengers in the middle of the night to check passports.

Bulgaria can also be entered by car through any one of the many border checkpoints. The usual international car rental companies are at the airport and foreign driving licenses are valid in Bulgaria. The speed limit is 60 km/h in populated areas, 80 km/h outside populated areas and 120 km/h on motorways, and there are petrol stations located every 30 to 50 km.

Getting around the country

As in most former communist countries Bulgaria has a good railway network connecting even very small villages with big cities and you can get almost anywhere by train, but trains are very old and slow, though some new trains are running the Sofia-Varna line, and the journey is considerably shorter.

Getting around the centre of Sofia is best done by public transport, rather than by car due to the shortage of parking spaces. Public transport is efficient, there are trams, buses, and trolley buses and public transport runs from 5am till midnight for buses and trolley buses, and until 1am for trams. Single trip tickets can be purchased at shop kiosks, newsstands or in the driver’s cabin and the ticket must be punched on the vehicle. A fresh ticket must be punched if you transfer bus/tram as tickets are regularly inspected by conductors.

The major tram lines include routes 1 and 7 which pass through the Central Railway Station, Sheraton Hotel, and Vitosha Blvd. Routes 2, 12 and 19 pass through the Central Railway Station, Graf Ignatiev St, Zhurnalish Square in Losetets, routes 6 and 9 through the Central Railway Station, the National Palace of Culture underpass, Losenets area and route 5 runs from the National History Museum down Tsar Boris 3rd Blvd to the Knyazhevo area.

Major buses include number 84 which runs from the Airport to Sofia University and 213 and 313 from the Central Railway Station through Lavov Most (Lion’s Bridge) down Tsarigradsko Shousse Blvd to Mladost area. The 280 runs from Sofia University down Tsarigradsko Shousse Blvd to Darvenitsa area and Student Town and number 94 runs from Sofia University through Losenets area to Darvenitsa area and Student Town.

Central Railway Station (Tzentralna Gara in Bulgarian) is the main railway station located to the north of the city centre which is well connected for all public transport and has recently had a bit of a makeover. Yellow taxis are readily available outside the station, but again be wary of taxi drivers who try to overcharge tourist.

Since 1989 and the fall of Communism, hotel accommodation in Sofia has improved greatly and you can now find a good choice of quality accommodation, whatever your taste and budget. A double room in a four starhotelin Sofia is generally priced around €90, and a double in a three star costs from approximately €50. Apartments are also available to rent from €30 a night to provide that ‘home-from-home’ touch.

The currency is the Bulgarian Leva and 1 Bulgarian Leva (BGN) and roughly equivalent to €0.50.

About Bulgaria

Bulgaria is a country at a crossroads both in terms of its physical position and its social and economic development. Geographically, Bulgaria lies across the main routes from Europe to Asia and the Middle East, bordering Turkey and Greece to the south, Romania to the North, Serbia and Macedonia to the West and the Black Sea to the East, with Russia and the former Russian republics beyond. This strategically important position has left this beautiful country with a rich history and heritage, including fascinating Roman and Greek ruins. Bulgaria has the most ancient monuments and historical sites of any country outside Italy and Greece.

A former Soviet Bloc nation, the Bulgaria of today still struggles with the ghosts of its communist past, although it is a European Member State, it has not advanced as much as some of its neighbours, although there have been many improvements since the austere years. In some ways these benefit the healthcare tourist as many doctors and dentists have set up in private practice to avoid low-paid state jobs, creating a strong and highly competitive private healthcare market.

Tourism is an important industry in Bulgaria, with stylish ski resorts in the Balkan Mountains, such as Pamprorovo and Chepelare, to the north, and miles of stunning Black Sea coastal resorts, with friendly names like Golden Sands and Sunny Beach, along the east coast, all developed to meet the high standards of European tourists. Prices are generally low, so your money will go just that bit further in Bulgaria.

Like many countries in the region, Bulgaria remains largely unspoiled, with a sparsely populated interior where the way of life hasn’t changed much for centuries. The vast forests and spectacular mountain ranges to be found here offer a wealth of outdoor activities including a choice of well marked and maintained tracks for hiking and horse-riding, especially in the Rila and Pirin mountain regions. And while the roads and public transport system may present something of a challenge to travellers used to a more modern infrastructure, the effort is well worth it once you reach your destination.

By contrast, Bulgaria’s cosmopolitan cities offer a much more modern take on life, with the capital Sofia leading the way with a typically European mix of street trams, cafes and cultural attractions. If you are coming here for orthopaedic surgery, cosmetic dentistry or for private work by a cosmetic dentist you will probably want to be within fairly easy reach of Sofia or one of the other larger cities but escaping into the countryside when you recover is always an option.