- For parents and caregivers
Which dental procedures does NHIF cover for children in 2026?
The four-treatment allowance in Bulgaria, patient contributions, dental X-rays and repeat treatment.
Created Updated
One examination and up to four treatments
For an insured child under 18, NHIF covers one comprehensive examination with oral status recording and up to four treatments per calendar year. These may include fillings, milk- or permanent-tooth extractions and treatment of pulpitis or periodontitis. No more than two of the four may be pulpitis or periodontitis treatments on permanent teeth. The examination is separate.
The allowance belongs to the child, across all practices and paediatric dental specialists visited. Primary and specialist paediatric dental care can be accessed without a GP referral at a provider with the appropriate NHIF contract.
Two fillings and two pulpitis treatments on permanent teeth can therefore use all four treatments. A fifth cavity is not automatically covered because it affects another tooth. The dentist checks both previous use and clinical need.
Which procedures require a contribution
These primary-care amounts apply from 1 September to 31 December 2026, under Article 105. The covered filling uses chemically cured composite. The pulp is the soft tissue inside the tooth. Pulpitis or periodontitis treatment is a separate procedure from a simple filling; the dentist determines the diagnosis and treatment.
| Procedure | NHIF pays the provider | Patient contribution |
|---|---|---|
| Comprehensive examination | 22.00 € | 0.00 € |
| Chemically cured composite filling | 45.67 € | 0.00 € |
| Milk-tooth extraction with anaesthetic | 18.35 € | 0.00 € |
| Permanent-tooth extraction with anaesthetic | 45.67 € | 0.00 € |
| Pulpitis or periodontitis treatment, milk tooth | 24.58 € | 2.40 € |
| Pulpitis or periodontitis treatment, permanent tooth | 79.27 € | 3.07 € |
NHIF pays a different tariff to contracted paediatric dental specialists, but the patient's contributions for these procedures remain the same: zero for examination, specified filling and extraction; 2.40 € for milk-tooth pulpitis/periodontitis and 3.07 € for a permanent tooth.
Children are exempt from the statutory consultation fee. That exemption does not cancel the treatment contributions above. For another quoted price, ask whether it concerns NHIF care, a different material or treatment outside the package.
X-rays are separate from the four treatments
When clinically needed, the dentist can prescribe an intraoral X-ray or panoramic radiograph (orthopantomogram) using diagnostic referral No. 4. The imaging provider must hold the relevant NHIF contract.
NHIF's clarification of 11 August 2026 states that these referrals and examinations do not have a fixed annual limit for the child. This is not an entitlement to unlimited imaging on request: clinical need and referral rules still apply. The four-treatment allowance is not an X-ray limit.
With the required conditions and electronic referral, the examination is free for the child. Confirm that the imaging practice accepts the referral for the exact prescribed examination. Show existing images to the treating dentist so they can assess whether a new one is needed.
Repeat treatment and an exhausted allowance
NHIF does not pay for a repeat filling within 12 consecutive months of placement. A new calendar year does not restart that interval. Article 98 provides exceptions for complications involving pulpitis or periodontitis and for pulpitis/periodontitis treatment.
If the same tooth needs further care, ask the dentist to explain the diagnosis, previous procedure and eligibility of the proposed treatment. The exception does not remove other conditions or the annual allowance. RZOK can investigate disputed records.
Outside the package, after the allowance is used, or for expressly chosen materials or methods outside it, the provider's price applies. Ask beforehand whether the amount covers all visits for that tooth. The professional NHIF reference contains procedure codes and reporting details.
Prepare for the appointment
Bring the child's booklet, any supplement and earlier treatment documents. For loss or full pages, follow the booklet guide.
When booking, give the child's age, reason for visiting and request for NHIF care. Confirm the practice's contract and examination terms. After assessment, ask about the treatment and charges. Report any suspected previous anaesthetic reaction instead of choosing a test yourself: allergy investigations require assessment and a separate referral process.
Collect the booklet and documents afterwards. Ask the practice to explain any mismatch between care, entries and charges. For an unresolved NHIF issue, contact RZOK with the documents.
Sources
- NHIF: reply no. 58390, 2026-05-12 НЗОК · BG
- NHIF: reply no. 58681, 2026-08-11 НЗОК · BG
- NHIF: reply no. 58785, 2026-09-17 НЗОК · BG
- Regional health-insurance fund contacts НЗОК · BG
