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Parents write to the Ombudsman Institution, insisting that the National Health Insurance Fund pay for the manufacture of corsets for children with scoliosis

Thursday, 10.07.2025
Every year, 1,000 adolescents receive the medical item, and 300 undergo surgery

10 July 2025 

 

The Ombudsman Institution has approached the Minister of Health, Dr. Silvi Kirilov, the Director of the National Health Insurance Fund (NHIF) Dr. Petko Stefanovski, and the Chairman of the Supervisory Board of the Health Insurance Fund, Yavor Penchev, urging them to consider the possibility of the state providing full payment from public funds for individual corsets to correct spinal deformities in children.

This recommendation was prompted by complaints and reports from parents who are concerned that the National Health Insurance Fund (NHIF) is not paying for the manufacture of corsets to correct spinal deformities (including scoliosis) in their children.

Studies show that in Bulgaria, 3 out of every 100 children have scoliosis.

According to statistics, every year in Bulgaria, patients suffering from scoliosis make more than 15,000 visits to orthopedists, approximately 1,000 children are fitted with corrective corsets, and about 300 are referred for surgical treatment.

Children between the ages of 9 and 16 are the most affected, with 80% of them being girls who are affected not only physically but also emotionally and psychologically.

In one of the reports to the Ombudsman, the mother of such a child says that her son has scoliosis, diagnosed the previous year. She points out that when the curvature is more severe, in addition to special exercises, a corset must also be worn, and these devices are individual and specially made. She emphasizes that last year she purchased such a corset, made by a company for her child, for which, after receiving approval in accordance with the relevant procedure, the National Health Insurance Fund paid the amount of BGN 700, but the family had to pay an additional BGN 700 for the item in question.

The woman also reports that due to the child's growth, a new corset needs to be made, for which they have been informed that the National Health Insurance Fund will not pay anything, so the family is forced to pay for the new corset themselves the amount of BGN 1,640 and they attached a fiscal receipt.

The mother raises other important issues related to the treatment of the disease—the lack of prevention and early diagnosis. She emphasizes that they themselves noticed the problem in their son. In addition, they had to pay for the child's examinations, as the specialists they visited at a specialized hospital for active orthopedic treatment do not have contracts with the National Health Insurance Fund.

 "The Ombudsman Institution would like to express its strong concern regarding the information from the National Health Insurance Fund that scoliosis corsets are not included in the list of specifications drawn up following negotiations under Ordinance No. 7/31.03.2025 on the basis of a specification approved by the Supervisory Board of the NHIF, and that following checks, companies that had concluded contracts for the provision of orthoses and had provided corsets to children with disabilities were sanctioned because the medical item was not included in the previous  specification list. At the same time, the NHIF has not announced any discussion or regulation of another procedure that would make it possible for the NHIF to pay for the medical item in question," wrote the Ombudsman Secretary General, Dr. Aysun Avdjiev, to the health authorities.

He points out that scoliosis is not always a permanent impairment and can be corrected with the medical item in question, which the NHIF refuses to pay for.

“In this regard, we believe that the right of children to access individual medical devices appropriate to their condition has been violated and we find the parents' dissatisfaction justified. It should also be noted that spinal deformities in childhood, when not diagnosed on time and in cases of, for example, severe and uncorrected scoliosis, can lead not only to significant physical limitations but also to disorders of the respiratory, cardiovascular, and nervous systems and, as a result, to serious consequences for children's health,” states Avdjiev.

He adds that in most cases the disease is identified by parents, usually at a more advanced stage, rather than by medical professionals in health clinics in kindergartens and schools, general practitioners, and pediatricians.

“Another serious problem is the lack of active prevention and awareness among parents about what they can do to prevent the onset and progression of the disease. All of the above necessitates the discussion of a strategy and specific measures for prevention, active screening, and early diagnosis of the disease, as well as its adequate and timely treatment, with sufficient scope and quality,” the Secretary General is adamant.

The condition is diagnosed when the curvature of the spine is greater than 10 degrees. This is determined by X-ray and examination by an orthopedist. Therefore, early diagnosis in children is crucial for the treatment of the condition.

He points out that providing the opportunity to have an individual corrective corset for scoliosis made and paid for it with public funds is a must for treating kids with advanced forms of the disease properly and keeping complications from happening, in line with the duty of the state and society to protect children.

“In this regard, understanding the need to find solutions that guarantee the rights of children and their parents, we turn to you for your opinion and information on the issues raised, and we look forward to discussing specific measures to resolve them, while fully guaranteeing children's rights to prevention, early diagnosis, and treatment of spinal deformities, including the payment of individual corrective corsets from public funds in cases where their use is deemed necessary by a doctor,” concludes Dr. Avdjiev.

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