Bulgaria

Bulgaria has three surprises worth the whole consultation. First, proof of medical insurance is required at the border — not recommended, required and enforced, and without it an ambulance runs 120 euros per trip with hospitals expecting payment up front. Second, the driving: Bulgaria is among the EU's most dangerous countries on the road — aggressive habits, potholed secondary routes, livestock — so take the motorways, keep headlights on, and know the blood-alcohol limit is 0.05%. Third, the money changed: Bulgaria adopted the euro on January 1, 2026, and the lev is gone.

Clinically: TBE is endemic in the Rila, Pirin, Rhodope, and Strandja mountains, so the vaccine discussion belongs in every hiking or camping itinerary from April through November — Black Sea beach trips carry minimal risk. Use ATMs inside bank branches only; skimming at Sofia Airport and coastal machines is the most common crime against Americans, and counterfeit medication is documented, so buy only from established pharmacies. Tokuda Hospital in Sofia is the private option built for international patients; mountain adventures put you one to two hours from any hospital, which is exactly the itinerary that justifies air-ambulance medevac coverage.