SGK Health Insurance – The main objective of the Turkish Republic Social Security Institution is to carry out a social security system based on social insurance principles, effective, fair, easily accessible, actuarial, and financially sustainable, at modern standards.
General health insurance refers to the insurance that primarily protects the health of individuals and provides financing for the expenses incurred in case of encountering health risks.
Before the reform, social security institutions were different, and insured people could only benefit from the health services provided by the social security institution they belonged to. Not everyone had equal access to healthcare.
With universal health insurance, it is ensured that all members of the society benefit from health services in an equal, accessible, and effective manner against the risk of illness that may arise regardless of the economic power and wishes of the individuals.
Complementary health insurance, on the other hand, is private health insurance that covers any different fees that private hospitals have contracted with the Social Security Institution (SGK) in outpatient and inpatient treatments. Insurance completes the amount paid by SGK.
If the citizen goes to the state hospital for a health problem, he/she gets treatment out of his / her pocket without paying any fee. However, if he goes to a private health institution, the hospital invoices the examination and treatment costs to the SGK. SGK also pays a fee to the hospital within the framework of the Health Implementation Communiqué (SUT). Private health institutions, on the other hand, have the right to demand money from citizens under the name of the different fees. Hospitals have been given the right to receive a difference of up to 200 percent. Complementary health insurance covers this difference fee.
What includes Turkey’s health insurance as known SGK?
Some rights have been granted to our insured and beneficiaries within the scope of short-term insurance branches. These rights are:
- Giving daily temporary incapacity allowance during the temporary incapacity period,
- Putting on permanent incapacity income,
- Putting income on the right holders of the insured who died as a result of a work accident or occupational disease,
- Giving marriage allowance to girls who are on an income basis,
- Daily temporary incapacity allowance from the sickness and maternity insurance during the incapacity period arising from sickness or maternity to the insured,
- Breastfeeding allowance within the scope of maternity insurance,
- Funeral allowance,
- Military service and birth debt rights,
The rights granted under long term insurance branches are as follows:
- Invalidity pension within the scope of invalidity insurance,
- Old-age pension and lump-sum payment within the scope of old-age insurance,
- Death’s pension within the scope of death insurance, lump-sum payment for death and marriage allowance, and funeral allowance for girls receiving a pension.
Can foreign citizens benefit from SGK?
There are foreign nationals residing in our country and also as it is known there are people who also benefit from rights provisions of the General Health Insurance in Turkey.
Residence permit areas, insurance in another country, or no health insurance and have resided for at least the first year and from one year to the requesting party in Turkey will benefit from the provisions of the GHI. Applications of foreigners who want to benefit from general health insurance must be made to the Social Security Center / Provincial Directorate of Social Security in their place of residence. The treatment expenses of the foreigners and their dependents, except for chronic diseases, are covered.
In order for foreign students to benefit from GHS, a 1-year residence requirement is not obligatory. However, they must apply to the Social Security Institution in order to have a GHS within 3 months from the date of first enrollment in the educational institution. Those who do not apply within 3 months cannot have a GHS during their education period.
How does the health insurance process work for foreign citizens?
Private foreign health insurances made outside the country are valid only on the condition that it is signed by the domestic branches (agents) of the insurance companies.
People with bilateral social security agreements should have their status confirmed by the city social security units. In addition, they must add the official documents from this directorate to the application documents.
In family residence permit applications, the sponsor must have foreign health insurance covering all family members.
A valid insurance condition is not sought for foreigners whose health-related expenses are covered by the relevant public institutions during their stay in our country.
If the students wish, they are covered by general insurance within three months from the date of registration, so they are not asked for valid insurance, but they must have general health insurance within three months and notify the Provincial Directorate of Migration Management.
No insurance requirement is sought for individuals under the age of 18 or older than 65. However, those who already have valid insurance must submit their documents.
Which rights and obligations are earned after the acceptance of SGK?
The rights gained under general health insurance are as follows:
- Providing financed medical products and services to general health insurance holders and their dependents,
- Contributing to the determination and effective implementation of personal protective health services policies with the relevant public administrations in order to protect universal health insurance holders and right holders from diseases,
- Informing universal health insurance holders, their right holders, and their employers about their rights and duties arising from the general health insurance legislation through all means of communication.
Are there any differences in SGK rights between Turkish and foreign citizens?
The fact that human mobility in the world has increased due to different reasons has been effective in each country creating its own legislation on foreign workers. In this regard, the insurance of foreign nationals working in Turkey different laws, regulations, and circulars is regulated by, being renewed in accordance with the relevant regulations and requirements are developed.
Above all foreign persons must not have private insurance in order to receive a residence permit in Turkey. In other words, one of the most basic conditions for obtaining a residence permit is to have private health insurance. Private health insurance is provided by various insurance companies operating in the country. There may be some differences between the coverage offered by insurance companies.
Just like in general health insurance, a monthly premium is paid to the insurance company in the private health insurance. In return, health services can be used free of charge. Again, it is worth mentioning: After obtaining a residence permit, foreign nationals can apply for universal health insurance by canceling the private insurance policy.
Do foreign citizens need health insurance for a Turkish residence permit?
With the new residence law, it has been made compulsory for foreign nationals who apply for a residence permit or residence permit to obtain universal health insurance. With the law that entered into force on April 11, 2014, regardless of the period of residence permit or residence permit application, a 1-year universal health insurance policy must be submitted with documents.
To sum up, living in Turkey T. C. There are two options for citizens and foreign nationals to benefit from health services. Having general health insurance or private health insurance is between these two options. General health insurance of these is covered by the state. Private health insurance is obtained through a person paying a certain monthly fee to an insurance company. There are also physicians who have their own practice. These physicians do not work under insurance and have their own fee scales.