How does the state health insurance system work?
Healthcare in Turkey is governed by the Ministry of Health and is generally considered to be of a steadily improving standard from its overhaul in the early 2000s: life expectancy and infant mortality are on average better than in the USA, for example. However, the country’s average annual expenditure on healthcare as a percentage of its GDP, at around 6.4%, is below the European average.
The SGK itself is based on a Bismarck model — employees make contributions into a central pool, which then funds the system — and aims to extend healthcare cover to everyone who is making contributions into the scheme and, in addition, to some vulnerable groups. If you are an expat and employed in Turkey, monthly contributions will automatically be deduced from the payroll by your employer.
Once you are signed up, you will be given an SGK health insurance ID card which you must take with your to your local hospital in order to access treatment. GPs usually work out of hospitals, rather than community surgeries, so you will also need to take it with you to see your GP. Most basic healthcare is free at the point of delivery but you may need to make some co-payment charges, so check with the SGK or your local healthcare provider as to what is covered by your insurance.
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Who is eligible for state healthcare?
As an expat, you will be eligible for public healthcare in Turkey if you have been resident in Turkey and paying contributions into the SGK for a year. You will need to have made 30 days’ worth of paid universal health insurance premiums within that year, prior to the date of your application.
Your EHIC card will not be valid in Turkey.
How do you apply to join the state health insurance system?
If you are working for an employer in Turkey you should be registered by your workplace with the SGK, but check to see if they have done this. Otherwise you can register yourself: you will need to go to the local SGK office. These are regionally governed so the application process might differ slightly from area to area, depending on where you are based, but you will need your passport and any ID cards, as well as proof of your residency in the country.
Under the Social Insurance and General Health Insurance Law (GHI), Turkey suffers from something of a catch-22 situation in that you cannot gain residency status unless you have approved health insurance, but conversely you will not be able to sign up to the SGK unless you have residency.
You can take out private coverage initially – however, note that although this will be recognized by Turkish hospitals, it may not be recognized by immigration if you are planning a longer stay. Thus your applications for residency and the SGK will overlap and both offices should issue you with a provisional document to take to each of the other departments. If you need to update your residency permit, make sure that you inform the SGK.
You will need all or some of the following documentation, depending on your local office’s rules:
- an application form
- a copy of your passport
- your residency application
- a health assessment carried out by an approved doctor
- proof of your address issued by the local Nufus office (this is the department which monitors the population)
Either your employer will deduct your contributions from the payroll, or if you are making your own contributions as a self-employed person, you will need to pay these in monthly, online or via a Turkish bank.
You should also check whether your home nation has a reciprocal healthcare agreement with Turkey: France and Germany do, for example, but the UK does not. If this is the case, you will automatically be covered under the public healthcare system but will need to make your presence known to them.
What is covered by the state health insurance system?
You will be covered for treatment in the Government Devlet hospitals, and you may also be subsidized for some private sector care too, under the SGK. This varies from hospital to hospital, but can be subsidized up to 60% in the private sector. You will also be covered for:
- check-ups in your local public hospital
- maternity care
- occupational injuries and diseases
- temporary incapacity allowance
- emergency treatments
- infectious diseases
- preventive health services
- extraordinary events (injuries from war and natural disasters)
- fertility treatment for women younger than 39
- cosmetic surgery deemed medically necessary
Make sure, if possible, that your healthcare provider is contracted to the SGK, otherwise you might find yourself facing high costs for your treatment. You will also need to take your health insurance card or proof of private cover to any appointments. If you are asked to pay, check too that the hospital takes debit or credit cards.
Emergency treatment is free of charge to everyone, whether or not they are insured.
Prescription medication will be free from the hospital pharmacy and will be subsidized up to 80% in pharmacies outside the hospital system.
The SGK will not cover pre-existing conditions, such as cancer or diabetes.
Are retirees covered by state medical insurance?
If you are over 65 you will be covered by the SGK. You do not need to have residency status in order to access public healthcare. Nor do you need to demonstrate proof of medical insurance in order to apply for residency.
However, note that if you are covered by a government pension, you will not be eligible to be covered by your partner’s national health insurance with the SGK.
Are students covered by state medical insurance?
Turkish universities have free medical centres on campus, but authorities recommend that international students either take out private cover or register with the SGK. All students holding a Turkish Residency Permit of more than six months will automatically be registered with the SGK. If you pay a universal health insurance premium over an amount corresponding to 30 days’ worth of the lower limit of daily earnings, however, you will also be eligible.
Students are responsible for their own monthly health insurance contributions. You will need to go to your local SGK office with the following documentation:
- resident permit
- student ID
and they will issue you with the relevant health insurance card.
Will your family be covered by your insurance?
Your family will be covered if you have national health insurance. This includes your spouse and any children under the age of 18. However, you must be legally married in order to qualify, otherwise your partner will need to pay for their own premium.
The SGK will not cover pre-existing conditions.
Is dental treatment covered by state health insurance?
Basic dental care is free if you are treated at your local hospital.
Dental treatment out-of-pocket is 50-70% cheaper than in the UK.
What are the contribution rates for state health insurance?
You will pay monthly contribution rates which are calculated according to your income. Rates change regularly but are currently around 618.00 TL (€98).
If you are self-employed, you will need to contribute around 12.5% of the general health insurance premium rate on a monthly basis.
Why buy private health insurance?
Although healthcare in Turkey is generally good, you may wish to consider private cover in order to speed up access to your treatment and also for better facilities. You may also want to cover any gaps in treatment that are not covered by the public system, and for additional peace of mind during your period of application to the SGK.
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What is covered by private health insurance?
Private health insurance will cover the full range of primary and secondary healthcare provision in addition to elective procedures and advanced dental care, such as cosmetic orthodontics.
If you have scheduled surgery or other treatment, it is also advisable to obtain pre-approval from any private providers.
How much does private health insurance cost?
Local Turkish health cover varies, but as an example, your premium at Ankara Sigorta is likely to be in the region of 400 TL (€63) per annum for someone in their 40s, and 349 TL (€55) per annum for a similar policy from Groupama Sigorta.
Local providers may not, however, give you the range of cover that you would experience with one of the larger international insurance companies. If you opt for a package from a larger company, premiums will depend on factors such as your age and any pre-existing conditions, and the kind of package you opt for; a more expensive insurance package will give you more a extensive range of treatment and facilities.
As so many variables have an effect on the cost of international private medical insurance in Turkey, it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40-year-old British male with no deductibles, no co-insurance, a middle-tier plan, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.
Which companies offer private health insurance?
There are a large number of local health insurance providers in addition to the main international companies, including:
- Aetna Global
- Cigna Global
Always request quotes from as many insurance providers as possible.
Glossary of health insurance terms
Genel Sağlık Sigortası - public health insurance
Sosyal Güvenlik Kurumu / SGK- department of social security