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Sunday, 24 February 2013 07:07

SGK - Universal Health Insurance (UHI)

SGK Health Insurance SGK Health Insurance

This article is aimed at British nationals who have Turkish residency (ikamet).  It briefly explains the Turkish state health system, as it applies to them.

If you are visiting Turkey as a tourist, we strongly advise that you take out travel insurance, to cover the cost of any treatment you may require, whilst on holiday.

This information was correct at the time of publication, however we strongly advise checking the latest position with your local SGK office.

State and private hospitals
Turkey has a two tier health service: there are state hospitals and private hospitals.

In private hospitals, you pay for the treatment you receive.  In state hospitals, treatment is free, for those paying a regular premium into the state Universal Health Insurance (UHI) scheme.

The UHI scheme has a number of sub-schemes, but for most foreign nationals, the scheme that they can subscribe to is called the Sosyal Güvenlik Kurumu (SGK).

It would be fair to say that the introduction of the scheme for foreigners in 2012 was chaotic, and there have been several twists and turns.  But now things appear to be relatively settled.

What is SGK?
SGK is the state health insurance system.  By paying a monthly premium, you are entitled to free treatment in state hospitals. 

You can also get treatment in some private hospitals, at a significantly discounted cost.  Check before you start treatment.  Please note that if you turn up at a private hospital on a Sunday or a public holiday, for non-emergency treatment, you will have to pay the full cost of treatment, as SGK will not cover you on these days.

Who is eligible?
Foreign residents with an ikamet, who have been resident in Turkey for at least 12 months.

What if I have not had residency for one year?
You can not take out SGK health insurance until you have been resident in Turkey for one year.

Is SGK compulsory?
No. Not for British nationals living in Turkey.

Is there an age limit for foreigners wishing to apply?
No. 

How much does SGK cost?
Foreign residents pay a standard charge, which is not means tested.  The cost increases every year, but as at January 2018, the monthly premium is 487.08 TL.  This premium covers a married couple (mand and woman) and any dependents under 18.  There is no discount for a single person.  Couples who are not legally married have to pay separate premiums.  Same sex marriage is not legally recognised in Turkey.  

Married and in receipt of a state pension
Please note that a married person in receipt of a UK state pension may not be a dependent on a spouse's membership - they must have their own SGK membership.  So a married couple who both receive a state pension will each pay their own premiums.  

Where one is in receipt of a state pension, and the other is not it's not so simple.  Here are some examples.

Mr & Mrs Smith are retired.  Mr Smith receives a UK state pension.  His wife, Mrs Smith does not yet receive a UK state pension.  

Example 1: Mr Smith has taken out SGK health insurance membership for himself and his wife, Mrs Smith.  This is fine.  He pays a single premium which covers them both.

Example 2: Mrs Smith wishes to take out SGK health insurance membership for herself and her husband, Mr Smith.  This is no longer permitted, because as Mr Smith is in receipt of a state pension he is not allowed to be a dependent on the SGK policy.  Mr Smith must have his own SGK membership.

For example 2, you are no doubt asking yourself, could Mrs Smith cancel her SGK membership, and Mr Smith take out membership in his name, with his wife as a dependent?  The answer is maybe.

If Mrs Smith joined before 29th May 2013, she can cancel her membership and Mr Smith's application would be treated as a brand new application.  As Mrs Smith may be regarded as a dependent, she would be covered on Mr Smith's membership, and they would pay a single premium.  

The thing to bear in mind here is that by submitting a new application, both parties would have to undergo a medical to establish pre-existing conditions. 

Please note that the above principle works either way, i.e. if the woman gets the pension and the man does not. 

I am a pensioner - why do I have to pay?
Turkish pensioners don't pay into the system when they have retired because, generally speaking they have contributed during their working life.  Most foreign nationals have not contributed to the Turkish system during their working life and so they must "pay as they go", even if they are retired.

How do I pay the monthly premium?
You can pay over the counter at most banks, and with some Turkish banks you can pay your monthly premiums online.

Unfortunately, it does not seem possible to set up a standing order for payment, unless you bank with Ziraat Bank, which is a state controlled bank.  You need to quote your kimlik number, (an eleven digit ID number beginning "99" shown on your residence permit card).

Can I take out private health insurance instead?
Yes you can.  Many banks and insurance companies provide health insurance.  You can have this instead of taking out SGK.

What if I don't take out SGK or private health insurance?
You will have to pay for any treatment in full.  If you have a serious illness or accident, this may run to several thousand Turkish lira.

Anecdotally, we have heard of some cases where foreign residents have been given some kind of discounted medical treatment in Turkey, without having SGK or private health insurance.  Whilst we have no reason to disbelieve these stories, we have no idea of the basis upon which discount has been provided. We wouldn't rely on this.

Can I stay out of the SGK scheme now, but join later?
Yes you can.

Medicals to establish pre-existing conditions
It is important to have a medical check up when you join SGK.  This is essential if you wish to benefit from health cover for chronic illnesses. To understand why please read this KTLN news article: Local hospital charges for foreigners explained

Documents / Information available in English
The website www.sgk.gov.tr is available in different languages.

On the Home page choose “En” in the top right hand corner for English.

What is covered by the healthcare scheme?
After choosing the English option, click on "Universal Health Insurance" on the left hand side menu. 

You can register with your local doctor (GP) in Kalkan, and have free consultations.

Under the SGK scheme you have to pay for any drugs prescribed, however you get them at a discounted rate.

In state hospitals, usually the full cost of any treatment is covered by SGK.  If you choose to be treated in a private hospital, you will find that some offer a discount of up to 90% if you are SGK registered, so you only pay 10% of the bill.  However, please check with the hospital before you have any treatment.

Does SGK cover optician and dentist charges?
The answer is yes, however the amounts recoverable are minimal, and you must have treatment in state facilities.  Most foreign residents that we know tend to go private, and pay the charges, which are significantly less than what you would pay in the UK.

How can I leave the SGK scheme?
There are only limited ways to leave SGK.  If you marry a Turkish national, then you may move in to a different UHI scheme.  The most likely way you would leave SGK is if you leave Turkey and you cancel your residence permit.  However, it would appear that there is an option to leave SGK, if you joined before 29th May 2013. 

The FCO web site says, "If leaving Turkey on a permanent basis an individual must surrender their residence permit to the Foreigners Police Department and write a letter to their [local SGK office], informing them that they are leaving the country".  

Renewing your short term residency or applying for long term residency
It is worth mentioning that when your residency permission expires, so does your SGK.  If you want your SGK to continue, you must take your renewed permit to your local SGK office to ensure you are reinstated on the system.  Failure to do so, will mean you are not insured.

Also, if your are moving from a Short Term Residence Permit (STRP) to a Long Term Residence Permit (LTRP) you must also tell the SGK to ensure continued cover.

SGK lapses on death
Your SGK insurance stops upon your death.  This may seem an obvious thing to say, but the point is that if you are covered as a married couple, and one person dies, the survivor should ensure that they have continuing SGK cover in their own right.

Where is my nearest SGK office?
The closest SGK office to Kalkan is in Kaş.  It administers health and social security matters.  The phone number is 0242 836 2670.

How do I join?
If you live in Kalkan, go to the Kaş SGK office.  Take your passport and ikamet (plastic residence card).  For a married couple, take your UK marriage certificate and a translated and notarised copy. 

You may have to provide confirmation of your address, in the form of a letter from the Nüfus office, headed up 'YERLEŞİM YERİ VE DİĞER ADRES BELGESİ'.  (In Kaş, the Nüfus office is in the same building as the tapu office, on the 2nd floor).  You need to know your Kimlik number - that's the 11 digit number beginning '99' as shown on your residence permit card.

Below: Photo showing the SGK office in Kaş behind the main street going down to the harbour. The SGK office is down some steps, near to the Akbank ATM.

SGK office Kaş

 

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