Under the scope of the general health insurance (GSS), individuals are granted the right to access healthcare services. With the law in force, medical costs can be covered through insurance, and many wonder whether health benefits can be received based on a deceased person’s entitlement.
Can Health Benefits Be Received Based on a Deceased Person?
Law No. 5510 defines how people benefit from health services within the general health insurance framework. According to the law, individuals who were already considered as receiving income or a pension under previous social security legislation are included in the GSS. Those who receive survivor pensions under Article 60/f are also covered and receive health assistance accordingly.
Therefore, survivors who receive widow(er)’s or orphan’s pensions based on the deceased—such as a surviving spouse, child, or parent—are treated as beneficiaries under GSS 60/f and their treatment costs are covered by the Social Security Institution (SGK). To obtain health benefits based on the deceased, one must be receiving a survivor pension. In other words, if a widow(er) or orphan’s pension has been granted, health benefits can be accessed through the deceased person’s record.
Conversely, a person who did not apply for a survivor pension, one who refused or did not qualify for it, or someone whose pension was not granted because the deceased lacked sufficient insurance contributions or premium days, cannot obtain health benefits through the deceased. If the statutory conditions for a survivor pension are not met, health coverage via the deceased is not available.
Health Situation for Those Outside the Scope
Eligibility for health assistance in the situations described applies to people with no social security coverage at all. Individuals who already have coverage under SGK in 4A, 4B, or 4C status do not receive health benefits via a deceased person; their own insurance contributions determine their coverage because their premiums are already being paid.
People who have no social security at all, and who also did not receive any income or pension from the deceased, are required to cover their own GSS premiums. In such cases SGK identifies those individuals and records monthly GSS premium debts under their names. Those unable to pay these premiums have the right to file an objection to avoid being held liable for the debt.
Poor Financial Situation Does Not Automatically Place Someone Under GSS
If a person did not receive a survivor pension from the deceased and is in poor economic conditions without income, they still have rights regarding general health insurance premium obligations. Individuals who cannot afford payments can apply to the Social Assistance and Solidarity Foundation through the district governor’s office in their locality. The first step is a means test (income test) to assess the applicant’s financial status.
The purpose of the income test is to determine the person’s economic situation. Based on the income test result, if it shows the applicant’s income falls below the specified threshold or that the person has no income, they may become eligible for free health coverage.
Qualifying individuals are issued a 60-c card (commonly known as the green card). Green card holders receive free treatment at state hospitals and can obtain medications from pharmacies without charge. Medicines covered by SGK are provided free; if certain medicines are not covered, the individual may purchase them by paying out of pocket.