What Is General Health Insurance?
General health insurance is designed to protect individuals’ health and cover medical expenses when adverse health events occur. Mandatory inclusion in the general health insurance system began on January 1, 2012.
Everyone residing in Turkey is covered by general health insurance. This includes insured employees, self-employed individuals, civil servants, those insured voluntarily, pensioners receiving monthly or income payments from institutions, recipients of the age pension, honor pensions, trainee lawyers, and people receiving unemployment or short-time work benefits.
Who Can Apply for General Health Insurance?
In addition to the groups listed above, persons who are not covered by any social security or are not dependents of an insured person—such as unemployed individuals who do not receive income or pension from an institution—are also included in general health insurance. These people are identified and enrolled automatically in the system by the Social Security Institution.
Because registration can be done automatically, it is important to monitor one’s status. We receive many questions on this topic.
How Can You Apply for General Health Insurance?
If someone is registered in the GSS (General Health Insurance) system automatically because they lack any social security, the Social Security Institution sends a notice detailing their status. Persons who believe that their household income per capita is less than one-third of the minimum wage must apply for an income test at the Social Assistance and Solidarity Foundations (SYDV) in their place of residence within one month of receiving that notice.
Persons who are disabled or elderly may apply through a legal representative.
Income Determination
To apply, a written application must be made in person to the relevant foundation based on the address-based population registration system. Income determination and related procedures must be completed within one month of application. Individuals already identified as covered by general health insurance or as dependents of an insured person cannot benefit from this application; they are notified in writing that the procedure does not apply to them.
Scope of Income Determination
- For those whose expenses, movable and immovable assets, and monthly per capita household income amount to less than one-third of the minimum wage, the state will pay the insurance premiums.
- Individuals who are outside the insurance system but have an income resulting in a per capita household monthly amount greater than one-third of the minimum wage must pay their own premiums.
- Those whose mandatory insurance has ended and who are not reinsured within 10 days will be considered subject to income determination.
What Changed on April 1, 2017?
On April 1, 2017, the conditions for accessing health services under General Health Insurance (GSS) changed for people without employment or social security. Prior to that date, individuals not covered by the Social Security Institution could pay monthly premiums based on income for themselves and their dependents, with premium amounts adjusted yearly according to the minimum wage. The April 1, 2017 reform introduced a single flat-rate premium system, eliminated the mandatory income test, and allowed restructuring of past premium debts. From that change, uninsured people could access health services by paying a fixed monthly premium; in 2017 the amount was 53.33 TL per month.
Why Is April 2, 2018 Important?
Approximately four million people with unpaid GSS premium debts prior to April 1, 2017, had about 12 billion TL of past debts restructured. At the same time, uninsured people were again required to complete an income test, and a one-year application period was set. The eligible application window became April 1, 2017 to April 2, 2018. Therefore, if you had outstanding GSS debts from previous years, you needed to restructure them by April 2, 2018, and if you had never taken an income test, you needed to complete it by that date.
Are Past GSS Debts Cancelled?
The arrangement was a restructuring, not a cancellation of debts. Late payment interest and penalties were waived. Importantly, past debts were recalculated based on the 53.3 TL monthly rate. This means you could clear outstanding months by paying 53.3 TL per month and resolve your past obligations.
The payment deadline for restructured debts was April 30, 2018.
Important Note: The final date for both restructuring general health insurance debts and completing the income test was April 2. Those who missed this deadline risked losing access to the health services provided by the state. Do not miss this date—mark it clearly and avoid leaving matters to the last minute.