One of the questions retirees ask most often when they begin their retirement is which rights they gain under this new social status. Among these, one of the most important is health-related retirement rights. When we talk about retirees’ health rights, the primary concerns are which treatments are covered and which institutions provide treatment under that coverage.
Retirees, like other citizens covered by General Health Insurance (GSS), have the right to receive treatment at public and private healthcare institutions contracted with the Social Security Institution (SGK). Under the rights of SSK retirees, it should be emphasized that every insured person can access services from contracted institutions without hospital surtax. It is known that before GSS, BAĞKUR and SSK participants often could not be treated in university hospitals.
The scope of covered treatments can be examined under two headings: services for which additional fees are not charged and services for which additional fees may be charged. Services that do not require additional fees include:
1- Emergency health services provided for acute conditions not covered by the green zone examination
2- Burn treatment
3- Intensive care
4- Tissue, stem cell and organ transplants
5- Cancer treatments (chemotherapy, radiotherapy)
6- Cardiovascular surgery (with some exceptions)
7- Hemodialysis treatment
8- Surgical procedures for congenital anomalies
Services for which retirees may be required to pay additional fees are detailed in the Health Implementation Communiqué (SUT). In addition, SGK covers the costs of certain services under the SUT rules—such as physical therapy and rehabilitation, dental treatments, dialysis and care following traffic accidents. Retirees also have rights regarding medical devices and medicines, which are specified in the Health Implementation Communiqué.
When discussing services available to retirees, it is useful to mention the co-payment (participation fee), since awareness of this charge helps users exercise their rights more effectively. The participation fee is the amount that a person covered by general health insurance—or the persons for whom they are responsible—must pay to access the health services specified by Law No. 5510 on Social Insurances and General Health Insurance. The participation fee includes both medicine contributions and consultation fees, and it applies only to certain drugs and treatment types.
For detailed questions about the health rights retirees are entitled to, consult the Health Implementation Communiqué (SUT) for the specific provisions and conditions that apply.