One of the most common questions for citizens seeking healthcare services in Turkey is how much the Social Security Institution (SGK) pays at private hospitals and how much out-of-pocket difference patients must cover. While examination and treatment in public hospitals are largely free, private hospitals operate differently. Private healthcare facilities reimburse certain services in line with agreements with SGK, and they may charge patients the remaining portion as an additional fee or “difference fee.”
As of 2025, SGK contribution rates and difference fees at private hospitals have been updated. These changes directly affect patients’ budgets and access to care. As private hospitals are increasingly preferred—especially in large cities—it has become more important to understand exactly what SGK covers, which services are free, and when difference fees may be charged.
Below we examine this topic in detail.
Services Covered by SGK in Private Hospitals
Under agreements between private hospitals and SGK, some services are fully or partially covered by SGK. In general, the services SGK covers include:
- Emergency department services (free at all contracted private hospitals)
- Basic consultation fees (for contracted specialties)
- Portions of surgery and operative procedures
- Part of inpatient stay and treatment costs
- Maternity and obstetrics services (at contracted institutions)
- Intensive care and life-saving procedures
It is important to verify whether a hospital is contracted with SGK. Procedures performed in private hospitals that are not contracted are not supported by SGK and all costs are billed directly to the patient.
What Are Contribution Fee and Difference Fee at Private Hospitals?
Two commonly confused terms at private hospitals are contribution fee and difference fee.
- Contribution Fee: A small mandatory amount set by SGK that is also paid at public hospitals. For example, a fixed contribution fee of around 30 TRY may be charged for a consultation.
- Difference Fee: The additional amount private hospitals request on top of the amount SGK reimburses. This amount can reach up to 200% of the SGK-paid fee in certain cases.
For example, if SGK pays 500 TRY for a procedure, the hospital may add up to 1,000 TRY as a difference fee, bringing the total cost to 1,500 TRY.
SGK Coverage Rates in 2025
According to the updated 2025 regulations, SGK covers between approximately 30% and 70% of basic healthcare services at private hospitals. These percentages vary depending on the type of service, the hospital’s pricing policy, and the SGK agreement.
- Outpatient Consultation: SGK generally covers around 40–50% on average.
- Surgeries and Operative Procedures: SGK’s coverage can reach up to about 50% for certain surgical interventions.
- Maternity Services: SGK contribution tends to be higher for normal deliveries; cesarean deliveries often involve higher difference fees.
- Eye, dental, and cosmetic procedures: These are typically excluded from SGK coverage or covered only very limitedly.
When Is No Difference Fee Charged?
Some healthcare services remain entirely free even at private hospitals. These include:
- Emergency department services for life-threatening situations (traffic accidents, heart attacks, strokes)
- Intensive care treatments
- Neonatal intensive care
- Cancer treatments and chemotherapy processes
- Organ transplantation and dialysis procedures
For these types of services, private hospitals cannot charge a difference fee; SGK covers the costs.
How the Additional Fee Is Calculated
Difference fees that patients must pay vary according to the hospital’s pricing policy. Calculation is generally performed as follows:
- The base fee set by SGK for the procedure is identified.
- The hospital may add a difference fee up to 200% of that base fee.
- Total amount the patient pays = SGK-covered amount + hospital’s difference fee + contribution fee.
Example Table:
| Type of Procedure | Amount Covered by SGK | Maximum Difference the Hospital Can Charge | Total Cost (Billed to Patient) |
|---|---|---|---|
| Consultation | 200 TRY | 400 TRY | 600 TRY |
| Surgery | 2,000 TRY | 4,000 TRY | 6,000 TRY |
| Delivery | 3,000 TRY | 6,000 TRY | 9,000 TRY |
Points to Consider When Choosing a Private Hospital
To avoid unexpected costs when receiving services at private hospitals, patients should pay attention to the following:
- Always ask whether the hospital is contracted with SGK.
- Get clear information in advance about any difference fees.
- For major procedures such as surgery or delivery, request the total estimated cost in writing.
- Know that charging extra fees in an emergency is not lawful; you should not be billed additional amounts for life-saving emergency care.
- If necessary, you can file complaints with the Ministry of Health or by calling the national health hotline ALO 184.
The amount SGK covers at private hospitals varies according to the type of procedure, the hospital’s agreement with SGK, and applicable difference fees. While SGK pays for emergency and life-saving services, patients are often responsible for part of the cost for routine examinations and treatments.
Therefore, before visiting a private hospital it is important to clearly learn the rates SGK covers and the difference fees applied by the hospital. Knowing these details helps with budget planning and protects patients’ rights.