An important development has been announced for those with mandatory general health insurance debt. Under the restructuring law for those covered by GSS, there will be an opportunity to pay outstanding premium debts in installments. For those who pay the principal of their premium debt by April, late interest and late penalties will be waived.
Advantage for Those Owing General Health Insurance
Individuals who are not employed in an insured job and are not dependents of a parent, spouse or another insured person must pay general health insurance premiums. These premiums cover access to examination and treatment at public hospitals. The obligation to pay GSS premiums begins after age 18. Students in high school or similar programs are exempt until age 20, and university students are exempt until age 25. However, if these young people complete their education and remain unemployed, they fall into the group required to pay.
The obligation to pay general health insurance premiums has been in effect since January 1, 2012. In the early years premiums were set in three income-based tiers, which led to significant debts for families when children finished school but did not work. In 2017 this tiered system was abolished and a single-rate approach was adopted. Accordingly, everyone subject to the obligation began paying a premium equal to 3% of the gross minimum wage. Under this arrangement the monthly premium was 88.29 TL in 2020; for employed persons this amount is collected from their salaries, while unemployed individuals must pay it themselves.
An Income Test Is Required
Unpaid GSS premiums can create substantial debts for those without coverage. For people who cannot afford to pay, the state may cover the premiums. To qualify, an income test must be completed. If the test shows that the per-person monthly income in the household is less than one-third of the minimum wage, premiums are not charged. In 2020, this threshold meant per-person income had to be below 981 TL for the state to pay GSS premiums. For example, a three-person household with a net income of 2,943 TL or more would be required to pay the premiums themselves.
Those with general health insurance premium debt who have not yet taken the income test have until March 31, 2021 to apply. If, by that date, the household per-person income is at or above 981 TL, the person will be held liable for premiums dating from the time the obligation arose. For example, a 29-year-old university graduate who turned 25 on December 31, 2017 would have debts calculated from January 1, 2018 onward. If the household per-person income is below 981 TL, no premium debt will be assessed.
Late Interest Will Be Waived for Early Payers
Under a bill approved by the Turkish Parliament’s Plan and Budget Committee, a significant relief will be offered for GSS premium debts. If outstanding debts for August and earlier months are paid by April 30, 2021, late penalties and interest on those GSS premium debts will be canceled. While other types of debts are adjusted with inflation differences, GSS premium arrears will not incur interest. In practice, this means those with GSS debt can clear past-due balances by paying only the principal and will retain access to healthcare services at public hospitals.