When health coverage begins after starting a job depends on the employer notifying the Social Security Institution (SGK). As soon as an employee starts work, the employer registers them in the SGK system with an employment entry declaration. After this declaration is submitted, the person becomes eligible to receive health services under the general health insurance. Although some procedures may require waiting periods, in general health services become available without delay.
From the day an employee begins work as an insured person, they fall under the obligation to pay insurance premiums. The SGK system activates health access as soon as the premium declaration is made. If the worker visits a health facility on the day the declaration is submitted, the system recognizes their insured status and allows them to benefit from basic health services such as examination, tests, and treatment.
Is There a Waiting Period to Access Health Services After Starting Work?
There is no waiting period within SGK for health services after starting a job. A registered insured employee can actively use health services from the day their employment registration is reported. It is sufficient that the employer submits the employee’s entry to SGK within the first day following the hire. Once this is done, the system recognizes the worker and issues health provsion.
However, there are some exceptions. For example, if an employee was previously removed from the system due to unpaid general health insurance premiums, a debt check will be performed when they start a new job. If prior debts remain unpaid, health services may be temporarily suspended despite the new employment registration.
In addition, some private-sector employees may be covered by private health insurance policies. Depending on policy terms, these private policies can impose waiting periods of 30 to 90 days. During those waiting periods, only emergency health services are covered; other services are not included until the waiting period expires.
The fundamental principle in the SGK system is: “As soon as the employment entry declaration reaches SGK, the right to health coverage begins.”
What Happens If Premiums Are Not Paid?
Access to health services depends directly on the payment of insurance premiums. Even if the employer has submitted the employment entry declaration, if monthly premiums are not paid to SGK on time, the employee cannot be included in general health insurance and cannot receive health services. Therefore, in addition to submission of the employment entry, maintaining disciplined premium payments is essential.
If premiums are not paid, the system may show a “no provision obtained” error when the employee goes to the hospital. In that case, examination and treatment costs are invoiced to the individual. The SGK provision system is checked in real time by each health facility and services are delivered according to the premium status.
If an employee has paid premiums for at least 30 days and then leaves their job, they can continue to use health services free of charge for 90 days. This period is called the “continuation right of general health insurance.” When this period ends, health coverage ceases until the person starts a new job.
In summary:
- If premiums are not paid, the system does not grant provision.
- A person who has paid premiums for at least 30 days can continue health rights for an additional 90 days.
- To benefit continuously, premiums must be paid regularly.
Health Services for Work Accidents and Occupational Diseases
In cases of work accidents and occupational diseases, employees’ rights to health services are protected regardless of whether insurance premiums have been paid. These cases are considered within the scope of mandatory insurance and the state ensures protection for the employee in such situations.
A work accident is defined as a sudden injury, fall, burn or similar event occurring while doing the job. This can happen at the workplace, on the way to work, or at a remote location assigned by the employer. Following such an event, emergency services, X-rays, surgery, medications and all related health services are covered by SGK.
Similarly, occupational diseases arise from exposure at the workplace to harmful gases, chemicals, dusts, or from long-term ergonomic problems. When these conditions are reported to SGK, the person benefits from the process with specialist physician reports, board assessments and workplace physician opinions.
In these situations:
- Notification to SGK within 3 working days is mandatory.
- Health facilities prepare medical reports.
- All treatment costs are covered during the treatment process.
- If necessary, temporary incapacity benefits may be granted.
Work accidents and occupational diseases are among the most fundamental rights of employees and cannot be excluded from health coverage under any circumstance.
Health Services During Pregnancy, Childbirth and Leave Periods
Pregnancy is a period when special health rights for female employees become active. SGK covers all obstetric examinations, ultrasound checks, blood tests and pregnancy follow-up procedures. If the female employee is registered with SGK from the day she starts work, she can benefit from these services free of charge.
Pregnancy leave consists of 8 weeks before birth and 8 weeks after birth, totaling 16 weeks of maternity leave, during which health rights are uninterrupted. In the case of multiple pregnancies, an additional 2 weeks are added to this period. During maternity leave, the mother is fully covered for hospital services, postpartum checkups and medication costs.
Breastfeeding leave is a daily 1.5-hour allowance during the first 6 months after birth. During this time the mother can continue working while maintaining access to health services. Additionally, SGK provides financial assistance known as breastfeeding allowance.
- Pregnancy follow-up and childbirth procedures are covered by SGK.
- Health coverage continues throughout maternity leave.
- During breastfeeding leave, examination and medication rights are preserved.
- Breastfeeding allowance is also provided to mothers.
Periodic Health Checks, Occupational Health and Safety
Within the scope of occupational health and safety, it is legally required that employees undergo periodic health checks at regular intervals. The purpose of these checks is to detect occupational risks early and take preventive measures. The SGK system treats such health examinations as the employer’s responsibility and supports them directly.
Employees must obtain health reports upon entering employment and at specified intervals during their duties. These reports:
- Are issued by the workplace physician.
- Include eye, hearing, chest X-ray, blood tests and similar procedures.
- The frequency varies according to the job performed (for example, annually for hazardous jobs and once every five years for less hazardous jobs).
These checks are particularly important in high-risk sectors such as industry, construction and mining. Early diagnosis is the key to preventing work accidents and occupational diseases.
Workplace physicians also provide protective health education, vaccination tracking and emergency interventions for employees. These services are supported under SGK’s occupational health policies.