People covered by the General Health Insurance include the entire working and non-working population. Every citizen of the Republic of Turkey is eligible for this service, although insurance contributions are paid by different parties depending on circumstances. If a person is employed, their employer pays the premiums.
If a person is not working, the state covers the payments. Participation in the General Health Insurance is mandatory for all citizens.
How to Benefit from General Health Insurance?
To benefit from General Health Insurance, individuals must make premium payments to the Social Security Institution (SGK). Failure to pay premiums can lead to accumulating debt and, in some cases, enforcement measures. This situation most often arises when no activity is reported under the insurance.
When applying to the Social Security Institution, employed applicants must provide proof of employment. For those with regular jobs, these procedures are usually handled by their workplace. Unemployed applicants must inform the Social Security Institution that they do not have a job.
Who Can Benefit from General Health Insurance?
People included in General Health Insurance include the following:
- Workers, civil servants or self-employed persons are all covered. Voluntary insured persons and those who cannot access employer-based health benefits due to special circumstances—such as poverty, apprenticeship, internship, neediness, refugee or stateless status—are included under General Health Insurance.
- Those sent to work in other countries are covered under certain conditions.
- Turkish citizens living abroad who encounter problems with the host country’s health services are covered by this insurance.
- When the employing institution or public offices determine that a family’s livelihood is insufficient according to established criteria, the family may be covered.
- Unmarried daughters who receive a marriage grant, or those who become divorced within two years after marriage and are not supported by their spouse, may be covered.
Who Cannot Benefit from General Health Insurance?
Those who cannot benefit from General Health Insurance include:
- Conscripts, non-commissioned officers and reserve officer school students,
- Turkish migrant workers abroad who have taken up insurance under the foreign country’s system in order to access that country’s health services,
- Foreign nationals residing in Turkey who are not Turkish citizens,
- Contracted staff employed at foreign representations of public administrations,
- Turkish citizens who can document registration with a foreign country’s social security system,
- Prisoners and detainees held in penal institutions and detention centers,
- Foreign nationals with residence permits are generally not included under this insurance.
What Is the Purpose of General Health Insurance?
The purpose of the General Health Insurance is to ensure that, within the framework of a social state, all citizens—regardless of financial condition—have access to health services provided by the state. The insurance aims to prevent any Turkish citizen within national borders from being left in hardship due to health-related needs.
Can Dependents of a Worker Also Benefit from General Health Insurance?
A worker’s dependents may be covered under certain conditions. Family members who earn their own income, are not students, or are not financially dependent on the worker are not eligible through the worker. Workers covered by General Health Insurance may not be able to include all family members automatically.
Which Dependents of a Worker Can Benefit from General Health Insurance?
Family members who can be included under a worker’s insurance are:
- The spouse, provided the spouse is not covered by any insurance (including voluntary insurance) and is not receiving a care pension.
- Children under 18 can benefit under the worker’s coverage. Those who have completed secondary education can be covered until age 20, and students in higher education until age 25, provided they remain unmarried.
- Children with a disability degree of at least 60% are eligible regardless of age.
- If the worker’s parents have total income below the net minimum wage and this can be proven, the parents may be included in the worker’s coverage.
How to Check General Health Insurance Premiums?
General Health Insurance premium debt inquiries can be made via the e-Government (e-Devlet) system. This platform allows users to query all government-related debts. Access is made through the official e-Government portal, where you log in with your ID number and password. Passwords can be obtained from PTT branches. After logging in, SGK-related pages provide detailed debt and premium information.
Is an Income Test Required for General Health Insurance?
An income test is required when determining entitlement for General Health Insurance because the family’s income result decides who will pay the premiums. For the state to cover premiums, the family’s per-person income must be at or below one-third of the minimum wage. This determination requires an income test, which can be applied for at local mukhtarliks or directly through the Social Security Institution.
How Much Is the General Health Insurance Premium?
General Health Insurance premiums are calculated on a daily basis and vary according to monthly income levels, with established upper and lower limits. The daily upper limit for General Health Insurance premiums is set at 76.75 TL. The lower limit effectively results in no payment when earnings are below one-third of the minimum wage and the person qualifies for state coverage.
Do Graduate and Doctoral Students Have to Pay General Health Insurance?
Graduate and doctoral students may be subject to premium payments depending on age. Male students over 25 are no longer considered dependents of their family for insurance purposes and must make their own arrangements. Female students over 25 can remain covered under a parent’s insurance until marriage. In general, male students lose dependent status once they turn 25 and become liable for their own contributions.
What Is General Health Insurance Registration?
Registration for General Health Insurance refers to the process after an individual learns they must have the insurance and then visits the Social Security Institution to complete the required procedures. The nearest SGK office can provide guidance and help finalize registration.
Can You Appeal General Health Insurance Premiums?
It is possible to appeal General Health Insurance premiums. If individuals are unsure about the assessed premium amount, they can start an appeal process by submitting a written objection to the Social Security Institution. To appeal, applicants generally must not have had an income test that determined the disputed amount. Other valid reasons for appeal include discrepancies between the notice date and the payment period. Appeals are submitted to the nearest SGK office where staff can assist with the necessary paperwork.