23March2015
About General Health Insurance Coverage and Income Test in Türkiye
Refer to the Q&A below for key information on benefiting from the general heath coverage in Türkiye and the scope of the income test.
- What is the Compulsory General Health Insurance?
According to Article 60 of Law no.5510, the main condition to benefit from general health insurance is to reside within the borders of Türkiye. In general terms, Turkish citizens residing in Türkiye (compulsorily) and foreigners residing in Türkiye (upon their requests) are within the scope of general health insurance.
- Who is considered 'insured' under General Health Insurance regulations?
According Article 60 of Law No.5510, Turkish residents, described below are considered 'insured'.
- Those who are employed under an employment contract,
- Those insured voluntarily,
- Those who have monthly income less than one third of the minimum wage as a result of their household income tests,
- Those who are under the age of 18 (exempt from income assessment and who have no dependants).
Foreign nationals with a valid residence permit: - Those who are not insured within the scope of the regulations of a foreign country,
- Those benefit from short-term work allowance,
- Those earning income or monthly salary in accordance with the Law No.5510, or with the social security laws applicable prior to the Law No.5510;
- Those not being insured in general health insurance within any scope,
- Those not being among the dependants of a person insured in general health insurance,
are deemed as being insured in general health insurance.
- In that case, who is considered as 'uninsured'?
- Those having documented that they are subject to social insurance in a foreign country,
- Among those who work either under the service of a person, or independently on their own behalves, those residing abroad and being subject to the social security regulations of the same country;
- Among those who are not insured within the scope of the regulations of a foreign country, those residing in Türkiye for a period less than one year,
are not deemed as insured in general health insurance, or as a dependent of a person insured in general health insurance.
- What is income test, and who is obliged to take it?
Income test is a process that determines the receivable income for the assessment of the GHI premium basis.
While those not being entitled to benefit from the health benefits within the scope of being insured in general health insurance or being the dependant thereof, have been registered as the persons being insured in general health insurance under Clause (g) of Article 60 of the Law no.5510, such registered persons should further appeal to the Foundations of Social Cooperation and Solidarity, and undergo an income test.
Families residing together are taken into consideration together in the income assessment.
Those being deemed in the same household:
Those being deemed in the same household:
- Spouse;
- Among the unmarried children, those being younger than age of 25;
- Father and mother of the person to be registered as being insured in general health insurance.
- When should the income test be taken?
Those who are registered as being Insured in General Health Insurance should appeal to the Foundation of Social Cooperation and Solidarity in no later than one month as from the date of their receipt of the notice for the application to income test.
Premiums of those who are not to appeal for income test within a period of one month are accrued (on the basis of double the amount of the minimum wage), and the payable premium amounts thereof are communicated by the provincial directorate of social security/social security center via registered mail.
Premiums of those who are not to appeal for income test within a period of one month are accrued (on the basis of double the amount of the minimum wage), and the payable premium amounts thereof are communicated by the provincial directorate of social security/social security center via registered mail.
- How Much Premium will be Payable as a Result of the Income Test?
|
GHI Status |
Income Level |
Premium Payable |
|
60/1(c-1) |
Amounting to lower than one third of the minimum wage |
To be covered by the Treasury |
|
60/1(g-1) |
Amounting from one third of the minimum wage up to minimum wage |
(Minimum Wage / 3) × 12% |
|
60/1(g-2) |
Amounting from the minimum wage up to double the amount of the minimum wage |
(Minimum Wage) × 12% |
|
60/1(g-3) |
Amounting to more than double the amount of the minimum wage |
(Minimum Wage) × 2 × 12% |
- Can one object to taking the income test?
Those who have decided not to undergo income test should appeal to the Institution, or to the Foundations of Social Cooperation and Solidarity, and should declare in writing that they have decided not to undergo income test.
Monthly incomes of those who do not have an income assessment are assumed as being double the amount of minimum wage.
Monthly incomes of those who do not have an income assessment are assumed as being double the amount of minimum wage.
- Is It Possible to object to the Result of the Income Test?
It is possible to object to the associated Foundation of Social Cooperation and Solidarity in writing regarding the result of the income assessment in no later than 15 days as from the date of the provincial directorate of social security/social security center's communication of "Notice of GHI Registration".
- What are the circumstances under which the income test can be retaken?
Those with income status changed, or those with family status changed (due to birth, decease, marriage, divorce, etc.) after taking their income tests should undergo income test again.
As long as the Institution or the foundation is appealed within a period of one month as from the occurrence date of the respective change, results of the income tests are renewed.
Except for the aforementioned circumstances, it is possible to demand a new income test only six months after the date of the income assessment.
- What is the General Health Insurance status of part-time workers?
While being 4 (a) insured,
- those working part-time or on call,
- those insured persons working at domestic services for less than 30 days a month,
are obliged to round their general health insurance premiums appertained to their missing days up to 30 days.
Such persons should round their missing days up to 30 days by way of undergoing income tests upon respectively appealing to the associated Foundations of Social Cooperation and Solidarity, and paying their premiums over their income levels determined according to the results of their income tests.
- How can foreign citizens benefit from the General Health Insurance coverage in Türkiye?
Foreign citizens who have been residing in Türkiye for a period more than one year, and:
- who are not insured within the scope of the regulations of foreign countries,
- who may not benefit from their insurance within the scope of the regulations of foreign countries
may be insured in general health insurance upon their request, and by way of appealing respectively to Social Security Institution (SSI), and paying their premiums by themselves. Family members of such persons who are dependent to them are also deemed as being insured in general health insurance.
- Under what circumstances does General Health Insurance expire?
- when the compulsory labour is terminated,
- voluntary insurance status of those expire,
- such rights of those earning income/monthly salary expire,
- rights of those to earn monthly salary expire,
- unemployment allowances/short-term work allowances of those are suspended,
- residences of those are transferred to other countries,
- or in cases where such persons die, general health insurance status of such persons expire as of the dates of respective occurrences.
References: www.sgk.gov.tr
