The Health Insurance System in Turkey

Understand which medical costs are covered by insurers and patients, how to pay for medical care and how to get private health insurance...

Turkey has a comprehensive public healthcare system, which is available to foreign residents paying social security contributions. However, the system lacks funding and many hospitals are overcrowded. Many doctors working under the state health system also work in the private sector, where waiting lists may be shorter.

All residents in Turkey are issued with a Turkish Identification Number (TIN), which is also their social security number (Sosyal Güvenlik Numarası - SGN). Employers request a social security number from the Interior Ministry’s Population Registry Directorate for their foreign employees who do not have a TIN.

• To find out more information about the TIN: Click here (in Turkish)

Universal Health Insurance

A system of Universal Health Insurance (Genel Sağlık Sigortası) is currently being implemented in Turkey (as of February 2012). Most foreigners with a residence permit and living permanently for at least one year in Turkey, and who do not hold health insurance under the legislation of their home country, must make compulsory monthly payments into the scheme. For some foreigners this scheme is voluntary, but other nationalities have to pay into this scheme or pay a fine. For most foreigners, this entitles them to unlimited healthcare for approximately TL 200 a month. Payments into the scheme are made monthly at a bank.

Treatments covered by health insurance

Residents registered with the social security system can get medical care free of charge from contracted hospitals. In the following cases, medical treatment is granted without conditions:

Residents with a social security number can get medical care free of charge from contracted hospitals. In the following cases, medical treatment is granted without conditions:

• Emergencies
• Work accidents and vocational illnesses
• Infectious diseases
• Preventive health services (drug and alcohol abuse)
• Birth
• Extraordinary events (war, fire, earthquake)

The following treatments are not covered by social security in Turkey:

• Fertility treatment for women older than 39
• Cosmetic surgery unless medically necessary
• Cosmetic dental work

Dental services

Most hospitals which are contracted to social security do not offer dental care. Patients are transferred to private dentists and pay for services themselves.

Private Healthcare

The private health sector in Turkey is growing rapidly, and many expatriates choose to have private cover, as waiting lists for treatments are shorter, and the standard of healthcare in private hospitals is generally higher. Supplementary healthcare insurance with private health insurers is not obligatory. Many employers of expatriates provide supplementary private health insurance cover for their employees.

The maximum age at which a person can enter the private health sector in Turkey is 65.

Most banks and insurance companies offer various pension and health insurance packages. Insurance companies provide a list of hospitals and doctors where people insured with them are covered for treatment.

Why travel insurance is essential for overseas travel

Travel insurance? Good idea, or waste of money?

Travel insurance should be an essential purchase for anyone before they head off on a trip overseas, and yet I still hear about so many who get themselves into situations because they didn’t want to spend the extra money. Is it really worth ruining your trip with health concerns, hospital bills, or lost luggage to save money by not buying insurance? Personally I think you’re a complete idiot if you travel without it.

Now over the years, I’ve gone on many trips overseas, all of which I’ve been covered by travel insurance. Granted most have gone without a hitch and without any need to claim. Yes I could have saved myself hundreds of dollars not buying travel insurance but ………………. I don’t own a crystal ball, and I am by no means psychic. There have only been a couple of times, but a couple all the same when I’ve needed insurance, and have been glad I was sensible enough to buy it.

Most travel insurance policies cover a wrath of different things including accidents, or health issues, doctors and hospital bills and even on some occasions medication. They also cover lost of damaged luggage, lost/stolen credit cards and money, lost or stolen passports including emergency replacement or sorting out travel documents. The list goes on but these definitely are the most important to pay attention to.

Hospital bills are not cheap overseas. There’s not only the initial cost of treatment, but also the possibility that you could be kept in hospital for days, weeks or even months. There’s also the post treatment costs. In my case I broke my leg once, and so it was very uncomfortable to fly, my leg would swell up like a balloon, and sitting in economy class was hell on earth. Luckily because I had travel insurance, I was upgraded for all my remaining flights to business class, making the journey home much more bearable. I also received help carrying my bags, and health checks in all the locations I travelled to make sure that everything was ok.

The other thing that can also put a dampener on your travels is lost of damaged luggage. Suitcases go missing every day around the world. Some turn up, eventually, some never do. And it’s not going to be cheap to buy a new suitcase full of clothes for your holiday. Luckily, (touch wood), this hasn’t happened to me on my travels, but on my recent trip to Argentina, I needed to claim for damage to my camera and iPhone.

I had travel insurance with CoverMore and had made it through the entire 3 weeks with no problems at all. When checking in for my flight home, I dropped my bag off the counter, onto the marble floor of the airport. This had my Nikon DSLR camera in it and also my iPhone, amongst other things. At first I didn’t think there was a problem. It was only when I was through customs that I took my phone out to use the internet, that I noticed the screen was totally smashed, and that it wouldn’t work. I then checked my camera and realised a piece of the camera lens had broken off and was floating around inside the camera. Not a great end to a holiday at all. However, I had travel insurance, so although annoying that things had broken, it was not the end of the world, and I knew that my insurance would cover repairing or replacing the items damaged. And that’s exactly what happened. Yes I had to fill out paperwork and get repair claims sorted, which let’s face it, isn’t the most interesting of things to do, but at the end of the day, my camera was fixed, and my iPhone was replaced.

The damage to my camera and iPhone cost nearly $2,000 to repair and replace. My medical bills when I broke my leg would have been at least $10,000 if not a lot more. Travel insurance, depending on where you are travelling, can start at less than $100. It’s not hard to guess which I  choose, and would choose every time.

It does pay to do a bit of homework before choosing your travel insurance. There are many different companies and many different types of policies. Be sure to check what is and more importantly isn’t covered before you make your final decision.

Insurance in Turkey

Developing and growing Turkey has continued to provide chance areas to insurance sector in 2013 too and has achieved a growth of 22% in premium production by the end of the year. 4.4% growth of Turkey, which has been over the expectations, in the first three quarters of the year, reflected positively on insurance sector. Lower insurance spending in Turkey compared to similar countries returns as growth to the sector as proper economic conditions are achieved with positive developments like growth of mid-class income levels and rising tendency of insurance awareness. A similar process was experienced in 2013, during which the economy had a positive course.

Despite the lack of profitability, which has become the chronic problem of the sector as a consequence of extreme competition and wrong pricing, Turkish insurance sector still keeps its attraction. If expected developments and improvements are brought into life in the sector, written premium amount in non-life branches may reach TRL 63 billion and possible to rank Turkey among first 16 in the next 10 years.

Solution of pricing problems in current market, taking prices to normal (where it should be) levels and with the elimination prevention of structural problems, which reduce profitability of companies, it is possible that profitability in the sector may reach better levels. This positive expectation makes insurance business one of the most dynamic sectors of the economy. Initiatives like founding new companies, mergers or acquisition of existing companies in 2013 are indicators for the liveliness in the sector.

By the end of 2013, total premium production has increased by 22.2% and reached TRL 24.23 billion. TRL 20.8 billion part of this has been obtained from nonlife branches, while TRL 3.4 billion part of it has been obtained from life insurances. Annual growth rate in non-life branches has been 21.7%, while it has been 25.3% in life insurances.

Passing to free tariff in traffic, new arrangements in vehicle insurances and possibility of 4 types of vehicle insurance preparation in addition to the renewal of Private Health Insurances Legislation can be considered among the most important developments of the year in terms of insurance sector outside of elementary branches. The most important one of these arrangement, which is related with both insurers and insurance companies is the guarantee of lifetime renewal of private health insurances with the same plan. Fullindependent implementation period will be passed in January 2014 for traffic insurance premiums, while bringing transparency and easy access to information by making companies obligatory to publish their premiums on their webpages. With the new arrangement in vehicle insurances, policy is made more informing to insurers with different options like repairing the vehicle in original service or any service desired by the insurer or with original parts or equivalent parts.

On the other hand, Personal Pension System (PPS), which has celebrated its 10th anniversary in 2013, had a bright year with state contribution practice started on January 1st and the number of people retired from the system has reached to 7,382. With the growth to be reached by PPS in the upcoming 5 years, it is expected that the issue will be intensely discussed in the finance sector. When annual inflation, which has been 7.4% based on Consumer Price Index, is taken into consideration, insurance sector had 14% growth in 2013. Non-life premium production covered 86% of total production and turned out to be TRL 20.83 billion. Meanwhile, life branch had 14% share and recorded as TRL 3.4 billion.

Motor vehicles liability (traffic) insurances increased by 37% in 2013 compared to previous year and reached TRL 5.38 billion, taking leadership from motor vehicles and increased its production share within the sector from 20% to 22%. Meanwhile, the growth rate in motor vehicles (vehicle insurance) with written premium of TRL 5.26 billion was recorded as 11%. Fire and natural disasters insurances followed with TRL 3.32 billion, illness/health insurances came as TRL 2.47 billion and general damages followed with TRL 2.19 billion.

When compared with previous year, an important improvement has been achieved in the sector and thanks to correct calculation premiums and control of costs, profitability has been achieved. Meanwhile, even though the prices increased in traffic insurances in 2013, there has been loss more than TRL 500 million by the end of the third quarter. It is inevitable to make arrangement in traffic insurances, just like in vehicle insurances.

Lower damage payment under previous years’ average in terms of natural disasters like earthquake, storm and flood in 2013, is another positive affecting element for profitability. It is expected that the sector, which has been growing in real terms for many years, to continue this trend in 2014 too. The sector’s total premium production in 2013 and its comparison to the previous year’s figures are shown in the below table: