Turks, expatriates to benefit from new health insurance scheme

It is a relatively easy to decipher, mandatory insurance scheme replacing previous piecemeal efforts that some critics say had made accessing the Turkish public health network rather cumbersome. For example, there had been confusion about which hospitals (private or public) would treat those residents below a certain income level, whether specifically issued insurance cards would automatically qualify its holders for free healthcare and who could access which local health center(s) in the first place. Besides, a complicated tariff structure often left patients in the dark about whether they would need to pay a contribution for their treatment or not.

Now (almost) fully operational, Turkish citizens will be able to insure themselves for a flat fee according to income. In all cases the monthly contribution covers not just the policyholder but her or his spouse and all children under the age of 18 living under one roof with their parents. The age limit increases to 25 as long as children attend educational institutions. The monthly fee for an entire family will now be fixed at just over TL 210 (initially set at TL 182 in 2010) and will decrease for those earning less than the national minimum wage.

As it is a general benefit to the public the scheme is to be administered by Turkey’s Sosyal Güvenlik Kurumu (SGK) (Social Security Institution) instead of the national Health Ministry.

A key part of the new law is the fact that it covers the entire spectrum of accidents at work and how a citizen can avail herself or himself of certain related benefits. Hence, it is much more than simply a legal framework regulating access to healthcare but stipulates the cases when policyholders will benefit from additional financial and/or logistical support. The monthly fee payment for Turkish citizens is to be managed in cooperation with their employers.

The reasonable fee structure makes it possible that each and every citizen will be covered and subsequently have access to the national public health system, a first! The fact that it has become mandatory does not mean that the government imposes something unwanted on its citizens on the contrary. Access to public healthcare similar to access to (almost) free public primary and secondary education is a citizens right but can only work out well once the individual citizen can afford to enrol, will be treated efficiently and above all else quick. Knowledge about the new scheme depends on creating awareness in the population as many citizens in particular away from the metropolises are still not adequately insured.

Expatriates to benefit, too –  if they so desire

As is the case with most local laws affecting life of expatriates in this (or any country for that matter) there was speculation about its impact on foreign residents’ wallets. From my personal perspective it is a great benefit for all expatriates and should be considered a bonus, not unnecessary extra payment. Without an insurance plan in place a single visit to a doctor plus ensuing minor operation would set you back more than TL 5,000.

As of today international residents can sign-up but do not have to, although this may vary from nationality to nationality. In order to allow international residents who under normal circumstances had to pay for expensive private health insurance to benefit from the system the Turkish government extends a helping hand to enable those who have resided in this country for more than 12 calendar months to sign up and pay the maximum amount, albeit without any options for reductions assuming that no expatriate would earn less than the national minimum wage.

As expatriates without Turkish private health insurance under normal circumstances had to pay in cash once visiting a public or private hospital they now enjoy the same rights as their Turkish neighbors –- and the same obligations, that is, to pay their premiums on time.

Expatriates interested in joining and ideally after having downloaded the English version of the law from the SGK website –- www.sgk.gov.tr –- will then need to contact their nearest SGK office.

Turkey’s stable economy makes improvements in the healthcare sector possible as without a solid national economy, investments in public health would not be possible. Whereas the GHI provides for the legal setting and enables all Turkish citizen who are employed as well as their families to benefit from this much improved scheme, the next step must be to add healthcare facilities in those regions of the country where access to family doctors as well as public hospitals remains scarce.

Even a strong economy would not allow a government to roll out GHI for free, critics should keep in mind that compared with most European countries Turkey once more sets trends by enabling its citizens to access almost all healthcare facilities yet for a very modest means-tested premium.