Foreign Healthcare Transactions
23 of all the social security agreements signed by our country are still in force and the agreements with following countries include healthcare insurance: Germany, Netherlands, Belgium, Austria, France, TRNC-Turkish Republic of Northern Cyprus, Macedonia, Azerbaijan, Romania, Czech Republic, Bosnia-Herzegovina, Albania, Luxemburg and Croatia.
However, the provisions on healthcare insurance in the agreements signed between Azerbaijan and Albania cannot be implemented due to the reasons stemming from their legislations.
Which persons can receive healthcare services abroad according to the social security agreements?
Unless otherwise provided in the agreement on social security, the following persons have the right to receive healthcare benefits on behalf of our Institution;
- Insured persons (banks, insurance and reassurance companies, chambers of commerce, chambers of industry, stock markets and the workers employed in the unions constituted by them) under the scope of letter (a) of the first paragraph of Article 4 of the Law No. 5510 and of transitional Article 20 of the Law No. 506 and their dependent family members. Of the persons specified in this scope, the following can receive healthcare benefits while staying or residing in a foreign country:
- Insured persons temporarily posted to a foreign country,
- Persons who are permanently posted to a foreign country and their dependent family members,,
- Dependent family members of the insured and retired persons staying abroad for educational reasons,,
- Insured and retired persons staying abroad for touristic purposes and their dependent family members,,
- Dependent family members of the insured persons who are permanently residing abroad and retired persons and their dependent family members,,
- Members of universal health insurance who are sent to another country for treatment and their dependent family members.,
- Apart from this; according to the legislation of our Institution, the following persons can avail themselves from the right to receive healthcare benefits provided by our Institution under the scope of universal health insurance on behalf of the contracted countries;
- For temporary stay; all the persons registered on the document (formulary) of right to healthcare benefits, only in cases of emergency,
- For permanent residence; persons specified in the social security agreements.
In this context, in order to receive healthcare benefits in our country, respective persons are required to be an insured member of universal health insurance or dependent of the insured in question.
Conditions for Receiving Healthcare Benefits for the Persons Having Foreign Insurance
Persons having foreign insurance, who either temporarily stay or permanently reside in our country, are required to get a formulary from the institution to which they are registered and submit it to the Departments of Foreign Services operating within the scope of Social Security Provincial Directorates/Social Security Centers in their place of stay or residence; or to the Social Security Centers designated by Social Security Provincial Directorates.
Through the Document of Healthcare Benefits under Social Security Agreement, they can avail themselves from right to healthcare benefits in contracted health facilities, like other insured members of universal health insurance, free of charge excluding the rates of contribution and share which have to be paid legally by the insured himself/herself.
In cases of emergency, the insured persons, coming from countries with whom a social security agreement including healthcare insurance applications has been concluded and who are temporarily staying in our country, can receive the formulary for the right to healthcare services from the “Department of Foreign Services” in their place of stay in Turkey by submitting the document issued by the social security institution in their country. Besides, these documents can be confirmed through Social Security Centers designated by Social Security Provincial Directorates.
Benefiting from Emergency Healthcare Services for the People Having Foreign Insurance
In order to receive healthcare services, foreign insured people are required to make an application to the contracted health facilities of the Ministry of Health or to the private or training health facilities with the “Document of Healthcare Benefits under Social Security Agreement.”
Only through the referral of our contracted units, services can be provided from the non-contracted health facilities. When a person applies directly to a non-contracted health facility, regardless of this regulation, his/her expenses of treatment can be covered by the Institution on condition that it is an emergency situation.
Whether the treatment is an emergency or not is determined through the inspection of the relevant submitted medical documents by the contracted health facilities.
In such a case, the insured person shall apply to the Social Security Provincial Directorate/Social Security Center together with the reports regarding his/her treatment and invoices if he/she has made the payment. If the treatment is accepted as an emergency, a reimbursement shall be made to the insured in accordance with the provisions set forth in Medical Enforcement Declaration (SUT).
