Article updated Tuesday 24th January

Some foreign residents - urgent action required.

For some time, we have been waiting for an official announcement on what foreigners are required to do in relation to SGK health insurance.

It's been a subject that has been up in the air for a couple of years, and KTLN has reported on it before.  The last time was back in September 2011 - click here to read the article.

Now, after much speculation and guesswork, we believe we have some news we can share with you.  However, there are still some points of detail that have yet to be explained.  In this report, we tell you what we know.

SGK is the name given to the state run health insurance scheme.  (There are other categories of state insurance, but for the sake of simplicity, let's just call it SGK).  

If you live in Kalkan, your local SGK office is in Kaş.  It administers health and social security matters.

KTLN's UHI/SGK further update (new section added Tuesday 24th January)
In order to keep everything in one place, we are simply adding our update to the existing KTLN report, which was originally published on Friday 20th January 2012.

Apologies for the length of this article, but it's a complex subject.

For those who don't want to read through the ins and outs of this latest update, we will cut to the chase and begin with this simple statement.

We strongly recommend that if you have any doubts or questions about whether you should register, you should go as soon as possible to the SGK office to get an official answer directly from them. 

Once again, may we reiterate that any analysis within our report, is just that - it's the KTLN view of the situation.  Feel free to disagree with our interpretation of the facts, and please don't sue us if we have drawn any incorrect conclusions.  You should make your own enquiries.

Latest KTLN update - Tuesday 24th January 2012
Firstly, here is an extract from an update, which was published today on the British Embassy in Turkey web site:

"We were not officially notified by the Turkish authorities that the scheme was being reintroduced this year and that it would be compulsory for all long-term residents. 

The Turkish authorities have now announced that the scheme became effective on 1/1/12. 

In the document passed to us, it appears that once a non-Turkish resident completes one year of residence in Turkey, they must apply to join the scheme.  It applies to all nationalities not covered by the health scheme of their own country.  British nationals who have lived in Turkey for one year will receive a letter about joining the scheme and then have one month to register."

For us, this is the key part of the message, but if you wish to read the whole page, here is the link: British Embassy in Turkey update

Unfortunately, this still leaves so many questions unanswered, and so many points of detail still to be explained.  However, let's analyse what is being said, and perhaps just as importantly, what has not been said.

KTLN analysis of what we have just been told
"The Turkish authorities have now announced that the scheme became effective on 1/1/12".  This is unambiguous.  The new system is here.

" In the document passed to us, it appears that once a non-Turkish resident completes one year of residence in Turkey, they must apply to join the scheme".  As KTLN has already reported, (see below), this pre-requisite of being resident for one year is something we concluded as being self-evident, based upon online news reports, and also a SGK leaflet.  And to us, there is no ambiguity in the words "must apply to join the scheme".

"It applies to all nationalities not covered by the health scheme of their own country".  If you spend most of your life in Turkey, you are not officially covered by the UK NHS, (save for A&E treatment), and so, subject to the other qualifying factors, this new Turkish law applies to you. 

"British nationals who have lived in Turkey for one year will receive a letter about joining the scheme and then have one month to register".  For us, this sentence conjures up a nightmare scenario of confusion. 

Who is sending out these letters?  Will they be sent centrally or from local offices?  We don't know.

When are they being posted?  We are informed that some people had their letters a week ago.  We know of many more who have not had them.  Does this suggest that local offices are sending them out to people in their area?  We don't know.

When does the one month clock start ticking?  When they were posted or received?  How will date of receipt be proved?  We don't know.

Can you rely on the PTT system to deliver it?  Do you have a PO Box?  Do you get all your mail on time?  Do you even have a letter box?  If you are going to wait until you receive your letter, we wish you luck.

Does this mean the deadline of 31st January 2012 has been suspended?  We think it is noteworthy that the British Embassy in Turkey web site does not say that.  The reason is simple - they have not been told that by the Turkish authorities.

So what's all this about having "one month to register"?  Truly, we have no idea what this means in practice.  Perhaps more importantly, we wonder how the different SGK offices will interpret this supposed one month period of grace.

Just to reiterate our advice: if in doubt, please go to the local SGK office and check, as soon as you can.

So many questions unanswered
KTLN has received so many questions on this, and we have to be honest and say, we simply don't know the answers.  We are working with other journalists and also the British Embassy, but so far we have been unable to get anything definitive.

• What if I need to register, but I am out of the country?
• Are pre-existing conditions covered by SGK health insurance or not?
• Where can I find full details of the cover provided by SGK?
• What is the situation for UK citizens married to a Turkish spouse?
• Are retired foreigners exempt from paying?
• How is "one year of residence" defined?

Registering with SGK
We, went to Kaş this morning and successfully registered for SGK. ('We' being a married and retired British couple).

We took our passports and ikamets (plus photocopies).  We had our UK marriage certificate translated and notarised, and submitted this with our application. 

We also each had to provide confirmation of our address, in the form of a letter from the Nüfus office, headed up 'YERLEŞİM YERİ VE DİĞER ADRES BELGESİ'.  (In Kaş, the Nüfus office is in the same building as the tapu office, on the 2nd floor).  You need to know your Kimlik number - that's the 11 digit number beginning '99'. How to obtain your Kimlik number. 

Monthly payments, (about 213TL), can be made at any branch of Ziraat Bank, where you need to quote your Kimlik number.

Payments must be made before the month end.  We recommend paying at least a few working days before the end of the month, to make sure the payment is registered on the system in time.

Below: Photo showing the SGK office in Kaş from the main street going down to the harbour. The SGK office is down some steps, near to the Akbank ATM.

Below: A photo from the other side of the block, showing the SGK entrance.

An update from the British Embassy in Turkey (new section added Monday 23rd January)
Here is an update from the British Embassy in Turkey web site:

"We are aware of the confusion surrounding the new compulsory healthcare requirements for British nationals. It seems that regional offices are applying the rules differently, adding to the confusion.

We have contacted the Ministry of Health again to ask them to clarify the requirements of the scheme immediately so that British nationals can make informed decisions about the options open to them.  The Ambassador has also raised this with the Ministry of Foreign Affairs." 

Registration with your local SGK office
All foreign residents who have had formal residency (an ikamet), for at least one year, must attend their local SGK office by 31st January 2012, to be registered on to the Turkish health system database.

If you don't attend, and fail to register, you may be fined 886TL.

If you already have SGK, then clearly you are already on the system, and don't need to attend.

You must have Turkish health insurance (section updated 20th January)
As a permanent resident of Turkey you must have Turkish health insurance.

When we first published this article, (an hour ago), we said that if you have private health cover, issued by a recognised Turkish insurer, such as Yapı Kredi, for example, you should provide evidence of your policy, when you go to the SGK to register, and it would not be necessary to take out SGK.

This was based on what we believed to be reliable information, however we have subsequently received conflicting advice, saying that even if you have private cover, you must still take out SGK - effectively paying twice.

This may seem harsh, but it reflects what would happen in the UK for example, where you can take out private cover, but you can't opt out of National Insurance contributions.

So, it would appear that you must purchase insurance from the SGK when you register your details. 

We do not have the precise cost of SGK health insurance, but we believe it to be just over 210TL per month, (about 2,500TL per annum).  This premium covers a single person, or a married couple. 

We understand that for couples who are not married, they will have to pay about 210TL per month each.

What should you take with you?
When you attend, you should take:

your private health insurance policy (if applicable),

your passport, and

your residency book, (ikamet).

Also take a photocopy of your passport (the page showing your photo), and also your ikamet.  

If you are a married couple, you should both attend.  You need to take along a translated and notarised copy of your marriage certificate.

There have been reports that UK citizens also needed to produce an official letter from the UK government, confirming that as residents of Turkey, they no longer qualify for free health treatment back in the UK.

However, we are now informed by the British Embassy that this letter is not required.  Instead, the UK government has provided a blanket letter to the Turkish authorities, confirming this. 

SGK managers in local offices, should have received a communication from the Director General of the SGK saying that this letter is no longer required from individuals. 

What if you have not had residency for a year?
Our understanding is that you are not required to register by the end of January deadline. 

Further, we believe that you can not take out SGK health insurance until you have been resident in Turkey for one year.

The question of residency for one year (new section added 21st January)
We are aware that there is some conflicting online information about this.  As this is an important subject, we are flagging this up now so that KTLN readers can be aware of the issue.

Some people are interpreting the new law as being applicable to foreign residents who have got residency permission for at least one year - i.e. the year ahead, in the future.

Here at KTLN we are interpreting the new rules in a different way.  We believe that the new law applies to those foreign residents, with an ikamet, who have already spent at least one year in Turkey.  We are happy to explain how we have arrived at our position.

KTLN first reported on this story back in September 2010.  We referred to an online article published by Hurriyet Daily News, which included the following statement,

"..if you are foreigner, if you are not insured in your country, if you have a residence permit and if you have been in Turkey for a year or more, you must become a Universal Health Insurance Holder".

Here is a link to that Hurriyet article: Hurriyet SGK article

Further, we have a leaflet published by the SGK, in English, entitled 'The conditions for foreign nationals having health benefits'.  The following is an extract from this leaflet: 

“those who reside in Turkey for more than one year are entitled to general health insurance from the date that their residence period exceeds one year in Turkey, and as of this date, they will be registered, after they give the entry statement of general health insurance to the Social Security Institution [SGK], within one month of that date”.

So our interpretation, rightly or wrongly, has always been that you must have been resident in Turkey for at least one year, before you can get SGK.

We hope that explains our reasoning.  However, in the absence of definitive advice from the British Embassy, or the Turkish authorities, we must stress that that what you see on KTLN is only our view. 

We do try to get things right on KTLN, but if we are wrong, we will hold our hands up.  We have asked the British Embassy for their advice on this specific point, and we will let you know what they say.

Further information
Please note this article will be updated as and when we have further information.  There are still many questions to be answered in relation to how this new scheme will operate.

Confirmation on the British Embassy web site is expected imminently.

If you have any questions about this new scheme, drop us a line and we will try to find out the answers. 

Please note we may not be able to respond personally to every question, but we may include the questions and answers in subsequent updates on KTLN.

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