Thanks to an American member of KTLN, we have discovered what the US Embassy in Turkey has to say about the new UHI/SGK laws.

Given that the new rules affect all foreigners, is there anything we can learn from our American cousins?

We will let you decide.  What follows is an extract from the advice they have issued.

This was communicated at approximately 17.00 on Tuesday 24th January.

"Effective January 1, 2012, the Turkish government implemented a mandatory health insurance law called the Social Insurance and Universal Health Insurance Law (UHI). It applies to foreigners who have resided in Turkey for more than one year as of January 1, 2012. All U.S. Citizen and foreign residents in Turkey have until January 31, 2012 to register at their nearest Social Security Provincial Directorate Office (Sosyal Guvenlik Il Mudurlugu). Those who fail to register by January 31, 2012 will be fined.

Exactly how this new law applies to U.S. Citizens and the foreign community is difficult to interpret.

Some of the key provisions of the law are as follows:

1) First, registration appears mandatory:
"[foreigners]... shall be deemed to be universal health insurance holder as of the date they complete one year residence period in Turkey and they shall be registered with a universal health insurance entrance notification to be submitted within month from this date" (Article 61, item c). It also mentions that fines will apply if the entrance notification is not submitted within the one month time frame. The amount of the fine is not specified.

2) Even if you already have health insurance that covers you in Turkey it appears that you will still be required to enroll. If you are not Turkish, and you have a Turkish residence permit, and you are "not insurance holders under legislation of a foreign country", you are - by legal definition - a holder of Universal Health Insurance (Article 60, item d) and you are obliged to pay premiums (Article 87, item b).

There are several different interpretations of "not insurance holders under legislation of a foreign country" - specifically with regards to whether private health insurance, or travel insurance qualifies - and therefore exempts you from the UHI law. The phrase “under legislation of a foreign country” implies a national health insurance plan. In the United States Medicare qualifies as a national health insurance plan but Medicare does not provide coverage outside of the United States. To learn more about Medicare coverage areas please click here. As a result, even if you are enrolled in Medicare in the United States you would still need to enroll in the Turkish UHI by January 31.

3) This law appears to apply to any foreigner residing in Turkey for at least one year, regardless of whether or not they are employed. There doesn't appear to be any clarification in the English wording. However, the absence of such wording in the definition in the English version (Article 61, item c) seems to imply that the UHI law applies regardless of work status.

The U.S. Embassy in Turkey strongly recommends that U.S. citizens contact their local Social Security Provincial Directorate Office (Sosyal Guvenlik Il Mudurlugu) as soon as possible to get further information and avoid the fine.

The information presented above is based on our best interpretation of information gathered up to January 24, 2012. Unfortunately, we are unable to guarantee the accuracy of this information. The information is provided as a guide and you should seek more information at your local Social Security Provincial Directorate Office (Sosyal Guvenlik Il Mudurlugu)."

Interestingly, you will note that there is no reference to letters being sent out to foreigners, as mentioned on the British Embassy web site. 

US citizens residing in Turkey are being encouraged to refer to their local SGK office as soon as possible.

A footnote
Just one more thing.

This new law has attracted a lot of debate, particularly in relation to the compulsory nature of the scheme, the lack of detailed information, and the sudden implementation. But whatever the whys and wherefores, you may want to consider this.

We were speaking to someone who works in the Turkish health service yesterday, who told us, (without going into personal details), about a foreigner who was recently rushed into hospital with a life threatening condition.  An emergency operation, and weeks of after care saved this person's life.

Fortunately, this ex-pat had SGK.  Had that not been the case, a bill for between 35,000TL and 40,000TL would have been presented for immediate payment.

We all think it's never going to happen to us, don't we.

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