The British Embassy in Turkey has released detailed information following a meeting with SGK officials in December 20.

The release states:

Opting out of the scheme
The SGK scheme was introduced as compulsory for foreign residents in Turkey on 31st January 2012 for foreigners who had held a Residence permit for over 12 months, and who were not part of a health scheme in their own country.

Between this date and the 29th May 2013 it remained a compulsory scheme, and anyone who wished to join after January 2012 was subject to back pay and penalties.

New regulations brought into force on 29th May 2013 changed the scheme from compulsory to optional for foreign residents.

As a result, anyone who joined the scheme before 29th May 2013 is able to opt out by declaring their intention to do so in writing at  their local SGK office.

The British Consulate has asked the Directorate to consider removing the date barrier so that anyone who is currently in the scheme but wishes to opt out may do so regardless of the date they joined. This point is now under discussion and the Directorate will let the British Consulate know the outcome in due course.

Joint/Family membership and policies
Under Turkish law only married couples can benefit from a joint policy where one spouse is the policy holder and the other is the dependent. Unmarried couples or civil partnerships are not currently recognised in Turkish law, so for these couples each person must take out individual membership.

Dependents
For a family with children under 18 years of age, these children are considered to be dependents and can benefit. However, once a child reaches 18 years of age, unless they are in full time education (if they are studying they can benefit up to the age of 25 years) they have to take out their own membership.

Adult dependents (i.e. 18 years and over) are defined as those individuals who are not working and are not in receipt of any other income or pension.

Retired but NOT in receipt of a UK state pension
If you have declared yourself as ‘retired’ on your application forms and/or on your Residency permit then as long as you are not in receipt of a UK state pension, you may remain as a dependent on your spouse’s policy or hold membership in your own right if you are single or unmarried.

If this does not apply to you then you must visit your local SGK office and declare that you are not receiving a UK state pension so you can continue to benefit. This written declaration is sufficient to ensure that you remain on the policy as your spouse’s dependent or hold your own policy, as the SGK system does not have access to the required information to differentiate between individuals who have classed themselves as ‘retired’ and are not in receipt of a UK state pension and those who are retired and do have this pension as income.

Definition of ‘Retired’
The Turkish authorities have asked the British Consulate to point out that their definition of ‘retired’ is very strict – it only refers to someone who has finished their working life and is now drawing a pension income.

The British Consulate has discussed the implications of this with the Directorate and explained the reasoning behind many British nationals stating that they are ‘retired’, when in actual fact for many this means ‘not working’. Problems with illegal working/work permits have resulted in many having to declare ‘retired’ as ‘occupation’ on residency permits.

To avoid future confusion the SGK Directorate is working with the new Department of Managed Migration (the department responsible for issuing residency etc. from April 2014) to decide on an appropriate term for the status of many foreign nationals.

Retired and RECEIVING a UK state pension
For anyone who is in receipt of a UK state pension they are no longer entitled to benefit from healthcare under the scheme.

This rule was written into the 2010 laws on SGK but has only just been enforced. The reasoning behind excluding pensioners from the scheme was based on the ruling that nationals of those countries who have signed a Reciprocal Health Agreement with Turkey automatically benefit from their own country’s health scheme on receipt of a state pension and whilst residing in Turkey.

The British Consulate have pointed out that this does not apply to British nationals in this situation who have lived out of the UK for over 6 months.

The SGK Directorate are keen to establish a Reciprocal Health Agreement with the UK and this will form part of bilateral talks between the two governments which will take place early in 2014.

If you are in receipt of a UK state pension then you must declare this in writing at your SGK office and will no longer be entitled to benefit from the scheme and should consider taking out private health insurance.

Example 1: I am receiving a UK state pension and I am the dependent spouse on my husband’s policy, what should I do?

You must declare that you are receiving a UK state pension at your local SGK office and will be removed from the policy as you are no longer entitled to healthcare benefits under the scheme. If your husband is retired but does not receive a UK state pension he can continue to benefit from the policy and must declare the he is not receiving this pension in order to do so.

If your husband is in receipt of a UK state pension he must declare this fact and will no longer be able to benefit.

Example 2: I am receiving a UK state pension and I am the policy holder with my husband as my dependent, what should I do?

You must declare that you are receiving a UK state pension at your local SGK office and the policy will be cancelled as you are no longer entitled to healthcare benefits under the scheme.

If your husband is not receiving a pension then he must not take out his own policy. In order to do so he must undergo medical tests and any pre-existing conditions will not be covered.

Useful link for the UK Department of Work & Pensions:
www.dwp.gov.uk/international/medical-services

Medical tests
These are compulsory for anyone who wishes to join the healthcare scheme.

Automatic payments of premiums
If you have online banking they you can pay your monthly premium by this method. There is no online payment system through the SGK website at the moment.

Individual premiums
There are no plans to reduce individual premiums and there is no negotiation on this issue.

Documents / Information available in English
The website www.sgk.gov.tr is available in different languages.
On the Home page choose “En” in the top right hand corner for English.

What is covered by the healthcare scheme?
After choosing the English option, click on “E-legislation” on the left hand side menu.  Click on “Social Insurance & Universal Health Insurance Law”.  Section 3 “Universal Health Insurance Provisions” articles 62 – 65 Provided Health Care Services and Other Rights”, detail what is/is not covered by the scheme.

Please note: If any of the changes referred to in this report are applicable to you, please can you allow time for this information to be circulated from Ankara Head Office to your local SGK office.

Staff at your local office will be given the information and will need time to understand and apply the changes. However, please do let the British Consulate know if you have any difficulties at your local office and they can pass this information on to the SGK Head Office.

The SGK Directorate have acknowledged that they have made some errors regarding the communication of processes and changes to foreign nationals about the Universal health scheme.