Using Residence Health Insurance in Türkiye 2026

[TURKIYE]

Using Residence-Permit Health Insurance in Türkiye: Hospitals, Patient Shares and Claims​

An accepted residence policy does not make all treatment free​

A residence policy has two functions:

• Immigration evidence: demonstrating acceptable health cover for the residence application.
• Treatment cover: paying eligible expenses under its provider network, limits, patient shares and exclusions.

A valid policy may still leave part of the bill to you. A particular treatment may be excluded or subject to a waiting period.

Useful Turkish insurance terms​

• Anlaşmalı Sağlık Kuruluşu: a provider contracted with the insurer.
• Anlaşmasız Sağlık Kuruluşu: a non-contracted provider.
• Ayakta Tedavi: outpatient treatment.
• Yatarak Tedavi: inpatient treatment.
• Katılım Payı: the patient's share or co-payment.
• Provizyon: the insurer's authorisation for a service or expense.
• Teminat Limiti: the benefit limit.
• Bekleme Süresi: a waiting period.
• İstisna: an exclusion.

Three provider groups​

The minimum-cover framework distinguishes:

1. Providers contracted with the insurer.
2. Non-contracted providers and public providers not named in Annex 1.
3. The public providers specifically named in Annex 1 to Circular 2024/34.

Your share can differ between these groups even for the same diagnosis.

Minimum annual limits and patient shares​

The Circular 2024/34 rules took effect on 1 April 2025.

Contracted providers

• Outpatient: annual minimum limit TRY 15,000; patient 20%, insurer 80%.
• Inpatient: no specified monetary limit for covered treatment; patient 0%, insurer 100%.

Non-contracted providers and public providers outside Annex 1

• Outpatient: annual minimum limit TRY 15,000; patient 40%, insurer 60%.
• Inpatient: annual minimum limit TRY 150,000; patient 20%, insurer 80%.

Public providers in Annex 1

• Outpatient: annual minimum limit TRY 15,000; patient 20%, insurer 80%.
• Inpatient: annual minimum limit TRY 250,000; patient 0%, insurer 100%.

These percentages concern the eligible amount accepted under the insurance contract. They do not necessarily apply to the entire hospital bill, which may include excluded services or amounts above the policy's recognised charging basis.

Examples of patient shares​

For an eligible outpatient expense of TRY 10,000:

• Contracted hospital: patient TRY 2,000; insurer TRY 8,000.
• Non-contracted hospital: patient TRY 4,000; insurer TRY 6,000.
• Annex 1 hospital: patient TRY 2,000; insurer TRY 8,000.

If a separate TRY 3,000 service is outside cover, you may have to pay it in full. The patient-share calculation applies only to the eligible part.

Care route	Check before the appointment
Insurer network	Branch, doctor, service and patient share
Outside the network	Authorisation and reimbursement requirements
Annex 1 public provider	Exact listing and policy terms
Genuine emergency	Urgent care first, then insurance arrangements

Discussing care during a medical consultation​

Is TRY 15,000 available for every visit?​

No. It is the minimum annual outpatient benefit limit, not a fresh allowance per visit.

For example, if TRY 4,000 is debited to a TRY 15,000 annual limit, TRY 11,000 remains. Ask the insurer how it accounts for patient shares and approved expenses against that limit.

Eligible expenses continue to use the remaining allowance during the policy period. Renewal generally starts a new insurance period and new limits, subject to the renewed contract. Check the remaining allowance if you make repeated visits.

Public hospitals listed in Annex 1​

Annex 1 identifies the following 20 hospitals:

Ankara

• Ankara Bilkent Şehir Hastanesi — Ankara Bilkent City Hospital.
• Ankara Etlik Şehir Hastanesi — Ankara Etlik City Hospital.

Antalya

• Antalya Şehir Hastanesi — Antalya City Hospital.

Bursa

• Bursa Şehir Hastanesi — Bursa City Hospital.

Gaziantep

• Gaziantep Şehir Hastanesi — Gaziantep City Hospital.

İstanbul

• İstanbul Eğitim ve Araştırma Hastanesi — İstanbul Training and Research Hospital.
• Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi — Bakırköy Dr Sadi Konuk Training and Research Hospital.
• Başakşehir Çam ve Sakura Şehir Hastanesi — Başakşehir Çam and Sakura City Hospital.
• İstanbul Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi — İstanbul Kanuni Sultan Süleyman Training and Research Hospital.
• İstanbul Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi — İstanbul Prof Dr Cemil Taşcıoğlu City Hospital.
• Haseki Eğitim ve Araştırma Hastanesi — Haseki Training and Research Hospital.
• Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi — Şişli Hamidiye Etfal Training and Research Hospital.
• Taksim Eğitim ve Araştırma Hastanesi — Taksim Training and Research Hospital.
• Göztepe Prof. Dr. Süleyman Yalçın Şehir Hastanesi — Göztepe Prof Dr Süleyman Yalçın City Hospital.
• Pendik Eğitim ve Araştırma Hastanesi — Pendik Training and Research Hospital.
• Bağcılar Eğitim ve Araştırma Hastanesi — Bağcılar Training and Research Hospital.

İzmir

• İzmir Şehir Hastanesi — İzmir City Hospital.

Kocaeli

• Kocaeli Şehir Hastanesi — Kocaeli City Hospital.

Mersin

• Mersin Şehir Hastanesi — Mersin City Hospital.

Muğla

• Muğla Eğitim ve Araştırma Hastanesi — Muğla Training and Research Hospital.

Public ownership alone does not put a hospital in Annex 1. Confirm the named provider against the applicable official annex and your insurer's current arrangements; a later official update takes precedence.

Your provider-network list​

SEDDK requires the insurer to supply written information about the contracted providers available under the policy.

Before attending, confirm:

• The hospital is in your product's network.
• The relevant department is included.
• The doctor is included, if separately required.
• The agreement is active on the treatment date.
• Whether prior authorisation is required.
• Whether the arrangement is direct settlement or reimbursement.

Networks can change. Check with both insurer and hospital before the appointment instead of relying solely on an old saved list.

Before a hospital visit​

1. Contact the insurer's customer service.
2. Provide the policy number, hospital and city.
3. Explain the specialty and service required.
4. Ask about your share.
5. Ask about waiting periods and exclusions.
6. Request a call reference or written confirmation for a significant expense.
7. Confirm acceptance with the hospital's insurance desk.
8. Take your passport or foreign identity document and policy details.

Authorisation at a contracted hospital​

Typically:

• You provide your identity and policy details.
• The hospital sends an authorisation request.
• The insurer reviews the diagnosis, service, limits and waiting periods.
• It approves all or part of the request, or asks for more documents.
• You pay your share and any uncovered services.
• The insurer settles the approved part directly with the provider.

For expensive elective treatment, obtain final authorisation before proceeding. An appointment is not a payment guarantee.

Claim document	Purpose
Invoice and payment evidence	Link the expense to the service and patient
Medical report and prescription	Establish the reason for treatment
Authorisation reference	Track the coverage decision and limits
Full terms	Identify limits, exclusions and deadlines

Organising documents and an online application​

Claims at a non-contracted hospital​

You may need to pay first and claim reimbursement. Keep:

• The official invoice.
• An itemised breakdown of services and prices.
• The clinician's report and diagnosis.
• The prescription.
• Test and imaging results.
• Payment evidence.
• The insurer's claim form.
• Identity and policy copies.
• Bank details if requested.

The General Health Insurance Conditions require written notification within eight days of learning of the accident or illness, or becoming able to notify the insurer. Submit the supporting expense documents.

Check the insurer's submission channel and whether original documents are required.

Sudden illness and emergencies​

The residence-insurance framework does not permit sudden-illness health services simply to be excluded from the required cover, subject to the permitted waiting-period rules and other applicable conditions.

This does not mean every visit described as an emergency is paid in full. The insurer considers:

• The actual diagnosis.
• The applicable sudden-illness or emergency definition.
• Any connection with a pre-existing condition.
• The service provided.
• The provider.
• The limits and lawful exclusions.

Seek urgent treatment first for a life-threatening emergency, then contact the insurer as soon as possible and keep the records.

Waiting periods​

Waiting periods must be identified in the policy and special terms. “Inpatient cover” does not mean every operation is covered from the first day.

The older residence-specific framework in Circular 2022/7 describes an outpatient period of up to half the insurance term, capped at six months, and an inpatient period of up to three-quarters of the term, capped at nine months. The general private-health rules effective from 1 January 2026 set a maximum of six months for non-maternity benefits and twelve months for maternity.

Do not automatically accept a nine-month wait for a policy issued in 2026. Obtain written confirmation of the period and rules the insurer applies to the particular residence product, the affected conditions and the end of each waiting period. If the wording conflicts or the answer is unclear, seek clarification from SEDDK before purchasing or undertaking non-urgent treatment.

For continuous renewal with the same insurer, confirm preservation of rights and the treatment of waiting periods for the same benefits under the applicable rules. Continuity does not automatically cover treatment during an uninsured gap.

Possible exclusions and restrictions​

Depending on the product and applicable rules, these may concern:

• Pre-existing or undisclosed conditions.
• Pregnancy and childbirth.
• Dental care.
• Glasses and vision correction.
• Preventive examinations.
• Non-therapeutic cosmetic procedures.
• Unlisted devices and materials.
• Treatment outside Türkiye.
• Expenses above annual limits.
• Charges above the policy's recognised pricing basis.

Ask for the actual policy provision and a written reason if a claim is refused.

If authorisation or a claim is refused​

1. Ask for a written reason.
2. Request the exact clause relied on.
3. Submit a written objection with the medical evidence.
4. Keep proof of when the insurer received it.
5. If unresolved, complain to SEDDK through e-Devlet.
6. For a financial dispute, check eligibility for the Insurance Arbitration Commission. For a member insurer, first make a written application to the insurer; a final unsatisfactory response or no written response within 15 working days can allow an arbitration application, subject to the Commission's other requirements.

Common mistakes​

• Attending without checking the product's network.
• Assuming a public hospital is free under private insurance.
• Starting elective surgery before final authorisation.
• Discarding original invoices and medical records.
• Delaying notification.
• Applying a patient-share percentage to the whole bill without identifying eligible expenses.
• Assuming the outpatient limit renews at every visit.
• Relying only on reception staff's assurance without insurer confirmation.

Check the network, specialty, patient share, waiting periods and authorisation before a planned visit. The policy's percentages apply to accepted expenses; excluded services and excess charges may remain your responsibility.

A healthcare waiting area​

Related topics​

• Residence Health Insurance in Türkiye 2026: Requirements and Cover
• Verifying Residence Health Insurance in Türkiye 2026
• Residence Insurance in Türkiye 2026: Renewal, Cancellation and Refunds
• Public, Private and University Hospitals in Türkiye 2026
• Consultation Costs in Türkiye 2026: Public, Private and SGK
• Surgery and Hospital Costs in Türkiye 2026
• Follow-up Costs After Hospital Discharge in Türkiye 2026
• Emergency Care for Foreign Patients in Türkiye 2026

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