As of 2013, anyone with SGK can now receive treatment at any time and at any quality they want, without paying a private hospital difference fee, with complementary health insurance; a person who goes to a private hospital with complementary health insurance can leave the hospital by paying only a 15 TL co-payment fee.
We will provide information about supplementary health insurance, but first, if you wish, let’s briefly talk about the SSI contribution fee and the difference fee you pay in private hospitals.
What is the Social Security Institution Participation Share?
SGK Participation Share refers to the amount to be paid by the general health insurance holder or his/her dependants during the examination process in order to benefit from health services, as stipulated in the Social Insurance and General Health Insurance Law No. 5510.
When you are examined in health institutions such as family physicians, state hospitals, university hospitals, private hospitals, etc., an additional 15 TL co-payment fee is charged to you in addition to the expenses and difference fee covered by the SGK.
What is the Social Security Institution Differential Fee?
If you are examined at a private hospital that has an agreement with SGK, a certain portion of your expenses will be covered by SGK. You will pay the remaining examination fee from SGK out of your own pocket. This requested amount is called SGK difference fee. For example; you went to a gynecologist in a private hospital to be examined. Let’s say the examination fee is 1000 TL. SGK will pay 340 TL to the hospital for this examination. You must pay the remaining payment to the hospital yourself. In other words, the amount you pay out of your own pocket constitutes the SGK difference fee.
Does SSI Cover Private Hospital Expenses?
SGK covers a portion of private hospital fees. As mentioned above, you pay the remaining amount from the portion paid by SGK to the hospital. If you do not want to pay the difference fee when you go to a private hospital, complementary health insurance can pay the difference fee to the hospital on your behalf! In this way, you can receive health services from Medical Park, Medipol, Medicana and other SGK contracted private hospitals.
All you need to do is to get complementary health insurance from insurance companies such as Allianz Insurance, Axa Insurance, Anadolu Insurance. You can get an offer and see the prices immediately by filling out the form below.
How Much is Private Hospital SSI Differential Fee?
In the table below, you can examine the amount paid by SGK to the hospital according to the branch examined. To examine other branches and current amounts, you can visit the “Additional Fee Calculation” page on the official SGK website.
| Polyclinics | Amount Paid by SSI to the Hospital | Maximum Additional Fee Amount That Can Be Charged | Maximum Additional Fee Rate (%) |
|---|---|---|---|
| Gynecology and Obstetrics | 102.30 TL | 204.60 TL | 200% |
| Urology | 89.10 TL | 178.20 TL | 200% |
| Cardiology | 112.20 TL | 224.40 TL | 200% |
| Eye Diseases | 80.30 TL | 160.60 TL | 200% |
| Ear Nose Throat | 82.50 TL | 165.00 TL | 200% |
| General Surgery | 95.70 TL | 191.40 TL | 200% |
| Medical Oncology | 93.50 TL | 187.00 TL | 200% |
Table Date: 25.10.2023 – Table showing SGK difference fees. You can examine all health institutions in Turkey in detail at https://gss.sgk.gov.tr/SaglikHizmetSunuculari/.
What You Need to Know to Avoid Paying Social Security Difference Fee
Does Supplementary Health Insurance Pay the Difference Fee?
Yes, TSS pays the SGK difference fee.
Who Does Not Pay Extra Fees Due to Supplementary Health Insurance?
Anyone between the ages of 0-80 who is a SSI member can get a supplementary health insurance and not pay the SSI difference fee.
For which procedures does Supplementary Health Insurance pay the difference fee?
It pays the difference fee for inpatient and outpatient treatment expenses. You can review all the details in our article titled “ What Does Supplementary Health Insurance Cover? ”
In Which Private Hospitals Are There No Extra Fees to Pay Using Supplementary Health Insurance?
You can avoid paying a difference fee by using complementary health insurance in many private hospitals that the insurance company and SGK have agreements with. You can access the entire list of private hospitals on our ” Contracted Healthcare Institutions ” page.
Can I get supplementary health insurance for my family?
Yes, it is possible. You can review the details in our article titled “ What You Need to Know When Getting Family Supplementary Health Insurance ”.
Stay healthy.