The scope of supplementary health insurance is quite broad, however, some special conditions and illnesses are not covered by SSI and therefore are not covered by supplementary health insurance. In order to benefit from your TSS policy in the best way possible, it is important to know what supplementary health insurance does not cover. The answer to the question “What is not covered by supplementary health insurance?” is on our page!
What is not covered by supplemental health insurance?
Supplementary health insurance does not provide coverage for any illness or disease that is not covered by SGK. In addition, insurance companies exclude the following conditions, diseases and diseases from the scope of TSS:
- Chronic diseases existing before the policy start date
- Congenital diseases
- All kinds of spinal curvatures (such as kyphosis, scoliosis)
- Nasal septum deviation, turbinate diseases, nasal valve insufficiency
- Medicine and vaccine expenses,
- Metabolic syndrome, obesity surgery
- Conditions resulting from substance addiction
- Psychiatric and psychological disorders
- Breast augmentation, reduction and all other aesthetic surgeries
- Orthodontic and pedodontic treatments
- Treatment of refractive errors, squint, strabismus, and amblyopia
- Birth control methods, infertility treatment, abortion on demand
We mentioned above some diseases and conditions that are not covered by supplementary health insurance. You can access the list of all diseases that are not covered by supplementary health insurance from the special conditions of insurance companies . Another option is to call 0216 368 45 45 and get detailed information from our insurance consultants.
Does Supplementary Health Insurance Cover Past Illnesses?
Supplementary health insurance does not cover treatment expenses for past illnesses. However, an insurance company that provides supplementary health insurance covers expenses for past illnesses. You can find detailed information here.
What diseases are covered by Supplementary Health Insurance?
There are many coverages within the scope of supplementary health insurance. Within the scope of these coverages, the costs of treatment of many diseases are covered by the insurance company. We recommend that you read our content titled “ What Does Supplementary Health Insurance Cover? ” to learn about TSS coverage and the answers to the following questions.
- Is Supplementary Health Insurance Valid in Hospitals That Do Not Have an Agreement with SSI?
- Can I get prescription drugs with supplementary health insurance?
- Are occupational diseases and work accidents covered by the policy?
- Does supplementary health insurance cover treatments abroad?
- Does supplemental health insurance cover nose surgery?
- Does supplemental health insurance cover psychologists?
Is Supplementary Health Insurance Valid in Hospitals That Do Not Have an Agreement with SSI?
Supplementary health insurance is not valid in hospitals that do not have an SGK agreement. If you go to a doctor who provides service in a health institution or private clinic that does not accept SGK patients, supplementary health insurance cannot be used. Private health insurance is valid in hospitals and private clinics that do not have an SGK agreement.
You can immediately review the complementary health insurance coverage, complementary health insurance exclusions, special conditions, general conditions and contracted institutions of 20 insurance companies on a single screen. In this way, you can make the best health insurance choice more easily. Don’t forget to get an offer from Tamamlayicisaglik.com !
What are General Terms and Special Terms and How Do They Affect Exclusions?
General conditions are the conditions that are valid in all insurance companies and determined by the Undersecretariat of Treasury. General conditions are the conditions that include the fundamentals of the insurance contract such as the scope of the guarantee, exceptional cases, damage procedure, duties and obligations of the insured, provisions that can be applied in case of disagreement, premium payment, recourse status.
Special conditions vary from insurance company to insurance company. They are in addition to general conditions and are specific to insurance companies. Insurance companies cannot narrow down the scopes specified in general conditions, but they can include situations not specified in general conditions in their special conditions.
Special conditions should not be contrary to the mandatory provisions of the TCC and should not be against the insured. The purpose of special conditions is to meet the needs of the insured or the insured according to their interests and risks.
What are the exclusions in the General Terms?
General conditions, when it concerns the general, are also very general conditions. The following items are included in the general conditions of health insurance. Supplementary health insurance is also subject to the general conditions of health insurance.
If you become ill and/or injured in an accident during the insurance period due to the following situations, your damage will not be covered. In short, the insurance company will not pay your health damage:
- War or war-like actions, revolutions, rebellions, insurrections and internal turmoil arising from these,
- Committing a crime or attempting to commit a crime,
- Except for the case of saving persons and goods in danger, the insured person knowingly takes actions that will expose him/herself to serious danger.
- Use of drugs such as marijuana and heroin,
- Nuclear risks or the use of nuclear, biological and chemical weapons or any attack or sabotage that will lead to the release of nuclear, biological and chemical materials,
- All damages that may occur due to biological and/or chemical pollution, contamination or poisoning resulting from terrorist acts specified in the Anti-Terror Law No. 3713 and sabotage resulting from these acts or as a result of interventions made by authorized bodies to prevent these acts and reduce their effects,
- Illnesses or injuries that may occur due to the insured’s attempted suicide are not covered.
What is the Difference Between the Waiting Period and Out of Coverage Situations?
You can examine the difference between the waiting period of supplementary health insurance and non-covered situations in the image below.
Stay Healthy