Expat insurance and health insurance in Turkey

Since the 2006 overhaul law no. 5510, the SGK (Sosyal Güvenlik Kurumu) has been the sole institution of the Turkish scheme, born from the merger of the former employee, self-employed and civil servant funds. It rests on three pillars: universal health insurance (Genel Sağlık Sigortası), social insurance (sickness, maternity, workplace accidents, old age) and unemployment insurance, reserved for employees. Outpatient and hospital care, medicines, vaccines and prosthetics are covered, with limited co-payments (around 20 to 50 Turkish lira per consultation) and an exemption for hospitalisations, life-threatening emergencies, chronic illnesses and workplace accidents. An employee must show at least 30 days of contributions over 12 months to open their rights (60 days for a self-employed person). For a foreign resident with no local employment, access to the SGK is neither automatic nor immediate: the large majority of French nationals settled in Turkey, particularly in Istanbul, in practice rely on private health insurance, the only realistic option for the first year.

• Short tourist stay (under 90 days in 180): no visa, no insurance legally required on entry, but France Diplomatie strongly recommends cover for medical costs, hospitalisation and repatriation — health costs can be high and are never covered by the embassy.
• Residence permit (ikamet), for nearly all purposes: mandatory health insurance covering the whole requested duration, under law no. 6458 on foreigners and international protection (article 15). An application filed without a compliant insurance policy is refused by the Directorate General of Migration Management (Göç İdaresi). Two options: SGK affiliation (subject to eligibility) or private Turkish health insurance meeting the requirements set by circular — in practice the only route for most profiles in their first year of stay.
• Employee hired locally: mandatory SGK affiliation from the signing of the contract, employer and employee contributions.
• Seconded employee (assignment ≤ 3 years, beyond that an exceptional agreement between the two administrations): remains affiliated to the French scheme on presentation of forms SE 208-01 and SE 208-02.
• Student : mandatory insurance within 3 months of university enrolment, via the university (student SGK) or private insurance — terms to check case by case with the institution.
• Residence of more than a year without affiliation: a one-month period is granted to register with the SGK; beyond that, a fine equivalent to one month of Turkish minimum wage applies, according to information from the French embassy in Ankara.

No fixed penalty for a simple tourist stay without insurance, but an incomplete ikamet application is automatically refused, and private clinics frequently require a payment guarantee before a scheduled hospitalisation.

The general France-Turkey social security agreement of 20 January 1972 (in force since 1 August 1973) coordinates health-maternity, workplace accidents and occupational diseases, old age-disability and family benefits — unemployment insurance is excluded.

Key point of caution: unlike the EHIC between EU member states, the agreement only provides for cover during a tourist stay for Turkish nationals insured in France, via forms SE 208-06 I and SE 208-06 II. A French national on holiday in Turkey does not benefit from this mechanism: they must take out standard travel insurance, and absent that can only hope for after-the-fact reimbursement from their French fund, on presentation of invoices and at French rates — never cover on the ground.

• Seconded employee: stays on the French scheme with no SGK contribution, forms SE 208-01 (secondment certificate) and SE 208-02 (extension).
• Retiree holding a French pension: can benefit from in-kind benefits of the Turkish scheme via the SGK fund of their place of residence, based on form SE 208-08 sent by the Turkish fund to the French fund, which validates the rights. No certificate is issued before departure: the process only starts once on the ground.
• The agreement covers neither unemployment, nor a tourist stay by a non-Turkish French national, nor most dental and optical care.

• Before any stay, even tourist: take out travel insurance covering medical costs, hospitalisation and repatriation — the France-Turkey agreement covers nothing on the ground for a French national on holiday.
• Seconded employee: request forms SE 208-01 and, if an extension is needed, SE 208-02 from Urssaf or the French fund before departure.
• Before any ikamet application (online appointment via e-ikamet): take out compliant private health insurance or check SGK eligibility, original policy to be presented at the appointment.
• Employee hired locally: SGK affiliation initiated by the employer from the signing of the contract.
• Retiree settling long-term: once on the ground, go to the SGK fund of the place of residence to start the form SE 208-08 process.
• Residence of more than a year: SGK registration within the month following settling, on pain of a fine equivalent to one month of Turkish minimum wage.
• Within 6 months: register with the roll of French nationals living abroad (Istanbul or Ankara consular district depending on place of residence).