The article explains that foreign nationals staying in Türkiye for a limited period for commercial or tourism purposes may receive emergency health services, including coronavirus treatment, without delay, and that the fee will be collected after the intervention.
The article states that valid health insurance is mandatory for a residence permit and that, under Article 11 of Law No. 5684, if epidemic diseases are not expressly excluded in a private health policy, they are deemed to be included in the coverage.
The article explains that the Social Security Institution brought certain treatments and medicines within the scope of general health insurance for the duration of the pandemic, and that foreign nationals holding a residence permit may benefit from this insurance under certain conditions.
Because of the coronavirus (Covid-19) outbreak, which emerged in the city of Wuhan, China, and was declared a “Pandemic” by the World Health Organization as of March 11, 2020, many countries took measures to combat the disease. In this context, Türkiye also canceled all international flights as of 23:59 on March 27, 2020. The cancellation of flights has also adversely affected foreign nationals who have come to our country for commercial purposes, such as meetings and congresses, or for tourism.
In this article, we will examine how foreign nationals who have come to Türkiye for commercial purposes such as meetings, trade fairs or congresses, or who are in Türkiye for commercial and tourism purposes, as well as foreign nationals residing in Türkiye with a residence permit, can benefit from health services in connection with the coronavirus.
1. Can foreign nationals diagnosed with the coronavirus while in Türkiye for commercial purposes such as meetings, congresses or trade fairs, or for tourism, benefit from health services free of charge?
If the foreign national has Travel Health Insurance and the policy coverage of this insurance also includes epidemic diseases, it is possible to benefit from health services within the policy limits.
Where the foreign national does not have Travel Health Insurance, on the other hand, Article 9 of the Regulation on International Health Tourism and Tourist Health, entitled “Services Within the Scope of Tourist Health”, specifies the circumstances in which a foreign national present in our country for commercial and tourism purposes will benefit from health services.
“Foreign nationals staying in our country for a limited period for meetings, congresses, commercial or tourism purposes may benefit from the health services offered at public, university or private health institutions for illnesses that develop and emergencies that arise while they are in our country. (...) Foreign patients who apply to a health facility to receive emergency health services must be admitted, and the necessary medical intervention must be performed unconditionally and without delay. The procedures relating to the collection of the service fee are carried out after the emergency intervention and care have been provided.”
If a foreign national needs health services while staying in our country for a limited period for commercial or tourism purposes, the foreign national benefits from health services unconditionally and without delay at public, university and private health institutions and organizations. What should be understood from this is that the health services and treatment to be provided in connection with the coronavirus must also be regarded, in this context, as emergency intervention and care. The service fee will be collected from the foreign national after the emergency intervention and care have been provided.
2. Is it mandatory for foreign nationals holding a residence permit in our country to have Health Insurance?
Article 19 of the Law on Foreigners and International Protection, entitled “Residence Permit”, regulates the circumstances in which a residence permit must be obtained, by providing: “Foreigners who will stay in Türkiye longer than the period granted by a visa or visa exemption, or longer than ninety days, are required to obtain a residence permit”.
Article 22 of the Regulation on the Implementation of the Law on Foreigners and International Protection, entitled “Examination and finalization of residence permit applications”, in turn provides: “Foreigners are required to have valid health insurance covering the residence permit period they request. Those covered by general health insurance in Türkiye are deemed to have valid health insurance.” It is also clear from this that foreign nationals residing in our country under any type of residence permit must have valid health insurance. Otherwise, a residence permit is not granted, or, if the insurance of those holding a residence permit does not continue, their residence permits are canceled. That said, this insurance may be Private Health Insurance, but it may also be General Health Insurance.
3. Does the insurance policy of a foreign national with Private Health Insurance include the coronavirus (Covid-19) within its coverage?
Circular No. 16/2016 on Health Insurance to Be Taken Out in Visa and Residence Permit Applications, dated May 10, 2016, sets out the minimum requirements for the Private Health Insurance to be taken out by foreign nationals. In addition, it is possible to add further coverage to the minimum coverage that must be included in the policy. If the foreign national’s policy coverage also includes epidemic diseases, the foreign national may benefit from health services within the policy limits.
Article 11 of Insurance Law No. 5684, entitled Insurance Contracts, states: “In insurance contracts, apart from the risks included within the scope, the risks excluded from the scope are expressly specified. Risks that are not specified are deemed to be within the scope of coverage”. Accordingly, where the excluded risks are not expressly specified, it must be accepted that they fall within the scope.
The way to find out whether epidemic diseases are covered by the policy is to look at headings of the insurance policy such as “Cases Outside the Scope of the Policy” or “Standard Exclusions”. If the phrase “Epidemic diseases” appears under these headings, we can say that epidemic diseases are not covered by the policy. However, some insurance companies have stated that, although this is not within the scope of coverage, they have created very limited additional coverage for epidemic diseases as a goodwill gesture.
4. Does General Health Insurance include coverage for the coronavirus (Covid-19)?
Following the emergence of the coronavirus, the Presidency of the Social Security Institution, through decisions and communiqués published in the Official Gazette, such as the Communiqué Amending the Social Security Institution Health Implementation Communiqué and the Decision of the Health Services Pricing Commission, has brought certain health services and medicines within the scope of General Health Insurance, solely for the duration of the pandemic and only for treatments of pandemic cases.
5. Can foreign nationals take out General Health Insurance, and what are the conditions for doing so?
Foreign nationals may apply for General Health Insurance if certain conditions are met. Article 60/1-d of the Social Insurance and General Health Insurance Law, entitled “Persons deemed to be insured under general health insurance”, by providing “Of persons whose place of residence is in Türkiye, (…) subject to the principle of reciprocity also being taken into account, citizens of foreign countries who have obtained a residence permit and are not insured under the legislation of a foreign country,” states that persons who have obtained a residence permit and are not insured in any other country for any reason may apply for General Health Insurance.
Likewise, Article 52 of the same law, entitled “Voluntary insurance premiums and their payment”, by providing that “from citizens of foreign countries, no general health insurance premium is collected unless they have been resident in Türkiye for one full year, and these persons are not deemed to be insured under general health insurance”, establishes that persons who have resided in Türkiye for less than one year cannot apply for General Health Insurance.
When all of our explanations above are considered together:
1. Provided that the principle of reciprocity is taken into account,
2. Having obtained a residence permit,
3. Not being insured under the legislation of a foreign country and not having the right to benefit from health insurance,
4. Having a period of residence in Türkiye exceeding one uninterrupted year and making a request from that date onward, citizens of foreign countries will be able to benefit from general health insurance.
6. Is it possible for a foreign national with Private Health Insurance to switch to General Health Insurance?
Foreign nationals whose Private Health Insurance does not cover epidemic diseases may switch to General Health Insurance. Indeed, it would be fair to say that switching to general health insurance is very important to enable them to eliminate now any financial burdens that may arise in the future. Foreign nationals covered by General Health Insurance will be able to benefit free of charge from treatment provided for epidemic diseases. Circular No. 16/2016 on Health Insurance to Be Taken Out in Visa and Residence Permit Applications, dated May 10, 2016, also provides that if the foreign national switches to General Health Insurance, it will be possible for them to terminate their Private Health Insurance and request a refund of the premium calculated on a daily basis.
7. Can persons holding a student residence permit apply for General Health Insurance?
However, Article 60 of the Social Insurance and General Health Insurance Law, entitled “Persons deemed to be insured under general health insurance”, imposes a 3-month time limit for persons holding a student residence permit to apply for General Health Insurance. If no application is made within this period, the provisions on general health insurance cannot be applied to these persons for the duration of their studies.
“Foreign students studying in our country, without the conditions in subparagraph (d) of the first paragraph and in the second sentence of the second paragraph of Article 52 being required, become insured under general health insurance if they make a request within three months from the date of their first registration. The provisions on general health insurance do not apply, for the duration of their studies, to those who do not make a request within this period”
8. Can the dependents of foreign nationals covered by general health insurance also benefit from health services?
The following relatives of foreign nationals, excluding those studying abroad, residing in Türkiye and not insured under the legislation of our country or of another country
1. Spouses,
2. Children under the age of 18,
3. Unmarried children under the age of 20, if they are in high school or equivalent education,
4. Unmarried children under the age of 25, if they are in higher education,
5. Unmarried children of any age who have been determined to be disabled,
6. Mother and father whose maintenance is determined, according to the criteria set by the Institution, to be provided by the foreign national, may benefit from health services.
This extraordinary situation will also bring many legal disputes to the fore. In order to avoid any loss of rights throughout all these processes, it will be in the parties’ interest to obtain legal support from a lawyer.
Att. Taha Hüseyin Çebi
Trainee Certified Public Accountant Cem Atakan Loç
This article is a general assessment prepared in accordance with the legislation in force on its date of publication; it does not constitute a legal opinion. This English text is a translation of the Turkish original; in case of any discrepancy, the Turkish version prevails.