Personal Insurance

TSS: Complementary Health Insurance for SGK Members

For active SGK members and retirees — covers the difference between what SGK pays and what private hospitals charge. Private hospital care without out-of-pocket top-up fees.

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What is TSS Complementary Health Insurance?

Tamamlayıcı Sağlık Sigortası (TSS) fills the gap between what the state SGK (Social Security Institution) pays and what private hospitals actually charge — the top-up fee and co-payments. When you visit a contracted private hospital, SGK pays its portion, and TSS pays the difference directly to the hospital. You pay nothing.

How it differs from private health insurance: Private health insurance is independent of SGK; anyone can take it out. TSS complements SGK and cannot function without it — it is available only to active SGK members, dependants, and retirees.

Core requirement: You must be an active SGK insured person, a registered dependant, or an SGK retiree. Without SGK coverage, TSS is not available — in that case, private health insurance is the appropriate alternative.

Coverage

What TSS covers

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Private hospital top-up fee

The difference between SGK's tariff and the private hospital's actual charge at contracted facilities.

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Co-payments

Co-payments for SGK-covered medications and medical supplies.

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Diagnostic co-payment

Partially-covered SGK tests — the patient's share of the diagnostic fee.

What TSS does NOT cover

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Non-SGK individuals

TSS cannot be purchased by anyone without SGK coverage; private health insurance is needed instead.

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Dental and vision

Dental and vision treatments outside SGK scope are generally excluded from TSS as well.

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Cosmetic procedures

Aesthetic treatments without medical necessity are excluded.

TSS or private health? If you have SGK, TSS is usually more cost-effective. If you have no SGK, private health insurance is the right solution. We can compare both for your specific situation.

Group TSS: Employers can arrange Group TSS for their employees — typically broader coverage and lower premiums than individual TSS. If your employer doesn't offer it, individual TSS is your next best option.

Exclusions

Note: The following are typically excluded from standard policies. Always read the policy wording carefully.

  • Individuals without SGK coverage
  • Treatments outside SGK scope
  • Pre-existing chronic conditions (waiting period or exclusion may apply depending on the policy)
  • Cosmetic and aesthetic procedures
  • Dental and vision (generally excluded; policy-dependent)

Who is it for?

  • Private-sector employees (4A/SSK): To access private hospitals without top-up fees.
  • SGK retirees: Eliminate private hospital top-up costs on a pension income.
  • Self-employed (Bağ-Kur / 4B) members: Freelancers and tradespeople with SGK coverage.
  • Civil servants (4C/Emekli Sandığı): Government employees and public retirees.

Frequently asked questions

What is the fundamental difference between TSS and private health insurance?
TSS complements existing SGK coverage — SGK membership is required. Private health insurance operates entirely independently of SGK. With SGK, TSS is often more cost-effective; without SGK, private health insurance is your option.
Can SGK retirees get TSS?
Yes. SGK retirees are eligible for TSS in the same way as active insured members. TSS can significantly reduce the top-up fees that erode a fixed pension income.
Does TSS work at all private hospitals?
Coverage depends on the insurer's contracted hospital network. We review the hospitals available in your city when recommending a policy.
What is the difference between Group TSS and individual TSS?
Group TSS is arranged by an employer for all employees — often broader coverage at lower premiums. Individual TSS is purchased directly by the individual. If your employer doesn't offer group TSS, individual TSS is the next step.
What do I need to qualify for TSS?
Active SGK registration or retiree status. A health declaration is required before signing. Some policies have waiting periods for specific conditions.