Is it possible to charge a "Newborn" fee (difference/additional fee) at a private hospital contracted with SGK (Social Security Institution)?
Can a private hospital contracted with SGK (Social Security Institution) charge a "newborn" fee (difference/additional fee)? What should be done if this is discovered later?
In private hospitals, it is common practice to charge fees outside the reimbursement rules set by the Social Security Institution (SGK) under headings such as "difference," "outside of package," "incubator," "neonatal doctor fee," and "intensive care difference." Especially when it comes to newborns, the legislation's approach is clear: no additional fees can be charged for healthcare services provided to newborns.
1) Distinction between “Social Security Institution Price”, “Additional Fee (Difference)”, “Co-payment” and “Excluded Fee”
A) The amount paid by SGK (Social Security Institution's Tariff amount)
The Social Security Institution (SGK) pays contracted healthcare providers (private hospitals/foundation universities, etc.) the treatment fees specified in the appendices to the SUT ( Healthcare Services Pricing Regulation). This fee is not an out-of-pocket amount for the patient; it forms the basis of the financial relationship between the SGK and the hospital.
B) Additional fee (commonly known as the "difference")
If a private hospital has a contract with the Social Security Institution (SGK), it may charge an "additional fee" in addition to the standard SUT (Health Services Pricing Regulation) fee; however, there is an upper limit to this fee , and it is subject to prior written consent . According to the SGK's information page, the maximum additional fee can generally be set up to twice the standard fee ; furthermore, an additional fee cannot be requested later with a "justification" without obtaining the written consent of the patient/patient's relative before the service .
Most after-detection scenarios are resolved here: If there is no written consent, or if a charge has been made despite a service being deemed "non-exclusive," a refund claim is strong
C) “Exceptional health services” (up to 3 times the standard rate for certain procedures)
For some special/exceptional procedures, the ceiling three times .
This limit is not automatically applied to every procedure; it is limited to the "Exceptional Health Services" list in the SUT (Health Services Pricing Regulation).
D) Co-payment (such as examination co-payment)
The co-payment is not an additional fee; it is a separate payment item in the Social Security Institution (SGK) regulations. For example, the co-payment for outpatient examinations at 2nd and 3rd level private healthcare providers is stated as 60 TL.
In practice, private hospitals sometimes confuse the co-payment with the "difference" and show a high amount collected in a single payment; therefore, requesting a breakdown is critical.
E) Services not covered by SGK (Social Security Institution) financing
Charges for services not financed by the Social Security Institution (SGK) may not be considered "additional fees."
However, hospitals sometimes covered by SGK by presenting them as "out-of-package/optional." The nature of the service actually provided and its coverage under the SUT (Health Services Pricing Regulation) are the determining factors in this case.
2) How Much Does the Social Security Institution (SGK) Decide to Charge Private Hospitals for Newborns?
A) Who is a newborn?
The commonly accepted definition in health legislation is: infant from birth to 28 days (neonatal period).
B) Critical rule: No additional fees can be charged for healthcare services provided to newborns
The Social Security Institution's (SGK) "Healthcare Services for Which No Additional Fee Will Be Charged" page clearly states: " No additional fee can be charged for healthcare services provided to newborns . "
✅ Therefore, the clearest answer to your question is this:
A private hospital contracted with SGK (Social Security Institution) cannot charge more than 0 TL as a "difference/additional fee" for healthcare services provided to newborns.
Furthermore, intensive care services, which are frequently discussed in newborn cases, are also listed among the services for which no additional fees will be charged.
C) What if the hospital charges a fee "under other names"?
In practice, the "newborn allowance" may come in the following forms:
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"Newborn doctor/specialist evaluation fee"
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"Incubator cost"
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"The difference in neonatal intensive care"
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"Consumable/device usage fee"
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"Out-of-package newborn service"
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"Newborn admission/room fee"
The logic behind the ban on additional fees is thatthese services, if they are classified as "health services provided to newborns," should not be legally disguised by simply changing their name. In other words, circumventing the protection provided by the legislation by "changing the label" is not legally defensible in most cases.
3) You Learned Later: A Practical Roadmap to Implement Within 24 Hours
Step 1 — Gather the documents (the backbone of the return and complaint)
No application is "complete" without the following:
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Invoice/e-archive, payment receipt, credit card slip
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Hospital service breakdown (item by item)
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Signed forms: fee information/additional fee approval, admission documents, consent forms.
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If applicable , a document showing the services and additional fees required upon discharge.
According to SGK (Social Security Institution) regulations, under certain conditions, a document showing the services provided to the patient and any additional fees must be given upon discharge.
Step 2 — Written refund request to the hospital (short, clear, time-sensitive)
In your petition, write these three points together:
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The service is classified as "healthcare provided to newborns" → no additional fee can be charged.
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Any claim for an additional fee requires prior written approval ; without approval, it cannot be requested later
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Return within 7 days + otherwise, application will be made to SGK/Provincial Health Directorate/Consumer
Practical note: Hospitals often try to stall by saying it's an "internal audit." Setting a deadline and submitting the application via registered mail/email with a registration number will work.
Step 3 — Complaint to the Social Security Institution (SGK) (collection of additional fees contrary to regulations)
From the perspective of the Social Security Institution (SGK), this is a matter of breach of contract and legislation. Specifically, since the "newborn" category falls under a heading where the SGK explicitly states "no additional fees can be charged," base your complaint on this premise.
Step 4 — Provincial Health Directorate / Patient Rights / SABIM
This channel provides administrative review regarding "fees and patient rights." It is particularly effective in cases of "fees charged without information / false information provided.".
Step 5 — Consumer Arbitration Board / Consumer Court
Refund requests in most cases constitute a consumer dispute (provider-consumer relationship). For 2026 , it has been announced that applications can be made to the Consumer Arbitration Board for disputes below 186,000 TL . For claims exceeding this amount, the consumer court route becomes the option.
4) The Strongest Legal Arguments in "I Learned Later" Appeals
1) Prohibition of additional fees for newborns (direct violation of legislation)
This is the “core” argument of our title: no additional fees can be charged for healthcare services provided to newborns.
2) No additional fees can be charged later if written consent is not provided
According to the Social Security Institution (SGK), written consent is required before the service for any additional fees ; without consent, no additional fees can be requested after the procedure. This directly addresses cases of "additional charges appearing later."
3) Service breakdown/data transparency (Appendix-1/B document)
Failure to provide a breakdown of services rendered and additional charges (if applicable) upon discharge weakens the hospital's position, both in terms of proof and administrative oversight.
4) In consumer law: "unjustified charge / defective service / lack of information"
A refund is issued if the fee lacks a legal basis; consumer protection also comes into play if the information provided is insufficient. (The type of request is selected according to the specific case under this heading.)
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