Can private hospitals charge for infants aged 0-28 days (newborns)? If so, what should be done?

1) Why is “0–28 days” important? (Definition of newborn)

In medicine, a newborn (neonate) is considered to be the first 28 days after birth . Therefore, when "0-28 day old baby" is mentioned, it usually refers to the "newborn" concept as defined in the legislation.

2) First, let's clarify the concepts: "Wage" is not always the same thing

You may encounter different charges in private hospitals:

• Healthcare services covered by SGK (Social Security Institution) + “additional fee/difference”: This is an additional fee charged by private hospitals contracted with SGK, on ​​top of the amount paid by SGK. The basis for this additional fee is Article 73 of Law No. 5510, and its details are regulated in the SUT (Healthcare Services Pricing Regulation).

• Fees for services not financed by SGK (Social Security Institution): A fee requested for a service not paid for by SGK may not be considered an "additional fee" in SGK terminology.

• Hotel/comfort services (single rooms, etc.): These are items regulated separately in the SUT (Health Services Pricing Regulation) and have specific conditions.

• Services covered by private health insurance: Additional fees may apply within the framework of the insurance policy + hospital contract.

Making this distinction correctly clarifies the question of whether an illegal fee was charged or whether an out-of-scope service was sold.

3) Basic rule in private hospitals contracted with SGK (Social Security Institution): No "additional fee" can be charged for newborns

The Social Security Institution (SGK) has a clear list in both its SUT (Health Services Pricing Regulation) text and its official notifications. This list includes:

• Intensive care services

• It is stated that no additional fees can be charged for healthcare services provided to newborns .
  

In the SUT (Health Services Pricing Regulation), the relevant provision is listed under the heading "Health services for which no additional fee will be charged"; "d) Health services provided to newborns" is explicitly stated.

Practical conclusion:
If a baby is covered by the Social Security Institution (SGK) and the private hospital consulted a contract/protocol with SGK , charging a "difference/additional fee" for SGK-covered healthcare services provided to the newborn is, as a rule, against the law.

Note: As a rule, no additional fees can be charged for "emergency room" visits; a limited exception, such as "green zone examination," is separately indicated in the SUT (Health Services Pricing Regulation).

4) “Is there absolutely no fee?” — ​​The most common exceptions/misconceptions

In practice, the point that most confuses families is this: "no additional charges" rule does not always mean "0 TL". The fee discussion differs in the following scenarios:

A) If the hospital is not contracted with SGK (Social Security Institution) (or if the relevant department/unit is not included in the contract)

Some hospitals may only have contracts with the Social Security Institution (SGK) for specific specialties. In Supreme Court rulings, whether a service falls within the scope of the contract is considered critical; the possibility of the hospital charging for services outside the contract arises.

What should you do?
Request written answers to the following questions from the hospital:

1. "Do you have a contract with SGK (Social Security Institution)?"

2. "Is the neonatal/neonatal intensive care unit included in your contract?"

3. "What is the authorization/tracking information received regarding whether this service can be invoiced to the Social Security Institution (SGK)?"

B) If a transaction/service has been sold for which the Social Security Institution (SGK) does not provide financing

Institution (SGK) also states that "fees charged for health services not financed by the Institution are not considered additional charges." In this case, the discussion shifts from "prohibition of additional charges" informed consent, price notification, and consumer law .

C) If there is no written consent/informed information

Even in the Social Security Institution's own statement, written consent is required before the transaction ; no additional fee can be requested afterwards without written consent. 
This principle becomes a very strong argument in consumer law regarding claims of "sale of services outside the scope": prior clear price + information + free will.

5) Step-by-step roadmap if payment has been received (or an invoice has been issued)

Step 1 — Gather documents (the most critical step)

You absolutely must demand/protect the following:

• Detailed invoice / receipt / POS slip

• Epicrisis, admission-discharge documents

• The "service record" provided by the hospital

• If possible, Annex-1/B document (SGK requires that the patient be provided with a document showing the services provided and any additional fees, if applicable) in certain cases).

Step 2 — Submit a written refund/appeal request to the hospital

With a short, clear petition:

• what components the fee consists of,

• If it was purchased for a newborn, whether this is an "additional charge"

• whether or not it was invoiced to SGK (Social Security Institution),

• your return request
  in writing.

Procedure suggestion: Using email + hospital registration number + recipient's signature/stamp (or KEP - electronic mail system) strengthens proof.

Step 3 — Complaint/Application to SGK (Social Security Institution)

the issue concerns "additional fees/differences" charged at a private hospital contracted with the Social Security Institution (SGK) , applying to the SGK is very effective. The SGK clearly defines the additional fee regime and rules; it also publishes a list of "services for which no additional fees will be charged". 
Include invoices and treatment documents in your application; specifically state that it is a "newborn service".

Step 4 — Provincial Health Directorate / Patient Rights / SABIM–CIMER

Simultaneously:

• Hospital's Patient Rights Unit

• Provincial Health Directorate

• SABİM/CİMER
  channels. (These methods are particularly useful in cases of allegations of "fees being charged without prior notification.")

Step 5 — Refund via Consumer Arbitration Board / Consumer Court

The private hospital-patient relationship is in most cases considered a consumer transaction/service . Your refund request will be subject to a monetary limit:

• Consumer Arbitration Board (under the limit)

• the Consumer Court (above borders)
  .

Here, the court/panel typically examines the following questions:

• Is the fee charged in accordance with SUT/SGK regulations?

• Was written consent and information provided?

• Is the invoice/service statement transparent?

6) Principles from Supreme Court precedents

(1) Emphasis on “commitment/consent obtained in difficult circumstances” and incomplete investigation

The Supreme Court's General Assembly of Civil Law, in its decision regarding disputes over additional fees, effective oversight ; and that the claim of an "undertaking obtained under duress" cannot be ignored. 
In practice , the debate over free will and informed consent is strong in forms signed during "urgent-mandatory" moments such as childbirth/intensive care.

(2) Courts review compliance with SUT according to the specific period

In a decision by the 3rd Civil Chamber of the Supreme Court of Appeals, the compliance of the collected additional fee with the relevant SUT (Health Services Pricing Regulation) provisions for the period in question was evaluated; if found compliant, the case could be dismissed or upheld. In practice , instead of adopting the approach that "every fee is definitely unfair," it is necessary to proceed item by item and according to the SUT provisions for each period .

(3) Possibility of "charging in the unit outside the scope of the contract"

In the summaries of Supreme Court decisions, the question of whether neonatal intensive care services fall within the scope of the relevant contract and whether the hospital should be considered a "non-contractual provider" has been debated; in some specific cases, it has been observed that it is possible for the hospital to bill the patient for services outside the contract. 
In practice: the question of whether there is an agreement with the Social Security Institution (SGK) is not sufficient; "which units/branches are included in the contract?" .

7) Quick checklist

The following mini checklist determines the outcome in most cases:

1. the baby is covered by SGK (Social Security Institution) → has the pre-authorization been received?

2. Is the hospital contracted with SGK (Social Security Institution )?

3. Does the invoice include an item like " additional charge/surcharge "?

4. the service neonatal/intensive care ? (Among those for which no additional fee can be charged according to SUT)

5. Is written consent and price notification provided before the procedure ?

6. Has Annex-1/B (service + additional fee breakdown) been provided?

In private hospitals covered by or contracted with the Social Security Institution (SGK) , no "additional fees/differences" are charged for healthcare services provided to newborns (0-28 days old) . However, in practice, factors such as the scope of the contract, whether the service is financed by SGK, and written consent before the procedure can alter the outcome.

This text is for general informational purposes only; in a specific case, an evaluation should be made by examining the invoice items, provision, and contract scope.