Can additional fees be charged for cancer treatment?

Guide to SGK (Social Security Institution) Legislation, Private Hospital Practices, and Fee Refund Cases

Cancer treatment is both a vital and costly healthcare service. In Turkey, the majority of cancer patients access treatment the Social Security Institution (SGK) . However, one of the most common problems encountered in practice is whether additional fees can be charged for cancer treatment and under what circumstances private hospitals can request a difference in fees from patients.

This comprehensive guide details whether additional fees can be charged for cancer treatment, when charging fees is unlawful, how to recover overcharges, and how the legal process works.

1. Is cancer treatment covered by the Social Security Institution (SGK)?

Cancer treatment is among the basic healthcare services covered by the Social Security Institution (SGK). Under general health insurance:

• Chemotherapy

• Radiotherapy

• Immunotherapy (under certain conditions)

• Operation

• Examination and imaging procedures

• Pathology examinations

• Intensive care services

is being met.

The scope and conditions of payment by the Social Security Institution (SGK) are determined by the Health Application Communiqué (SUT). Private hospitals are obliged to comply with the rules specified in the SUT for procedures included in the SUT.

2. What is the Additional Fee?

The surcharge is the difference in price that a private hospital may request from a patient in addition to the amount paid by the Social Security Institution (SGK).

However, there is an additional fee:

• It is not available for every transaction.

• It cannot exceed a certain limit.

• It is completely prohibited in some services.

Additional charges for life-saving procedures such as cancer treatment are strictly restricted.

3. Situations Where Charging Additional Fees for Cancer Treatment is Prohibited

According to the regulations, no additional fees can be charged in the following cases:

1. Intensive Care Services

No additional fees can be charged for the duration of a cancer patient's stay in intensive care.

2. Emergency Response

No additional fees can be charged for life-threatening emergency procedures.

3. Organ Transplantation and Burn Treatment

There is a ban on additional fees for organ transplants related to cancer.

4. Vital Interventions Related to Public Health

Charging high co-pays for essential treatment services in serious illnesses like cancer may be illegal.

4. Additional Fees for Chemotherapy and Radiotherapy

Chemotherapy and radiotherapy are generally covered by the Social Security Institution (SGK). However, the following problems are observed in practice:

• Charging a fee under the name of "device difference"

• Requesting "difference from oncology doctors"

• Charging a fee on the grounds of "private room requirement"

• Imposing expensive alternatives to drugs covered by the Social Security Institution (SGK)

If the transaction falls under the scope of SUT (Social Security Institution's Tariff) and the additional fee limit has been exceeded, the amount charged is unlawful.

5. Responsibility of Private Hospitals

Private hospitals contracted with SGK (Social Security Institution):

• They must comply with SGK (Social Security Institution) regulations.

• The additional fee limit cannot be exceeded.

• They cannot charge extra for prohibited services.

Otherwise:

• They are obliged to refund the overcharged amount.

• They may face administrative sanctions from the Social Security Institution (SGK).

• The contract may be terminated.

6. Package Cancer Treatment Agreements

Some private hospitals offer bundled prices under the name "cancer treatment package".

But in practice:

• Services included in the package must be billed separately

• Second collection under the name of additional examination

• Adding a fee under the name of consumables

Such practices are observed.

Unless explicitly stated otherwise in the contract, these collections are illegal.

7. Legal Nature of Unjustified Collection

Unlawful additional charges for cancer treatment:

• unjust enrichment

• Breach of contract

• Defective service

• Consumer rights violation

It can be considered as such.

The patient can request a refund of the overcharged amount.

8. How to Request a Refund?

1. Written Application

A written objection must be submitted to the hospital administration.

2. Complaint to the Social Security Institution (SGK)

An application can be made to the SGK Provincial Directorate. SGK can initiate an audit.

3. Provincial Health Directorate

An administrative review of the hospital may be requested.

4. Consumer Arbitration Board

Applications for disputes below a certain monetary limit can be made free of charge.

5th Consumer Court

Legal action will be taken for claims exceeding the monetary limit.

9. Claim for Monetary Compensation

Due to unlawful additional charges:

• Overpayment

• Borrowing

• Credit card interest

• Additional accommodation expenses

If this has occurred, monetary compensation can be claimed.

10. Is Compensation for Non-Pecuniary Damages Possible?

Cancer patients are going through a delicate and fragile process. If:

• If treatment has been delayed

• If wage pressure has been applied

• If the patient's psychology has been negatively affected

Compensation for emotional distress may be claimed.

The court will make its assessment based on the severity of the incident.

11. Criminal Liability

Illegal debt collection in cancer treatment:

• Qualified fraud

• Causing financial loss to SGK (Social Security Institution)

• Irregularities in official documents

It may constitute crimes.

A complaint can be filed with the prosecutor's office.

12. Means of Proof

• Detailed invoice

• Payment receipt

• Social Security Institution (SGK) service record

• Treatment plan

• Package deal

The court may order an expert examination.

13. Statute of Limitations

Generally:

• 2 years for consumer transactions

• Two years for tort

• Probably 10 years

However, the statute of limitations for criminal penalties differs if there is gross negligence or fraud.

14. The Court of Cassation Approach

In the practice of the Supreme Court of Appeals:

• Refund of collections made in violation of SGK (Social Security Institution) regulations

• If the additional fee limit is exceeded, the amount will be refunded

• Joint responsibility of the hospital and the physician

It appears that a decision has been made.

15. Frequently Asked Questions

Is cancer treatment completely free?

Transactions covered by SGK (Social Security Institution) are free of charge; however, additional fees may be applied in accordance with regulations.

They charged me extra for chemotherapy, can I get it back?

Yes, if the additional fee limit has been exceeded.

Was a fee charged for intensive care? Is that legal?

No, no additional fees can be charged for intensive care.

16. Conclusion: Additional charges for cancer treatment are strictly limited

Charging additional fees for cancer treatment is subject to specific rules. Specifically:

• Intensive care

• Emergency response

• Vital treatment processes

Additional charges are prohibited in areas such as these.

If the additional fee limit is exceeded or fees are charged for prohibited services, the patient:

• Refund

• Monetary compensation

• Moral compensation

• Complaint to SGK (Social Security Institution)

• Consumer lawsuit

They have rights.

To avoid losing your rights, it is important to keep the documents safe and to handle the process carefully.