Cancer treatment (chemotherapy, targeted medicine, immunotherapy) can be costly. SSI and private insurance processes are critical.
Scope of SSI
- Drugs listed in SUT
- Chemotherapy (traditional)
- Targeted drug treatments (restricted)
- Smart drugs (with special approval)
Off-label Drug
- Except for the disease for which the drug is approved. usage
- SGK rejection is common
- Objection possible - Ministry of Health approval
- "Life-saving" claim
Overseas Treatment
- Drug/method not available in Türkiye
- Overseas referral approved by SSI
- Upper limit amount
- Additional approval process is long
Private Health Insurance
- Oncology additional packages (high annual limit)
- "Pre-existing disease" exception attention
- Waiting period (usually 12 months)
Supreme Court 21st HD and 11th HD
21st. HD accepts that SSI's refusal of life-saving treatment should be evaluated within the scope of "right to life", and that rejection is limited to financial reasons. 11. HD, on the other hand, makes the "pre-existing" claim in private insurance subject to strict proof.
Practical Recommendations
- Correspond with SSI before the treatment begins
- Let the physician's reports be detailed
- Start international referral without delay
- Get lawyer support (long processes)
Health law/malpractice lawyer recommended.