Healthcare in Turkey: the CAK route that almost nobody knows
Turkey is a treaty country: pensioners with a Dutch statutory pension get access through the CAK to the Turkish state system SGK, for a treaty contribution — so no lifelong private policy. Whoever doesn't fall under it has the private-insurance requirement of the ikamet, the policy for the ikamet and after a year the voluntary state insurance.
5 min read
Written and checked by Auke on , against the sources at the bottom. Is something no longer right? Report it below and I'll fix it.
With a Dutch statutory pension you don't need a private policy for life in Turkey. Via the CAK you enter the Turkish state system, the SGK. You pay a treaty contribution for it with country-of-residence factor 0.0682: the factor that converts your contribution to what healthcare costs in Turkey.
That makes Turkey the exception in the list of faraway destinations. For Thailand and Indonesia the healthcare paragraph is a warning:
- no treaty;
- private insurance for life;
- age limits as a dealbreaker.
This article sets out the routes, per situation.
How does the CAK treaty route to the SGK work for pensioners?
The Netherlands has a social-security treaty with Turkey. Do you live in Turkey with a Dutch statutory pension or benefit, such as AOW (the Dutch state pension), WIA (the Dutch incapacity benefit) and relatives? Then you register with the CAK, the Dutch Central Administration Office. You receive a treaty form: the 121 form, the counterpart of the European S1. You hand that form in at the office of the Turkish social-security service SGK in your place of residence. From that moment you fall under the Turkish state system: GP, hospital and medicines at SGK-contracted providers.
For that you pay a monthly treaty contribution to the CAK. It consists of a fixed part plus an income-related part, and is withheld from your pension or benefit. Family members without income of their own can be co-insured after approval by the SGK.
And then the figure that makes this corridor special. The contribution is first calculated on your Dutch contribution income: a fixed part of € 157 per month, plus 4.85% for the Zvw (the Dutch Health Insurance Act) and 9.65% for the Wlz (the Dutch Long-term Care Act). It is then multiplied by the country-of-residence factor of your country of residence. That factor expresses how much healthcare in that country costs relative to the Netherlands. For Turkey in 2026 it stands at 0.0682.
That is one of the lowest in the whole scheme. For comparison: Germany stands at 1.0000, Spain at 0.4408, Croatia at 0.3201. In Turkey you therefore pay roughly seven per cent of what the same person would pay in Germany. For a single person with around € 26,000 in contribution income that comes down to an order of magnitude of a few tens of euros per month instead of a few hundred.
Work out your own amount with the CAK's calculator, and not with this example: tax credits and your precise income shift the outcome. What stands is the ratio: financially this is the most favourable healthcare route of all destinations outside the EU on this site.
| Component of the treaty contribution (2026) | Amount or percentage |
|---|---|
| Fixed part (nominal Zvw contribution) | € 157 per month |
| Income-related Zvw part, on AOW and other income | 4.85% |
| Income-related Wlz part, on income in the first and second bracket | 9.65% |
| Country-of-residence factor Turkey | 0.0682 (2025: 0.0623) |
| For comparison | Germany 1.0000; Spain 0.4408; Croatia 0.3201 |
| Deduction | monthly from your pension or benefit |
| CAK route on early retirement | stays open; the restriction expected from 1 November 2026 applies only in the EU, the EEA and Switzerland |
Also know what the route is not: no worldwide cover and no cover in the Netherlands. You're insured for the Turkish package, at Turkish providers. For visits to the Netherlands and travel beyond, travel cover belongs alongside it.
Leaving on early retirement before AOW age? Then in Turkey you can simply go through the CAK. From 1 November 2026, the expected start date, early retirement no longer gives new registrants a right to the CAK route, but only in the EU, the EEA and Switzerland. The CAK names Turkey explicitly as a country where early retirement, RVU and wachtgeld still give that right.
What applies to non-pensioners: the ikamet requirement and the GSS?
For the residence permit, health insurance covering the whole permit period is compulsory. A policy that meets the minimum requirements is affordable. Broader cover and higher ages quickly make it a multiple, and above seventy private insurance becomes difficult.
Much circulates about the age exception, and it exists: the frequently asked questions of Göç İdaresi, the Turkish migration authority, state that for the short-term and student permits there is no insurance obligation under 18 and over 65, and that you then pick that option in e-ikamet. It isn't on the conditions page itself. There the service names only whoever shows they pay their treatment costs and carers of at most two people. So bring a printout of that question to your appointment, and ask about a family permit: there the sponsor has to insure all family members.
The long-term route for families and remote workers is the general state insurance GSS. The social insurance act only admits foreigners to it once their residence in Turkey has completed a year. Until then no contribution is levied and you are not insured. After that, partner and children are co-insured. In the long run that is calmer than a private policy that rises with age.
What is the quality like, and how do you arrange the transition?
Turkish healthcare is readily accessible on the coast and in the cities, with private hospitals where the staff speak English. The state system works in Turkish, so count on an interpreter for the first visits.
And then the transition itself. Your Dutch basic insurance stops on deregistration, and the treaty cover or your policy only begins once the registration is complete. Cover the gap with a bridging insurance that carries medical costs in Turkey. Arrange it before you deregister, and have it join seamlessly onto the end date of your Dutch policy.
In Vertrekklaar this is phase 1 of 5 of the journey, step 1.2: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to Turkey or go straight to step 1.2 in the open plan.
What this rests on
The facts in this article come from these official pages. Rules change. When in doubt, go by the source, not this article.
- CAK — the country-of-residence factors and the structure of the treaty contribution — hetcak.nl
- CAK — living in Turkey with a Dutch pension or benefit — hetcak.nl
- CAK — treaty entitlement with a pension or benefit — hetcak.nl
- CAK — frequently asked questions on early retirement: the countries where the right remains — hetcak.nl
- Göç İdaresi — the insurance requirement for the residence permit — en.goc.gov.tr
- Göç İdaresi — frequently asked questions on the ikamet: no insurance obligation under 18 and over 65 — goc.gov.tr
- Mevzuat — law 5510 on social insurance, article 60 (GSS after a year of residence) — mevzuat.gov.tr
Read on
- BelizeOrientation4 min
Healthcare in Belize: no CAK, an NHI that only buys primary care, and your own policy
Belize is not a treaty country for healthcare: when you emigrate your Dutch basic insurance stops and there is no CAK scheme. Belize's National Health Insurance buys primary care from affiliated clinics, for $ 2 per consultation, but only for people with a valid Social Security card. A QRP member or visitor does not have one, and so arranges a policy themselves.
Updated 19 October 2026
- BoliviaOrientation4 min
Healthcare in Bolivia: the SUS from age sixty, the Cajas for employees
Bolivia gives foreigners aged sixty and over who are not insured through an employer free care in public healthcare, the SUS. Anyone working as an employee falls under short-term social security. A Dutch health insurance through the CAK does not exist there: Bolivia is not a treaty country.
Updated 16 October 2026
- BonaireArrival5 min
Healthcare on Bonaire: one hospital, and the flights are in the package
On Bonaire you are insured as a resident by operation of law — no premium, no excess. What the island cannot do, the insurance arranges with medical referrals abroad to Curaçao, Colombia or the Netherlands, including tickets and accommodation. The flip side: a dental package that is almost empty from the age of eighteen, physiotherapy of which the first twenty sessions are at your own expense, and a transition gap you have to insure yourself.
Updated 26 September 2026