3S Health Insurance System

3S Health Insurance

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3S Private Health Insurance

Life is certainly is full of beauty and opportunities! But the medical risks around can sometimes prevent us from enjoying these beautiful moments. To boot, they often crop up at the most inconvenient of times from a financial point of view. Wouldn’t it be great to ensure you and your loved ones have some security against these risks?

Thanks to the 3S Health Insurance System designed to meet any requirements and budget constraints, you can do away with any economic concerns you might have when it comes to medical problems, and protect yourself and your loved ones.
Visit our nearest agency and get 3S Health Insurance to start enjoying the security we offer.

You can contact our sales channels for detailed information.

*If health comes first, our wide network of medical institutions comes a close second.

Frequently Asked Questions

What is a health insurance policy?

Health insurances are those insurance products that make your life easier by providing assurance according to your chosen coverage against unexpected sudden health problems that can arise. You can get support from our nearest agency about any questions you may have with respect to health insurance coverage.

Can I choose my own plan/program?

You can develop your own plan by choosing in-patient and out-patient coverage depending on your needs. You can get additional out-patient treatment coverage catered to you, however you cannot choose out-patient treatment coverage as a stand-alone option.

What should I take into account when filling out the application form?

You should read the medical application forms carefully and fill them out completely. Any questions left unanswered on the application form will be considered as a “NO” response. Furthermore, leaving any question or section unanswered can delay the issuance of your policy, or prevent your application from being considered. You should answer the questions in the application form with statements about any past and present complaints and conditions, even if no doctors were consulted and no treatment was received for them. Any matters that you know are significant in terms of assessing the covered risk should be specified during the application, even if we don’t ask about them in the application form. If any changes occur after making the contract, you must report these to the insurer.

What is In-Patient Treatment Coverage and which treatment expenses does it cover?

The In-Patient Treatment Coverage provides assurances for hospital stays related to internal medicine and/or surgery, emergency medical cases that may be life-threatening for the Insured and small interventions, subject to the special and general terms of insurance, provided that such are required on a medical basis and are justified in detail by the doctor, in his or her report.
If the Insured receives in-patient treatment at a hospital the following costs shall be considered for coverage and paid for in accordance with the Special and General Terms of Insurance, in line with the coverage limit and contribution rates specified on the certificate;

Daily room charges (up to the charges for a standard single-room)
Food and attendant charges
Doctor fees
Medicines
Operating room
Surgeon
Anaesthetist
Nurse (up to standard nursing fees)
Intensive care
Expenses for any kind of consumables
Chemotherapy
Radiotherapy
Dialysis
Coronary angiography
Kidney stone treatment (ESWL)

Physical therapy related to a condition within the scope of the coverage (having commenced during the hospital stay or within 3 months of it)

What is Out-Patient Treatment Coverage and which treatment expenses does it cover?

Out-Patient Treatment Coverage is not offered as a stand-alone option, but can be received alongside In-Patient Treatment Coverage.
It covers the following treatment expenses:

Medical examination
Prescribed medicine
Diagnostic tests (radiology, laboratory, etc.)
Modern diagnosis (MRI, BT, etc.)
Physical therapy and rehabilitation

How are claims submitted under the insurance agreement reviewed and the payable figure established?

The claims figure arising under the Insurance Agreement will be taken into consideration with reference to the following.
Exceptions Review: The claim will be reviewed with respect to the exclusions stated on the Insurance Agreement as well as the special exclusions, if any, introduced by the Insurer, to see if any such exclusion applies to the present case.
Service Level Review: The special exclusions, restrictions, limits, co-pay or minimum deductible limits applicable in the policy will be taken into consideration through this review.
Service type, Territory and Contracted Institution Review: The Insurer’s liability is based on the type of service, inherent emergency, territory and the type and contracted status of the service provider. The Plan/Program attached to the policy specifies all the countries where the coverage is valid and the borders of that coverage. The amount remaining once the co-payment and/or deductibles are taken from the expenses made for the medical services received from a specific provider in a given Territory, reflects the amount the Insurer is required to cover.
Overall Minimum Deductible Review: Any Overall Minimum Deductible amounts will be deducted from the Admissible Expenses identified through the previous reviews.
Overall Limit Review: Admissible Expenses identified through the previous reviews will be paid up to the overall limit.

How do I become entitled to lifelong renewal guarantee?

Provided that you have maintained insurance in a given plan for a continuous period of 3 years, received insurance coverage before the age of 55, and had a loss ratio of less than 80% in the last three years, you will be entitled to consideration for “Guarantee for Renewal without a New Risk Assessment”.

What is the waiting period?

This is the waiting period required before certain conditions can be covered by the insurance. The waiting periods apply only in the first year of the policy and will cease to be applicable for renewal.

What is an exclusion?

Exclusions are those cases detailed in the Special and General Terms of the Policy and left outside the scope of coverage provided by your policy.

How can I make premium payments?

You can make your premium payments in cash, with a credit card, by bank transfer or by cheque.

Can the Insurance Holder take leave for military service?

A policyholder who is conscripted into the military cannot benefit from the rights conferred in the Medical Insurance. This is why the insured should leave the Medical Insurance policy when he is conscripted and a portion of the premium he paid will be returned, on a pro-rata basis.

Will the treatments received at a non-contracted institution be covered?

Should you choose to receive your treatment at a non-contracted medical provider, upon submitting the applicable documents and invoice to us, your expenses will be taken into consideration subject to your payment rate, special and general terms of the policy, and the coverage and limits specified on your certificate.

What is the pre-authorization process for in-patient treatment procedures?

Pre-authorizations received for treatments provided at contracted medical providers shall stand for 7 days. A new pre-authorization will be required for any procedures that were not performed during the said time frame. MAPFRE GENEL SİGORTA A.Ş. is entitled to refuse any procedures that have not been executed within 7 days and for which a new pre-authorization has not been obtained.
In all hospital admittances for which a pre-authorization has been received, the Insurer’s renewed authorization will be required on the 11th day, to enable the coverage of the relevant expenses incurred after the 10th day.

How long will it take to issue reimbursement for my claims?

Provided that there are no missing documents and that the cost incurred is covered by the special and general terms of the policy, the payments are sent to your account within a maximum of 5 working days.

World of Privileges

Receive services at our contracted clinics, without any contribution payments, subject to your limits!

If you visit one of our over 600 contracted doctors specialized in their relevant fields, you can get medical examination services without co-payment, subject to your policy limits.
You can check the current list of our contracted doctors by clicking here.
* You can review the general and special terms of your policy and your coverage table to see if this privilege is included in your policy or not.

Insurance without contribution fee requirement for blood analyses and imaging procedures!

With just a single phone call you can receive the services of Biruni Laboratories, Gelişim Medical Laboratories, Medilab and Synevo at your home/workplace for any blood analyses requested by your doctor, without paying co-payment and subject to your policy limits. You can also keep your claims use rates under control thanks to our affordable rate deals.
For appointments with Biruni Laboratories: 444 18 64
For appointments with Medilab: 444 29 75
For appointments with Gelişim Medical Laboratories: 0 216 349 51 51 – 0 212 231 49 67
For Synevo Laboratory: 444 6 522 (Istanbul) – 0 232 422 38 25 (İzmir) – 0 312 386 30 71 Ext: 4501 (Ankara)
* This service is offered in Istanbul, Ankara and İzmir provinces.
* Imaging services are provided by Medilab only.
** Appointments can be made six days a week (excluding Sundays) between 08:30-18:30 on a weekday or 08:30-14:00 on a Saturday.
*** Calls should be made 24 hours in advance and an appointment should be received to make use of the service.
**** You can review the general and special terms of your policy and your coverage table to see if the privilege is included in your policy or not.

Ambulance Service

MAPFRE SİGORTA Medical Claims Processing Center is at your service 7 days a week, 24 hours a day. All you have to do is call 0 850 755 0 755 – 0 from anywhere in Turkey.
This service arranges the dispatch of an ambulance and/or doctor’s visit at home in case of emergencies. In non-urgent cases, we provide the insured with Medical Counsel services, offering important recommendations.
Emergency: These are cases requiring emergency medical intervention within the first 24 hours following a sudden illness, accident, injury, or similar incidents, where life and/or medical integrity would be considered at risk in case of failure to provide urgent medical intervention or the patient’s referral to another medical provider.
* You can review the general and special terms of your policy and your coverage table to see if this privilege is included in your policy or not.

Nursing at Home Service

MAPFRE Sigorta’s Nursing at Home Service is offered to patients requiring treatment in their own home. The service covers the provision of affordable medical services by trained and experienced medical staff at the residence or location of the patient or his or her family.
Nursing at Home Services cover a wide range of solutions from the provision of nursing care at home, to medical device or bed rental, and even to respiratory treatments at home.
The following services and advantages are offered within the framework of Nursing at Home Services:
•   Home doctor
•   Home nurse
•   Home rehabilitation
•   Medical device at home
•   Intensive care at home
•   Medical training at home
After the Medical Claims Processing Center approves the necessity of treatment and care at home we cover any expenses that may arise and we also offer the option to make the necessary arrangements.
* You can review the general and special terms of your policy and your coverage table to see if this privilege is included in your policy or not.

Check-Up Service

We offer a check-up package to anyone who uses the 3S Medical Insurance System product.
The Customer Services Department makes extensive check-up arrangements, taking into account risks which vary with age and gender, at institutions specified by MAPFRE GENEL SİGORTA.
* You can review the general and special terms of your policy and your coverage table to see if this privilege is included in your policy or not.

Newborn Nursing Service

We provide newborn nursing services to our insured customers who have given birth at contracted providers in Istanbul, Ankara, İzmir, Kocaeli, Bursa, Adana and Antalya provinces, through our cooperation with Aileden Biri Care-at-Home Center.
* You can review the general and special terms of your policy and your coverage table to see if this privilege is included in your policy or not.

Relevant Documents

Information and documents you may need with respect to the product you are interested in are provided below. Should you have any questions, you can get even more detailed information by contacting our nearest agency.

General Terms of Health Insurance
Special Terms of 3S Health Insurance
Special Terms of 3S Group Health Insurance
Informatıon Form For 3S Health Insurance
Informatıon Form For 3S Group Health Insurance