With the growth of health tourism, the length of stay of foreign nationals coming to Türkiye for the purpose of treatment frequently exceeds the period allowed by the visa. In that situation, the instrument that preserves the foreign national’s legal status is the residence permit for medical treatment, a sub-type of the short-term permits. In practice this permit is also referred to as the “residence permit for treatment purposes”.
The grant of the permit is subject to two conditions together: satisfaction of the substantive requirements listed in the Act and the complete performance of the procedural steps. A refusal decision is frequently seen in files where the ground for the treatment and its programme cannot be established by documents.
In this briefing note we assess the definition of the permit, the technical flow of the application, the conditions and the set of documents required, the legal position of accompanying persons, the term of the permit, the extension application and the legal remedies that may be pursued against adverse decisions.
Definition of the Residence Permit for Medical Treatment
This permit is the type of permit for which foreign nationals coming to Türkiye for the purpose of receiving treatment may apply, and by its legal nature it falls among the short-term residence permits.
How Is the Application Made?
The permit is obtained by completing the preliminary application form through the e-residence system and by attending the provincial directorate of migration management in person, with the necessary documents, on the day of the appointment.
When the preliminary application form is completed, the short-term residence permit is selected as the type of permit and, in the section for the ground, the option “those who will receive treatment” is marked. Once the information requested by the system has been entered, the form is completed and printed out, and the name and surname are written at the foot of it and it is signed. That signed form is at the same time among the documents to be placed in the application file.
Following completion of the form, the system notifies the applicant of an appointment day and of the directorate of migration management at which the application is to be made. The foreign national must be present, together with the file of documents, at the relevant provincial directorate of migration management on the date determined. The contents of the file are explained in detail below.
The process has a multi-stage structure extending from the preliminary application to the preparation of the documents and, in the event of refusal, to the objection and the action for annulment. An error made at any of these stages directly affects both the outcome and the length of the process.
Conditions Required for the Permit to Be Granted
The conditions required are regulated in Article 32 of the Law on Foreigners and International Protection No. 6458 under the heading “Conditions for a short-term residence permit”.
Within that framework, the following conditions are required:
- To make the request asserting that treatment is to be received and to submit the information and documents supporting the request (a doctor’s report diagnosing the illness or a hospital reservation are examples of such documents)
- That the illness to be treated is not among the illnesses that threaten public health
- To have accommodation conforming to general health and safety standards
- Not to be in the position of an inadmissible passenger (persons holding no passport or visa, those in respect of whom it is established that these documents were obtained by deception or are forged, and those against whom a deportation decision has been made fall within this scope; no residence permit whatsoever is issued to such persons)
- To produce, where requested, a criminal record or an equivalent official document
- To notify the address details at which the person will stay in Türkiye
Among the conditions listed, two are decisive as regards this type of permit: the submission of documents establishing that the ground for the stay is treatment, and the fact that the treatment is to be carried out on an inpatient basis and over a lengthy period. Files that do not clearly establish the purpose and the programme of the treatment are for the most part refused.
The way is not closed to foreign nationals who do not satisfy these conditions; it is open to them to apply for a different type of permit. Our study entitled “residence permit”, in which all types of permit are addressed, will provide guidance in this respect.
Documents to Be Placed in the Application File
The papers that must be present in the file for this type are set out below:
- A printout of the application form completed through the e-residence website (with the name and surname written at the foot of it and signed)
- The document obtained from the hospital evidencing the record of admission to the hospital and the commencement of the treatment
- The document issued by the chief physician of the hospital where the treatment is to be carried out and by the physician undertaking the treatment, showing how long the treatment will last
- A receipt showing that the treatment costs have been paid in full; an insurance policy covering those costs; or, where the costs are borne by the state, a document to that effect
- The original passport and a photocopy of it
- A receipt or bank slip showing that the residence permit fees have been paid
- A document relating to the place where the patient will stay: a notarised lease agreement if the stay is in rented accommodation, the title deed record if the stay is in the person’s own home, or a letter to that effect if the stay is at the hospital
- 4 biometric photographs
- A certificate of residence
Some of these documents are obtained from the applicant’s own country. Papers obtained abroad must bear an apostille and must be submitted together with a notarised Turkish translation. Where a deficiency or an error is found in the file, the administration allows the applicant a certain period to complete it; if the deficiency is not remedied within that period, the application is refused.
The documentary burden is eased at two points. If the foreign national evidences that he or she has paid all of the costs, an insurance policy is not additionally required. Nor is a policy or a document establishing financial means requested from persons whose costs arising over the course of the treatment are to be met by public institutions.
Legal Position of Accompanying Persons
There is no valid type of permit under the name “accompanying person residence permit” in the legislation. That said, there are certain possibilities available to a foreign national who wishes to accompany a foreign patient.
The first step should be to investigate whether a health cooperation agreement has been concluded between our country and the country of which the accompanying person is a national. If the agreement provides for an exemption, the accompanying person may be present in Türkiye without a residence permit being required.
The second route is to apply for the other types of permit. If the person who is to accompany the patient is the patient’s spouse or child, he or she may apply for a family residence permit; where no such tie exists, an application may be made for a short-term residence permit. Naturally, the accompanying person must also satisfy the conditions of the permit for which he or she applies.
The legislation also contains a concession in favour of accompanying persons. Under Additional Article 14 of the Fundamental Act on Health Services No. 3359, no health insurance requirement is imposed on the accompanying person of a foreign national holding a residence permit for medical treatment when the latter applies for a residence permit.
For How Many Years Is the Permit Granted?
Since the permit for medical treatment is a type of short-term permit, it is issued for a maximum of 2 years. However, it is in no circumstances possible for the term of the permit to exceed the duration of the treatment. The report obtained from the hospital shows the approximate duration of the treatment; the permit too is determined according to that duration, subject to the two-year upper limit.
Where the treatment is not completed within two years and the foreign national wishes to continue treatment in Türkiye after that period as well, two options arise. If the conditions for the permit have not fallen away, an extension application may be made; alternatively, a transfer to another type of permit may be requested. The details of the transfer application are explained in our study entitled “residence permit transfer application”.
How Long Does the Application Take to Be Concluded?
In practice the permit is issued within approximately 30 days. That period may vary according to the workload of the provincial directorate of migration management to which the application is made. As regards the statutory upper limit, applications are concluded within 90 days.
It is possible for the foreign national to travel abroad while the application is at the assessment stage; for that purpose, notification must be given to the provincial directorate of migration management. However, the foreign national must return to Türkiye within 15 days; otherwise the permit is not granted.
Fees and Costs
The costs relating to the permit for medical treatment stand at approximately TRY 8,000 as regards 2023. Since health insurance is obtained from private companies, the amount of that item varies. Moreover, since insurance is not required where all of the treatment costs have been met, that expense is not taken into account.
Extension of the Permit
The extension procedure is subject to the same provisions as the extension of other residence permits. For the permit to be extended, the conditions for the application must continue to exist. In addition, it is examined whether the permit has been used otherwise than for the purpose for which it was granted.
If the conditions persist, the extension application may be made 60 days before the expiry of the permit and must in any event be completed before the term expires. For example, where a one-year permit for medical treatment was obtained on 12.05.2023, the extension application may be made between 12.03.2023 and 12.05.2023.
Following the application, the system determines an appointment day and time; the necessary documents are submitted in person to the provincial directorate of migration management on that date. The documents requested consist of papers showing that the conditions for the permit continue to be met, and they overlap with the documents requested on the initial application. In addition to those, the existing permit document for medical treatment and a report from the chief physician showing that the treatment is continuing are also added to the file.
Where a foreign national whose permit has expired has made an extension application, a document is issued to him or her so that he or she may remain in Türkiye until the request is concluded. By contrast, a different result arises for a foreign national who has made no request for extension or transfer: he or she must leave the country within 10 days beginning from the moment the term of the permit expires.
All the details relating to the extension application are addressed in our study entitled “residence permit extension”.
Refusal of the Application, Cancellation of the Permit and Non-Extension
These three outcomes arise from a deficiency in the conditions. If there is a deficiency in the conditions from the outset, the permit ought not to be granted at all. Where the deficiency is noticed subsequently or arises subsequently, the permit is not extended or is cancelled. In addition, use of the permit for medical treatment must begin within 6 months; otherwise the permit is cancelled.
The decision to refuse, to cancel or not to meet the extension request is notified to the foreign national. Where the administration leaves the application unanswered for 90 days, the result is an implied refusal. The periods for the objection and for the action for annulment begin to run, in the case of an express refusal, on the day following notification and, in the case of an implied refusal, on the day following the 90th day.
Objection and Action for Annulment
Where the application is refused, the permit is cancelled or it is not extended, the foreign national may object to those decisions and may equally bring an action for annulment. The period for both routes is 60 days.
The period is calculated, in cases of express refusal, from the day following notification of the decision and, in cases of implied refusal, from the day following the 90-day period for a decision. The authority for the objection is the governorship to which the provincial directorate of migration management that took the decision is attached. Where the objection is refused or left unanswered, the foreign national may bring an action for annulment before the administrative court. It is also possible to omit the objection stage and proceed directly to litigation.
Detailed information on the legal remedies that may be pursued in cases of refusal and cancellation is set out in our studies entitled “refusal of a residence permit application” and “cancellation of a residence permit”.
Independent Legal Assessment
Although the residence permit for medical treatment is a sub-type of the short-term permits, it differs markedly from the others in terms of its conditions. The centre of gravity of the file is the medical documents establishing the existence and the programme of the treatment; the quality of those documents most often determines the outcome directly.
Where there is a deficiency in the documents or in the conditions, refusal of the application arises. The practical consequence of that is not merely the failure to obtain the permit; grave consequences may also follow, such as a deportation decision being taken against the foreign national and the ongoing treatment being left unfinished. For that reason, constructing the file correctly at the first application is more effective than any legal step taken afterwards.
In a concrete application, the following headings should be given priority:
- Obtaining in full the document signed by the chief physician and the treating physician showing the duration and the scope of the treatment programme
- Determining which of the policy, the receipt or the public institution document is to be submitted, according to the manner in which the treatment costs are met
- Satisfying the requirement of an apostille and a notarised translation for papers obtained abroad
- Structuring the request accordingly, bearing in mind that the term of the permit cannot exceed the duration of the treatment
- Beginning to use the permit within 6 months of its issue and not departing from the purpose of the permit
- Calculating the 60-day period in the event of refusal or cancellation, having regard to the distinction between express and implied refusal
- Assessing at the outset, as regards the accompanying person, the options of a health cooperation agreement or of an alternative type of permit
Independent Legal provides advisory services and conducts litigation in the field of immigration law in the preparation of applications for residence permits for medical treatment, in the pursuit of extension requests and in the follow-up of actions to be brought against adverse decisions.