Guide
Home care and medical devices
For a patient cared for at home: the state’s home health care service, SGK payment for devices and preparing for power outages. Simple safety and an emergency plan for the home.
The Ministry of Health’s home health care service
For a homebound patient, treatment and care are given at home by state teams.
Who can use it?
Under the regulation, a home health patient is a person who is dependent on a device, a bed or the home because of a diagnosed disease. A person who has difficulty reaching health services because of old age also falls under this definition. The person or their family must request it, and the request must be found appropriate. The service covers examination, treatment, medical care, rehabilitation and monitoring. The rule is in Article 4 of the Evde Sağlık ve Palyatif Bakım Hizmetlerinin Sunumu ve Koordinasyonuna İlişkin Yönetmelik (Regulation on the Provision and Coordination of Home Health and Palliative Care Services).
How to apply?
The patient or their legal representative applies. You can apply through e-Nabız (the Ministry of Health’s personal health record system), by calling the Ministry’s contact center (ESHİM) or in person. The family doctor can also apply. ESHİM can be reached between 08:00 and 22:00. On the websites of Ministry hospitals, this line’s number is given as 444 38 33.
- Have the patient’s ID details and address ready.
- Keep your reports and discharge summary close at hand.
- Apply through e-Nabız or by calling 444 38 33.
Source: Evde Sağlık ve Palyatif Bakım Yönetmeliği, md. 14 ve md. 15 · Sağlık Bakanlığı – Bolu İzzet Baysal FTR Hastanesi: Evde Sağlık İletişim Merkezi 444 38 33
What happens after you apply?
The application first goes to the family doctor. The family doctor makes a preliminary assessment within one working day. The coordination center at the provincial health directorate (ESKOM) concludes the application within three days at the latest. The first home visit is also made within this time. The responsible doctor joins the first visit. The doctor decides whether the patient is a home health patient.
Source: Evde Sağlık ve Palyatif Bakım Yönetmeliği, md. 15 ve md. 16
What does the team do at home?
The service can be ongoing or for a set period. A set-period service lasts up to thirty days after discharge. If the doctor considers it appropriate, it is extended by another thirty days. The team gives you a visit plan. The family is trained in care and in the medical devices used at home. If needed, a pharmacist joins the team and reviews the medicines.
When does the service end, and where can you complain?
The service ends when the patient dies, when the doctor finds it is no longer needed, or when the patient or an authorized relative asks for it to end. Each province has an executive committee. This committee reviews complaints from patients and their relatives. Requests that were not approved and objections are also decided here. The home care allowance is a separate benefit; it is explained in the “Rights and support” guide.
Source: Evde Sağlık ve Palyatif Bakım Yönetmeliği, md. 6 ve md. 17 · Aile ve Sosyal Hizmetler Bakanlığı – Evde bakım yardımı SSS
Oxygen, respiratory devices and home ventilators
These devices are provided on a health board report, on condition that they are returned to SGK (Social Security Institution).
Which devices are provided on a return basis?
Article 3.3.6 of the SUT (Health Implementation Communiqué) lists these devices. They are respiratory support devices used with a mask, home oxygen devices, home ventilators and powered wheelchairs. An uninterruptible power supply for a home ventilator is also on the list. These devices are given to you in return for a signed undertaking. When you no longer need them, they are returned to SGK.
How to apply?
First, a health board report is obtained. The report states that an application to SGK is needed for the device. You apply with the report and prescription to the Sosyal Güvenlik İl Müdürlüğü (Provincial Social Security Directorate). This application must be made within 10 working days of the prescription date. SGK first checks its own stock. If there is no device in stock and SGK approves, the cost of the device you buy is paid. The cost of a device bought without approval is not paid.
- Get the health board report and prescription.
- Apply to the provincial directorate within 10 working days.
- If there is no device in stock, wait for SGK approval before buying the device.
Report for home oxygen
The oxygen report is issued by a board that includes a specialist from certain fields. For children, this specialist is a pediatric pulmonologist or a pediatric neurologist. The report states the diagnosis, the type of device, the oxygen flow and how many hours a day it will be used. A blood gas result is attached to the report. SGK pays for oxygen cylinders, oxygen concentrators and portable oxygen devices. There are extra conditions for a portable device. The patient must not be bedridden and must be working or attending school.
Source: SUT, md. 3.3.6.B
Mask devices for long-term respiratory failure
In long-term respiratory failure, SGK pays only for certain bilevel pressure devices. The report must include at least one pulmonologist, neurologist, anesthesiologist, intensive care specialist or pediatric pulmonologist. These doctors also prescribe the device. The report states the type of device and accessories such as the mask. This is covered in Article 3.3.6.A-2 of the SUT.
Source: SUT, md. 3.3.6.A-2
Consumables and report validity
For supplies used continuously, the report is usually valid for at most 2 years. Prescriptions are written for at most 2 months’ supply. A new prescription can be written up to 15 days before the supply runs out. Suction catheters and incontinence pads are among the report-tracked supplies.
Wheelchairs, orthoses and prostheses
These aids are paid for according to the lists in the SUT annex and their usage period (miat).
Usage period (miat) and renewal
Orthoses, prostheses and similar aids are on the EK-3/C lists in the SUT annex. Aids not on the list are not paid for, except for the exceptions in the SUT. These aids are not renewed before the miat period ends. But if one breaks without misuse and cannot be repaired, it can be renewed early with a report. The renewal report must state the old aid and the reason for renewal.
For growing children
Because a child grows, an aid may no longer fit. If this is shown with a medical report, the aid can be renewed before its period ends. The rule is in Article 3.1.2 of the SUT, ninth paragraph, subparagraph (a). At check-ups, you can ask your doctor whether the aid still fits.
Source: SUT, md. 3.1.2 (9) a
Custom-made orthoses and prostheses
Custom-made aids are paid for if they are obtained from centers licensed by the Ministry of Health. There must be no more than 4 months between the report date and applying to the center. For ready-made aids, there must be no more than 2 months between the report and the invoice.
Source: SUT, md. 3.1.2 (4), md. 3.1.2.1 (1) ve md. 3.1.2.2 (6)
If it is lost or breaks
If an aid paid for by SGK is lost or stolen, a new one is not paid for until the miat period ends. During the warranty period, contact the seller for maintenance and repair. After the warranty ends, contact the relevant SGK unit. The cost of a fault caused by not following the usage rules is not paid.
Source: SUT, md. 3.1.2 (7) ve (8)
Device care and a backup plan
Maintenance and a backup plan help make sure the device works every day.
User manual and phone list
Read the device manual and keep it at hand. Clean the device as the manufacturer instructs. If there is no manual, ask your health team. Write down the phone numbers of your doctor, the home health team and the device company in one place. Also note the device’s model and serial number.
Source: FDA – Frequently Asked Questions About Home Use Devices
If the device breaks: a backup device
For some devices that SGK takes back, the SUT sets a backup device rule. If the device is under warranty, the seller provides a free backup device until the repair is finished. If the warranty has ended, the SGK unit provides a backup from stock. If there is none in stock, the company doing the repair provides a free backup. You can ask the provincial directorate whether your device is covered.
Source: SUT, md. 3.1.2 (8) b
Batteries and backup power
Find out from the manual or the company whether the device can run on batteries or a generator. Keep the batteries and backup power source charged. Have spare batteries and a charger. Do not plug in a wet cable or a wet device. When the power comes back, check the device settings. After an outage, the device may return to its default settings.
Source: FDA – Tips about Medical Devices and Natural Disasters · CDC – Prepare Your Health: Power Sources
Generators and carbon monoxide
Generator exhaust gives off carbon monoxide. This gas has no smell and can kill. Do not run a generator inside the home, in a basement or in a garage. This rule applies even if doors and windows are open. Do not run it next to an open window either. A battery-powered carbon monoxide detector is useful.
Source: FDA – Tips about Medical Devices and Natural Disasters · CDC – Prepare Your Health: Power Sources
Power outages and notifying the distribution company
People who use life-support devices can register with the electricity distribution company.
Registering with the distribution company
There is a special rule for people dependent on electrically powered life-support devices, such as a respiratory device or a dialysis unit. A person with the supporting document applies to the distribution company in writing. The company registers the household. The rule is in Article 52 of the Elektrik Piyasası Tüketici Hizmetleri Yönetmeliği (Electricity Market Consumer Services Regulation).
- Get a valid medical report from your doctor.
- Apply in writing to the electricity distribution company in your area.
- Give them a phone number or other way to reach you.
Source: Elektrik Piyasası Tüketici Hizmetleri Yönetmeliği, md. 52 (1)
Notice before an outage
If a planned outage is coming, the distribution company notifies these people first. In an unplanned outage, it also provides information about the situation. Notice is given through the contact method the person has chosen. So it is important that your phone number is up to date. Even if you get notice, keep your own backup plan ready for outages.
Source: Elektrik Piyasası Tüketici Hizmetleri Yönetmeliği, md. 52 (5) ve (6)
Power is not cut off because of debt
The electricity of a person who has submitted a valid medical report is not cut off because of unpaid ordinary consumption bills. Payment in installments can be requested for the debt. The installment period is at most four months. The distribution company warns you at least 20 days before the report expires. You must submit a new report within 30 days after the report expires.
Source: Elektrik Piyasası Tüketici Hizmetleri Yönetmeliği, md. 52 (2)–(4)
Where is the fault line number?
Distribution companies must run a call center open 24 hours a day. The number to call for faults and emergencies is on your electricity bill. Save this number next to the device and in your phone. EPDK (Energy Market Regulatory Authority) is not a fault line; for faults, call the distribution company.
Source: Elektrik Piyasası Tüketici Hizmetleri Yönetmeliği, md. 54 (2) · EPDK – Elektrik Piyasası Sıkça Sorulan Sorular
Preventing infection and staying safe at home
Clean hands and simple safety rules reduce risk at home.
Handwashing
Wash your hands with soap and water for at least 20 seconds. Wash them before and after cleaning a wound. Wash them while preparing food and before eating. Wash them after using the toilet and after changing a diaper. If soap and water are not available, a hand sanitizer with at least 60 percent alcohol can be used.
Source: CDC – About Handwashing
Fire risk in a home where oxygen is used
Oxygen makes fire burn much faster. No one should smoke in a room with oxygen. Keep oxygen about 2 meters away from cooktops, stoves, candles and heaters. Keep oil- or alcohol-based products away from oxygen. Have a working smoke detector and a fire extinguisher at home.
Source: MedlinePlus – Oxygen safety
Care with a tracheostomy
A tracheostomy is an opening made in the neck for breathing. Always have a spare tube (cannula) with you. If there is fever, redness, swelling or discharge from the opening, call your doctor. Thick mucus that does not come out with suctioning and shortness of breath should also be reported to the doctor. If the tube comes out and cannot be put back, call 112.
Source: MedlinePlus – Tracheostomy care
Emergency plan at home
Writing down in advance what to do in an emergency saves time.
When to call 112?
112 is the single emergency number in Türkiye. Health, police and fire lines are combined in this number. If a home health patient has an emergency, emergency medical services step in. The home health team is not an emergency team. If there is a threat to life, call 112 without waiting.
Source: İçişleri Bakanlığı – 112 Acil Çağrı Merkezleri Projesi · Evde Sağlık ve Palyatif Bakım Yönetmeliği, md. 16 (16)
A written emergency plan
Write a list of the devices at home. Add the numbers of the doctor, the home health unit, the electricity fault line and the fire department. Write down how to use each device in short steps. Share this note with family, neighbors or people who will help you. You can also fill in the emergency card on the disease page and carry it with you.
Source: FDA – Tips about Medical Devices and Natural Disasters · FDA – Frequently Asked Questions About Home Use Devices
For a long outage or a disaster
Think in advance about what you will do if the power is off for a long time. Find out how many hours your device runs on battery. If needed, decide on a place you can go. You can discuss this with your doctor and home health team. Do not reuse single-use supplies; if you run short, contact the health team.
Source: FDA – Tips about Medical Devices and Natural Disasters · CDC – Prepare Your Health: Power Sources
Questions to ask your doctor
You can print this list, take it to your appointment and note the answers below each question.
- Is our patient eligible for home health care? Will you apply, or should we?
- How often will the home health team visit us? Can we get the visit plan?
- Which hospital, with which specialists, can issue the health board report for the device?
- Are the device type, settings and accessories written correctly in the report?
- How many hours does the device run on battery? What should we do during an outage?
- If the device breaks, where can we get a backup device and how quickly?
- As our child grows, when should the orthosis or wheelchair be renewed?
- Which report can we give to the distribution company?
- For which symptoms should we call you, and for which should we call 112?
- What should we pay special attention to at home to reduce the risk of infection?
This guide is for information only and does not replace medical or legal advice. If you notice missing or incorrect information, please write to us.