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18 yaş altı çocuklar anne ve babanın tesciline bakılmaksızın GSS kapsamında yer alıyor ve primleri devlet tarafından ödeniyor. Dolayısıyla gündemden düşmeyen konular arasında Genel Sağlık Sigortası (GSS) yer alıyor. Vatandaşlar GSS'nin kapsamını ve primlerini merak ederek sıkça araştırıyor. Genel Sağlık Sigortası hakkında merak edilen tüm bilgileri haberimizde bulabilirsiniz
KİMLER GENEL SAĞLIK SİGORTASI (GSS) GELİR TESTİ KAPSAMINDADIR? Genel Sağlık Sigortası için gelir testi yapılıyor. Gelir testinde ilk bakılan şart sosyal güvencesi olup olmadığı. Bunu belirledikten sonra prim ödeyip ödemeyeceğini karara bağlayan testtir. Genel sağlık sigortalısı ya da genel sağlık sigortalısının bakmakla yükümlü olduğu kişi statüsünde olmayanlar ile genel sağlık sigortalılığı ya da genel sağlık sigortalısının bakmakla yükümlü olduğu kişi statüsü sona eren Türk Vatandaşları için gelir tespiti yapılmaktadır.
Başvuru yapan kişinin, aynı ev içinde yaşayan eşi, bekar çocuğu ile anne ve babası GSS gelir tespiti kapsamına alınmamaktadır.
GELİR TESPİTİ BAŞVURULARI NASIL YAPILIR? Genel Sağlık Sigortası yani GSS başvuruları SYD 'ye yapılmaktadır. Kişilerin ikamet ettiği adresteki Sosyal Yardımlaşma ve Dayanışma (SYD) Vakfına giderek bizzat başvuru işlemleri alınmaktadır. Başvuru yapmak isteyen kişiler süre sınırlaması yoktur.
GENEL SAĞLIK SİGORTASI KATEGORİLERİ NELERDİR? 1 Nisan 2017 tarihinden itibaren iki kategoriye (G0, G1 olarak) indirildi.
G0: Aile içindeki kişi başına düşen gelirleri brüt asgari ücretin üçte birinin altında olduğu tespit edilenler G1: Aile içindeki kişi başına düşen gelirleri brüt asgari ücretin üçte biri ve üstünde olduğu tespit edilenlerdir.
GELİR TESTİ HANGİ DURUMLARDA YENİLENİR? Ailedeki birey sayısının değişmesi ile beraber yapılır. (Evlenme, boşanma, doğum, ölüm gibi durumlarda) Devlet tarafından primi ödenenler ve asgari ücretin 3/1'i kadar prim ödeyenlerin haneye ziyaretleri her yıl yapılmaktadır. Vatandaşın prim yönünde bir azalma ya da artma olduğunda, gelir değişikliği bildirimlerinde gelir testi yeniden yapılır. Prim borçlanması ne zaman başlar? Sorusunun yanıtı SGK'ya prim bildirimi geldiği ve kabul edildiği zaman ödeme zorunluluğu başlatılır. GSS kapsamında tescil ve tebliğ işlemleri Sosyal Güvenlik Kurumu (SGK) bünyesinde olup, en yakın SGK İl Müdürlüklerinden öğreniliyor.
GELİR TESTİNE İTİRAZ NASIL YAPILIR? Gelir tespiti kararlarına karşı itiraz için, GSS kararınca bildirim tarihinden itibaren 15 gün içinde gelir tespitinden sorumlu SYD Vakfına yazılı dilekçe ile itiraz etme hakkınız vardır. İtirazın değerlendirilmesi ise; SYD Vakfı heyeti toplanarak itirazı değerlendirir. Heyet sonucu çıkan karar SGK'ya bildirim yapılarak tescil işlemleri için SGK'dan yanıt beklenir.
2020 yılı için GSS Prim tutarı ne kadardır? Geliri brüt asgari üçte birinin üzerinde olan kişilerin ödemesi gereken prim tutarı brüt asgari ücretin %3'ü tutarındadır. Bu nedenle 2020 yılı için bu kapsamdaki kişilerin ödeyeceği prim tutarı aylık 88,29 TL'dir.