Healthcare in Turkey

Healthcare is right at the top of people’s concerns when moving to - or even visiting - a new country. Will it be of a good standard? How do I access it? What will it cost? Will the doctor - and the nurses and other health workers - speak my language?

This guide should help you answer those questions. But be warned. In any country, there is a huge variation in the quality of healthcare from place to place: between rich areas and poor, and between rural areas and the city.

Healthcare in Turkey consists of a mix of public and private health services.

There are (2016) 27,954 medical institutions in Turkey, with (2017) 1.7 doctors for every 1,000 people (US 2.54, UK 2.8, France: 3.37, Germany 4.17) and (2015) 2.7 hospital beds per 1,000 people (UK 2.7, US 2.9, France 6.2, Germany 8.2). Per capita expenditure in US$ (adjusted for purchasing power parity) is the second lowest amongst OECD countries at US$1,064 in 2015 (UK $4,003, France $4,407, Germany $5,267, US $9,451).

Medical emergencies in Turkey

In the case of a medical emergency, call an ambulance (dial 112). The ambulance crew will assess your condition and, in most cases, take you to the nearest public or private hospital, as you specify. In some places, ambulance response times can be slow. Think about taking a taxi instead.

If you wish to be taken to a private hospital they will do this but will bill the hospital – and therefore you – for the trip.

In the case of tourists (and, by extension, all foreigners) they may be tempted to take you directly to a private hospital as they will assume that you are not entitled to the benefit of the state health care system.

If you wish to be taken to the public hospital, say so.

When you arrive at the hospital you will be asked for details of your health insurance or entitlement to state funded healthcare. If you cannot give immediate proof of either entitlement or insurance you will be treated as a private patient until you produce such proof. The hospital is entitled to ask for a deposit and/or a credit card imprint. This does not always happen.

Many doctors offer an emergency service for less dramatic but still urgent cases. Your doctor will give you details of their service. This might avoid the need for you to go to the hospital. It can be quicker and cheaper.

It is also commonplace for Turks to visit their pharmacy (eczane) in the case of a minor emergency. They are often capable of dealing with the problem far more quickly than the public hospital and far less expensively than a private doctor. Pharmacies can be identified by a green cross – often illuminated: very vibrant and flashing.

The state healthcare system in Turkey

Turkey provides universal health care under its Universal Health Insurance (Genel Sağlık Sigortası) system. Under this system, all residents registered with the Social Security Institution (SGK) can receive medical treatment free of charge in hospitals contracted to the SGK.

Foreigners who are legally employed in Turkey (and so contributing to the social security system) or who have a Turkish spouse are eligible for publicly funded healthcare in Turkey. Others are not.

Most foreigners with a residence permit, who live permanently in Turkey and who do not hold relevant private health insurance, must make (compulsory) monthly payments into the Turkish state scheme. For most foreigners, this entitles them to unlimited healthcare for approximately TRY270 (US$75/€67/£58) per month. This covers you, your spouse (but not an unmarried partner) and children under 18.

The state system covers most aspects of medical care, including (in some places) dental care.

Public facilities consist of a network of government-run hospitals, supplemented by privately owned clinics and health centres that have contracted to take part in the scheme.

However, in contrast to the facilities available in the private sector, state-run hospitals are still suffering the effects of poor funding, resulting in critical shortages of medical personnel as well as outdated and poorly maintained equipment. While doctors in the public sector are well-trained, treatment options can be limited due to the lack of necessary medical supplies. Many of the doctors do not speak English, and expats who cannot speak Turkish usually arrange to bring along their own translator.

As with most public hospitals in the world, public hospitals in Turkey also have to deal with overcrowding and lengthy waiting periods.

Patients pay part of the cost of drugs prescribed.

Private healthcare in Turkey

There is also a large private healthcare sector.

Private health care often offers shorter waiting lists and higher quality services than the state system.

The quality of Turkish private hospitals varies tremendously. Istanbul and Ankara have newer private facilities, with modern equipment, but they still may not be able to deal with all medical conditions. In other cities too, particularly those that are wealthy and/or have an active foreign community, there are hospitals offering very high standards of patient care. Ask locals what the hospitals are like in the area where you are going to be living.

In fact, local medical expertise, a high-quality private healthcare infrastructure, ease of access and a convenient location have resulted in Turkey becoming a ‘health tourism’ destination. It is a regional hub for health and medical services for people from Eastern Europe, the Baltic states and the Middle East. Neighbouring countries such as Syria, Iran and Azerbaijan rely on Turkey’s services for medical emergencies.

Increasing numbers of foreigners from Western Europe visit Turkey for (much cheaper) cosmetic surgery and dental work.

This will, no doubt, increase when such treatment becomes VAT-free for foreigners. This will be in March 2018.

Health insurance is widely available.

Foreigners in Turkey favour private medical treatment over public due to the higher quality of treatment available, access to internationally recognized English-speaking doctors and high overall standards within the sector. Many employers of expatriates provide supplementary private health insurance cover for their employees.

The private health insurance market is well developed. However, it can become expensive as you get older.

Many residents pay for private cover as well as contributing to the state insurance system in order to guarantee access to the best quality health services available, and to cover any extra unexpected costs or treatment not usually covered by the state.

While the cost of medical treatment is much lower than in the United States or the United Kingdom, the expat patient without the benefit of health insurance can still face considerable expense when using private facilities, especially if there are complications. It is worth repeating that the EU health card, which allows the holder to access free medical treatment in European countries, is not valid in Turkey.

Most banks and insurance companies offer various pension and health insurance packages. Insurance companies provide a list of hospitals and doctors where people insured with them are covered for treatment.

The maximum age at which a person can begin to take part in the private health sector in Turkey is 65.

In addition to the health insurance options available within Turkey, many foreigners continue to benefit from the health insurance they have previously taken out in their own country.

Healthcare preparations: what to do about healthcare in Turkey

There are no specific vaccinations required for entry into Turkey, although those coming from a yellow fever infected area should have a yellow fever certificate.

It’s also recommended to have a rabies injection, especially if travelling outside of the main urban areas, as Turkey has one of the highest incidents of rabies in Europe.

Before coming to Turkey: paperwork

This section applies, mainly, if you are moving to Turkey and may seem a little over-the-top if you are only going there on holiday. However, if you intend to visit Turkey on a regular basis these precautions may still be worthwhile: particularly if you have known health problems.

  • Visit your doctor. Obtain a copy of your medical records and have them (or, if they are huge, what your doctor considers to be the important parts) translated into Turkish
  • Ask your doctorfor a full list of all your prescription medicines, using their proper pharmaceutical names rather than any brand names. If your doctor won’t do this, in most countries there are private doctors who will
  • Get all your prescriptions topped up before you move to Turkey. Aim to arrive a with at least two (better three or six) month’s supply of all your prescription medicines. This will give you time both to settle in to sort yourself out
  • Sort out your health insurance, whether you are travelling as a tourist or going to Turkey on a permanent basis. See our Guide to Health Insurance in Turkey for more details

Upon arrival in Turkey

Register with a local doctor. Do this now, before you need one!

If you have a choice of doctors:

  • Seek a recommendation from other foreigners who live in the area. Your needs will be different from those of local people, particularly regarding the staff’s language skills
  • Choose one who speaks your language fluently. It is not a good time to be searching for a phrase book when you have chest pains!
  • Try to find one familiar with any existing medical problems you may have.

To register with a doctor, you will need to give the doctor details about you and your medical history.

You may also need to supply the doctor with two passport size photos.

Although your doctor will, no doubt, be your primary point of contact with the healthcare system, you do not need to access it all via your doctor. If you feel the need of the services of a specialist, you can approach one directly. However, the downside of doing this is that if the specialist decides that you do not need any treatment of the type they can provide, you will be charged for the assessment session. This will not happen if you are referred by your doctor.

If you have a known medical condition, and without – in any way – wanting to diminish the role of your doctor, it is also worth checking out which local specialists might be best if and when you need one. Once again, language skills weigh heavily when making this decision.

If you find no local doctor with the necessary language skills, look into the availability of translation services. Many hospitals and doctors have lists of recommended translators. If you have ongoing health problems, you could get to know your translator really well.

Treatment by your Turkish doctor

The first thing you will usually do is telephone for an appointment. A few doctors are beginning to offer an online booking service. You will, normally, receive an appointment within three days; or on the same day if you believe your condition makes seeing a doctor a matter of urgency.

The doctor’s appointment will be free of charge if you benefit from the state healthcare scheme. Otherwise you (or your insurance company) will be charged for the visit. Charges are, typically, about TRY150 (£25, €30, $40). Any charges are paid at the time of the visit. All doctors are required to accept payment by credit card.

If the doctor thinks that you need any medicines, he will prescribe them.

Proof of entitlement to ‘free’ treatment in Turkey

Every time you use the healthcare system, you will be asked for either proof of entitlement to the benefit of the state programme or proof of health insurance. It is, therefore, a very good idea to carry these at all times.

Proof of healthcare insurance takes several forms, depending upon your insurer. If you benefit from private health insurance, the doctor will usually make contact with the insurer to obtain their agreement to the treatment proposed.

If you cannot produce proof of cover by the state programme or insurance, you will be treated as a private (paying) patient. If you later produce your proof of entitlement the accounting will be undone and your ‘free’ entitlement backdated to the date your treatment started.

Paying patients may be required to pay a deposit towards the cost of treatment (usually by credit card) and to leave a credit card imprint. The deposit is, typically, €250-500. This is not always taken.

Treatment in a Turkish hospital

This will be charged for on the same basis as treatment by your doctor: either as a state (free) patient, as an insured patient or as a private (paying) patient.

Please note that, whilst the staff and the care in Turkish hospitals and clinics are excellent, the way the system operates may well be different to what you are used to.

You may see lots of relatives around other beds, helping the nurses by feeding their family member, bringing in clean pyjamas etc. This is a normal part of the Turkish system. As a result, staffing levels in hospitals – and so the level of personal care – tend to be lower than other countries.

You should try to have some such support yourself. Clearly, if you are living in Turkey and your children are in Germany or China, this can be a problem. Fortunately, a number of the local associations of foreigners offer a support service staffed by volunteers, to help people in difficulties for this reason. Incidentally, serving as a volunteer is a great and rewarding was of making new friends! Ask about availability.

The other problem you may encounter is that of language. Even if you have learned some Turkish, it is unlikely that you will have the vocabulary or fluency to converse freely and without error with the nurses, doctors and other staff. Obviously, that can be a bit of a problem!

Until a few years ago, this was a major problem. Now, if you speak English, Russian, German or (increasingly) Mandarin Chinese and live in a large city or a place frequented by foreigners, there is likely to be at least one person on duty in the hospital who speaks your language and who has been trained to help foreigners by translating.

As already started, some associations of foreign residents also provide some translation facilities.

Longer-term medical requirements

Ongoing treatment from a specialist for longer term conditions such as (say) a heart condition or diabetes is best arranged via your doctor.

It will be charged for on the same basis as treatment by your doctor: either on a free basis, as an insurance patient or as a private (paying) patient.

Obtaining medicines in Turkey

Some basic medicines – mild pain killers, cough medicines, anti-histamines etc. – can be obtained without a prescription. They can be bought at any pharmacy or from many supermarkets.

All other medicines can only be obtained from a pharmacy. Many larger supermarkets have their own pharmacy.

The price of your medicines will be heavily subsidised by the state if you benefit from the state healthcare scheme. Otherwise, you I’ll have to pay the full cost.

‘Alternative’ medicine in Turkey

Since the 2014 medical reforms, 14 alternative treatments can now be legally practiced in Turkey: acupuncture (the stimulation of points along the skin with thin needles), apitherapy (the use of honeybee products for treatment), phytotherapy (treatments based on traditional herbalism), hypnosis, leeches, homeopathy, chiropractic (massage-like treatment on the muscles, the spine and the skeleton affecting the nervous system), wet cupping, larval therapy (the introduction of live, disinfected maggots into the skin), mesotherapy (the injection of special medications into the skin), prolotherapy (the injection of irritating solutions into an injured spot to provoke regenerative tissue response), osteopathy (nonsurgical treatments of the muscle and skeleton system), ozone therapy (the introduction of ozone and oxygen mixtures into the body) and reflexology (massage-like treatment by way of pressure on reflex areas).

Only specially certified physicians and dentists can practice these treatments. Today (2017) there is only a small number of practitioners of alternative medicine in Turkey.

Most insurance policies do not cover alternative medicine.

Going ‘back home’ for treatment

Largely because of the language and care difficulties, many foreigners resident in Turkey choose to travel ‘home’ for serious, but non-emergency, treatment.

Be aware that, if you are living as a resident in Turkey, you may no longer be entitled to the use of any state subsidised facilities in your ‘home country’. If you have health insurance, you need to make sure it gives you the option of going home for treatment. Many policies do not.

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