[Diary of an Expat Bride] Getting covered

While my experience at state hospitals in İstanbul has not been that bad, the crowded waiting rooms and long waits can put a lot of people off and make a private hospital seem more appealing. Most doctors at private hospitals also know and speak English, which was the main reason I chose to go there instead of a state hospital for my needs. I love learning Turkish, but when it comes to my health my Turkish goes out the window and I need to have the option of communicating in English.

Anyone following the news can see that the health care system in the United States is under attack, and in my opinion, for good reason. Going to the doctor in America even with insurance is still very expensive. When I first came to Turkey and started going to a private hospital in İstanbul for my checkups, I was shocked at how inexpensive it was, despite being the most expensive hospital in the city. My checkup, without insurance, cost me TL 150, and I happily gave cash, not believing it was real. Even though at the time this was affordable for me, I eventually purchased insurance from a private insurance company once I knew I was staying in Turkey long term.

Lots of options

There are lots of options available renewable on a yearly basis, and expats need to look carefully at each package. Not every package, for example, will cover you if you choose to go to the American, German or International Hospitals in İstanbul. If you want those hospitals in your coverage, make sure they are specifically stated in your plan. Since my doctors are at those hospitals, I paid extra for that particular plan. Unfortunately, most private insurance plans I looked at offered limited traveler’s insurance for when I went to the US. The plan would cover me or reimburse me if I went to Europe, most of Asia and parts of Africa, but limited my coverage to only the first two weeks of my visit in America. Since I normally go home for about a month per year, this was something to carefully consider, as even a simple trip to the doctor in the US for a fever can run to about $500 (including medicine) without insurance. There are add-on options that I could purchase for my duration in the US, for a fee of course. My British and European friends are always stunned to hear me talk about how wonderful and cheap Turkish health care is in the private sector, as they think the opposite and don’t have the issues of purchasing additional insurance from a Turkish company to insure them on visits to their home country.

When Can and I found out we were expecting a baby, our first concern was our insurance plan. Since we hadn’t “planned” on having a baby until next year, we hadn’t added birth coverage to my plan. The hospital where my obstetrician/gynecologist practiced in İstanbul was also the most expensive hospital to give birth in, and we needed to see what our insurance company could do for us. Without telling our insurance representative that we were pregnant, we met with him to find out our options. If we added birth coverage that day, I could not (under their plan) get pregnant for five months. After that they would cover my birth, even though I had been paying the extra premium for five months. I asked the agent (as nicely as possible) if he thought I was stupid; if I got pregnant five months later, by the time our policy was up for renewal I would be seven months pregnant. They would renew our policy, most likely at twice the cost, and we would end up paying for birth insurance for two years. I am not a mathematician, but I added it up and it would cost us almost twice as much than if we paid for the birth to the hospital in cash, without insurance. What was the advantage then? I could see none. We contacted a few other companies and they had a similar, ridiculous plan. We instead talked with a representative from the hospital, who informed us about the specifics of their birth plan. I wasn’t sure if it was funny or sad that at only six weeks pregnant, we were bargaining about the future birth!

Even though Can and I chose not to add birth coverage to my existing plan, my current policy included prenatal care and visits under the existing policy. I used this for my office visits, lab work and even a few unfortunate emergency visits related to my pregnancy. My insurance covered me every time. Can and I also had the added benefit that the new company he worked for also provided both of us with private insurance from a different company. For a few months until my old insurance expired, I had double coverage. We decided to pay for the birth in cash, and set up a separate “birth fund” to save money for the big day. For us, this was the most economical option but not something that would work for everybody.