Surgery and Inpatient Treatment: A Step-by-Step Guide for Policyholders

When your doctor recommends surgery or a hospital stay, your health is naturally the first thing on your mind and insurance comes second. Yet sorting out the insurance side in advance reduces uncertainty during your stay and lowers the chance of an unexpected bill at discharge. This guide explains how to manage planned surgery or an admission as a policyholder in Türkiye. Medical decisions always belong to your doctor; we cover only the insurance side. It can be helpful to think of the process in four stages: preparation, admission, discharge and aftercare.

Before surgery: preparation

1. Read your policy: Check the scope of inpatient cover, any co-payment, room type and companion (refakatçi) conditions.
2. Confirm the hospital: Check that the hospital, and if possible the surgeon, are within your contracted network. Sometimes the hospital is contracted but the surgeon’s fees are assessed differently.
3. Start pre-approval: Ask the hospital’s insurance desk to send the approval (provizyon) request, with a complete doctor’s report and test results.
4. Wait for the reply: Fix the surgery date only after the insurer has responded.
5. Ask about items not covered: Find out whether any amount will be charged to you.

Example: a planned knee operation

A policyholder whose doctor recommends a planned knee operation calls us before agreeing a date. Reading the policy together, we see that inpatient cover is comprehensive but companion costs are not included. The hospital is contracted; the surgeon’s fees are checked separately with the insurance desk. The approval request goes with the doctor’s report and imaging; the insurer asks when the complaint began and approves once that is supplied. The date is then fixed, and at discharge the policyholder pays only the items they already knew about. That is the value of preparation: surprises are dealt with before surgery, not at the desk.

Admission and your hospital stay

On the day of admission bring your ID (for foreign residents, your residence permit card showing your foreign identity number) and any approval details, and confirm at admissions that the approval is recorded.

• Room type: If you ask for a different room from the one your policy covers, you may pay the difference.
• Companion: Whether companion costs are covered depends on the policy.
• Personal spending: Phone, extra food and similar items are generally not covered.
• Unplanned procedures: If a new test or procedure is needed, the hospital may request a separate approval.

At discharge

Discharge is where the insurance process closes. The hospital sends the total cost to the insurer, the insurer pays under the policy conditions and any balance is charged to you.

• If you are charged an amount, ask which item it relates to.
• Take a copy of the discharge summary (epikriz).
• Ask for a copy of the invoice and itemised statement.
• If you need follow-up visits, physiotherapy or medication, ask which cover applies.

If the amount differs from what you expected, you can ask the insurance desk for the insurer’s payment notice and the reason for any deduction, often a co-payment, limit or item outside cover. If anything remains unclear, share the documents with your agency.

After surgery

Follow-up visits, medication and physiotherapy after discharge are often assessed under outpatient cover rather than inpatient cover. If your policy is inpatient-only, some of these costs may be yours. Some policies link tests in a period before and after admission to the inpatient claim; this depends entirely on the policy. If you have complementary insurance, see our guide on using complementary health insurance at the hospital.

Emergency surgery and how we help

In an emergency there is no preparation stage; hospitals usually treat first and handle approval afterwards. Make sure family members can easily find your policy details and the insurer’s helpline, and ask them to collect the discharge summary, invoice and itemised statement. If the emergency admission was at a non-contracted hospital, these documents will be decisive for reimbursement.

Ailenizin Sigortacısı has worked in insurance since 1996. Before planned surgery we can read your policy with you and help with approval delays or questions after discharge. For policies with strong inpatient cover, see our Maslak health insurance page.

To review your policy before surgery, call +90 530 375 89 61 or message us on WhatsApp. English-speaking support is available.