Installment Payment Options with Credit Cards, Cash Discounts, and Special Offers at Private Hospitals

1. Introduction: Is Healthcare a "Payment Facilitation" or a Debt Trap?

Private hospitals have become an important part of the healthcare system, especially in large cities.
From outpatient examinations to emergency operations, from childbirth to cosmetic procedures, we encounter phrases like these in many services:

• “Credit card installments up to 12 months”
• “20% discount for cash payments”
• “Special interest-free installment plan campaign with partner banks”
• “Buy 3, pay for 2 on check-up packages!”

For patients and their families, such payment options certainly seem attractive when dealing with high healthcare costs. However, healthcare is both a vital need and a commercial service. This directly leads us the Consumer Protection Law(Law No. 6502).

In this article, regarding private hospitals:

• Installment payments via credit card
• Cash payment discount,
• Bank/hospital promotions

We will discuss the risks that such practices pose from a consumer law perspective , what rights you have , and how you can file a complaint, in detail and in a language that everyone can understand

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2. Payment in Private Hospitals and the Framework of "Consumer Transaction"

2.1. Are private hospitals covered by the Turkish Health Insurance Law?

Articles 1 and 2 of Law No. 6502 clearly emphasize that it covers all types of consumer transactions and practices directed at consumers , and that the purpose of the law is to protect the health, safety , and economic interests of consumers

Private hospitals:

• They provide healthcare services for professional/commercial purposes
• A patient is a consumer who.

In legal doctrine and practice, a "hospital admission contract" with a private hospital is considered a consumer transaction within the meaning of the Consumer Protection Law

Indeed, the 13th Civil Chamber of the Supreme Court of Appeals has ruled that the competent court in compensation cases arising from malpractice in private hospitals is the consumer court (Supreme Court of Appeals, 13th Civil Chamber, Case No. 2016/18107, Decision No. 2018/3804)

What does this mean?

• Healthcare services provided in private hospitals are considered a "service" within the scope of the Turkish Healthcare Law.
• Practices such as fees, installments, campaigns, and discounts are also subject to consumer law.

2.2. Hospital admission agreement and defective service aspect

The relationship with patients admitted to private hospitals is often based on:

• Service (agency) contract(for a general definition of service contracts, see: https://ferhatkule.av.tr/genel-hizmet-sozlesmesi/)
• Sometimes, it also has a mixed structure that includes elements of a contract for work . (See: https://ferhatkule.av.tr/eser-sozlesmesi-turk-hukukunda-kapsami-unsurlari-ve-uygulamadaki-onemi/ )

Articles 13-16 of Law No. 6502 introduce specific provisions regarding "defective services"; healthcare services can also be evaluated within this framework to the extent that their nature permits.

Since this article focuses on consumer risks in pricing and payment methods , not medical malpractice, the issue of defective service will only be addressed in the following way:

• Lack of information,
• Misleading campaigns,
• Excessive and unfair payment

We will address these topics under various headings.

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3. Installment Payments via Credit Card: Legal Nature and Limitations

3.1. BDDK's installment payment restrictions and healthcare expenditures

In Turkey, the general framework regarding credit card installments is defined by the Bank Cards and Credit Cards Law and the regulations of the Banking Regulation and Supervision Agency (BDDK) . The BDDK's published decisions and tables specify the maximum number of installments for various product and service groups .

In the regulations made in recent years;

• It has been stated that the general installment limit for health and social services can be extended from 9 months to 12 months .

So, in a private hospital:

• The phrase "12 installments" comply with banking regulations .
• Otherwise, the hospital and bank's actions violate the limits set by the Banking Regulation and Supervision Agency (BDDK) .

From the patient's perspective, increasing the number of installments means an increase in the total debt and interest burden

3.2. Installment sale or consumer loan?

Law No. 6502 regulates "installment sales" and "consumer credit" separately:

• Installment sales (Articles 17–19): Sales contracts in which part or all of the price is paid in installments
  
• Consumer credit (Articles 22 et seq.):
  Credit provided by a bank or financial institution to a consumer.

Payment in installments via credit card a consumer loan . According to Article 22 of Law No. 6502: if the payment is deferred or spread over a period longer than three months, the credit card transaction may be considered a consumer loan agreement.

Why is this distinction important?

Because when it comes to consumer credit:

• Right of withdrawal,
• Pre-contractual information obligation,
• Clearly stating the total cost,
• The contract shall be established in writing or via a durable data storage medium

Additional protections such as these come into play.

For example:

A private hospital is charging 60,000 TL for surgery.
They offer "12 installments with a partner bank card, at the cash price." If
the patient isn't adequately informed about the credit agreement with the bank, including interest rates, processing fees, insurance, etc., then the hospital's obligation to properly inform the consumer becomes seriously questionable.

3.3. The linked credit relationship and the bank's responsibility

In many campaigns:

• The hospital is making an agreement with a specific bank,
• "X Bank cards offer payment convenience with up to 9 installments," the advertisement says.

The definition of tied credit in Article 30 of Law No. 6502 comes into play when there is an economic link between a consumer loan and the purchase of a specific good or service

Economic union is considered acceptable, especially in the following cases:

• The hospital is arranging the loan itself;
• The bank prepares the loan agreement through the hospital's system;
• The loan agreement explicitly the name of the hospital and the services received .

In this situation:

• In cases where treatment is not given at all, is given incompletely/incorrectly, or is cancelled;
• Consumers can file claims not only against the hospital but also against the bank

In tied loan agreements, if the consumer cancels the contract or requests a reduction in the amount, the loan must be terminated or reduced proportionally.

Therefore, promotional credit card agreements offered by private hospitals often create additional responsibilities in favor of the consumer; however, in practice, patients are often unaware.

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4. Cash Payment Discount, "Installment Payment at Cash Price" and Interest Charges

4.1. Price tags and transparency obligations

According to Law No. 6502, price tags and clear, understandable information for consumers are mandatory.

Common practices in private hospitals:

• "List price 50,000 TL, 20% discount for cash payment"
• "40,000 TL for cash payment, 50,000 TL in 12 installments with credit card"
• "12 installments at cash price" (with hidden fees, commissions, and interest added)

What is legally important here is:

1. What is the base price?
   • The hospital must first display the regular list price, then the discounted cash price, and finally the installment price, all separately and transparently
2. Is the interest rate difference clearly stated?
   • Interest may be charged on installment sales; however, the rate of this interest and its impact on the total cost must be clearly explained.
3. Is "installment payment at cash price" actually a valid option?
   • If separate charges (e.g., "card commission," "installment fee") are added to the price to cover the commission paid to the bank when making installment payments with a credit card, the phrase "cash price" may constitute misleading advertising

4.2. Discussion regarding excessive interest rate differences and unfair terms

Articles 4-5 of Law No. 6502 regulate unfair terms in consumer contracts . Terms that are detrimental to the consumer, clearly contrary to the principle of good faith, and not subject to contract negotiation are not binding .

Example:

• Cash price is 40,000 TL
• The price with 12 installments is 70,000 TL
• There is no interest rate or explanation for the 30,000 TL difference .

In this situation:

• Interest charges exorbitant .
• If the hospital says, "Either you pay upfront or you accept these terms," ​​and doesn't offer any opportunity for negotiation,
• If the contract clearly puts the consumer at a disadvantage,

The installment price difference an unfair term . In such a case, consumer courts consider the exorbitant interest rate invalid and order a reasonable reduction; proof and expert examination become important in each specific case.

4.3. Is it permissible to say, "Discounts are only available for cash payments, not for card payments"?

Commonly encountered in practice:

• "You will receive a 15% discount if you pay in cash; the list price applies if you pay by credit card."

Here's the principle:

• Offering a discount for upfront payment is not, in itself, illegal.
• However, if the discount rate is set so high that credit card use is effectively penalized, the argument may arise that the consumer's freedom of choice is restricted and an imbalance is created
  

Also, in the price listings:

• Only the "20% cash discount" is highlighted,
• If the true base price and installment cost are concealed for payments other than cash,

This deceptive advertising and unfair trade practices .

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5. Private Hospital Campaigns, Packages, and Commercial Advertising Rules

5.1. Check-up, maternity, and cosmetic packages

Many private hospitals:

• "Maternity package",
• “Check-up packages”,
• “Cosmetic surgery campaigns”,
• "Dental implant + zirconium packages"

They run campaigns based on packages like these. These packages often include:

• A certain fixed price,
• Installment payment option,
• a cash payment discount .

The point that should not be forgotten here is this:

No matter how "commercial" advertisements and campaigns may seem, when it comes to health, the public health aspect also comes into play.

5.2. Commercial advertising principles and sensitivities in the health field

Article 61 of the Turkish Consumer Protection Law and the Regulation on Commercial Advertising and Unfair Commercial Practices definecommercial advertising as follows:

• Honest, truthful,
• It should not be deceptive/misleading to the consumer,
• Not to exploit the consumer's lack of knowledge and experience,
• It should not be exploitative of patients, the elderly, children, or people with disabilities.

He clearly states that it is necessary.

Healthcare advertisements, in particular:

• "A miraculous result,"
• "Definitive treatment"
• "Zero risk"
• If it is done using phrases like "Last day, last quota";

This can lead to allegations of misleading advertising and unfair trade practices before the Advertising Board , resulting in administrative fines or advertising bans.

5.3. Examples of deceptive campaigns

Here are some scenarios that could be problematic from a consumer law perspective:

1. Unreal discount
   • While the "list price" for the surgery was not 80,000 TL,
   • A supposed 25% discount on 80,000 TL, reducing the price to 60,000 TL, and calling it a "campaign.".
2. Additional costs added later
   • While the campaign brochure stated "12 installments at cash price,"
   • The hospital charges additional fees such as "card commission" and "installment fee" during the payment process.
3. The impression is that only installment payments are available via credit card
   • The advertisement emphasizes "12 installments,"
   • The bank actually charged additional interest, insurance, and processing fees for this installment;
   • This information should not be included in the advertisement.

In such cases, both administrative proceedings before the Advertising Board and claims for compensation and refunds before consumer arbitration boards/consumer courts may arise

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6. The Most Common Risks for Consumers

6.1. Hidden costs, processing fees, and card commissions

Common problems:

• The bank also charges an "installment fee" for credit card installment payments .
• The hospital adds a "%X commission for those paying by card".
• Despite being advertised as "installment payment at cash price," the total amount charged is higher

Law No. 6502 and legislation concerning financial consumers require that fees and commissions be communicated to the consumer in advance, clearly and understandably

The consumer is responsible for the costs that arise later:

• It was not explicitly stated in the contract,
• He said he had not been informed

To the extent that it can prove it, it can request a refund of these amounts.

6.2. Lack of consent and information

In private hospitals, most of the time:

• "Hospital admission agreement",
• "Informed consent form"
• "Payment undertaking"

They can be signed all at once and in a hurry.

Risks:

• Information such as installments, campaigns, interest rates, and maturity differences verbally and not included in the written text.
• General terms and conditions regarding card and credit card acceptance are written in small print at the bottom of the forms
• The patient signs these documents without actually being able to read them, due to excitement, stress, and the emergency situation .

In this case, a general terms and conditions assessment can be made within the scope of the Turkish Consumer Protection Law:

• Prepared unilaterally in advance,
• Non-negotiable,
• Provisions that create a significant imbalance to the detriment of the consumer
  unfair terms and may not be binding.

6.3. Issues regarding discontinuation, cancellation, and refunds of treatment

After making an installment payment with a credit card:

• If the patient discontinues treatment,
• If the operation is postponed,
• If the procedure cannot be performed due to medical risks,

Often, serious disputes arise regarding refunds.

This is where:

• Tied loan provisions (Article 30 of Law No. 6502),
• Defective service – rights to price reduction / termination of contract,

by entering;

• The hospital offering a discount on the fee,
• The lending bank will reduce or terminate the debt according to the plan,
• Consumers must use the notification and cancellation periods correctly

It is necessary. If these processes are not managed well in practice, the consumer will neither be able to fully benefit from the servicenor will they be able to continue paying off the debt for a long time.

6.4. Difference in fees, the relationship between the Social Security Institution (SGK) and private hospitals

Private hospitals contracted with SGK ( Social Security Institution) may charge additional fees for certain branches and procedures in accordance with SUT (Health Application Regulation) ; however, there are legal limits to this. Additional fees charged secretly and exceeding the amounts payable under SGK coverage also constitute:

• Defective service / unfair terms,
• Exorbitant price,
• Deception of the consumer

It raises the possibilities.

At this point, the consumer can pursue a dual-channel approach to seeking redress by applying to both the Social Security Institution ( SGK) and the Ministry of Trade (ALO 175, CİMER, Consumer Arbitration Boards)

6.5. Sharing personal data for campaign purposes

During campaign and installment payment offers:

• Information such as phone number, email address, address, and national identity number (TCKN),
• Health data (diagnosis, tests, treatment plan),

Often, they want to share this information with banks, call centers, and advertising companies.

At this point:

• Health data considered special categories of personal data.
• In accordance with the Personal Data Protection Law (KVKK) and secondary legislation, explicit consent must be obtained, and data must not be used for non-health-related purposes.

Although this article focuses on consumer law, data sharing during payment and campaign processes may a violation of the Turkish Personal Data Protection Law (KVKK), and consequently, to liability for damages .

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7. Your Rights and Remedies

7.1. First step: Written application to the hospital

When you encounter a problem, it's practically important to first take these steps:

1. Written application to the hospital's patient rights unit / chief physician's office
   • Request an explanation regarding the fees you paid.
   • Request a written copy of the installment, discount, and promotional terms and conditions
2. Getand keep your invoices and receipts.
3. Request a copy of the contract, consent form, and payment undertaking documents provided to you.

This stage often allows the dispute before it goes to court ; if not, it provides strong evidence for subsequent applications.

7.2. Application to the Bank, Social Security Institution (SGK), and Ministry of Trade

• Complaint to the bank/financial institution
  • In cases involving allegations of unfair interest, insurance, file fees, and hidden commissions;
  • File a written complaint with the bank, and if necessary, (BDDK) and the Turkish Banks Association .
• Application to SGK (Social Security Institution)
  • If you believe that an unfair difference fee has been charged for transactions that should be paid by SGK (Social Security Institution),
  • with the SGK provincial directorate/social security center along with your invoices and receipts .
• Ministry of Trade – ALO 175 and Advertising Board
  • If there is misleading advertising, false discounts, or false campaign claims,
  • Applications can be made to the Advertising Board within the framework of the Regulation on Commercial Advertising and Unfair Commercial Practices.

7.3. Consumer Arbitration Board (2025 monetary limits)

Consumer Arbitration Boards are boards that examine consumer disputes according to Law No. 6502 and are the mandatory application body for disputes below a certain monetary limit .

For the year 2025:

• For disputes below 149,000 TL, application to the Provincial/District Consumer Arbitration Boards is mandatory; a lawsuit cannot be filed directly.
• For disputes exceeding 149,000 TL, arbitration cannot be initiated;
  first, mandatory mediation is required as a prerequisite for litigation, and if no agreement is reached, then the consumer court proceedings begin.

Applications:

• TÜBİS system via e-Government ,
• Alternatively, you can contact the provincial/district consumer arbitration boards (Provincial Directorate of Trade / District Governor's Office) in person or by mail

It can be done.

Your experience with the private hospital:

• Excessive fees, unfair campaigns, "cash discount / installment difference",
• Failure to issue a refund, overcharging the card, collection despite cancellation

In disputes like these, if the amount is below 149,000 TL, the Consumer Arbitration Board effective and cost-effective solution.

7.4. Consumer court and mandatory mediation as a prerequisite for litigation

Dispute settlement amount:

• If it is 149,000 TL or more,
• Or if the problem remains unresolved despite the arbitration panel's decision,

respectively:

1. Mandatory mediation as a prerequisite for litigation (compulsory in consumer disputes),
2. After that, the case goes to the consumer court (or the civil court of first instance if there is no consumer court)

During the trial process:

• Legal grounds such as defective service, unfair terms, tied credit, and deceptive advertising,
• Expert witness reports,
• Contracts, invoices, and advertising materials become important evidence.

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8. Frequently Asked Questions

Question 1: Is it illegal for a private hospital to say, "20% discount for cash payments, no discount if paying in installments by card"?

Offering a reasonable discount for upfront payment is not prohibited in itself. However:

• If the discount rate is too high,
• If installment payments are effectively "punished",
• If misleading advertising is being done regarding discounts and list prices,

Under Law No. 6502, unfair commercial practices and misleading advertising may arise. Furthermore, the failure to clearly display the interest difference is also detrimental to the consumer.

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Question 2: They offered me 12 installments on my credit card, then the bank charged extra insurance and fees. Is this normal?

According to Law No. 6502 and related consumer credit regulations:

• Compulsory insurance cannot be taken out without the explicit request of the consumer .
• Interest, fees, and expenses must be clearly stated prior to signing the contract and included in the contract itself.

You have the right to file a complaint with the bank and, if necessary, with the Banking Regulation and Supervision Agency (BDDK), as well as to apply to the consumer arbitration board.

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Question 3: I cancelled my treatment, but the hospital isn't refunding the installments deducted from my card. Should I go to the bank or the hospital?

If:

• If there is a promotional installment plan between the bank and the hospital,
• If the loan agreement was established for a specific treatment/surgery,

This is most likely a tied loan . In this case:

• First, you must submit a written application to the hospital
• Then, based on the terms of the linked loan, the applicant should request the bank to terminate/reduce the debt
• If the issue cannot be resolved, you should pursue legal action through a consumer arbitration board or the courts.

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Question 4: A private hospital charged me a very high co-payment, even though I am covered by SGK (Turkish Social Security Institution), and divided it into installments. What can I do?

In this situation:

1. a complaint with the Social Security Institution (SGK) and request an investigation into whether the difference in payment complies with the regulations.
2. If you encounter any situations where you are misled or given incomplete information regarding the difference in fees or the installment payment process,
   to the Consumer Arbitration Board or, if the monetary limit is high, to the consumer court .

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Question 5: What happens if a private hospital's advertisement offering "installment payments at cash price" isn't actually true?

If:

• If the fees paid to the bank during the installment plan are passed on to you,
• If the total price is later increased with items such as "card commission" or "interest charge",

The phrase "installment payment at cash price" misleading advertising . Complaints may be filed with the Advertising Board, and claims for refunds and material and moral damages may be brought before a consumer arbitration board/court.

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9. Conclusion: Legal Transparency Before Payment Convenience

In private hospitals, installment payments via credit card, cash discounts, and promotions convenient solutions for patients at first glance. However, in a vital area like healthcare, and when dealing with high-value debts, the following reality should not be forgotten:

Whether "ease of payment" is truly easy or not on the small print in the contract and the protective provisions in the legislation .

• No. 6502 on Consumer Protection,
• BDDK's installment payment limits,
• Regulation on Commercial Advertising and Unfair Commercial Practices,
• Tied credit, unfair terms, defective service, and deceptive advertising provisions

When used correctly, it offers tools that significantly protect the consumer.

As a practical suggestion:

1. Request all terms and conditions regarding installments, discounts, and promotions in writing .
2. Question the real cost behind the claim of "installment payments at cash price" .
3. Don't rush into signing contracts; even in an emergency, seek support from a close relative if possible.
4. If you believe you have been wronged, remember that mechanisms such as the Consumer Arbitration Board, the Advertising Board, the Social Security Institution (SGK), and consumer courts exist

Being an informed consumer is just as vital as the treatment itself , especially in areas like healthcare where the consequences are difficult to reverse . When you encounter offers for installment payments or cash discounts at private hospitals, before asking "How many installments are available?", don't forget to ask , "What will I pay in total, and what legal terms am I signing?"