OBJECTIVES: This poster presents a comparative analysis of the private healthcare insurance systems (PHI) in Turkey, USA and South Africa.  METHODS: OECD publications, Turkish Private Health Insurance Association, World Bank Reports, Publications of Turkish Social Security Institution (SSI) and official web pages of US and South Africa Departments of Health are examined for 2001-2011.   RESULTS: In comparison to Turkey; USA and South Africa have similar characteristics in terms of PHI dependence prevailing with a higher coverage. Due to lower PHI level in Turkey, Out of Pocket (OOP) payments constitute a significantly higher amount. In Turkey, PHI coverage has almost tripled over the last 10 years, but still accounts only for 3.40 % of the total population. The trend towards strengthening the PHI is basically due to the promotion of PHI solutions such as supplementary coverage that has been implemented in Turkey since December 2012. Total volume of PHI in Turkey is expected to expand more as the scope of the supplementary health insurance implementation increases. There exists a diminishing trend of OOP expenses across all three countries however this is again relatively much lower for Turkey. Since 2003, Turkey has been implementing a Health Transformation Program where PHI is expected to play a crucial role to reduce OOP health expenditure. Despite this ten-year program, OOP spending has decreased slightly (11%) when compared to South Africa where there is a threefold decrease. CONCLUSIONS: Turkey has still room to improve its private insurance system along with its public system to reduce OOP payments. South Africa with private dominant health insurance system and lower OOP spending is trying to transfer its resources towards a national health insurance system. USA stands as a stabilized private dominant health insurance model which significantly differs from Turkey and South Africa.