ole1291

Duly noted. Thanks.

And with regards to his age, would it maybe be better to wait a few years? The hernia only 'descends' some days and the operation seems to be elective.

Also forgot to mention, the operation will be sewing only, no net, which I thought were common now. Again, not something you get to choose.

Thanks for your advice. Very valuable. I'll definitely keep it all in mind next time we speak with them. Umphang was enticing because of the proximity for all the follow up meetings etc... (once you choose a hospital for a particular problem, all the meetings take place there)

I'm not sure that they would allow us to go to Nakhon Sawang, the choice given to us was either Umphang or maesot, and in my understanding, in the public system you don't get to choose so much... I will try nonetheless. In any case, do you think this is an important thing to push for, or is the risk so negligible we can pass over it? And assuming Maesot doesn't have a PICU, is there any reason to go there rather than Umphang?

Thank you for your input. As we are doing this through the public system, we have no say on who would perform the operation, but I'll keep this in mind. My main concern however would have to do with any complications resulting from the anesthesia, as the doctor told us it's more delicate at this young age. Is there any equipment (resuscitation?) might be missing in a local hospital vs a province capital one?

Hello, My 4 years old son (turning five in a month) son has a inguinal hernia. We've already been at the Umphang public hospital, met a very nice young doctor who told us that though these operations were previously done at maesot (bigger) hospital they have recently started doing them in Umphang as well ( a team of doctors and anesthetist traveling from maesot a few days a months to cary them out). She also gave us the option to go all the way to maesot to do it but assured us there's no difference from a safety point of view, she made a good impression on me. I just want to ask if someone knowledgeable knows if that is correct? Or is there some equipment (which one) in the bigger hospitals that makes these kinds of operations safer there?

Then it is indeed different. Thanks for clarifying those points. Very helpful.

I see. I've known numerous people however whom either weren't offered any life prolonging treatments or turned them down, with months remaining to live. They still required extensive medical attention to (somewhat) control their symptoms and reduce the pain. Towards the end, they had to be hospitalized, the last few months. In such a case, it is my understanding the insurance wouldn't cover those expenses (pain medication, home nursing, ultimate hospital stays). I understand this varies and I've also known other people who were switched to palliative care only a few days from death. The whole point of an insurance however, is to avoid those kind of gambles.

Thank you Sheryl for this informative reply. Previously, while corresponding with AAinsure, this is what they told me about the applicability of palliative care: With regards to hospice care generally, is it so that once an illness is declared terminal, hospital stay will only be covered by the amount stipulated under "palliative care" or be paid by the insured own pocket? Whether or not a condition is qualified as palliative is evaluated based on medical reports and international medical definitions as regards to palliative care/treatment. Should it however come to a stage where the condition is labelled as palliative care, coverage is indeed limited to palliative cover of the policy. It does seem to indicate that insurances would terminate normal coverage in case an illness is terminal. I guess the crux is whether the hospital notifies the insurance... but one would assume the insurer would be eager to find out.

While browsing the benefit table for the different options for private health insurance in Thailand, I noticed a hospice/palliative care column. This, it turns out, is the amount the insurance will pay for all the comfort/pain treatment you will be given once your condition is declared non treatable (with usually a 6 months max life expectancy). As an example, April Thailand's extensive plan will offer ฿ 1,637,500 in such a case. The problem is I have no idea what the typical cost for such matters run at in Thailand, but I guess a multi month stay in a private hospital could run in the millions. I realize this is something hard to estimate, depending on the condition, life expectancy etc... but a ballpark figure would help, perhaps someone who works in the insurance business here would have seen sample cases he can share with us? I think it's important for people to realize that once an illness is declared untreatable, the insurance will only cover medical expenses up to the amount specified under palliative care (which is usually way below the policy overall coverage, sometimes even zero). A little underhanded and could be a bad surprise for someone who thought he was covered. That leads me to my second question which is how good is palliative care in Thai public hospitals (insurance would be for my Thai wife)? My feeling, at least in the country hospitals, not good. Huge wards, indifferent/rude nurses etc...

Yes, that's the thing I guess, being far from the big cities (12h from BKK, 9h from CM), health care options are pretty limited, one way or another, and there's no perfect solution As we're both still under 40, I think we're fine here for now, but it might make sense to move as we get older. Thank you for advice. Very useful to have all this in mind before committing to something.

Will do. Thanks for the advice.

Thank you for explaining. The plan is to stay here long term, perhaps until we're old. But it's not 100%, hence why a worldwide excl USA policy is appealing. We're trying to get insured while relatively young and without preconditions as per your recommendations. That's why I'm trying to be so careful, don't want to pay 20 years of premiums only to be swindled later or have a company go broke on us just at the time we will need them.

She has a residence permit valid to 2027. The country is Norway, not technically EU but schengen EEA area (I think it's the same regs). While there she was uninsured (I thought her being my wife entitled her to local health care, but it's not 100% clear). Having a house shouldn't equal with permanent residence. We have a house in Norway too. But I see how things could get dicey. Frustrating because we wouldn't be technically committing fraud, just circumventing protectionist regs.

Sure that's a factor, though I think it's also cultural. Perhaps you missed my question with regards to community rated plans, do you think this is just an empty promise made by insurers on which they could go back any time?

That's another aspect of public vs private. In a private setting, you can at least try to discuss to things with a doctor. Otherwise, I've often found out doctors here think they are part of a higher caste that cannot be questioned by the lower peasants (everybody else).

It's obvious when a Thai has spent time abroad or not. Maybe I wasn't precise enough. And yes I have met doctors that could hardly speak English... I thought most of the doctors in the private hospitals also worked in the public sector... anyway, I am well aware that the up country private sector is not so good. When talking private, I mean the best hospital's in bkk or cm, they're not perfect too (no where is) but my experience there were much better than Umphang/Maesot.

Except with Thaï insurance you get the worst of both worlds because they cost nearly as much as that of big name international insurers, while offering smaller amount for coverage, and are not bound by very by good (from the customer point of view) regulations. Which got me to think, me and my wife sometimes spend extended amounts of time in Europe, in fact stayed the last year in a half in a EU country for which she holds a 5 year residence permit. Couldn't we, based on that, get her insured by a big international insurer as an expat in said EU country and then also use the policy in Thailand claiming we were just on a trip there? How would the insurer know the difference? And if they did, would it be sufficient ground to deny a claim?

Maybe that's true for bkk area, but with regards to Umphang, I'd put a lot more faith in what an English speaking (and therefore I assume western trained) doctor says than one of the local ones. That's based on multiple interactions with them. You haven't commented on the snippets I provided from the AAINSURE website. I'm not bringing it for arguments' sake but because I am genuinely not sure about who's right: they state community rated premiums cannot be increased based on claim but you say the opposite... Is it that the Thai regulations allow them to raise them but that they offer the customers of their community rated plan "a promise" ,not bound by law, that they will not do it?

I actually was wondering about the feasibility of the reverse: Doing scans, diagnostic etc privately (cause that's where the delays are) and then seeking treatment under universal coverage in the public sector. But would public hospitals accept implementing a treatment based on the recommendations of a private hospital?

Finally, an explanation on that subject that makes sense. So it all comes down to Thai protectionism in the end. I wouldn't mind, if their own regulations were better.

Me too. But major international expat insurers will not insure a Thai national residing in Thailand, that is because "In general, international insurance plans are designed for expats living part of the year outside of their home country. If you are a Thai national, you are not." Apparently it's that simple...

Thanks for looking into it. Basically, we seem to reach the same conclusion that VUMI is small, somewhat shady, player with mixed reviews: https://www.reviewcentre.com/health_insurance/vumi_group_-_wwwvumigroupcom-reviews_2512473 Getting insured with them seems a gamble as no one knows if they'll still be around in the medium to long-term future.

Then AAinsure, which is promoted by this website are misleading us: Their faq pages: https://www.aainsure.net/faq_health-insurance.html 18. Can an Insurer change my premium based on claim history? This depends on the kind of policy you have. There are 2 types available. 1 Community rated plans: With a community rated plan everybody from the same age and the same plan is paying the same premium regardless the claim history. The premium of an individual will never be loaded based on claims. 2 individually rated plans (also called experience rated plans): With an individually rated insurance plan the premiums can change based on the claim history. You can also receive a No Claim Discount after a year with no claims. If you do claim however, the insurer might load your premium at the next renewal date. The maximum percentage with which the premium can be loaded depends on the Company. AXA and April Thailand both offer policies that are renewable for a lifetime or up to 99 years: Option 3: April Thailand April International is a French company from origin. Over the years we have built a strong long-term relationship with April. Their claim handling is efficient and reliable and takes place from their own management center in Bangkok, which is well known amongst the Thai private hospitals, and available 24/7 in case you need assistance. Some of the highlights: Direct payment to private hospitals in case of a hospitalization Annual limit of 3,275,000 Baht or 16,375,000 Baht (higher coverages are available) Choice between 3 different cover zones Standard private room is covered in full Community rated plan: no individual loadings Cancer treatment is always covered (also Outpatient treatment when you have the Inpatient plan) Free Hospital Choice Outpatient add-on available (against extra costs) Lifetime renewable Deductibles possible to lower the premium (discount up to 65%; please see discount schedule below) Option 1: AXA SwitchCare plan AXA Thailand General Insurance was founded in 1998. The AXA group is a global leader in insurance and wealth management, serving more than 105 million customers in 54 countries. Their SwitchCare plan is designed to meet the insurance needs of both Thai and foreign nationals who want the security of a trusted global health insurer and are looking for insurance with a more extensive zone of cover. Some of the highlights: Direct payment to private hospitals in case of a hospitalization Annual limit ranging from 3.500.000-30.000.000 THB Choice between 3 different cover zones Community rated plan: no individual loadings Wide network of contract hospitals Outpatient add-on available (extra costs) Renewable up to 99 years of age Deductibles possible to lower the premium (discount up to 40%; please see discount schedule below)