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NancyL
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Not to change the maudlin direction this thread has taken but I really wanted the topic to be, "have you known anyone who used long term health insurance in Thailand when they died?" Is it available or necessary? I know all the nanny guys think it is but they are not going to die in Thailand are they?
Yes. As mentioned, some polices pay out internationally. Also, our financial manager in the U.S. said he's had experience with overseas expats who have policies that pay out only for U.S. care, but when the client told the insurance company they were returning to the U.S. to go into a nursing home, the insurance company was willing for them to stay in Thailand or Mexico (or whereever it was that they'd been living overseas) and set up care there and the insurance company would pay because it was cheaper for the insurance company than having the client return to a U.S. nursing home.
Can an old guy living in Thailand buy a long term health care policy in the USA?
I doubt it.
Hubby and I started ours when we were in our 20s (nothing like planning ahead!). Unfortunately, in that era, they only offered U.S. coverage. When we got ready to retire to Thailand (in our mid-late 50s) I talked with the insurer about switching to a policy with international coverage. The monthly rate was going to be about five or six times higher because we would have been considered as "new" customers. The insurance company lady, in effect, said "don't worry, we'll probably still pay out in Thailand" without coming right out and saying it. Our financial manager was more direct because he'd had experience with clients who owned policies from this same insurer. -
Not to change the maudlin direction this thread has taken but I really wanted the topic to be, "have you known anyone who used long term health insurance in Thailand when they died?" Is it available or necessary? I know all the nanny guys think it is but they are not going to die in Thailand are they?
Yes. As mentioned, some polices pay out internationally. Also, our financial manager in the U.S. said he's had experience with overseas expats who have policies that pay out only for U.S. care, but when the client told the insurance company they were returning to the U.S. to go into a nursing home, the insurance company was willing for them to stay in Thailand or Mexico (or whereever it was that they'd been living overseas) and set up care there and the insurance company would pay because it was cheaper for the insurance company than having the client return to a U.S. nursing home. -
I'm not a coffee drinker, but the only complaint I hear with the breakfast buffet at the CEC Coffee Mornings is that they set out little tiny coffee cups. If you ask at the bar, they can come up with a real mug that you can use for the coffee. They're mismatched, freebie mugs that look like sale reps have given them, but at least they hold the proper amount of coffee for breakfast.
The last few times I have attended the CEC Coffee Mornings, the breakfast has been excellent along with large coffee mugs and good coffee. :-)
Oh, by all accounts the coffee's good at CEC Coffee Mornings. I'm not a coffee drinker, but I see K. Charn, the manager personally fussing over their super-high speed coffee maker. But, their standard coffee cup is more like a tiny tea cup.
Their large coffee mugs were something they scored from the American Express sales rep. And they only have about a dozen of them. Come to think of it -- every time Hubby goes to a district or countrywide Rotary convention he scores at least one Rotary coffee mug. Since Rotary meets at River Market, he's going to start donating them to enlarge their collection of decent-sized coffee mugs.-
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The living will comes into play only if you are unable to speak for yourself. You can always give indtructions to the contrary as long as you are conscious and coherent. You do not in any way forfeit the ability to change your mind or make specific choices.
if you are not conscious and coherent and you do not have a living will, other people are going to decide for you. Do you really prefer that?
need also to understand that living wills do NOT say "If anything happens just let me die" (and no one eould honor it if it did). Rather they usually say in effect "if I am terminally ill with no chance of recovery, keep me comfortable rsther than subject me to painful treatments that only prolong the dying process".
Indeed, Sheryl. Recently, I was involved in a situation where someone who had suffered a stroke (but had an uncertain prognosis) made the decision to accept a feeding tube and ventilator, even though in her Advance Directive she had checked every box to refuse those (and all forms) of life support in every case (terminal illness, coma, advanced progressive disease, etc) Her condition worsen to where she clearly met the criteria for refusing life support, as spelled out in her Advance Directive. It was very difficult to watch her being kept alive via artificial means, knowing that's not what she would have wanted at that point.
What probably wasn't clear to her and those around her is that once life support is started in Thailand, it cannot be stopped by the hospital, the way it can be stopped in hospitals in the west. It is possible for the "family" to take a comatose patient home and for the life support to be removed as the patient is left at home by the hospital transport crew, but it cannot be done in the hospital, in a humane way with palliative care available. -
There is no free medical care for foreigners in Thailand and concepts like pain control and end-of-life care are a couple generations behind what is practiced in the west --.
Right so even if you could afford and have the insurance after 70 lets say, and you get cancer, the backward Thai health care would still see you dying in a lot of pain and discomfort? This is a pretty worrying scenario and the only answer might well be to see yourself off before a very unpleasant end
It's more important to plan ahead here -- to have a primary care physician, an Advance Directive (Living Will), a Health Care Advocate, discussions with your family/friends about how you want to die. Even about things we take for granted. For example, my husband had a high PSA reading and the urologist wanted to do a biopsy. OK. He had the foresight to ask about anesthetic. Doc said "no need -- pain just last a little while" huh? Hubby found another doctor. A friend wasn't so lucky with the doc who did her colonoscopy recently. He just kept pushing ahead saying "moment please" as she lay on the table in agony. Don't assume the Thai medical system will provide the same level of pain control as in the west -- discuss and demand it in advance of treatment and have an advocate to act on your behalf when you can't.-
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A third party can do your 90 day reports for you -- a friend, spouse, a visa agent, whomever. In many provinces 90 day reports can be done by mail.
As for once-a-year visa extensions -- yes, you do have to show up in person, but a third party can go and present your paperwork and you can sit in the car in the parking lot at the Immigration office and the officer will come out to talk with you there, if you are physically unable to get into the office. In you're very infirm, the immigration officers have been known to make housecalls.
Same for the American consulate/embassy -- they can make housecalls or hospital visits to do income letters. However, you have to be mentally competent enough to swear to the veracity of your income letter. They aren't going to attest to the thumbprint of someone in a coma!
As I said in my earlier post about living here successfully in your eighties -- the immigration hoops can be successfully jumped by someone in their eighties with a little planning and perhaps some training of helpers.-
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Oh the confidence of youth. All this talk of "when the time comes, I'll do this" The problem is the few people recognize "when the time comes" or when they do they physically aren't able to put their plan in action.
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If invited to a social event by Thais, It would not make any difference whether there were farang guests there or not.
From experience, especially here in Chiang Mai, the chances are if there were farangs present you have not met before and don`t know them, these farangs will not be sociable, inhospitable and will blank you anyway and if approached maybe vague, or curt, brush you off or ignore you completely, especially if they are with their own cliques or a part of some of the Thai groups.attending..
In such situations I have found that many farangs who we may meet out at social events will be unapproachable and will often make that absolutely clear even just by the expressions on their faces and deliberate behaviours of totally ignoring the other farang, giving them a wide berth, hardly making eye contact.
Beetlejuice, you really know a very different group of foreigners than I do in Chiang Mai! But, the ones I know don't deliberately isolate themselves in a Thai village, thinking they're somehow better than other foreigners who have chosen to live here.
I must say, the type of event described could be equally painful even if everyone speaks the same language. I'm thinking about how my own dear husband grinned-and-beared-it thru holiday celebrations of my extended family in the U.S. Way too long, too much discussion of events long ago and people he didn't know, topics of no interest to him, to much consumption of heavy food and too much alcohol, interfered with his afternoon nap time, etc, etc. Of course, I loved it, but I knew he went to these events just to keep me happy, the sweetheart that he is. (Once wifi came on the scene, he appointed himself the official umpire for disputes of fact that came up in conversations. This just served to deflate much of the endless speculation my family loved to do about questions of fact, when he'd pipe up with the real fact to settle a family dispute -- the rat!) -
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I'm privileged to know about a dozen expats in their eighties who are enjoying very successful retirements in Chiang Mai. Many of the ways they do it have already been presented in this good thread.
They have themselves and their stuff organized -- Finals Wills, Advance Health Directive/Living Wills, all their investment, banking records, insurance policies organized. They have a "financial buddy" they trust -- usually someone of the same nationality who could step in if/when they're unable to handle their financial affairs. Some have already turned over day-to-day financial management via a limited power of attorney.
They take care of their health, eat right, don't smoke or drink (too much). They have a primary care physician whom they see regularly and bring their Health Care Advocate (the person listed on the Advance Directive) along to the medical appointments to help them "listen" to want the doctor is saying, to make sure they understand the doctor's recommendations. Sometimes they have that Health Care Advocate visit them every week to sort out the week's medications into one of those weekly pill minder containers with little compartments for each day.
They stay active, making sure they have a reason to go out and be around people every day -- computer club, chess club, music society, watching sports with buddies at the pub, whatever. Chiang Mai is full of expat activities.
They have a system in place where they "check in" with someone every morning if they live alone. Maybe a phone call or SMS and that person knows how to get help if they don't respond.
Visas and 90 day reports are the least of their problems. There are several very good visa agents in town. So is getting around. No shortage of accommodating tuk-tuk and songthaew drivers.
If they need help with bathing, dressing, having someone walk with them because they might fall -- then they can hire a Thai caregiver. But, they don't rely solely on a Thai caregiver to do everything I've mentioned above. You want to split the responsibility for your life among several friends. It serves as a "check and balance" so that no one person exploits you.
They're not living isolated lives out in the boonies. They're involved with the expat scene in Chiang Mai. If something isn't right, they're missed or it's noticed. People know who their friends are.-
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I assist older foreigners in Chiang Mai www.LannaCareNet.org and I think the OP's experience is probably typical for younger foreigners -- i.e. just 4 out of 10 having on-going medical expenses before death. But for those 4, I suspect their medical expenses were sizable. You don't fight AIDS, cancer or live three years in bed due to a broken back without running up some big bills. That's the point of having health insurance.
But, as you age the likelihood of dying from road accidents, in bar fights or being shot in a domestic dispute decreases. Most people get more sensible about their actions, or maybe physical infirmity just limits their tomcat urges. Anyway, you become more likely to fall victim to medical problems that will be chronic, debilitating and make it difficult to control the circumstances of your death.
There is no free medical care for foreigners in Thailand and concepts like pain control and end-of-life care are a couple generations behind what is practiced in the west -- especially for someone without money. It really is something you should think about if you plan to spend the rest of your life in Thailand. Your Thai family may mean well when they say they'll take care of you for life, but they'll probably be ill-equipped to provide the care you'll truly need if faced with one of the conditions the OPs four friends suffered during their final days -- AIDS, cancer or a broken back that keeps you confined to bed.-
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There are multiple ways to end up with permission to stay in Thailand long-term due to retirement. An O-A visa granted in one's home country isn't the only way to obtain that permission. It's confusing, however, because nearly everyone who has retirement extension thinks they actually have a "retirement visa" and that's what they call it.
If someone is over age 50 and meets the financial requirements (one way or another), then there are several ways to obtain long term permission to remain in Thailand due to retirement. They've all been outlined in this thread. Don't let Hull create the impression that the British have to be age 65 to obtain permission to remain in Thailand due to retirement. That's absolute rubbish.
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Why can't the guys from the UK just do what the US people have done for years? Enter the country on 30 day visa exempt status, open a Thai bank account, immediately transfer 800,000 baht into that account, then convert the visa exempt status into a 90 O visa. During the final 30 days of that 90 "o" visa, return to Immigration with a bank letter telling them all about your nicely aged 800,000 baht account and presto, you'll have a 12-month visa extension due to retirement.
The OP can jump start the process by opening the bank account and transferring the money early.
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You could open a bank account in Thailand (only in your name) and deposit 800,000 baht to meet the financial requirements of a retirement visa.
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Which immigration office would you be visiting? I know it isn't possible in Chiang Mai, but I have seen passports that would indicate it is possible elsewhere.
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I'm going to stop contributing to this thread. If anyone wants my input, they know how to contact me.
I'm too busy assisting several folks right now -- people who are living in town, in rental condos or guest house rooms. If I can't convince people to go live at Dok Kaew Assisted Living (too isolated, nothing to do, no restaurants close by, how would I get my books from the AUA/Raintree, I'm not ready ready for that yet, it's full of old people) -- people who really shouldn't be living own their own any more, then I fail to see why a project out in the country is going to be any more appealing. -
but i do take a very dim view of your last line # saying that i do not want to see the elderly up and around#, , not very nice comment coming from a professional person,and completly unwarranted to boot
but never mind, because ....its a great life as long as u dont weaken:D
No, I think that is a valid comment. There are many comments on Thai Visa that would indicate the younger crowd seems to feel that people over a certain age should just go home, commit suicide or otherwise disappear.
It's a view that goes beyond just the Thai Visa crowd. That's part of why younger people find the idea of these "retirement communities" so appealing for their parents and grandparents. They think they can be placed there and forgotten.-
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Rent inflation? Hah! As long as they keep building new condos in this town and we keep paying our rent on time and making improvements to the condo out of our own pocket, the owner is more than happy to hold the rent -- for years and years now.
Free-shuttle service. Yeah, like the Central Festival shuttle? When I investigated, it looked like it would take 90 minutes to get out to Central Festival by the time it stopped at all the hotels. Sawang my favorite tuk-tuk driver goes just about everywhere for less than 100 baht.
Guaranteed food supply, organic, fixed price? Let's see, there's Tanin Market, JJ Market's Saturday Market, the CMU organic market, Tops, Rim Ping, all either within walking distance or if I'm really lazy then I just phone Sawang.
Drinking water. Well right now, Hubby the water boy does haul it up in five-liter jugs from the water machine in the car park. But, when he gets really infirm we'll do what all the single women who live in the building seem to do -- order home delivery of drinking water.
If I want to look at a peaceful, calm environment -- I just look out my window at Doi Suthep.
Yes, I know this isn't for everyone -- but it's for many, many people and it's for much, much less than 40,000 baht/month all-in for a single person. Someone really needs to do their market research.-
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I will be there in spirit. Can't wait to hear about all the stuff you guys are doing. Wish I could make your next audition.
The Gate Theater Group will be presenters at the August Chiang Mai Expats Club meeting. It should be an informative meeting with video excerpts from past performances.
That will be at the Chiang Mai Expats Club next General Meeting -- Saturday, August 23 at Le Meridien hotel. Arrive at 10 am for 10:30 am start.
I've talked with Mike, who is editing video from past Gate Theater performances to be used as part of the presentation. It sounds like it's going to be a "not to be missed" event, with many excerpts from past performances.
I expect they'll talk about ways you can get involved and support Gate Theater, even if you aren't able to attend their August 2 meeting.
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I suggest the OP seriously look at Care Resort (the former Away Suan) and ask himself why those places aren't sold out.
I've assisted elderly people who were settled into these places by their well-meaning children -- active folks, who started going nuts with the isolation and high cost of transport into town from their remote locations.
the very reason that the care resort have not been sold out , is that they are not up for sale , but on a rental basis, which i do not have the nuts and bolts of, but i am led to beleive the rent is around about the 40.k a month mark, full board ,plus plus,
the main development is still in the building stage,perhaps later in the year it will be completed, do feel that, this magnicent peice of property fills the bill for less mobile etc etc . elderly people who want
a peaceful, fresh air, cooler temps ,rural enviorment ,as for the care resort being in a remote location, and being isolated , fiddle sticks , city slicker:D
mae rim district, in recent years, has progressed in leaps and bounds, and beautiful developements of this nature is a blessing for all mae rim ites, not only for the elderly less mobile people
gosh we have the steak of the day nosebag, say three years back, they would have went broke(, no passing trade and money) times are moving in the right direction in the mae rim district,make no mistake about that
a very nice afternoon to all:)
When I said ask why these places aren't "sold out" I more properly should have said "at capacity with a waiting list". That's the norm in the west for places like this, but not here.
At 40 K/month for full room, board and "plus, plus" an active elderly person can rent a lovely studio in serviced building, participate in a full range of expat activities, shop in western food markets, dine in gourmet restaurants -- all within reach via an 80 baht tuk-tuk ride. They can be part of a community, a neighborhood, instead of being stuck out in the boonies with a bunch of other old people. Oh and they can reach their hospitals and doctors within minutes via that same 80 baht tuk-tuk instead of being caught in traffic for 30 min - 1 hr in case of an emergency.
As I said earlier, potential investors would be wise to look at the few in operation here now and ask why they aren't "at capacity" before moving ahead. I still think the opportunity is for "in town" development. You may not want to see the elderly out and around, but they want to be out and around. -
There are karaoke studios in the basement of Kad Suan Kaew mall, near the door to the soi in the back that goes to Ram hospital and also in Central Airport Plaza near the movie theater. Those studios would be totally legit, seems like people go there just to sing, although the studios are set up with couches for group singalongs. (from what I can tell in looking thru the windows -- not much privacy, I'm afraid.)
One of my Thai teachers told me she and her friends used to go to the studio in KSK as a form of stress relief -- they'd sing along with popular Thai tunes and dance around. Sounds like something teenagers would consider fun.
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Joke Sompet is open 24 hours, isn't it? It's located on the north side of the old city, right next to the moat. It's near the north gate. It serves joke, or boiled rice soup, the Thai breakfast staple. Great with ground pork balls and an egg or two tossed in. I've gotten where I like it for breakfast sometimes.
I think they may have western-style breakfast, too, but their joke is so good that's all I ever order. (I've never been there in the wee hours, though. Sometimes I feel like a bowl of joke as a late afternoon snack, too, and stop by if I'm in the neighborhood.)-
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I suggest the OP seriously look at Care Resort (the former Away Suan) and the more down-market Dok Kaew (part of McKean Rehabilitation Center) and ask himself why those places aren't sold out. Also, he's being very unrealistic with the comment "I'm not thinking target for the infirm"
I've assisted elderly people who were settled into these places by their well-meaning children -- active folks, who started going nuts with the isolation and high cost of transport into town from their remote locations. They soon made contact with other expats at Ladies Lunches or Expats Club meetings and before too long figured out how to move to a serviced apartment in town, where to go for meals, how to arrange their own transport via tuk-tuk, etc.
It's the infirm to need a specialized living center -- not active elderly people. Chiang Mai already is "retirement tailored living"
At least Dok Kaew is part of McKean Rehabilitation Center where they can handle the needs of the infirm. It's not realistic to promote a facility as a "retirement facility" if they can't provide for someone's needs through the end-of-life.-
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My. my Mapguy, you certainly were posting late.
It's my understanding that it's difficult for tourists to purchase travel insurance now given that Thailand is under military rule. If that's the case, then wouldn't the TAT policy be a good option, even though it does just cover one country?
From time-to-time I receive calls from the nice nurses and social workers at Suan Dok hospital about tourists in need of assistance. Not often, usually they call me about elderly resident expats, but sometimes it's tourists. It's always refreshing to discover a tourist who actually had the foresight to purchase travel insurance. Those policies do pay and they do get people back home when they have problems.
Oh, as an aside Mapguy, you really do need to get out more and mingle with the newer expats retiring to Chiang Mai. It isn't the same crowd as 2007. Many more expat/expat couples. More women on their own -- women who had successful careers and have resources -- not women who spent a lifetime living on the edge, rattling around the world as backpacking English teacher. Men who had businesses and yes, maybe a failed marriage, but are still on cordial terms with their wife and kids. It's been a real treat for me to assume the presidency of the CM Expats Club a few months ago and to get to meet the new, incoming retirees. It's an impressive group.
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mesquite is right -- many people have already created this type of environment of themselves. They live in a rented room, condo or serviced apartment either in the old city or along Huey Kaew between Kad Suan Kaew and Maya Mall. They know lots of people in their building and neighborhood. They can walk to the cinema, restaurants, grocery stores, spas, beauty and barber shops, etc. People help them. For leisure activity they can go to quiz nights at a pub, or daytime activities like bridge club, computer club, hiking club.
Where I think there is a more realistic business opportunity is for someone to purchase some condo units in one of the older buildings, like Nakorn Ping or Srithana, refurbish them to be handicap and senior friendly with emergency call buttons, easy-entry showers, grab bars in the toilets, etc. Have 24 hr assistance available in the building to respond to a call button, to help someone who has fallen. That same assistant can stop by daily to check blood pressure and that the client has taken medications appropriately.
I would expect other residents of the building would enroll to be clients for the daily nurse visits even if their apartment wasn't one owned by the company.
Cinema at Maya Mall
in Chiang Mai
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