SammyJ

I would wonder in much older years, that, like CIGNA did, allow applications but then turned it over to underwriting and they reject it outright or exclude so much that the policy is not worth having--it is just common sense for a profit company--do we really think they are going to accept individuals in their 80's and 90's when the payout risk is so far greater than any premiums paid?

Absolutely correct--and i am not familiar with these companies' rules--do they allow adding the health insurance rider at any time, regardless of age?

Again, i cannot dispute what may happen per UK/EU regs--but what you describe is what happens in the US--especially with individuals seeking insurance. In the US, is a horrible system--i am from the US and lived the system and worked it for many years on behalf of employees, so i know it well. There is no national health--Medicare, which is not entirely free--requiring older Americans to by supplements for the 20% of inpatient coverage not provided--and, crazy, but in the US, that 20% cost can be huge to a patient---plus, one must pay additional for outpatient and prescriptions--the good thing is there is no exclusion for pre-existing conditions with Medicare, or Medicaid which is for those that simply cannot afford any private insurance and their employer, if they have one, does not provide coverage. Employers, can often negotiate, it they have a large pool of employees, better benefits and window enrollment periods where one cannot be denied because of pre-existing conditions--but individuals are often at the mercy of the insurance carriers. I have actually found most Thai companies i have dealt with BETTER than the US. But, again, the US is foolish for how it offers health care--why some politicians wanted a "medicare for all" or offer to expand medicaid, so less fortunate may also be able to have access to decent health care--but, other politicians, and for the life of me i don't understand, an expansion of health care for US citizens. Ridiculous--it's not politics, it's basic human decency.

Exactly, and that is why that additional "barrier" or cost, may make such plans not all the bargain that some may think!

Accepting applications and actually offering coverage are two different things. I also tried with CIGNA global and got the same rejections, based on pre-existing conditions--and, from their end, it seems perfectly reasonable--they are "for profit" businesses--we all know if someone is 60, 70, and certainly 80 or more, the claims are likely to be coming in and be expensive and far more payout than any premiums collected--and then the premiums are also likely to be so expensive that few could realistically afford them. Better to put the money aside and self insure--as it goes back to paying very premiums to pay for coverage that excludes your primary health care concerns. Can you tell me what about being under the UK/EU regs is a big plus--from the Thai regs--I see that most private insurance companies operate primarily in the same fashion--i am not familiar with UK/EU regs, but am familiar to US and Thai practices seem to be quite similar--the US companies would love to be more restrictive, but there are limitations, but not many. There is, of course, no national health--Medicare is overall very good, but not free, as many may think it is--inpatient coverage, if one paid into it, is covered up to 80%, but outpatient care and outpatient prescription coverage must be purchased--as US medical costs are simply outrageous and outpatient dr visits and prescribed medicines are so expensive, one needs that coverage, where in Thailand, outpatient costs are much more reasonable.

This is for the health insurance "rider", correct--you still have to qualify and pay for the life insurance premiums each year as well, correct or not?? That increases an overall cost.

Yes, i agree that brokers can be helpful, and i agree, as i do now, and most of my senior expat friends do--self insure, and as you/Sheryl has advised, look for alternative hospitals that are still very proficient--in Chiang Mai Chiang Mai Ram and Bangkok Chiang Mai, are the two leading hospitals that seem be favored by foreigners/expats, and are, depending upon dr/speciality/procedure, more expensive than most other. But, Sriphat, McCormick, and others are also fine hospitals, with more reasonable rates, and you can often find the same doctors working there some days of each week. I have inquired with most, not all, of the larger, reputable insurance carriers here--CIGNA, Aetna (formerly BUPA), Pacific Cross, LUMA, AXA, etc, and all excluded for pre-existing conditions and all drew the line (except CIGNA) at no new coverage age 65 and up. If you were already with them prior to age 65, then they would still cover you but for ever increasing premiums. CIGNA wrote that they took applications up to age 70, but several friends of mine applied, and after listing all medical conditions on the application, these conditions were not excluded, my friends were told that CIGNA underwriting had decided NOT to offer coverage at all. My congrats to any among us more senior expats who get into our 60's or 70's and don't have something that is a "pre-existing condition", but most of us do ---and to me, anyway, if a plan for which you are paying already a very high premium doesn't even cover one's key medical concerns, what good is it--you are better off, setting money aside and self insuring--but, get a choice of some doctors, and a hospital you like, in advance--do NOT wait, until you have a serious medical crisis to make choices--if an ambulance, Thai local here, comes to get you, you can direct them to take you to what hospital you want.

Not meant to "ominous", meant to be transparent by the insurance carrier that this is what can happen--and, it is all so individual to person, company, etc--what happened to you, may never happen to another, or the rate might go up and not go down--that's the thing, one needs to be aware that it can--many do not understand that, and when rates are raised, they complain, and then the company points to that type of language, which will certainly be included in any contract signed, and say, "See, it's right there that allows us to do that."

well, that quote i copied comes right from the AIA brochure--as i stated, the "devil is in the details"--they are protecting themselves so that might raise premiums beyond what originally predicted due to one's utilization (a favorite insurance industry word), or another favorite--sorry, they say, there has been an increase/inflation in overall medical costs--so, they see that they might be paying out more, per type of surgery or room stay, etc than before--they predict, the hospitals will charge them more, so they, in turn, charge their customers more.

Totally understand, it is a common practice in insurance companies--so i do not mention it as a surprise to me, i mention as some may think they can 100% rely on what an insurance company says they might charge for future years.

yes, both, as expected, allow the companies to make "adjustments on one's premium each year based on a variety of factors.

Yes, this seems to be the correct pdf--there certainly do appear to be some nice benefits, as there are with other carriers--but, with exclusions for pre-existing conditions, the costs are still pretty high for plans when you are older--plus, they also include the following caveat: * Renewal premium AGE (Years) A rider is a one - year and renewable insurance contract. The Company reserves the right to adjust the premium rate in a policy year due to various factors such as age, occupational class, historical claim payments of the Company, etc. For the rider attached to a healthcare insurance policy, other factors such as the medical inflation rate and medical expenses, etc., may also be taken into consideration. Such adjustment of premium rate is subject to approval of the Registrar.

i think it is the individual's claim experience--they are having the caveat, so they could make adjustments

I may be looking at the wrong thing--but are you referring to the link that shows a pdf of the AIA new standard plan? Or is there another version?? In looking at that pdf there does seem to be caps on coverages--and the sample case given is not really a practical example. Is there a different link to the plan you mention? The Elite health in another pdf does seem to offer some more flexibility in payments--but, see the caveat that reads: (it appears to give them quite a bit of flexibility in changing things. Policy Renewal on Anniversary Date This rider may be renewed on the policy’s anniversary date without having to provide evidence, but the Company reserves the right to adjust the premium as specified in Section 14 Re: Premium Adjustment, as approved by the regulator, except in any of the following events, the Company shall reserve the right not to renew the rider. If the insured decides not to renew the rider, Company must inform the insured in writing at least 30 days before the end of the effective period. 1) In case there is the evidence that the insured omits the disclose any fact in the insurance application form or reinstatement form, health declaration form and other declarations related to the formation of health insurance rider which is material so that the Company may be induced to charge higher premium, or refuse to enter into the insurance contract, or provide the coverage with conditions. 2) The insured makes a claim from the fact that he/she has requested for the treatment for injury or illness without medical necessity. 3) The insured makes total claims from all companies for compensation from hospitalization higher than the actual income. Premium Adjustment The Company may adjust the premium on policy anniversary date due to many factors such as: 1) Age, career class of each individual; 2) Higher medical expenses or overall claim experience of the portfolio of this rider or claim experience of each insured whereby the Company shall notify the insured in writing via a registered mail or other means accepted by the insured at least 30 days in advance. For premium adjustment due to the claim experience of each insured, if this general provision is removed from the contract, the Company shall issue endorsement or insurance contract that does not contain such clause for every insured.

However, thinking of 5 mil coverage is a bit misleading, as the various caps/maximums on certain areas likely prevent coverage anywhere near 5 million--with the caps, on procedures and hospital treatments, it would be difficult, if not impossible, to reach too high an amount--it's nice marketing and sounds good, but... Additionally, looking at the various coverages and max's in the example provided in the pdf, the cap for surgery and anesthesia seem a bit low--easy to exceed those if in larger, more modern hospitals in larger cities (bkk and chiang mai) that farang expats may favor. Additionally, it does appear that there are exclusions for pre-existing conditions, and simply because they say they may accept one at older ages, doesn't mean they will--it's subject to their underwriting dept--CIGNA said they will accept new coverage up to age 70, but I know several friends that applied in their mid-60's and were denied because of pre-existing conditions--they did not simply exclude certain medical conditions, but rejected any coverage. I think it takes common sense to understand that the CIGNA, Aetna, Pacific Cross, AXA, LUMA, are some of the leading Thai companies who provide health insurance here, and see what their rates are, and then think you can get the same thing for a fraction of their costs. If it's too good to be true......

Yes, i agree--very sorry to hear about your problems--please be sure that any "family" here, actually do have your best interests at heart.

Also, from talking with some fellow expats who have looked into these kinds of plans, and an expat i know who actually has one, please review the plan benefits and limitations. You indicate the premium is cheaper than CIGNA, but that doesn't mean a lot if the plan benefits are also far less. The "devil is in the details" as the saying goes, and I have found far too many people here and previously in the US, really have no idea what exactly their plan covers--what are its co-pays, limits, etc--so when time comes that they need to make a claim, they can just recall years later that "Well, the agent told me......" and then to be told that one's claim is rejected. The details are all written in the policy which you should review carefully. Similar plans i have seen from friends have pretty low limits on most areas of coverage, leaving you with a fair amount of "out of pocket expense:, and often require the individual to pay first and then seek reimbursement. Additionally, it is my understanding that such plans, as they are actually just a "rider" as you indicated, not a full blown health insurance policy, will still exclude for pre-existing conditions. And as was mentioned in Sheryl's post--is automatic renewal guaranteed regardless of what claims you may make against the health insurance rider? What happens if then, they deny your renewal, or price it such that you cannot afford it, and then, at a more advanced age, and with more pre-existing conditions, you are left with no coverage at all, and unable to purchase any new coverage? As has been written about by others, far too many assume health insurance in Thailand must be easy to obtain and easy to afford--compared to US rates, it is much less expensive, but most, at least those coming from the US having an employer pay for health coverage, or other countries, UK, etc, with a NHS, they find themselves in a whole different health insurance environment here--you must do your hw and make sure you can qualify for insurance or can afford to self insure.

Having worked extensively in insurance in the US, and it's not all that different here, one sometimes thinks they are being "clever" by not disclosing something--even if not directly asked, and then later, find that a major claim is rejected because at that time the insurance carrier discovers something, in their view, that wasn't truthfully disclosed--remember, insurance carriers (Im not talking brokers, but the actual carriers) are not your "friends", they are in a for-profit business, and if there is any valid reason to decline payment, they likely will. So, to think you are covered for something, then to find out in your moment of need that you are not actually covered for that something could be financial disaster.

Well, the dental service you had before, may just be one that is recommended--if you want :first rate", it does tend to be more expensive. All of my children have used various dentists at Dentaland--but it is fairly expensive compared to more regular Thai dentists--but it likely is comparable to other "first rate" dentists.

Chiang Mai--the Mae Hia area.

Hello, I am looking for any recommendations for a Thai tutor (preferably a woman as the students are girls aged 7/8) to be of assistance with English homework--as girls are enrolled in an excellent Thai private school, yet, hey are given limited English instruction, but given some extensive homework in writing and reading English. I do not want a tutor who does their work for them, but actually provides some additional instruction and assistance so the girls can complete assignments independently. Yes, I am looking for a Thai woman, as the girls' first language is Thai--and their spoken English is fairly good, but need help in reading and writing, so the tutor's ability to converse and instruct in both Thai and English is necessary. I would need for this tutor to travel to my house later afternoons to work with the girls--of course, I will not only compensate for the tutor's instructional efforts but for travel as well. If anyone has someone they might recommend, we would greatly appreciate it! Thank you

I see far too many foreigners who wish to travel for extended times or retire here without having done their homework on medical insurance. They assume that since it may be less expensive to live in Thailand than in their home country, that it must be true that excellent health insurance coverage is also inexpensive and easy to obtain.

When I contacted PC in the past regarding coverage, they told me they write no new coverage for 65 and older--they will continue to cover past 65, of course, if you were initially covered prior to age 65, but of course, with increasing premiums. And, as others, they do exclude for pre-existing conditions.

What hospital? While not always up to standards i have seen in the best hospitals in the US in major cities, still have seen very good care here.

If you paid that, then you got ripped off also--the actual fees are as has been offered in other posts here--40 baht or something a month, and common fees for whatever, are built into the rent--not paid separately,--additionally, as has been suggested, check to see if electric and water are charged at govt rate or an artificial rate, often double, created by the landlord--so you could end up paying double for your air con use, etc.