Expat Health Insurance

[serpent32]

I have a question what type of health insurance do those of you living here on retirement visas use?  I’m retired United States Military living here on a marriage visa but I’ve never used VA or Tri-Care here and I’m not sure if I can.  I’ve just been paying for our doctors visits out of pocket.  What is a good insurance company for expats in Thailand that preferably covers pre-existing conditions?

[yooper]

lots of posts on this under various topics ... try the search feature.  If you are over 70 you're on your own unless you have very deep pockets.  It seems as long as I leave the country once a year I can get travel insurance at reasonable rates, it says it does cover pre-existing conditions and also has an evacuation benefit if I have to get into a stateside VA hospital.

'

[longball53098]

Serpent, if you are retired military and have Tricare / Medicare in the USA then your Tricare will cover you here in Thailand. Get in touch with the RAO at the JUSMAGTHAI compound in Bangkok for more info. Also depending where in Thailand you are there are several VFW posts that have folks that can steer you where you need to go for using Tricare. I have had two operations here in Thailand in the last 2 years and both covered by Tricare. There of course are some hoops to jump through but not bad. Start here:

http://www.jusmagthai.com/rao.html

 

http://www.jusmagthai.com/medical.html

[serpent32]

On 11/10/2017 at 10:03 AM, longball53098 said:

Serpent, if you are retired military and have Tricare / Medicare in the USA then your Tricare will cover you here in Thailand. Get in touch with the RAO at the JUSMAGTHAI compound in Bangkok for more info. Also depending where in Thailand you are there are several VFW posts that have folks that can steer you where you need to go for using Tricare. I have had two operations here in Thailand in the last 2 years and both covered by Tricare. There of course are some hoops to jump through but not bad. Start here:

http://www.jusmagthai.com/rao.html

 

http://www.jusmagthai.com/medical.html

That’s awesome I didn’t know they covered us overseas I’m going to use it.  

[serpent32]

Does anyone know of any extra health insurance companies that expats use?  I’m well under the age 70 years old.  Regardless at least it’s good to know that TRICARE covers us overseas.  

[tonray]

7 hours ago, serpent32 said:

Does anyone know of any extra health insurance companies that expats use?  I’m well under the age 70 years old.  Regardless at least it’s good to know that TRICARE covers us overseas.  

Thai companies: BUPA, AIA

 

Foreign:: CIGNA Global

 

many many others

[Manon Fe]

Hello, what are the better place to have healthcare, do you know good doctors in Bangkok ? thank you :)

[JLCrab]

48 minutes ago, tonray said:

Thai companies: BUPA, AIA

 

Foreign:: CIGNA Global

 

many many others

BUPA Thailand is now owned by Aetna International out of London same as CIGNA Global also out of London. They will be co-branding the BUPA/Aetna name (or v.v.) and will then eventually be dropping the BUPA name altogether starting next year.

[tonray]

52 minutes ago, Manon Fe said:

Hello, what are the better place to have healthcare, do you know good doctors in Bangkok ? thank you :)

The forum moderator, Sheryl can help but you should let us know what type of doctor you are interested in finding.

[Sheryl]

1 hour ago, JLCrab said:

BUPA Thailand is now owned by Aetna International out of London same as CIGNA Global also out of London. They will be co-branding the BUPA/Aetna name (or v.v.) and will then eventually be dropping the BUPA name altogether starting next year.

Key question: will their policies then come under Thai or UK insurance regulations?

[JLCrab]

I don't know and there has been little published info since the July 2017 press releases. Can a majority non-Thai owned insurer operate under Thai insurance law?

Edited November 14, 2017 by JLCrab

[JLCrab]

Well my answer to the above is still I-don't-know but, unless a foreign majority interest in the Thai insurer was acquired as part of a financial bail-out agreement, the answer per the JAN 2017 Thai Insurance regs is that it would likely have to operate as a non-Thai company.

Edited November 14, 2017 by JLCrab

[BuddyDean]

For a US citizen, their home country is always the US even if they live here all the time.  Many claim the security of health insurance is better than travel medical, but it is really a false sense of security, as those companies could jack your rates big time at renewal.  They are also much more expensive with higher deductibles.  I have researched this a lot, as an annuity pays mine.  It comes down to two companies:   IMG and TOKIO MARINE....TM is a little better and has an A rating.  You can talk to a real agent with WWW.INSUBUY.COM. if you buy direct from TM, they will assign you an agent, and it cost the same.  So might as well use a licensed agent in Texas.  Residents of certain States are excluded from using non ACA policies.  I just bought four months, 250 deduct, and spoke with the guy at length, stating I wanted for it to be legit and basically, I might be here for years, and even own my own home here.  Talk to them.  Cancer isn't covered...but you could go to India..a friend in the US has prostate cancer, Cadillac insurance and still owes 42,000 USD for this year...brutal.  Just check the ratings of any advertisers...

Edited November 14, 2017 by BuddyDean

[Sheryl]

BuddyDean I am not clear...are the policies you refer to:
Insurance cover in the US
Travel insurance
Or what?
I haven't come across any US insurance policies that vover care abroad except as an emergency...?

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[al007]

5 hours ago, Sheryl said:

Key question: will their policies then come under Thai or UK insurance regulations?

It is likely, note I only say likely, that if the premium is pain to a uk company you are likely to be covered under UK FCA and Insurance Ombudsman, two separate organisations, if it is The Thai subsidiary of a UK company unlikely to have cover

 

Before paying premium ask if FCA regulated,  then check with FCA and they will confirm one way or the other, at least you then know and can make your decision on an informed basis

[BuddyDean]

10 hours ago, Sheryl said:

BuddyDean I am not clear...are the policies you refer to:
Insurance cover in the US
Travel insurance
Or what?
I haven't come across any US insurance policies that vover care abroad except as an emergency...?

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

It is travel medical, but as a US citizen, you can use it, even if you are living here full time, without bending any rules.  No it does not cover preventative maintenance, or routine office visits, but why on earth would someone insure against having to pay for a 300 THB office visits.  For the amount extra you would pay in premiums for that type of coverage, you could go to the doctor twice a week, all year and it would still be less to pay cash.  Now if you had 20 office visits after an accident, or physical therapy, that would be covered. Some, just front realize that there is no comprehensive affordable plan that covers people on multiple meds, with multiple pre existing conditions.  If there were, there would be jumbo jets full of sickly people Tom ng over here to get treated.  Many, should stay in their nanny states and pay the outrageous taxes that go with it.  So, yes covered for any emergency or accident, which will include getting sick.  Aso, it ius 33 million in coverage, who h is multiple times higher than what the health policies here cover.  The situation is differs t for non us citizens, especially those actually living abroad.  I gave you a website of a reputable company, that is an agent for other reputable companies.  Anyone, who answers their toll free number is a licensed agent.  Just try telling the truth.  It will be a lot simpler and give you piece of mind.  Get to know a good pharmacist.  Their inventories are somewhat streamlined and most are highly educated.  A spot of excema or poison ivy can be taken care of for about one Dollar.  There is no healthcare insurance on the planet that can beat that....they would still require a visit or two, and heaven forbid you need a dermatologist. People need to be realistic and look at the big picture.  If you could come over here, sign up for insurance, and get a hip replacement, then imagine how many others would do the same thing.  It wouldn't be sustainable.  

 

[JLCrab]

11 hours ago, al007 said:

It is likely, note I only say likely, that if the premium is pain to a uk company you are likely to be covered under UK FCA and Insurance Ombudsman, two separate organisations, if it is The Thai subsidiary of a UK company unlikely to have cover

<snip>

Well that's the rub -- given the current regs on majority foreign ownership of insurance companies in Thailand, Thai subsidiaries of foreign insurers are mostly if not exclusively Thai-majority owned joint ventures even if they are using the foreign insurers name.

 

Other non-Thai insurers sell and administer policies that cover Thailand but operate without a Thai subsidiary even though they may have a large physical support presence in Thailand.

Edited November 14, 2017 by JLCrab

[BuddyDean]

7 minutes ago, JLCrab said:

Well that's the rub -- given the current regs on majority foreign ownership of insurance companies in Thailand, Thai subsidiaries of foreign insurers are mostly if not exclusively Thai-majority owned joint ventures even if they are using the foreign insurers name.

Yes, AXA is a Chinese company, but most likely a Thai subsidiary.  Sane with BUPA.  In the US, BC is different in just about every state they operate in.  Same with the banks...an HSBC US account gets you nothing at HSBC Mexico.

[JLCrab]

30 minutes ago, BuddyDean said:

Yes, AXA is a Chinese company, but most likely a Thai subsidiary.  <snip>

From Wikipedia:

"AXA is a French multinational insurance firm headquartered in the 8th arrondissement of Paris that engages in global insurance, investment management, and other financial services."

Founded 1816

[BuddyDean]

My mistake, meant AIA.  However, you should have quoted the next part about AXA.  "AXA is a conglomerate of independently owned businesses, that operate according to the laws and regulations of many different countries.". AXA Thailand being one of them, with the name AXA Thailand Public Company.

[JLCrab]

Yes and on the AXA Thailand website it says that it is majority owned by AXA Group. However what is germane as far as I'm concerned is not AXA but what happens when a Thai insurer such as BUPA-Thailand is acquired by an international insurer based in London. Does it then operate as a Thai insurer maybe as does AXA or does it operate as a foreign insurer selling policies that cover medical expenses in Thailand such as CIGNA Global?

 

The current laws of Thailand regarding foreign majority ownership require approval by both the insurance commissioner and the Ministry of Finance so it is possible that AXA got approval for a majority ownership by acquiring a distressed Thai insurer. I don't know that a case could be made that BUPA-Thailand is a distressed insurer.

 

BTW I've been with BUPA-Thailand long enough and am Medicare registered in USA so whether Aetna stays as a Thai insurer or operates as a UK insurer really makes no difference to me 'cause at my age I ain't switching.

 

 

Edited November 15, 2017 by JLCrab

[BuddyDean]

Yes, there are exceptions, such as CIMB's acquisition of Bank Thai.  Took special permission, but it was considered urgent.  But, as far as BUPA-Thailand being acquired by a London company...IMO, it will still be operating under the laws and rules of Thailand, as a Thai Company.  Kind of links CIMB- Thai.  Or look at it this way.  I can get a Blue Cross plan in my home state that covers me in countries I declare...and it is subject to the laws and regulations of insurers in my home state.  OTOH, I can get a policy here with BUPA-Thai that is subject to the rules and regs here.  I can open an account with Citi-US and use it here, and still get charged foreigner fee at the Cities ATM Asok, or I can bank with Citi-Thai, and not be considered a foreign account.  In your case, you likely won't have to do anything...except pay the higher premiums, that they usually set after a bean count.  But someone like you, or the military guy with solid coverage in the states might be just as well off with evacuation insurance and emergency medical.  You would just have to compare your annual premiums to what your out of pocket expenses are.  For me, Medicare in the US may be about the best thing going, but by then, they may realize giving expats vouchers would save them billions.  They currently spend about 1000 per month per recipient.  A voucher for 700 could Gert you a ton of coverage here.

Edited November 15, 2017 by BuddyDean

[Sheryl]

9 hours ago, BuddyDean said:

It is travel medical, but as a US citizen, you can use it, even if you are living here full time, without bending any rules. ..

 

OK if it is travel insurance that makes sense, though usually companies will not issue a travel policy for more than 1 year in a row, are you sure these will?

 

As you already know, being travel insurance it will pay only for emergency care,  and there are a LOT of expensive and very necessary, but non-emergent, conditions that would exclude e.g. hip replacements, cataract surgery, cancer treatment etc etc. So this is a feasible approach only if you are fully insured in your home country (and most travel policies include fine print to the effect that you must be so insured). If you have Medicare make sure you are also enrolled in at least part B, preferrably a Medicare Advantage program as you will then have to plan on getting all costly non-emergency care back in US - and obviously also have the necessary funds for an unexpected airfare put aside.

[JLCrab]

1 hour ago, BuddyDean said:

<snip>  Or look at it this way. <snip2>

... or not.

 

However I will not be comparing my out of pocket annual expenses to my annual premiums because my out of pocket expenses are very low because I am not sick. I buy insurance in Thailand in case I get sick ... and unlike it seems many on here, I never know when  I'm going to get sick.

Edited November 15, 2017 by JLCrab

[BuddyDean]

35 minutes ago, Sheryl said:

OK if it is travel insurance that makes sense, though usually companies will not issue a travel policy for more than 1 year in a row, are you sure these will?

 

As you already know, being travel insurance it will pay only for emergency care,  and there are a LOT of expensive and very necessary, but non-emergent, conditions that would exclude e.g. hip replacements, cataract surgery, cancer treatment etc etc. So this is a feasible approach only if you are fully insured in your home country (and most travel policies include fine print to the effect that you must be so insured). If you have Medicare make sure you are also enrolled in at least part B, preferrably a Medicare Advantage program as you will then have to plan on getting all costly non-emergency care back in US - and obviously also have the necessary funds for an unexpected airfare put aside.

Tokio marine is up to 364 days, and you can buy another 364 days with no lapse.  Health insurers only do a year at a time, and while theory may guarantee renewal; there is no limit to changes in cost and terms.  You want to be covered for hip replacement here?  while you would be covered under Medicare in the US?  You should get your head examined, not your hip.  Do the math and multiply by millions.  

[impulse]

10 hours ago, BuddyDean said:

It is travel medical, but as a US citizen, you can use it, even if you are living here full time, without bending any rules.  No it does not cover preventative maintenance, or routine office visits, but why on earth would someone insure against having to pay for a 300 THB office visits. 

 

If you live in Thailand, does it make any sense to have a policy where a $500 MRI requires a $2,500 (and week of travel) trip back home to be covered?  Maybe if Thailand is your winter getaway, but that's a small wedge of those tuned in here.

 

Or leave behind your life and a home and family to spend months and perhaps years being treated for cancer, a bad car wreck, or other debilitating condition?  Especially if you no longer maintain a home "back home".  Not only do you have to deal with leaving your Thai life and family behind, you have to set up housekeeping, possibly maintaining 2 households.

 

Health care needs rarely show up exactly the way we expect them to.  Anyone expecting to hop a flight to India (or the USA) right before they get struck unconscious is in for a rude awakening and a huge bill when they wake up in the hospital that paid the ambulance the highest finders' fee.  And then settle in for months of rehab...

 

Travel insurance is designed to handle emergencies, get you ambulatory and back home to be treated by your main insurance carrier.  It works well for a segment of the population, but it's not appropriate for a big slice of the overseas demographic.

 

Between NancyL and Sheryl, they've probably seen more health care horror stories in Thailand than you and I and any dozen other posters will ever see in our lifetimes.  That's by virtue of what they do here.  Stories that often started out with someone trying to outsmart themselves with that $200 annual "travel policy" instead of the $200 a month health care coverage.  Or crossing their fingers and calling it "self insuring".

 

[Sheryl]

54 minutes ago, BuddyDean said:

Tokio marine is up to 364 days, and you can buy another 364 days with no lapse.  Health insurers only do a year at a time, and while theory may guarantee renewal; there is no limit to changes in cost and terms.  You want to be covered for hip replacement here?  while you would be covered under Medicare in the US?  You should get your head examined, not your hip.  Do the math and multiply by millions.  

I can only repeat that I have nto known travel insurance policies to be issued year after year, indefinitely, with no lapse. Time will tell on that.

 

To be covered adequately for hip replacement and other things in US once would need to have at minimum Medicare Parts B and D as well of course as the airfare and lodging costs unless you have friends/family you are sure of being able to stay with.

 

Parts B and D alone will cost around $2,000 a year. And there is of course a deducitible coming to about 2,000 a year Parts A, B and D combined.

 

So basically if you do the math, a combo of Medicare (A,B and D) plus travel insurance will cost about the same as an expat insurance policy with similiar deductible...more if you end up needing to travel back often for care, and more still if you have to pay for lodging while there.

 

I am not saying it is not doable, but it is not cheaper. Would make sense for someone who cannot get regular health insurance due to pre-exisitng conditions, or for someone who plans on spending significant time in US each year regardless.

 

 

 

 

[BuddyDean]

But you state things you don't know for a fact, instead of simple calling their toll free number and speaking to a licensed agent.  Yes you can string together multiple 364 day policies and it is OK to buy the policy after your trip has started.  I just returned from the US, where I had a 21 day policy with a different company, same agency.  My new card came today.  No, they aren't going to cover hip and knee replacements, hearing aids, cataract surgery, or quite a few others.  They will cover follow up care and it s in their best interest to get you treated here.  200 per year?  Try 100+ per month.  The difference in Santa Claus and a comprehensive policy that you could come over here and obtain that will cover elective surgery is there was such a thing as St. Nick.  Stateless?  Yes, many old folks have become stateless here in CM, and are more than willing to become a burden on Thailand or any place else that will treatvthem.  Maybe living check to check your entire life wasn't a good idea.

[serpent32]

Actually another question, currently the United States government is operating off of a stopgap budget which expires on December 8th because of all the budget issues and the arguments over the debt sealing.  I’ve only been retired less than 3 years.  If they don’t pass an actual budget or another temporary stopgap budget by midnight eastern standard time on 8 December there could potentially be a government shutdown on December 9th.  If this happens does anyone know would our Military Retirement Pay and VA Disability Pension payments be delayed as a result of a government shutdown in December 2017?  I was still on Active Duty during the last government shutdown in 2013.  The current temporary stopgap budget expires in only 3 weeks.

Edited November 16, 2017 by serpent32

[Sheryl]

Hasn't happened AFAIK in prior shutdowns.

 

Would cause a pretty big uproar if it did.