Health insurance - Half in and half out approach

[trevoromgh]

Thought I'd share my approach to sorting out the complexities of medical cover here in Thailand whilst retaining my access to NHS cover back in the UK. 

I have adopted the half in half out approach where I spend six months of the year in each country which usually provides the following health and lifestyle benefits:-

1.  Ensures I get to visit when the weather is usually at it's best (I've picked November - May in Chiang Mai)
2.  Health cover free in UK via NHS (as long as you spend at least 6 months of the year there) and my GP even agreed to give me 6 months medication prescriptions in advance to carry over with me
3.  Health cover in Thailand (up to £10 million) for six months provided by a longstay travel insurance including several pre-existing medical conditions (£509 per trip with medical excess of £400)
4.  UK and Thai home insurance companies advised of long term absence so cover continues (normally requires someone to visit regularly during absence)
5.  Retain cost of living national pension increases (which would otherwise be frozen if I was to migrate overseas)
6.  Have old but reliable cars in each country which are looked after by friendly garages or relatives so we have wheels of our own
7.  Bills in both countries paid by direct debit and monitored over the internet
8.  Empty places put into hibernation whilst not there and costly lighting and heating bills avoided during the winter UK season

Obviously there are disadvantages to this approach in that I don't get to spend 100% of my time here in Thailand and I have chosen not to rent out the places whilst we are away so no revenue generation at the moment but right now it works for me at least until I can work out how to sort out  a replenishable medical contingency fund or Thailand government can offer expats an affordable medical plan. 

 

Does anyone else follow a similar approach or have other suggestions to avoid the shock of medical emergencies and the financial implications of them?  

 

 

Edited January 31, 2018 by trevoromgh

[theguyfromanotherforum]

Sounds like a plan.

 

Myself I'm thinking of doing 6 months in Canada/Thailand.

 

I am a bit suspicious about "travel" insurance. Normally the travel insurance is limited in duration, so who the heck knows what kind of clauses they have.......

 

 

[trevoromgh]

Well my insurance was a special backpackers and longstay policy for 6 months and whilst I don't intend to come within a mile of a backpack the cover seems fine for my situation but with any insurance you have to spend an hour or two reading the small print and asking questions if anything is of concern.  Hopefully I shall never have to make a claim but reviews on the internet about the insurance company were mostly positive.  Good luck with your planned trip.

[scorecard]

16 hours ago, theguyfromanotherforum said:

Sounds like a plan.

 

Myself I'm thinking of doing 6 months in Canada/Thailand.

 

I am a bit suspicious about "travel" insurance. Normally the travel insurance is limited in duration, so who the heck knows what kind of clauses they have.......

 

 

 

 

Agree, some 'travel' policies provide some cover for one payment death benefit, flight delayed, etc etc., but zero hospital, doctors care, transport to hospital etc., cover. Always need to check this carefully.

 

Further one budget operation lists the details of the benefits in their travel insurance policy but when the policy comes from the actual insurance company it's different to whats' on the airline site.  Beware.

[topt]

54 minutes ago, scorecard said:

 

 

Agree, some 'travel' policies provide some cover for one payment death benefit, flight delayed, etc etc., but zero hospital, doctors care, transport to hospital etc., cover. Always need to check this carefully.

 

Further one budget operation lists the details of the benefits in their travel insurance policy but when the policy comes from the actual insurance company it's different to whats' on the airline site.  Beware.

"but zero hospital, doctors care, " - never seen this before with any travel insurance policy I have taken out in the last god knows how many years even with fairly standard annual cover max 30 days style insurance. You must have been searching in the bargain basement barrel.......

 

[Card]

1. It is unfair on the NHS to have it finance your drugs whilst you are in Thailand, when you can clearly afford to pay for them yourself. I am surprised it is even legal and surprised your doctor doesn't realise that the NHS loses millions on giving free treatment to those who are not eligible. 

 

2. Is it really worth having to spend 6 months of the year in blighty just to get free access to the long waiting lists for NHS treatment and a minimal increase in your pension each year? Really?

[topt]

17 hours ago, theguyfromanotherforum said:

I am a bit suspicious about "travel" insurance. Normally the travel insurance is limited in duration, so who the heck knows what kind of clauses they have.......

There are a lot of "long stay" travel insurance policies. I was always able to get a copy of the wording before I purchased.  I am guessing the OPs is World Nomads or similar based on the pricing. I have had these policies in the recent past and you can get for up to 18 months in some cases. Some even although travelling on a scooter........

[topt]

2 minutes ago, Card said:

1. It is unfair on the NHS to have it finance your drugs whilst you are in Thailand, when you can clearly afford to pay for them yourself. I am surprised it is even legal and surprised your doctor doesn't realise that the NHS loses millions on giving free treatment to those who are not eligible. 

 

2. Is it really worth having to spend 6 months of the year in blighty just to get free access to the long waiting lists for NHS treatment and a minimal increase in your pension each year? Really?

Re point 1 - What is your problem? The OP says it is a lifestyle choice. I think many others would go this route if they could.

Also depending on his age and health living full time in Thailand the cost of health insurance may be completely prohibitive. See the current thread on the (Chiang Mai?) vlogger who is facing a potential huge bill for a bypass operation for comments from others.

If you are not aware I can only assume you are young enough, or rich enough, for it not to currently be an issue.

[ujayujay]

18 hours ago, theguyfromanotherforum said:

Sounds like a plan.

 

Myself I'm thinking of doing 6 months in Canada/Thailand.

 

I am a bit suspicious about "travel" insurance. Normally the travel insurance is limited in duration, so who the heck knows what kind of clauses they have.......

 

 

Simple: Read the t&c of the contract before sign

[Card]

Just because others would do the same dies nut make it right when the NHS has to forgo

51 minutes ago, topt said:

Re point 1 - What is your problem? The OP says it is a lifestyle choice. I think many others would go this route if they could.

Also depending on his age and health living full time in Thailand the cost of health insurance may be completely prohibitive. See the current thread on the (Chiang Mai?) vlogger who is facing a potential huge bill for a bypass operation for comments from others.

If you are not aware I can only assume you are young enough, or rich enough, for it not to currently be an issue.

Just because others would also cheat the NHS drug supply system does not make it right when the NHS is struggling to care for those who are eligible. That is 'my problem'.

 

I am not young, nor particularly rich, but I made sufficient provision before I came out to Thailand so that I can take care of my own expenses, unlike the guy you quote as facing an enormous bill and now wants others to pay it. I sold my home in the UK, and declared non-residency to the UK govt, which many keep and then claim they are too poor to pay. I do not want others to pay my bills. You have a problem with that?

Edited February 1, 2018 by Card

[laochef]

Hi ! What are the names of your insurance companies ?

[trevoromgh]

1 hour ago, Card said:

1. It is unfair on the NHS to have it finance your drugs whilst you are in Thailand, when you can clearly afford to pay for them yourself. I am surprised it is even legal and surprised your doctor doesn't realise that the NHS loses millions on giving free treatment to those who are not eligible. 

 

2. Is it really worth having to spend 6 months of the year in blighty just to get free access to the long waiting lists for NHS treatment and a minimal increase in your pension each year? Really?

I disagree with it being unfair as for a start I have paid my NI contributions in full and have only relatively recently had to start taking the medications and the cost for these is clearly offset by the fact that I am no longer a burden to the NHS for 6 months of the year which could have cost them considerably more.  As for staying in the UK this is likely to be a temporary situation until I have finally decided that Thailand is the place I wish to migrate full-time to and that decision will not be rushed.

[trevoromgh]

17 minutes ago, laochef said:

Hi ! What are the names of your insurance companies ?

Hi there... have sent you a private message with details as I don't think we are allowed to advertise on the forum.  Cheers

[Dene16]

20 hours ago, trevoromgh said:

Does anyone else follow a similar approach or have other suggestions to avoid the shock of medical emergencies and the financial implications of them?  

I do exactly the same although normally terms of 3 months but definitely avoid the winter months in UK. i also use the backpackers long term insurance although at a young 54 years it was only £75 for 4 months and includes cover in case of motorcycle accident ( not all have it) and  rated highly. Don't like leaving the house empty so am going to rent a room to a friend in the future and will also give me some extra income.

You do not have to be in the UK for 6 months for it to be your main residence ( what about people that work abroad etc) if you were to spend 9 months it would still be ok as long as there was not an exact pattern

As far as taking money from the NHS you have paid into it all your life,a lot more than the dole lifers of the UK, and the money you save them when not there is a bonus. You still pay council tax, electric and gas standing charges, etc while not there so don't take any notice of the grumbleweeds on here.

[trevoromgh]

4 minutes ago, Dene16 said:

I do exactly the same although normally terms of 3 months but definitely avoid the winter months in UK. i also use the backpackers long term insurance although at a young 54 years it was only £75 for 4 months and includes cover in case of motorcycle accident ( not all have it) and  rated highly. Don't like leaving the house empty so am going to rent a room to a friend in the future and will also give me some extra income.

You do not have to be in the UK for 6 months for it to be your main residence ( what about people that work abroad etc) if you were to spend 9 months it would still be ok as long as there was not an exact pattern

As far as taking money from the NHS you have paid into it all your life,a lot more than the dole lifers of the UK, and the money you save them when not there is a bonus. You still pay council tax, electric and gas standing charges, etc while not there so don't take any notice of the grumbleweeds on here.

Thanks for the support.  The 6 months limit was a stipulation of the particular insurance company I used but other companies may have longer but not cover the pre-existing medical conditions I have. You certainly have to search around a lot when you have them and it bumps the premiums up dramatically.

[Kron]

Interesting read.

 

For me, my UK tax liability, if I would became resident, plus the additional cost of maintaining a second home far outweighs what I'm having to pay Bupa.

 

Also if like what happens with my Mother, her cancer checkup times are always being changed. Trying to work this into when you would be in the UK might be rather difficult.

 

 

 

[Dogbarker]

12 hours ago, trevoromgh said:

Well my insurance was a special backpackers and longstay policy for 6 months and whilst I don't intend to come within a mile of a backpack the cover seems fine for my situation but with any insurance you have to spend an hour or two reading the small print and asking questions if anything is of concern.  Hopefully I shall never have to make a claim but reviews on the internet about the insurance company were mostly positive.  Good luck with your planned trip.

similar to me .. I do not rent out my homes in either place. Cannot get my doctor to cover my meds while I am in cnx ...shame. BUT as I could not get an operation on the last trip to UK I am booked in for that in cnx next week self funded. I also ensure I have a full medical check BEFORE I go back to the UK as getting treatment in the UK or even a check up is so difficult. Even though I have paid full NI for all these years I do not abuse it as I'm relying more and more on Thailand private medical to ensure i can check my vitals - a ultrasound on my prostrate is a great check annually. Used world nomads but as soon as I reach 60 it went up significantly so went elsewhere... Look at cash back sites too saved me an additional hundred quid buying my insurance .

Live the life 

[Chicken George]

1 hour ago, Card said:

Just because others would do the same dies nut make it right when the NHS has to forgo

Just because others would also cheat the NHS drug supply system does not make it right when the NHS is struggling to care for those who are eligible. That is 'my problem'.

 

I am not young, nor particularly rich, but I made sufficient provision before I came out to Thailand so that I can take care of my own expenses, unlike the guy you quote as facing an enormous bill and now wants others to pay it. I sold my home in the UK, and declared non-residency to the UK govt, which many keep and then claim they are too poor to pay. I do not want others to pay my bills. You have a problem with that?

The guy is on holiday six months of the year so no probkem.. He is within the law. Good luck to him.. I bet he has paid his tax and NI so is entittled. I myself still pay tax and NI in the UK but live here in Thailand so I cannot use the NHS free.. Ilegals in the UK get treated free with no chance of getting money back.. 

You seem to be a very bitter person why?

[SEEDGER]

About a year ago I tried to get accident insurance. You know hurt in a bike wreck need care. Did not want huge policy just something extra in case of broken leg or something similar. Went to local English agent met with office staff filled out paper work; at the bottom it asked about high blood pressure, Diabetes, Heart conditions ect.  I marked the Diabetes box. Huge mistake being truthful I was told by office staff very bad. 

 

The company refused me. I only wanted a 500,000.00 baht Coverage yet they said no. 

This is the problem with insurance, if  your truthful you get screwed. 

As  for home country insurance can't afford it my last quote for a policy was 15,000.00US$ a month. $180,000.00 US a year. So for those of you that comment on not being able to come in with out insurance I say ...... I won't say it. But I believe you get the meaning.

[Acemaker]

2 hours ago, Card said:

1. It is unfair on the NHS to have it finance your drugs whilst you are in Thailand, when you can clearly afford to pay for them yourself. I am surprised it is even legal and surprised your doctor doesn't realise that the NHS loses millions on giving free treatment to those who are not eligible. 

 

2. Is it really worth having to spend 6 months of the year in blighty just to get free access to the long waiting lists for NHS treatment and a minimal increase in your pension each year? Really?

Hey, maybe the OP has paid into the NHS all his life and feels justified in what hes doing, he is hardly a Medical Tourist scrounging off the NHS, sounds like your a member of the Croc wearing Brigade coupled with a touch of envy!

[Enoon]

2 hours ago, Card said:

Just because others would do the same dies nut make it right when the NHS has to forgo

Just because others would also cheat the NHS drug supply system does not make it right when the NHS is struggling to care for those who are eligible. That is 'my problem'.

 

I am not young, nor particularly rich, but I made sufficient provision before I came out to Thailand so that I can take care of my own expenses, unlike the guy you quote as facing an enormous bill and now wants others to pay it. I sold my home in the UK, and declared non-residency to the UK govt, which many keep and then claim they are too poor to pay. I do not want others to pay my bills. You have a problem with that?

 

Did the OP pay NI contributions all his working life?

 

Is he still liable for tax in the UK?

 

If the answers to those questions are "yes" (I'm guessing they are) then he is completely "eligible" in the eyes of the vast majority of the UK public.

 

This is but one example of the "law" being completely out of touch with the realities, possibilities and demands of early 21st century living/people.

 

 

 

[Lacessit]

3 hours ago, ujayujay said:

Simple: Read the t&c of the contract before sign

You're a better man than I am if you can fully comprehend all the fine print of most insurance contracts. They are not one-pagers for a reason.

I keep it simple by self-insuring. At my age and with pre-existing conditions, I doubt I could get health insurance anyway.

[scorecard]

4 hours ago, topt said:

"but zero hospital, doctors care, " - never seen this before with any travel insurance policy I have taken out in the last god knows how many years even with fairly standard annual cover max 30 days style insurance. You must have been searching in the bargain basement barrel.......

 

 

It was the travel insurance offered on one of the budget airline sites, specifically for a trip from Thailand to a nearby country and return.

 

 

[London Boy]

I use also use Worlds Nomad insurance.  I unfortunately  injured my 2nd toe in early January, playing football, and underwent surgery at the weekend to repair a Torn Plantar Plate. The surgery went well, but currently have a metal pin in my toe and recovery time is estimated around 8 weeks.The total cost was Bt280,000 and has been totally covered by Nomads. The care I received at BNH was absolutely top notch (Nomads preferred Hospital) and  Nomads were fantastic, fully covering the costs and constant support over the phone. Although never nice to undergo surgery, but so glad I had it done here rather then in the UK.

[Colabamumbai]

22 hours ago, theguyfromanotherforum said:

Sounds like a plan.

 

Myself I'm thinking of doing 6 months in Canada/Thailand.

 

I am a bit suspicious about "travel" insurance. Normally the travel insurance is limited in duration, so who the heck knows what kind of clauses they have.......

 

 

Am Canadian and looked at that a few years ago Blue Cross etc. They want proof of your travel dates and six months was not possible, although I live here full time. I know Bhupa has a plan for less than 30, 000 Baht a year. Yesterday I was quoted 123,000 Baht per year, by a company advertising on fb. if I can say that here. Both for living here, with a three month wait for coverage to start, 90 days.

[stevenl]

4 hours ago, SEEDGER said:

About a year ago I tried to get accident insurance. You know hurt in a bike wreck need care. Did not want huge policy just something extra in case of broken leg or something similar. Went to local English agent met with office staff filled out paper work; at the bottom it asked about high blood pressure, Diabetes, Heart conditions ect.  I marked the Diabetes box. Huge mistake being truthful I was told by office staff very bad. 

 

The company refused me. I only wanted a 500,000.00 baht Coverage yet they said no. 

This is the problem with insurance, if  your truthful you get screwed. 

As  for home country insurance can't afford it my last quote for a policy was 15,000.00US$ a month. $180,000.00 US a year. So for those of you that comment on not being able to come in with out insurance I say ...... I won't say it. But I believe you get the meaning.

Be glad you told the truth, if you would have lied a future claim could be rejected, even if unrelated to diabetes, just because you lied.

[natway09]

So you sound as though you have your Shi...... together.

Good on ya.I wish more people would plan & not become a burden to Thailand when 

things go pear shaped.

[topt]

3 hours ago, scorecard said:

 

It was the travel insurance offered on one of the budget airline sites, specifically for a trip from Thailand to a nearby country and return.

 

 

Oh, sorry I had presumed it was for travel insurance out of the UK. A good warning for me to check if I buy any here

[scubascuba3]

I was doing the same, 6 months UK, 6 months Thailand but i wanted to spend more time in Thailand, there is the flaw in the plan. If reasonably healthy, self insure and/or get personal accident medical insurance

[KKr]

On 1/31/2018 at 2:05 PM, trevoromgh said:

 

Does anyone else follow a similar approach or have other suggestions to avoid the shock of medical emergencies and the financial implications of them?  

hi, good post.
have been looking into similar idea for the Netherlands, but the government requires 8 months per year spending there in order to maintain the registration as a resident that is compulsory for the government sponsored health insurance.
Some insurances were prepared to write the cover anyway, but risk is that they annul the cover in case of a large claim and no 100 % compliance with the regulations concerning registration, (no way around that as passport gets stamped in TH.)
Also, in such case it will be difficult to get cover from another government plan insurer because insurance companies maintain an official register of terminated policies, and moreover due to the underwriting process in Private health insurance.
If it works in the UK for now, the savings are obviously gigantic.