Pre-existing coverage finally found through a health provider

[4MyEgo]

After living here for 2.5 years and not having private health cover I decided to self insure, this has always been a worry for me. I will explain my reason as we move along.

 

Background:

 

Living back in Sydney Australia, I was covered under the Medicare system (government public system) because I would pay a compulsory tax levy of 2%.

 

In 2008 age (47) I had a mild heart attack and had a stent placed in one of my main arteries, been on some medication since, never had an issue and see the Cardiologist every 2 years by choice. The procedure was all covered by Medicare and of course there was no waiting time as it was deemed an emergency.

 

In 2014 a procedure called UroLift was carried out by the Urologist to get my flow of urine back on track as I was urinating too frequently, I went to a private hospital and paid for it myself in the sum of $6,000AUS as the waiting list in a public hospital could have been from 3 to 24 months, 12 months if I was lucky, the procedure took half a day and the results came out perfect, no medication, no issues since.

 

In 2017 had a Basil Carcinoma removed from my right cheek by a plastic surgeon here in Thailand, it was detected by the Dermatologist I saw when I was on a brief visit back to Sydney, and the biopsy later showed that he didn't get it all, with the Dermatologist advising me a week later to get to a plastic surgeon to get the rest out, and thanks to Sheryl here on TVF a public hospital with a plastic surgeon near my area in Khon Kaen was located, and the day procedure was carried out with a great success, no noticeable scare from the 80mm long incision, and at a low cost to me, from memory around 5,000 baht with 50 baht follow up visit to see the plastic surgeon, oh the cream cost 500 baht...go figure 555

 

I have tried about 3 times to get private health insurance with the main pre-existing condition to be covered for the amount of money they are seeking, i.e. I have been quoted upwards of 100,000 baht at age 57 with no pre-existing conditions covered, i.e. no one will touch any of them, fed up with this and hearing how much it cost Mr A for this and Mr B for that, I said to myself, grin and bear it, even though you have a fair few reserves, you don't want to be out of pocket in an emergency situation outside of your pre-existing conditions, so I emailed the broker we use who does our home and car insurance and she came back to me with options and said that David Shield who she is with are good with pre-existing conditions, worth giving them a try if over 5 years since you had the pre-existing condition treated, now I was going in on the basis that whether or not they covered me, it was time to get covered, I have this thing that because I am a farang, I would probably have a better chance in a private hospital ?

 

I filled in the forms and the insurer came back asking for letters from the specialist, so I made a few calls and a drive to Khon Kaen hospital to see the plastic surgeon and after 3 weeks of waiting and follow up calls to the Cardiologists and Urologists offices, put everything together and then they came to me with the exclusions outlined, however said that they would apply an additional premium of $177.50USD for the hypertension and High Cholesterol, this was totally unexpected, but is a major bonus for me, because if I have an issue with my cardiovascular system tomorrow, I am covered, yes excited, after being shut down a few times before, as if I am a high risk customer, anyone can have a heart attack at any age.

 

So just wanting to let anyone out there who has pre-existing conditions over 5 years and are under 64 you might be in with a chance if your looking for private health insurance.

 

I took out the Essential cover, i.e. the basics, 1.2 mil USD cover for emergency or elective private hospital cover in Thailand and 4 neighbouring countries, no outpatient care, the policy also included is world wide emergency coverage for 90 days, the total cost is $177.50 USD per month or $2,130 USD per annum, or 68,300 baht per annum or 187 baht per day, this is far less than what I was quoted previously by other insurers, i.e. upward sof 100,000 baht and without the pre-existing coverage for my heart which to me is worth a gold.

 

Those of you out there who are under 64 who have pre-existing conditions over 5 years old, if you have been knocked back and self insure, but are in a position to want to get private health insurance, send me a personal message and I will assist you in whatever way I can.

 

As for the health insurers paying up when the time comes, that is always a worry, but I think if you follow procedure, are honest and comply, you should be fine, there website once you log on after becoming a member is also user friendly with access to your health cover certificate to print off, etc etc.

 

Apologies for the long winded post, but if it helps one TVF member getting international private health insurance here in Thailand with a pre-existing condition at a cost which in my opinion is much more affordable than most, its worth it. 

 

Too good health, coverage 555

 

 

 

 

 

Edited May 29, 2018 by 4MyEgo

[JLCrab]

So is the 1.2 million USD an annual cover or for the lifetime of the policy?

[MJCM]

4 minutes ago, JLCrab said:

So is the 1.2 million USD an annual cover or for the lifetime of the policy?

According to this (I hope it's the same insurance as the OP only gave a name) it's annual !

 

http://www.davidshield-intl.com/pages/37.aspx

[JLCrab]

Well OK looks like annual but he didn't say.

[Sheryl]

Yes, annual.

 

Another possible option for people with pre-exisitng conditions would be HCI opting for their "Moratorium" as opposed to FMU (full medical underwriting) option. Under that pre-existing conditions will be excluded for the first 2 years of the policy only (5 years in case of cardiac condition or cancer). Lifted after that provided there have been no additional occurrences.

 

https://www.healthcareinternational.com/

[impulse]

1 hour ago, Sheryl said:

Yes, annual.

 

Another possible option for people with pre-exisitng conditions would be HCI opting for their "Moratorium" as opposed to FMU (full medical underwriting) option. Under that pre-existing conditions will be excluded for the first 2 years of the policy only (5 years in case of cardiac condition or cancer). Lifted after that provided there have been no additional occurrences.

 

https://www.healthcareinternational.com/

 

I can't help but wonder what they would consider "additional occurrences"?  Coming from the land of the free, home of the brave, I wouldn't be surprised to get really disappointed when I discovered that a routine checkup with a normal EKG, or a script for a statin was flagged as an "additional occurrence".  And that after diligently paying premiums for 5 years, crossing my fingers.

 

Bottom line is that, while it's great to get information about policies that promise to pay out for this and that, it's always better to hear about them from someone (or someones) who have actually been on the receiving end of such a payout.  A whopper.

 

Edit:  And I'd add that it would also be comforting to hear from someone who has made a big claim, and didn't get dropped like a hot potato or see their premiums go ballistic the next time the insurer had the opportunity.

 

 

Edited May 29, 2018 by impulse

[4MyEgo]

1 hour ago, JLCrab said:

So is the 1.2 million USD an annual cover or for the lifetime of the policy?

That is a good question, I cannot answer it, but have copied and pasted some clauses that might assist you with your question, and if its only for the life of the policy, I am ok with that, commensurate with what I am paying, when compared to what I could have been paying without my pre-existing cover being covered by others.

 

Section 6:
Insurer’s Limits of Liability
6.1 The limits of the Insurer’s liability according to the Policy to each
of the Members is to the maximum sum prescribed in the Table of
Benefit Maximums that is attached to this Policy and in accordance
with the plan chosen.
6.2 The limits of the Insurer’s liability for the total sum of the Medical
Services covered according to the Policy, for each one of the Members,
throughout the period of insurance, is up to the maximum sum
prescribed in the Table of Benefit Maximums and in accordance with
the plan chosen.
6.3 The limits of the Insurer’s liability for each of the Medical Services
covered by the Policy is in accordance with the medical expenses
as stated above in Paragraph 1.19, but no more than the limit of the
Insurer’s liability for the total of each of the Medical Services.
The Tables of Benefit Maximums and Member Cost Sharing that are
attached form an inseparable part of the Policy, and should be read
over by the Member.

 

1.19 Medical Expenses
Payments for medical services received by the Member, as a result
of an Insured Event, for essential, suitable and appropriate medical
services that are consistent with the specified price levels (Usual,
Customary and Reasonable - UCR) of similar medical service providers
for the same medical services.

[4MyEgo]

1 hour ago, JLCrab said:

Well OK looks like annual but he didn't say.

MJCM did a fine job finding that out, I didn't include that, because I am only new to health insurance, but am glad MJCM pointed that out.

[sfokevin]

Who is your local broker in Thailand that recommend David Shields?

[simon43]

... that a routine checkup with a normal EKG, or a script for a statin was flagged as an "additional occurrence". 

 

I can't see in any way that a routine check-up with a normal EKG could be held against you, rather the opposite.  I have annual EKGs and exercise stress tests (treadmill) to double-check that all is OK.

 

OTOH, being prescribed a statin seems to indicate (to my non-medical brain), that something is amiss with your health, and would certainly warrant further investigation by your insurer.

[4MyEgo]

26 minutes ago, sfokevin said:

Who is your local broker in Thailand that recommend David Shields?

Assuming that it is ok to put the broker in, I was dealing with Wim Fokkema at

 

AA Insurance Brokers Co. Ltd. 

 

565/62 Moo 10, (next to Big C South Pattaya)
Nongprue
Banglamung
Chonburi 20150
T. +66(0)38 415795

E. [email protected]
Office hours Monday to Friday 8.30 a.m. to 5.30 p.m.

Edited May 29, 2018 by 4MyEgo

[4MyEgo]

16 hours ago, 4MyEgo said:

Those of you out there who are under 64 who have pre-existing conditions over 5 years old, if you have been knocked back and self insure, but are in a position to want to get private health insurance,

Correction, it is under 65 years of age

[fellig]

On 5/29/2018 at 3:35 AM, Sheryl said:

Yes, annual.

 

Another possible option for people with pre-exisitng conditions would be HCI opting for their "Moratorium" as opposed to FMU (full medical underwriting) option. Under that pre-existing conditions will be excluded for the first 2 years of the policy only (5 years in case of cardiac condition or cancer). Lifted after that provided there have been no additional occurrences.

 

https://www.healthcareinternational.com/

Sheryl, I went to the site for a quote, and noticed it says: How long? with choices of 3 months or 1 year (https://www.healthcareinternational.com/international-health-insurance-quote). But from your post, it sounds like they do offer long term policies?

 

4MyEgo, I'll be interested to hear how David Shield works out; it's only been a few months so far, right?

 

I'm in my mid-fifties, will be living in Chiang Mai, looking for insurance company that covers pre-existing conditions (waiting period is fine). High deductible/catastrophic a priority; don't mind paying out of pocket for small things. 

[Sheryl]

Click on one year. Policies are issued for a year at a time but with gurantee of renewal.

Ss you live in CM you can get this as part of the CM Expat Club group policy. Suggest you contact them.

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

[fellig]

20 hours ago, Sheryl said:

Click on one year. Policies are issued for a year at a time but with gurantee of renewal.

Ss you live in CM you can get this as part of the CM Expat Club group policy. Suggest you contact them.

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

 

Very helpful, thanks!

 

[Alotoftravel]

4MyEgo, I am planning to sign up with DavidShield too. I would appreciate an update if any before I signup. THanks