Pattaya / THExpats / Health-Self-insured?

[moonseeker]

What is the opinion on self-insuring for expats? I feel it is high risk, unless you are very well off. And even then, who likes to spend his hard earned money

on some expensive medical treatment. Cancer treatment can now run into Mio. of Baht in a year, with the many new therapies. Major surgeries can cost

a fortune, if done in a private hospital. 

I see many people returning to their home country in a hurry, if they get seriously ill. Lucky if their Gov. pays the bills, but probably long waits to access the

system. At least here in TH access is fast and in general good standards. How are you insured? Or what are your thoughts?  MS>

[ThaiBob]

My insurance from my home country covers me for emergencies overseas. I would buy insurance here but insurance companies here are permitted to exclude pre-existing conditions in their policies and/or age restrictions. That doesn't work for me or many other expats here. If you have a work permit perhaps you have more options. 

[Sheryl]

The problem with self-insuring is that people do not understand what it is and use the term to mean no insurance.

 

To be truly self-insured you need ready access to at least 1 million baht (3 million if you want the option of private hospitals) and a plan for what to do when that is expended.

 

There is no need to buy insurance here to be covered in Thailand. Many good international expat policies and (for those here short-term) travel insurance policies. Some of which will enroll people up to age 100. And some of which will cover pre-exisitng conditions after an initial moratorium period, if they are stable.

 

Pattaya expats club has a group policy, I do nto know the detaila but worth looking into.

 

 

[moonseeker]

I am well & fully insured personally, but must say premiums are getting painfully high. Many of my friends have no insurance and just take the gamble. Great, if some countries offer the option you mention. Most probably have time or geographic restrictions. Good night for now.   MS> 

[ThaiBob]

I checked out the Pattaya City Expat Club policy, doesn't work for me; age, pre-existing conditions, low coverage for the cost. 

[altcar bob]

2 hours ago, moonseeker said:

I am well & fully insured personally, but must say premiums are getting painfully high. Many of my friends have no insurance and just take the gamble. Great, if some countries offer the option you mention. Most probably have time or geographic restrictions. Good night for now.   MS> 

Trey are going to get a whole lot more expensive also,apparently all made hefty losses last year

[scubascuba3]

Different options,
Self insure (if healthy maybe its a good gamble),
Go back home if something serious.
Explore India treatment options.
Personal accident insurance.

The guys i know, play golf with, cycle are 60-70 and they don't have insurance and aren't cheap charlies, they are all healthy and are gambling and hoping for the best.

Also there are options in that you don't have to have treatment and allow yourself to peg it, up to you, maybe you'll be 85 and won't want any treatment

[Antonymous]

I have health insurance (Aetna/BUPA Thailand) but I have never made a claim on it (15+ years). Yet my premiums increase drastically every year and that pisses me off.

 

I maintain a healthy diet and lifestyle to ‘self insure’ that I never need to see a doctor or take any medication. To me, taking care of yourself is the ultimate self insurance.

 

Yet I see so many expats who abuse their bodies. They all get sick and blame their cancer/heart problems/high blood pressure, etc on getting old. They use the health insurance business as their personal bank, which they willfully rob.

 

The reasons that health insurance premiums are so high and continue to increase well above the rate of inflation year on year are basically twofold:

 

1. Those with insurance cover tend to USE and abuse their insurance because they feel able to take more risks with their health and/or go for unnecessary treatments to get ‘value-for-money’ from their premium payments. I bet you know people who deliberately use up or exceed the cost of their insurance premiums each year as a matter of course, as if it is their right.  

 

2. Doctors and hospitals tend to PRESCRIBE more medication and services to those who are insured, because they are in business to make money.  

 

If you want to have both a healthier population and healthcare at affordable prices, then you have to scrap health insurance cover for avoidable conditions. That’s most conditions – a statement only controversial because pharmaceutical businesses dispute it and ignorant or willful individuals won’t accept it. Accidental injuries and trauma care and a well-defined limited number of non-avoidable conditions could still be insured against.

People would either have to pay for their own medical care, or have to adjust their diet and lifestyle to make healthier choices, thereby eventually living their lives without any pharmaceutical drugs or the need for hospital services - as I do now.

 

Those who could afford to get sick and couldn’t care less, would be free to continue to indulge themselves in non-healthy options. There would be no law against it. It would be their choice and when they do inevitably fall ill, the costs of their care would not become a burden on everyone else who made healthier choices, as is the case with the prevailing insurance system.

 

So to answer the OP, self insurance is definitely an option to consider for those who understand what self insurance actually implies and take steps to stay healthy accordingly.

 

I would highly recommend that you take out the best personal accident insurance you can afford however. We all know how prevalent accidents are in Thailand and they can happen to anyone anytime. Because people don’t willingly incur accidents in order to abuse their insurance, premiums are much lower than health insurance and are affordable.

[1FinickyOne]

Some of the policies available to older people here have an aspect of self insuring. And an aspect of risk as to what is covered, what is not and what will be in the future... Insurance companies are not in it to lose money. Nor are hospitals. 

 

Quality anything is expensive and quality medical is surely no exception. 

 

I have read policies of people who thought they were fully insured just because they bought a policy and were actually covered for very little. Whatever you decided, know what you are getting so you won't be surprised... 

[kingstonkid]

OP. I HAVE both first because my policy requires me to pay then claim and second because along with a self instance it also leaves money for my other half 

 

I put the money in a money fund. Not much interest but it will be all there no matter.

[TheFishman1]

I have insurance now So when I need it I have it

[Kerryd]

I do both.

I have a medical insurance policy, an additional smaller policy that gives me extra coverage in the event I have an accident on my motorcycle (for which I also have Class 1 Insurance) and I keep enough in the bank to deal with most problems in an emergency.

 

The problem with "self insuring" is the presumption that you will be conscious (and coherent) enough to be able to access the needed funds. If you are unconscious or otherwise incapable of getting the money needed (assuming you actually have enough) then there could be a problem. Of course, if you are coherent but immobile you could just give your ATM card and PIN to a total stranger (i.e. one of the hospital staff) and trust that they will only take out enough to pay the bills (but you'd be better off just getting them to contact your bank and having a rep from that bank come see you to make any arrangements).
Different story if you are married and have a spouse that has access to your money (and thinks you are worth more alive than dead). 

 

Also, most non-governmental insurance policies "back home" do NOT cover "pre-existing" conditions (they aren't that stupid). Government Healthcare doesn't really have a choice in the matter but YOU have to check YOURSELF to make sure. Never assume (like all the people who buy travel insurance and find out, after they've had a motorcycle accident, that they aren't covered).

 

For example - if you have Provincial Healthcare coverage from Canada - READ the fine print - you are most likely NOT covered the instant you leave the province !! Doesn't matter if you keep paying your premiums. There have been a few threads about that on TV over the last couple of years. In some cases, you may not be covered even if you just travel to another province for more than a day, let alone outside of the country. If you ask them, they will tell you that you need to get additional coverage, usually from a 3rd part Insurer, to cover you once you leave the province.

Also, many (Provincial) Gov't Healthcare policies have "residential" requirements. For example, if I were to return to Canada tomorrow and enrol in the BC Healthcare plan, I'd have to stay in the province (and pay my premiums) for at least 3 months before I could get anything done under the plan (life-threatening emergencies aside).

 

(Unless of course I was a terrorist that was able to fool people into thinking I was kidnapped until a medical situation happened and I had to arrange to be "rescued" so I could fly my family back to Canada - at someone else's expense - and get my daughter into a hospital without the hassles of premiums or waiting lists or residency requirements.)

Those policies (like pre-existing conditions and residency requirements) are in place so that people will pay for the coverage, even if they end up never actually needing it. Wouldn't it be great if you could buy your insurance coverage the day before going into the hospital to have a very expensive triple by-pass surgery, and then cancel the premium as soon as you get out of the hospital.

Or, for a lot of the expats in Thailand - wait until your liver is completely shot, then fly home, buy an Insurance policy and check into the hospital the next day and get on the transplant list.

Of course, doing that would put all the Insurance companies out of business within days which is why they DON'T do dumb things like that.

In Canada they set a residency requirement to keep people from jumping Province to Province looking for a better deal. Healthcare is Federally funded (for the most part) but Provincially managed and there are a lot of people that would flood into a province to try and take advantage of more lenient rules or shorter wait lists and so on, which could overload the resources in that Province.

Kind of like the welfare system. Federally funded but Provincially managed. When one Province makes a change (i.e. cuts the welfare rates) other provinces with better "pay-outs" suddenly experience a wave of new applicants as those bums travel around looking for the best payouts.

When you are young, you think you are invulnerable and insurance is just an annoyance. When you are old(er) you realize that isn't true and hope you can find coverage (or pray nothing bad every happens - note - prayer never works).

I prefer to hope for the best, but plan for the worst. I'd rather be disappointed at having paid 30 years of premiums and never making a claim, than end up in a life threatening situation that I can't afford to resolve. Of course, no one can predict the future (except the writers on the Simpsons it seems) so it can be a crap shoot either way.

 

[scorecard]

1 hour ago, Antonymous said:

I have health insurance (Aetna/BUPA Thailand) but I have never made a claim on it (15+ years). Yet my premiums increase drastically every year and that pisses me off.

 

I maintain a healthy diet and lifestyle to ‘self insure’ that I never need to see a doctor or take any medication. To me, taking care of yourself is the ultimate self insurance.

 

Yet I see so many expats who abuse their bodies. They all get sick and blame their cancer/heart problems/high blood pressure, etc on getting old. They use the health insurance business as their personal bank, which they willfully rob.

 

The reasons that health insurance premiums are so high and continue to increase well above the rate of inflation year on year are basically twofold:

 

1. Those with insurance cover tend to USE and abuse their insurance because they feel able to take more risks with their health and/or go for unnecessary treatments to get ‘value-for-money’ from their premium payments. I bet you know people who deliberately use up or exceed the cost of their insurance premiums each year as a matter of course, as if it is their right.  

 

2. Doctors and hospitals tend to PRESCRIBE more medication and services to those who are insured, because they are in business to make money.  

 

If you want to have both a healthier population and healthcare at affordable prices, then you have to scrap health insurance cover for avoidable conditions. That’s most conditions – a statement only controversial because pharmaceutical businesses dispute it and ignorant or willful individuals won’t accept it. Accidental injuries and trauma care and a well-defined limited number of non-avoidable conditions could still be insured against.

People would either have to pay for their own medical care, or have to adjust their diet and lifestyle to make healthier choices, thereby eventually living their lives without any pharmaceutical drugs or the need for hospital services - as I do now.

 

Those who could afford to get sick and couldn’t care less, would be free to continue to indulge themselves in non-healthy options. There would be no law against it. It would be their choice and when they do inevitably fall ill, the costs of their care would not become a burden on everyone else who made healthier choices, as is the case with the prevailing insurance system.

 

So to answer the OP, self insurance is definitely an option to consider for those who understand what self insurance actually implies and take steps to stay healthy accordingly.

 

I would highly recommend that you take out the best personal accident insurance you can afford however. We all know how prevalent accidents are in Thailand and they can happen to anyone anytime. Because people don’t willingly incur accidents in order to abuse their insurance, premiums are much lower than health insurance and are affordable.

Add, re personal accident policies, can be worthwhile because there's usually a death (from accident) payout however most (maybe all) insurance companies have a maximum to start or continue, many (maybe most, maybe all) have max. age of 65, not all that old. 

 

 

 

[altcar bob]

Options,to have or have not?   Older you are gets damned expensive insurance and at that you may never need,or are excluded by whatever reason     Accident yes,more than likely,other stuff is elective and selective,so govt.hospital in first instance for stabilisation,then the choices,Thailand? def not,Malaysia ?(very good)  or India? (extremely good)   both only two hours away far far cheaper than Thailand and Thai govt. hospitals are quite good actually (and cheap)

  Having lasik soon,not Thailand) in India

[wwest5829]

13 hours ago, ThaiBob said:

My insurance from my home country covers me for emergencies overseas. I would buy insurance here but insurance companies here are permitted to exclude pre-existing conditions in their policies and/or age restrictions. That doesn't work for me or many other expats here. If you have a work permit perhaps you have more options. 

Agreed. I have a retirement benefit policy that will pay up to $5000 per year overseas. I continue to pay US Medicare premiums in case of need to return to US. Otherwise, I self insure as insurance policies here exclude anything to dowith pre-existing heart issues (my biggest risk) and now eaching an age exclusion....

[scorecard]

.... and Thai govt. hospitals are quite good actually (and cheap).  

 

I add... and getting better.

 

And many have excellent board certified specialists etc.

 

Sometimes a bit of a wait but patients needing urgent care and treatment get just that.

 

My own plan....

 

Way too old for private health insurance.

 

If i'm suddenly needing urgent hospitalization my Thai adult son will take me quickly to a close by private hospital (less than 10 minutes by car), not 5 star buildings etc., but good expert care for a diagnosis. Way cheaper than 5 star places but still too expensive if it's a long stay and lots of tests etc. and I will possibly stay one night.

 

Then he will quickly move to a very good government hospital (already checked for what services they provide, the level of care they are capable of (all 10/10), about 30 - 40 minutes away.

 

 

 

[Skeptic7]

It's a very good question. I've had company paid health insurance for nearly 35 years and really never used it...and gladly never needed it. I know 3 healthy retired expats here (70, 60 & 58). All of them self-insured. By "healthy" just generically refers to being fit, trim, no history of health issues, good diet (all vegan), active, etc. The above also describes me and I will have to make this decision in about 18 months when go from semi-retired to full retirement. 

 

Of course it's a gamble either way and anyone can come down with nearly any illness at any time, regardless of apparent/perceived health and lifestyle...but like them am leaning towards self-insuring. 

 

After watching the quality of life deteriorate for some friends and relatives whom subjected themselves to radical chemo therapy, only to perish anyway...doubtful any of us would choose such treatments if faced with that awful choice. 

 

Good question. No easy answer. 

[scorecard]

10 minutes ago, Skeptic7 said:

It's a very good question. I've had company paid health insurance for nearly 35 years and really never used it...and gladly never needed it. I know 3 healthy retired expats here (70, 60 & 58). All of them self-insured. By "healthy" just generically refers to being fit, trim, no history of health issues, good diet (all vegan), active, etc. The above also describes me and I will have to make this decision in about 18 months when go from semi-retired to full retirement. 

 

Of course it's a gamble either way and anyone can come down with nearly any illness at any time, regardless of apparent/perceived health and lifestyle...but like them am leaning towards self-insuring. 

 

After watching the quality of life deteriorate for some friends and relatives whom subjected themselves to radical chemo therapy, only to perish anyway...doubtful any of us would choose such treatments if faced with that awful choice. 

 

Good question. No easy answer. 

 

"Of course it's a gamble either way and anyone can come down with nearly any illness at any time, regardless of apparent/perceived health and lifestyle...but like them am leaning towards self-insuring. "

 

Good point, eating healthy keeping fit etc., sure it will help.  But it doesn't prolong life forever, the day will eventually come when the body starts to malfunction simply because of age,  sudden heart attack, heredity based factors kick in, etc., then there's a good chance hospital care will come into the picture

 

[Skeptic7]

13 minutes ago, scorecard said:

 

"Of course it's a gamble either way and anyone can come down with nearly any illness at any time, regardless of apparent/perceived health and lifestyle...but like them am leaning towards self-insuring. "

 

Good point, eating healthy keeping fit etc., sure it will help.  But it doesn't prolong life forever, the day will eventually come when the body starts to malfunction simply because of age,  sudden heart attack, heredity based factors kick in, etc., then there's a good chance hospital care will come into the picture

 

Sure...and that is the time to put the self insurance money to work...along with all the baht saved over years of not paying expensive premiums and going to one of those very adequate, much cheaper, government facilities mentioned in your previous post. 

[scubascuba3]

Add, re personal accident policies, can be worthwhile because there's usually a death (from accident) payout however most (maybe all) insurance companies have a maximum to start or continue, many (maybe most, maybe all) have max. age of 65, not all that old. 
 
 
 

I'd prefer a policy that only covered medical expenses in an accident, a lot of the other cover just isn't useful to some of us such as compensation in death. Best I've found is cover of 625k baht per accident

[scubascuba3]

I have health insurance (Aetna/BUPA Thailand) but I have never made a claim on it (15+ years). Yet my premiums increase drastically every year and that pisses me off.
 
I maintain a healthy diet and lifestyle to ‘self insure’ that I never need to see a doctor or take any medication. To me, taking care of yourself is the ultimate self insurance.
 
Yet I see so many expats who abuse their bodies. They all get sick and blame their cancer/heart problems/high blood pressure, etc on getting old. They use the health insurance business as their personal bank, which they willfully rob.
 
The reasons that health insurance premiums are so high and continue to increase well above the rate of inflation year on year are basically twofold:
 
1. Those with insurance cover tend to USE and abuse their insurance because they feel able to take more risks with their health and/or go for unnecessary treatments to get ‘value-for-money’ from their premium payments. I bet you know people who deliberately use up or exceed the cost of their insurance premiums each year as a matter of course, as if it is their right.  
 
2. Doctors and hospitals tend to PRESCRIBE more medication and services to those who are insured, because they are in business to make money.  
 
If you want to have both a healthier population and healthcare at affordable prices, then you have to scrap health insurance cover for avoidable conditions. That’s most conditions – a statement only controversial because pharmaceutical businesses dispute it and ignorant or willful individuals won’t accept it. Accidental injuries and trauma care and a well-defined limited number of non-avoidable conditions could still be insured against.
People would either have to pay for their own medical care, or have to adjust their diet and lifestyle to make healthier choices, thereby eventually living their lives without any pharmaceutical drugs or the need for hospital services - as I do now.
 
Those who could afford to get sick and couldn’t care less, would be free to continue to indulge themselves in non-healthy options. There would be no law against it. It would be their choice and when they do inevitably fall ill, the costs of their care would not become a burden on everyone else who made healthier choices, as is the case with the prevailing insurance system.
 
So to answer the OP, self insurance is definitely an option to consider for those who understand what self insurance actually implies and take steps to stay healthy accordingly.
 
I would highly recommend that you take out the best personal accident insurance you can afford however. We all know how prevalent accidents are in Thailand and they can happen to anyone anytime. Because people don’t willingly incur accidents in order to abuse their insurance, premiums are much lower than health insurance and are affordable.

I agree that people with private health insurance and hospitals milk it. I've had private insurance in the UK for a long time and the consultants are always quick to offer an unnecessary op, or have a whole series of physio which isn't needed. This is one of the reasons i won't buy private medical insurance in Thailand, I'll be paying for all this milking

[Sheryl]

Add, re personal accident policies, can be worthwhile because there's usually a death (from accident) payout however most (maybe all) insurance companies have a maximum to start or continue, many (maybe most, maybe all) have max. age of 65, not all that old. 

 

 

 

Not the case. I just got an accident polucy that covers through age 80 or 85 (forget which). Bangkok Insurance. Covers medical costs up to 200k per accid3nt for annual premium of 6k.

 

I also have more comprehensive health i surance but inpatient only and with a deductible. The accident cover has no deductible and covers in and outpatient.

 

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

 

 

 

[Sheryl]

I'd prefer a policy that only covered medical expenses in an accident, a lot of the other cover just isn't useful to some of us such as compensation in death. Best I've found is cover of 625k baht per accident

What policy is that? Best I accident policy could find was 200k medical cover.

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

[scubascuba3]

What policy is that? Best I accident policy could find was 200k medical cover.

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

It's Siam City, through AA Brokers in Pattaya

[OzMan]

7 hours ago, Antonymous said:

I maintain a healthy diet and lifestyle to ‘self insure’ that I never need to see a doctor or take any medication. To me, taking care of yourself is the ultimate self insurance. 

 

Yet I see so many expats who abuse their bodies. They all get sick and blame their cancer/heart problems/high blood pressure, etc on getting old. They use the health insurance business as their personal bank, which they willfully rob.

I hope you never get in a car accident.

[Antonymous]

9 minutes ago, OzMan said:

I hope you never get in a car accident.

I hope not too. But I have 1st class car insurance, plus personal accident insurance with Bangkok Insurance, plus Aetna/BUPA health insurance that should cover me if I do.

 

What was your point?

[Sheryl]

1 hour ago, scubascuba3 said:

It's Siam City, through AA Brokers in Pattaya

Thanks. Unfortunately they do nto insure people over 65 so of limited use to many of our members, but good for those under 65.

[Tacuisse]

Over 70 with pre-existing conditions? Yes, we will insure you for the modest premium of USD 10K pa. If we feel like it. Otherwise, rack off.

Insurance companies did not get those skyscrapers in most big cities by shelling out on all customer claims. Or taking on high risk customers. That's why they employ actuaries.

I self-insure here, and maintain private cover in Australia. Cost of a plane fare for zero cost treatment there. Here, I just hope to avoid the homicidal clowns on the roads.

[altcar bob]

2 hours ago, Antonymous said:

I hope not too. But I have 1st class car insurance, plus personal accident insurance with Bangkok Insurance, plus Aetna/BUPA health insurance that should cover me if I do.

 

What was your point?

Cannot speak for original poster making inquiry,not one bit. 

   Yes I too have first class  car insurance plus plus,as for Bangkok Insurance,I figure (rightly or wrongly) it may well have something to do with accident insurance,the BUPA insurance ,is another matter. 

  Assuming your age is around 76, a fit and healthy 76 that is, it is indeed a policy worth having for peace of mind alone,maybe a little costly,but I'm sure easily affordable

    Maybe as other posters have concurred ,especially for the older insured it may well be adjudged a load of old <deleted> actually

[khunPer]

10 hours ago, Sheryl said:

Not the case. I just got an accident polucy that covers through age 80 or 85 (forget which). Bangkok Insurance. Covers medical costs up to 200k per accid3nt for annual premium of 6k.

 

I also have more comprehensive health i surance but inpatient only and with a deductible. The accident cover has no deductible and covers in and outpatient.

 

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

Bangkok Bank has a senior accident insurance "PA 1st Senior" covering from 50 to 100 years – it's also Bangkok Insurance – however medical is only 60,000 baht per case, whilst 600,000 baht for loos of life or permanent disability; cost about 5,000 baht a year.

 

Most of us retired expats would probably prefer the opposite, i.e. 600k baht medical and 60k baht loss-of-life.