Advice- how much to put aside for self health insurance?

[peterb17]

I’ve recently received my invitation to renew my health insurance, I have no idea what everybody else pays - this year $3600 - with $1000 excess - I’m 66 , never claimed . This covers me for SE Asia not worldwide.

In the last five years the premium has trebled .

Has the cost of treatment here trebled?

 

At the present rate of increase by the time I’m 70 - could be $10000

 

So would it be more sensible just to put say 5 million into a savings account for any possibility?

 

I’m not going to lose any sleep paying the premium ( I’m a pesky Brit by the way )

 

It just seems crazy paying out for something you may never need - as I was told as a child - always wear clean underwear- you might be run over by a bus tomorrow ( typical British humour )

 

 

 

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[BestB]

It’s impossible to answer . Private hospital minor surgery can easily cost 130000 baht, anything little more serious and you looking at 300000-400000. Anything serious or long stay and you could be into millions.

 

i say pay the premiums and you can have some piece of mind. 

 

That’s my thoughts 

[OneMoreFarang]

17 minutes ago, peterb17 said:

Has the cost of treatment here trebled?

No. You are getting older and statistically this means you will be more expensive for the health insurance. And this will get worse every year.

If you can afford it pay it and then it is out of your mind.

If you can't afford it you should think about going back to the UK. I know that is what most people want to avoid. It's your risk - maybe a deadly risk.

[BestB]

50 minutes ago, OneMoreFarang said:

No. You are getting older and statistically this means you will be more expensive for the health insurance. And this will get worse every year.

If you can afford it pay it and then it is out of your mind.

If you can't afford it you should think about going back to the UK. I know that is what most people want to avoid. It's your risk - maybe a deadly risk.

Spot on premiums go up i believe every 5 year intervals and the older you get the higher the rise. Then add on medical inflation and premiums are crazy high. I am 42 and i am paying 1600 euro.

 

OP is actually lucky in a sense that his insurance company has not cut him off, might be wise to check small print if there is a cut off age as well.

[peterb17]

Spot on premiums go up i believe every 5 year intervals and the older you get the higher the rise. Then add on medical inflation and premiums are crazy high. I am 42 and i am paying 1600 euro.
 
OP is actually lucky in a sense that his insurance company has not cut him off, might be wise to check small print if there is a cut off age as well.

Hi there

My policy has no age limit whatsoever.

You are paying € - so presume that is for Europe?

Yes - premiums may go up every 5 years .

4 years ago when I was 62 - premium $1200 - now $ 3600, every year an increase, not just a big jump. Next year probably $5000

All I am saying - is it worth just putting some cash into long term savings - instead of paying out every year - for nothing in return .

I cannot access the NHS anymore in answer to the previous post and have absolutely no desire to return to the UK .


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[BestB]

1 hour ago, peterb17 said:

 

Hi there

My policy has no age limit whatsoever.

You are paying € - so presume that is for Europe?

Yes - premiums may go up every 5 years .

4 years ago when I was 62 - premium $1200 - now $ 3600, every year an increase, not just a big jump. Next year probably $5000

All I am saying - is it worth just putting some cash into long term savings - instead of paying out every year - for nothing in return .

I cannot access the NHS anymore in answer to the previous post and have absolutely no desire to return to the UK .


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My policy is world wide, excluding USA, the reason for price in euro because its a French Insurance company, but i got the policy in Thailand and they have office in BKK.

 

Price increases generally year on year due to medical inflation as they like to call it. but also big jumps with age brackets.

 

Just like yourself, i can no longer access free medical care back home.

 

Problem with self insuring in my opinion is that how much is enough? and the answer is no one knows.

 

You mentioned 5 million. Sounds enough, but that means having to put aside 5 million up front, where as insurance policy may take you 5-10 years before you rich 5 million(hope it makes sense)

 

Then if anything happens, they fix you up, with current insurance policy you are covered for anything going wrong again, without one, once 5 million is gone, you will need another 5.

 

In the end of the day, its a personal choice, to me, if i can afford an insurance policy, i would rather have one. ????

 

[KittenKong]

11 hours ago, BestB said:

OP is actually lucky in a sense that his insurance company has not cut him off, might be wise to check small print if there is a cut off age as well.

They may not cut you off but most if not all will try to price you out of the market by increasing premiums exponentially as you get older or as you start to make claims. At some point you give up and leave.

They are not on your side.

[peterb17]

They may not cut you off but most if not all will try to price you out of the market by increasing premiums exponentially as you get older or as you start to make claims. At some point you give up and leave.
They are not on your side.

KittenKong

I think you are probably correct, I have money in the bank- but not a vast income from my various pension schemes.

I just had this idea, put a reasonable sum into a long term savings account ( I think you could access the money- but lose any interest)

Then top it up with say £3000 a year ( the premium they want me to pay this year )

This way you are saving - not providing dividends for the insurance company shareholders.

It was just the way the premium has trebled in such a short time- at 66 I’m hardly ancient- many people are still in work at that age .

I had heard that one reason the premiums are increasing here is that the hospitals have become greedy- once they realise you have decent insurance the costs become much more expensive- this may be true- I’m not sure .

Thanks for your reply


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[Sheryl]

First of all, it is not going to hit $10,000 by the time you are 70. Depending on which policy you have, and assuming you have inpatient cover only, it will likely be in the range of $4-5,500. Your insurer should be able to give you a chart showing current rates by age group. Note that many insurers raise rates in 5 year increments with only small cost of living increases in between and then big jumps every 5 years. others do the age based increases annually. age related increases reflect the higher average pay outs to people in older age groups whereas inflationary adjustments reflect changes in cost of medical care. I suspect your policy works in 5 year brackets and you just jumped a bracket.

 

Secondly if as it sounds your health is good, there are less costly options. For example, under 3,000 with April International (My Health International NOT My Health Thailand! You do not want a policy issued out of Thailand if you plan to live out your life here.)

 

Thirdly this is not something you "may never need".  The odds of never needing it are astronomically small if you are planning to stay permanently in Thailand (or anywhere else you don't have access to free care).  You will need it, sooner or later and probably more than once or twice..probably several times at least. Health problems are not a rare occurrence  -- they are a universal facet of growing old. Both life threatening problems (heart disease, cancer etc) and problems that impact severely in quality of living (cataracts, arthritis leading to constant pain unless you get a joint replacement etc).  It is true that you will probably end up having paid more in than you get paid out, but you might also end up getting back many fold what you paid in, that is how it works. And you have no way at all of knowing if you will be in that minority or not.

 

If you want to self-insure instead then you need at least USD$150,000  put aside and a way to immediately replenish it as it is spent. Which it could be in just one hospitalization. Or else a clear plan in place for returning to your home country once it is spent.

 

A more sensible approach if you want to bank on your current state of health remaining the norm for most of the rest of your life (a questionable bet IMO -- your present state of health in no way renders you immune to accidents nor the development of serious illness in future) would be to up the deductible, most policies will let you go as high as $5000. Of course, that means you have to have that amount of money set aside and be able to replenish it every time any of it is used, but likely more affordable than $150,000.

 

Be forewarned though that once you take a higher deductible, the insurance company can refuse to let you lower it later and likely would if you had developed a chronic health condition. So think carefully about how well you can afford this for the long run, keeping in mind things like currency flunctuation and rising  cost of living in Thailand.

 

We have had a number of  self insured people here deplete their savings and have to return to their home country, broke or near broke. Many of them had little choice because they were uninsurable due to pre-existing conditions from the time they first arrived in Thailand. Others were short-sighted and made decisions based on assuming they would always stay healthy or the only health costs they would ever face would be small. And by the time they found out otherwise they were no longer insurable.

 

You are very fortunate to still be healthy at your age and would be foolish IMO to give up your insurance. I suggest you look into a possible change of policy as now is the time to do that, before you have any claims. Contact a good broker, they can help you make a selection as well as help with claims later on. Suggest AA brokers. If you are in Pattaya, Hua Hin or Phuket they have offices you can go into otherwise by email www.aainsure.net

 

They can tell you  not just the current premium for different policies under different deductible scenarios  but what premiums you can expect, at current rates (i.e. without cost of living adjustment), at older ages. Actual will end up being a bit higher because most years there is some inflationary adjustment but it gives you a pretty good idea.

 

 

 

 

 

[Sheryl]

3 hours ago, KittenKong said:

They may not cut you off but most if not all will try to price you out of the market by increasing premiums exponentially as you get older or as you start to make claims. At some point you give up and leave.

They are not on your side.

All policies raise premiums as you age though to very different degrees and this information is readily attainable in advance.

 

Internationally issued policies (EU, UK) cannot raise policies on an individual basis due to claims or change in health status  as the insurance regulations in their country of incorporation does not allow it. Thailand does. This s exactly why I advise against a Thailand-issued policy for people planning to live out their old age here.

[GarryP]

I read these threads about insurance and get nervous. While in my case I will continue making social security payments here in Thailand and will be able to seek treatment under that scheme, I will be limited to the hospitals I can use - I have to name the hospital each year. Also, if a push came to a shove I could also use the 30 Baht health care scheme here (I just got Thai citizenship a couple of years ago) but then would be limited to government hospital care at a specific hospital. Therefore I would have very little choice as to where I could seek treatment. If, however, I had my own insurance coverage, I would have a much greater choice of hospitals, which could be important if you want to see certain specialists in your field of illness.

 

Would I, as a UK passport holder, but who has not lived in the UK since I was 19, still be able to get an internationally issued policy (UK)? And would it be worth my while or should I just stick with social security coverage? I am also covered by my office's insurance for both inpatient and outpatient treatment until I am 60. I am 56 (near enough), have slightly elevated blood pressure and started to suffer mild prostate issues. 

 

As I will be living off my savings upon retirement - no pension, being hit with very large medical bills is a nightmare for me.  

[Ctkong]

17 hours ago, OneMoreFarang said:

No. You are getting older and statistically this means you will be more expensive for the health insurance. And this will get worse every year.

If you can afford it pay it and then it is out of your mind.

If you can't afford it you should think about going back to the UK. I know that is what most people want to avoid. It's your risk - maybe a deadly risk.

You are correct there.  My health insurance (AIA) has increased premium every 5 years.... I think it is prudent to insure until you are 70. Then it gets really expensive. After 70, there is no reason to insure as you are not liable to be operated upon and if it I still the big C , you still have some time to make peace.  

[Sheryl]

(replying to GarryP)

 

Any nationality can get a UK issued expat health policy. Ditto French issued etc.

 

But, it will cost you, and there will be exclusions - certainly prostate and possibly also cardiovascular. On this last point I have found Cigna Global to be pretty reasonable as long as the BP is well controlled. The only way to know for sure, though, is to apply and see what they come back with. Of course even with exclusions you do have the fallback of the SS. The big issue is what they do re the hypertension as if they apply an exclusion, depending on the insurer it could be a pretty sweeping one that encompasses heart disease, stroke, kidney disease etc.

 

As long as you have SS and are a Thai citizen to boot you should be protected against large medical bills. (Incidentally you cannot claim under the 30 baht scheme while under SS - they cross check that database, you'd only be eligible if no longer under SS. But no reason to prefer one to the other).

 

Being able to choose oner's doctor and hospital -- and avoid the long waits, crowds and other hassles of govt hospitals - is definitely an advantage but you need to weigh that against the cost of private insurance. Which will be around 2,000 now rising to around 3,000 in your 60's and on up to around 5,000 by age 75-80 (this is without a deductible - you can lower it a bit by accepting one).  Only you can decide if that is worth it.

 

Making sure you are enrolled at the best possible hospital under SS is a priority.

[Sheryl]

8 minutes ago, Ctkong said:

You are correct there.  My health insurance (AIA) has increased premium every 5 years.... I think it is prudent to insure until you are 70. Then it gets really expensive. After 70, there is no reason to insure as you are not liable to be operated upon and if it I still the big C , you still have some time to make peace.  

After 70 you are quite likely to need surgery, often for things that if not done will mean severe pain and disability. There are many operations where the average age is over 70.

 

70 is not at all old these days, at least not if you have taken reasonable care of yourself. My mother at 88 still walks a mile each day, drives by herself long distances, undertakes international travel etc etc, has a full and completely active life. And has had a few surgeries along the way, all of them after age 70, bouncing right back after them just fine. And she is not at all unusual.

 

Cancer is not always (or even usually) terminal these days.

 

You are more likely to need surgery and need and want other treatments after age 70 as before. Which is why the premiums go up -- you will use the insurance more.

[melvinmelvin]

51 minutes ago, Sheryl said:

All policies raise premiums as you age though to very different degrees and this information is readily attainable in advance.

 

Internationally issued policies (EU, UK) cannot raise policies on an individual basis due to claims or change in health status  as the insurance regulations in their country of incorporation does not allow it. Thailand does. This s exactly why I advise against a Thailand-issued policy for people planning to live out their old age here.

 

so you reckon 150 k US would serve as a decent buffer? in most cases?

 

maybe I am totally wrong but I figure worst case triggers would be traffic accidents,

with such, there is no end to what could be smashed/go wrong

 

had a sojourn in a hospital this winter

step 1 very reluctantly accepting to be admitted, 2 days ICU then 1 day non ICU

step 2 left the hospital against medical advice and went home

step 3 the week after; collapsed at home, factotum had the brains to call the same hospital and request EMS

step 4 stayed a short week in ICU, a total of 5 weeks + in ward

total for my insurance company about 2.5 million

 

what was done;

a couple of stents

terrible infection in right lower leg, huge open wound in ankle - dripping dripping dripping took very long time to sort

some skin cancer stuff on arms was sorted

pneumonia - in stereo

plenty liquid in lungs

crapped down lungs 'cause excessive smoking - very lousy oxygen saturation

right leg swollen to gigantic proportions, liquid being pressed out through the skin, upper thigh pressing on prostate

     frustrating Jimmie Riddle

 

I reckon pretty straightforward stuff compared to what could be the aftermath of a severe car crash.

 

2.5 million - no giveaway.

 

 

 

 

[Sheryl]

around 150K USD (4.8 million baht) will suffice in most cases including bad accidents. But as explained that is an amount per event not per year and a self insured person would need to be able to keep replenishing it, which could involve doing so more than once in a year and frankly very, very few people can afford to do that.

[Aforek]

Try CFE ( Caisse des Français de l'étranger ) , opened now to other countries under certain conditions

no conditions of age, just following the amount of your pension ( but  next year there will be a new law when voted by parliament )

many partnerships with other third party insurances ( among them April ), very easy to send bills ( by e-mail ) and refund in 15-30 days 

next year even  more opened to foreigners 

for us , French expatriates, it's a good solution and not too expensive 

 

https://www.cfe.fr/en/adhesion-entreprise

 

[peterb17]

Dear Sheryl

You always give sage advice on the forum- and it is much appreciated.

I think you are correct - actually something I had not thought through- if perhaps after an accident you deplete your back up plans - then you really have to replace them .

My policy seems very good - and the medibroker always seems an efficient company. It very much suits my needs - and is specific to SE Asia ( not Singapore ) This is where I travel to these days .

I just bung it on a credit card - and have a standing order to pay over a few months - relatively painless .

Not sure about one comment - over 70 - that’s it. I have a good friend who is 96 - he is off on a cruise to New Zealand this week and although frail still enjoys life very much ( I do realise that is unusual )

Thanks again

P



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[GarryP]

1 hour ago, Sheryl said:

(replying to GarryP)

 

Making sure you are enrolled at the best possible hospital under SS is a priority.

Thank you for your detailed answer. I will start checking to see which is the best SS hospital. 

[ross163103]

On 11/5/2018 at 6:45 PM, peterb17 said:

 

It just seems crazy paying out for something you may never need

I thought the same way for many years..........until I needed the insurance, then it seemed cheap. It's a gamble.

[murraynz]

On 11/6/2018 at 11:42 AM, KittenKong said:

They may not cut you off but most if not all will try to price you out of the market by increasing premiums exponentially as you get older or as you start to make claims. At some point you give up and leave.

They are not on your side.

thats why i dont insure...

even though i have good health---i believe at 67, the chances of an insurance company, actually paying out on a claim, are minimal.

fortunately, i have funds to cover myself, if needed..

id rather not be cheated by any insurance company....

[holymoly]

This is my way..................

 

Have been in Thailand 18 years. Age 85 now. No Health Insurance. 750,000 Baht in Bank for health emergencies.

 

Excellent health looking after myself with food and exercise: 5/6 a week in the gym, about 1 hr or more. 2-3 km walk at 6 am. Positive outlook on life and health. Additional vitamins - calcium, magnesium, multiple B, D. 

 

For advice I see doctor at Bumrungrad, Rankhamhaeng or, most important. Dr. Google. Two smallish operations so far. I take blood pressure daily and half a Concor (5mg) as required. 

 

Because of my efforts and attitude my medical age is 20 years less than my passport age. 

 

My Best to all of you..............

[steve73]

I had my gall bladder removed at age 46, just before settling in T/L 12 years ago... Now according to BUPA T/L, my entire gastro intestinal system is a pre-condition and excluded.  I had a slipped disc "trimmed" (twice) in 2012, and the insurers welched after first approving the surgery (costing me around 400k for both operations), and now my entire spinal column is excluded.

Not much left now that wouldn't be a pre-condition, so I'm happy to self-insure.... I keep about 2MM equivalent in readily accessible funds (some of it for the retirement extension).

[TKDfella]

52 minutes ago, holymoly said:

This is my way..................

 

Have been in Thailand 18 years. Age 85 now. No Health Insurance. 750,000 Baht in Bank for health emergencies.

 

Excellent health looking after myself with food and exercise: 5/6 a week in the gym, about 1 hr or more. 2-3 km walk at 6 am. Positive outlook on life and health. Additional vitamins - calcium, magnesium, multiple B, D. 

 

For advice I see doctor at Bumrungrad, Rankhamhaeng or, most important. Dr. Google. Two smallish operations so far. I take blood pressure daily and half a Concor (5mg) as required. 

 

Because of my efforts and attitude my medical age is 20 years less than my passport age. 

 

My Best to all of you..............

I am over 70 years, a long time martial artist and workout every morning. Small ailments I attend to myself and avoid taking drugs. I don't smoke and am TT. Apart from some ear problem (from way back when I was about 7 years old) which needs the odd clean out now and then, I've been very fortunate. However, I did have a vasectomy when I was 30 years old and have had two operations since then to remove a sperm glanuroma (that's what the doc called it, sperm ball) and one to remove a hydrocele. The latter was done in a Thai general hospital. Now at that time I was married to a Thai nurse and got automatic health coverage and only had to pay for a ac. room and extras. Now being divorced I cannot get health coverage at an affordable rate and saving is my only option. But being British, that saving rate has dropped since the rate of exchange plummeted over Brexit. Although my health is reasonable and stable at present insurance coverage is foremost on my mind. One never knows.

[gamini]

I don't think health insurance is really worthwhile when you get old.I have a large amount of health problems at 87 like cancer, lung disease and heart problems.  I use the government hospitals, most of which are very good and reasonably priced. For a major heart operation I would travel to Chiangmai,  for other  major problems I would go to Siriraj Hospital in Bangkok. However I always consult my Thai friends to find out which are the best doctors at these hospitals. For smaller problems I would use the local government hospital. 

The health insurance fees which I would have had to pay during the last 10 years far exceed what I have paid out myself. 

 

[srowndedbyh2o]

22 hours ago, melvinmelvin said:

 

so you reckon 150 k US would serve as a decent buffer? in most cases?

 

maybe I am totally wrong but I figure worst case triggers would be traffic accidents,

with such, there is no end to what could be smashed/go wrong

 

had a sojourn in a hospital this winter

step 1 very reluctantly accepting to be admitted, 2 days ICU then 1 day non ICU

step 2 left the hospital against medical advice and went home

step 3 the week after; collapsed at home, factotum had the brains to call the same hospital and request EMS

step 4 stayed a short week in ICU, a total of 5 weeks + in ward

total for my insurance company about 2.5 million

 

what was done;

a couple of stents

terrible infection in right lower leg, huge open wound in ankle - dripping dripping dripping took very long time to sort

some skin cancer stuff on arms was sorted

pneumonia - in stereo

plenty liquid in lungs

crapped down lungs 'cause excessive smoking - very lousy oxygen saturation

right leg swollen to gigantic proportions, liquid being pressed out through the skin, upper thigh pressing on prostate

     frustrating Jimmie Riddle

 

I reckon pretty straightforward stuff compared to what could be the aftermath of a severe car crash.

 

2.5 million - no giveaway.

 

 

 

 

Your lucky your insurance still covered the costs. I worked at a hospital in the US, and if a patient went AMA, their insurance company would deny all claims for the hospital stay, and the patient would be responsible for paying all the hospital costs out of pocket.

[Sheryl]

2 hours ago, murraynz said:

thats why i dont insure...

even though i have good health---i believe at 67, the chances of an insurance company, actually paying out on a claim, are minimal.

fortunately, i have funds to cover myself, if needed..

id rather not be cheated by any insurance company....

Absolute nonsense, as the experience of hundreds millions of people around the world attest.

 

There are whole countries where the health care system rests entirely upon insurance. Do you seriously think that all the claims of the people of the Netherlands, for example, are not paid?  That no American's health claims get paid?

 

Countless TVF members who have had their hospital bills in Thailand paid for by insurance, myself included.

 

You are no more or less likely to have a claim paid at 67 than at any other age. Where problems arise is if it is suspected to be due to a condition that pre-existed prior to taking out the policy.  If you are lucky enough to still have no pre-existing conditions at age 67 you should insure now while you can. You may well regret it later when your savings have been wiped out paying for health care. No matter how large your savings, once spent, they are gone.

 

 

[Sheryl]

2 hours ago, holymoly said:

This is my way..................

 

Have been in Thailand 18 years. Age 85 now. No Health Insurance. 750,000 Baht in Bank for health emergencies.

 

That is way, way too little.

 

You need a minimum of 1 million baht if you will use only government hospitals. To be able to use private hospitals, 3-5 million.

 

And that is just to have enough to pay all bills for a single hospitalization. You also need to have a way to then replenish it once spent.

 

Try to increase that amount and, for anything serious, make sure you use only government hospitals.

[melvinmelvin]

40 minutes ago, gamini said:

I don't think health insurance is really worthwhile when you get old.I have a large amount of health problems at 87 like cancer, lung disease and heart problems.  I use the government hospitals, most of which are very good and reasonably priced. For a major heart operation I would travel to Chiangmai,  for other  major problems I would go to Siriraj Hospital in Bangkok. However I always consult my Thai friends to find out which are the best doctors at these hospitals. For smaller problems I would use the local government hospital. 

The health insurance fees which I would have had to pay during the last 10 years far exceed what I have paid out myself. 

 

re Siriraj,

is that a mix of private and government? or government only

 

am treating smth at Siriraj now, outpatient, they told me that they up prices by 25% for foreigners

 

anybody know if Siriraj overcharges grossly for medicine? or are they reasonable?

 

[melvinmelvin]

45 minutes ago, srowndedbyh2o said:

Your lucky your insurance still covered the costs. I worked at a hospital in the US, and if a patient went AMA, their insurance company would deny all claims for the hospital stay, and the patient would be responsible for paying all the hospital costs out of pocket.

no, not lucky - not paying is an option not available to them

comfortable not having anything to do with US, apart from visiting

 

countries and companies are different,