Health Insurance in Isaan

[Nkpjed]

I am trying to find a health insurance plan that will cover me at government hospitals as well as private.   I am 60 have lived in Thai for 6 years and up until now have self-insured.   I live in Nakhon Phanom.   I have had two hospital stays here for 3-4 days each and the cost was 3000-4000 baht including everything.   The care I recieved was very good.   My issue now is although I am in good health I am getting older and need to prepare for the inevitable.   I have talked with insurance companies in and outside of Thailand as well as brokers and have found no company who will cover me at a hospital in Nakhon Phanom.    They only contract it seems with private hospitals and we have only government and community hospitals here.    I have nothing against private hospitals but I really don't want to have to leave the province every time I need inpatient hospitalization.   And God forbid if it's an emergency I doubt they are going to rush me outside the province for care.   I shouldn't say I couldn't find any companies willing to insure me.    There were a couple but they wanted me to pay the entire bill out of pocket then sit back with my fingers crossed hoping they will reimburse me.    Doesn't sound ideal to me.   I can't be the first expat who has asked this question but I can't find it anywhere on here.   If anyone knows of a company or broker who will cover at government/community hospitals as well as private (without me having to pay the entire bill myself first) Please let me know.

 

Thanks,

Jeff

[Lewis711]

I am also looking for affordable health insurance in Thailand and found 2 below, 

 

https://www.thaivivat.co.th/en/contact.php#nogo

 

https://www.thaisri.com/indexThaisri.php?lang=Mg==

 

 

[Nkpjed]

Thanks for the reply.  Thaivivat was one of the many companies that told me they do not cover any hospitals in Nakhon Phanom.   I will give Thaisri a looksee.   Thanks.

[pikao]

Hi Jeff,

just had a phone call from my insurance broker this afternoon. The annual rate (I´m 58, 59 in Jan.) is due to pay:

70.000 THB. The company is LUMA health insurance. They payed a 180.000 THB bill (Bangkok Hospital, very expensive) last year. Inpatient. They give clearance after a previous consultation. Means...they pay. Good coverage in good hospitals.

All private, as far as I´ve seen. (with LUMA)

I got your point about the government hospitals. (Just wanted to tell you about my case)

The broker I´m dealing with offered me quite a number of various contracts with different companies. He takes care of clients very well (in my personal experience). He is German (as I am) but I`m sure that he speaks English. What I want to say is, that this could be a person able to help you and your needs (hopefully).

Bastian Lobemeier, www.global-solidor.com

Best of luck

[Nkpjed]

Hi Pikao,

 

Luma is one of the companies I have looked at and seem reputable.   But as you say they cover strictly private hospital as seems to be the norm here.   I will give your contact a try tomorrow and see if he can get me in the right direction.   

 

Thanks for your help,

Jeff

[yosib157]

Like yourself. I have had good service/pricing from Nakhon Phanom Hospital and am currently attending every 2 weeks for an ongoing problem. Doctors and general staff are greatly improved from years ago.

 

A friend of mine recently had an operation there and 8 days stay costing 45,000.

 

 I did go to Sakhon Nakhon Private Hospital 2 1/2 years ago for a serious problem. However NKP have greatly improved so I'll continue going there.

 

Back to your question, last week I was waiting around and took a stroll along the corridors and saw an Insurance office. Go to second floor (or first as we call it), turn right and go to the end. I don't know if they have anything like an annual retainer scheme. Everything was in Thai language, but,if you have time, it's worth taking a look. 

[Rdrokit]

I have no idea why members do not contact AA Insurance Brokers. They advertise on TV and are very good at finding the right policy for you. I have my car, motorcycle and health insurance with them for the past 12 years. The main office is in Pattaya but you can do everything by email and or phone. They speak English and are owned by an Englishman.

 

https://www.aainsure.net/

[racyrick]

18 hours ago, Nkpjed said:

Hi Pikao,

 

Luma is one of the companies I have looked at and seem reputable.   But as you say they cover strictly private hospital as seems to be the norm here.   I will give your contact a try tomorrow and see if he can get me in the right direction.   

 

Thanks for your help,

Jeff

 

4 hours ago, yosib157 said:

Like yourself. I have had good service/pricing from Nakhon Phanom Hospital and am currently attending every 2 weeks for an ongoing problem. Doctors and general staff are greatly improved from years ago.

 

A friend of mine recently had an operation there and 8 days stay costing 45,000.

 

 I did go to Sakhon Nakhon Private Hospital 2 1/2 years ago for a serious problem. However NKP have greatly improved so I'll continue going there.

 

Back to your question, last week I was waiting around and took a stroll along the corridors and saw an Insurance office. Go to second floor (or first as we call it), turn right and go to the end. I don't know if they have anything like an annual retainer scheme. Everything was in Thai language, but,if you have time, it's worth taking a look. 

I have LUMA as well. They cover ALL hospitals it's just that they have a "cashless" agreement with the private hospitals so you don't need to pay anything yourself, but with the public hospitals, you must pay first and then file a claim to get your money back.

[racyrick]

2 hours ago, Rdrokit said:

I have no idea why members do not contact AA Insurance Brokers. They advertise on TV and are very good at finding the right policy for you. I have my car, motorcycle and health insurance with them for the past 12 years. The main office is in Pattaya but you can do everything by email and or phone. They speak English and are owned by an Englishman.

 

https://www.aainsure.net/

I use them also and they are very honest and friendly and reply quickly. Bottom line-great service.

[Nkpjed]

Yosib157 what health insurance do you ise at Nakhon Phanom hospital?   I have also ised the Crown Prince hospital in That Phanom and found them very good.

[mistabent]

Yes, what racyrick said above. I think you'll find that the insurance companies you are looking at fully cover government hospitals as well, it's just that they are "out of network", so you pay the hospital first and then get reimbursed from the insurance. With an in-network hospital insurance pays your bill directly. I've used Pacific Cross for 6 years here for me and my family and that's how they work. We've claimed several times over the years and have never had an issue, both in and out of network. Claims are quick and easy and we've always gotten every satang back.  

 

It's nice to have both options as for something major or specialized you can travel to a major city to use private and still be covered, but can still use government hospitals locally when that's best.

 

I've attached Pacific Cross plan brochures so that you can see the costs and details. We have the Maxima Plan (no out patient so 20% off the listed price) but may switch to a Premium Plus Plan (no out patient) next year.

website-Ultima_Plan-OCT-2015 (1).pdf

website-Maxima_Plan-OCT-2015 (1).pdf

website_Premier_Plan-OCT-2015 (1).pdf

[Nkpjed]

Thanks for the information on Pacific Cross.   I had already contacted them so it was good to hear that they are reliable.  I am interested in their Premier Plus Plan (no out patient).   The agent I was in contact with said I could use government/community hospitals and they would issue a garuantee of payment if I contacted them as soon as I was admitted.  I would only have to pay out of pocket what was not covered.    

 

I do like the idea of using local government hospitals for smaller issues.   I have used hospitals in Nakhon Phanom, Renu Nakhon, Nakea, That Phanom as well as Sakhon Nakhon and have been very satisfied with the level of treatment I recieved in patient and out patient.   If a major issue does happen traveling to a private hospital for treatment seems the best way to go.   

 

Thanks again for the good information.

[yosib157]

18 hours ago, Nkpjed said:

Yosib157 what health insurance do you ise at Nakhon Phanom hospital?   I have also ised the Crown Prince hospital in That Phanom and found them very good.

I have never  used insurance to pay as 10 years ago when I reached 60, the company I had been with 5 years reduced my premium AND cover. Tried unsuccessfully to get another company so now pay cash for all my treatment. Too old now to ask for cover as I already have two major health issues.

My last 4 day stay in NKP with food, special watch and monitored 24 hours including other daily meds I need was only 3,400 thb. Things were different 10 years ago so obviously I wouldn't suggest anybody not having cover --- just the way it worked out for me.

 

Did you check out that insurance office on the second floor? If it is then this would also be useful for other (younger) members.

 

[DepDavid]

Cigna global may be an option. They have direct billing and cover anywhere in the world except USA but you can get that added as a rider.


Sent from my iPhone using Thaivisa Connect

[kamalabob2]

The OP was misinformed about coverage in his province at a Government hospital. I've had Thai Health Insurance, which is a company, BUPA Thailand, which was bought out and now Aetna. The sponsor AA Brokers might be able to explain to the OP how easy reimbursement is for using a hospital "out of direct pay network".  I recall BUPA paid in less than one week a direct deposit to my Thai bank account for in patient expenses at a Private Hospital in Surin.  Here are some details https://www.aetna.co.th/en/individuals/health-insurance/individual/index.aspx#.W-_WCugzaUk

Here is the actual invoice of a 65 year old with Aetna on a policy with covers up to 2 million baht on EACH incident.   AA Brokers can better explain to the OP how claims work with in network hospitals (and clinics) and out of network hospitals, both public and private. 

[Michael Hare]

When I came to settle in Ubon Ratchathani in 1994, I took out Health and Accident insurance with AIA. So far, I have not made single claim. Pay the premiums every year. My wife though, has had a couple of garden accidents and the accident insurance covered everything at out-patients. The AIA Ubon agents took care of everything from seeing my wife through the hospital and then the revisits to get the wounds cleaned and dressed. We didn't pay anything. Billed directly to AIA.

 

Three years ago when I turned 65, I found out that when I reach 75, AIA will most likely no longer cover my health insurance. Pretty annoying after all these years and not a single claim. So I contacted Pacific Cross and they will insure me with health insurance for the remainder of my life. I still keep the AIA insurance going just in case by the time I reach 75 they may extend the age limit for another few years. 

 

I also contacted Bupa at the same time three years ago, but because I had already turned 65, they could not offer me health insurance. Pacific Cross don't have this age limit. 

 

 

 

 

[Nkpjed]

On 11/17/2018 at 2:58 PM, yosib157 said:

I have never  used insurance to pay as 10 years ago when I reached 60, the company I had been with 5 years reduced my premium AND cover. Tried unsuccessfully to get another company so now pay cash for all my treatment. Too old now to ask for cover as I already have two major health issues.

My last 4 day stay in NKP with food, special watch and monitored 24 hours including other daily meds I need was only 3,400 thb. Things were different 10 years ago so obviously I wouldn't suggest anybody not having cover --- just the way it worked out for me.

 

Did you check out that insurance office on the second floor? If it is then this would also be useful for other (younger) members.

 

I have not checked that out yet.   I live in pla pak so I am 50 km from town.   I will probably go this week for a dental cleaning (you may have to wait a little but Nakhon Phanom Hospital's dental service is also good and affordable) so I will check it out.   Although I have already submitted a proposal to Pacific Cross.      

[Sheryl]

It is not that insurance doesn't cover government hospitals - they all do. It is that they do nto have direct payment arrangements with the government hospitals i.e. you have to pay first and get reimbursed. This is because the hospitals do not have the necessary staff and administrative capacity to set this up and meet the paperwork requirements (and little reason to invest in it since so few of their cases are paid for by private insurance). 

 

[Nkpjed]

On 11/19/2018 at 7:41 PM, Sheryl said:

It is not that insurance doesn't cover government hospitals - they all do. It is that they do nto have direct payment arrangements with the government hospitals i.e. you have to pay first and get reimbursed. This is because the hospitals do not have the necessary staff and administrative capacity to set this up and meet the paperwork requirements (and little reason to invest in it since so few of their cases are paid for by private insurance). 

 

Thanks Sheryl I finally figured that out.