SURVEY: Health Insurance -- Are requirements fair?

[Scott]

Do you agree with the health insurance proposal for expats?

 

As many of our readers know, the Thai government is considering requiring health insurance for those staying in Thailand with an O-A visa.   Which of the following best fits your opinion on health/accident insurance for foreigners in Thailand?

 

Feel free to leave a comment.

 

For further reading:

 

[JLCrab]

As someone who is considering an O-A visa following my current and last extension via income affidavit, I am wondering this:

 

If I apply at the Washington DC Embassy for an O-A visa with an international inpatient-only healthcare policy from a US-based insurer in the 30 million baht range per year not lifetime versus the 400K baht inpatient policy mandated, will the embassy really not grant me an O-A visa because I do not have the mandated 40,000 baht per year outpatient coverage?

[YetAnother]

5 hours ago, Scott said:

the Thai government is considering requiring health insurance for those staying in Thailand with an O-A visa.

about as much 'makes-no-sense' comes out of thai lawmakers as does 'makes sense';

this new proposal will likely be pushed thru based on soft thai insurance lobbying by the thai insurance companies; guessing they will add surcharges to policies for those unwanted foreigners

[nong38]

This seems to me all about   increasing revenues for Thai insurers who want their cut. Is it really that big a problem the health issue? How much does it cost the country? Is it a problem in other countries?

[Crossy]

Like others I think the requirement for out-patient cover is over the top, not that it's not possible to rack up significant costs with out-patient treatment. I got to 60k Baht in out-patient a couple of years back. https://www.thaivisa.com/forum/topic/934025-your-mother-was-right-that-splinter-could-make-your-finger-drop-off/

 

 

In-patient however is a different kettle of fish entirely. The numbers can rack up very rapidly, insurance is an absolute requirement for ALL visitors. If we cannot be trusted to get insurance ourselves then it needs to be enforced.

 

 

 

[mikebell]

I'd love to be able to afford Medical Insurance (at 76 the cost is prohibitive) and keep 800,000 in a Thai bank.  If I am forced to do both I will have to take my pensions elsewhere.

[fforest1]

The OA is just a trial balloon.....The number of OAs issued is pretty small so not to many people will be complaining....But sure as the sun comes up the insurance scam will start to spread to other visa classes....

The OX visa already has the insurance scam requirement and look how popular that visa is....Its as popular as warm beer......

 

Farangs are not given the opportunity to skip out of paying hospital bills in Thailand.....Is a huge lie that loads of deadbeat farangs are a burden to the Thai health care system....

[mrmazinkle]

22 minutes ago, mikebell said:

I'd love to be able to afford Medical Insurance (at 76 the cost is prohibitive) and keep 800,000 in a Thai bank.  If I am forced to do both I will have to take my pensions elsewhere.

and that is the point.. ..It says that at 70+ the cost will be prohibitive if they will insure at all..It says to me that there is no long term future for most of us in Thailand.Dont retire here at 55+take out a retirement visa and plan to invest and settle here long term,Compulsory insurance makes this an impossible dream.

[sfokevin]

If the government would require the insurance companies to cover preexisting conditions and have no age limit at a reasonable cost I would gladly buy health insurance...  

[The Old Bull]

I usually get an 0 visa but seldom stay more than three months. I used to stay six but the government back home is watching a little closer and I may loose Canadian health benefits for staying more than three months. I already have a drivers license ,a yellow house book, a pink card and a couple of bank accounts. So next year I will get a tourist visa that means $100 dollars less f.or the Thai government

[quandow]

Since when did the concept of "fair" EVER enter the formula of Thai thinking, especially when regarding the love/hate relationship (love the $$$/hate the guy holding it) with foreigners?

[bambula]

A pressure of the insurances lobby to make more money on foreigners which in fact are not welcome in this country, excepted Chinese. 

If you have an inpatient insurance and pre-existing conditions or have been treated for an heavy disease you can't change your policy and contract for an outpatient one. What will happen then... Out of the country after 15 years of stay and married with a Thai woman? Would it be a problem for these xenophobic people? Not sure... 

[nong38]

So you can get a Retirement Visa at 50 but as the years advance any insurance you had at 50 either becomes a no-no or cost prohibitive and that's a fact at some point you will have no insurance, the only alternative is to have money in the bank to cover yourself, pay-as-you-go and if you cant pay you go ( out in the corridor laying on a gurney waiting to go ).

[bert bloggs]

So if your 70 plus with a family ,but cannot get insurance ,will you be deported ,even after living here for over 10 years?

[garyk]

 

Banks are getting their share, next insurance company's.

With billions of U.S. dollars being pumped into the economy yearly by expats. They should be able to buy into the Thai health care system period. Should of been done long ago.

The economy will be hurt big time with the poor management of expats here. 

Honestly anyone that considers these changes and actually abides with them is daft in the head IMO.

Curious to see what the actual changes are going to be after the first of the year. Regardless, expats should not consider Thailand a secure retirement destination.  It never has been and never will be.

[Sheryl]

As someone who is considering an O-A visa following my current and last extension via income affidavit, I am wondering this:
 
If I apply at the Washington DC Embassy for an O-A visa with an international inpatient-only healthcare policy from a US-based insurer in the 30 million baht range per year not lifetime versus the 400K baht inpatient policy mandated, will the embassy really not grant me an O-A visa because I do not have the mandated 40,000 baht per year outpatient coverage?

I have no idea but will be quite interested to find out!

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

[Sheryl]

To put into perspective all these statements about cost of insurance for older people being "prohibitive":

 

It is (for say 80 years and above) around 160 -200k, much less before that.

 

You are required to have an annual income of 760-800k depending on method used.

 

If you meet that requirenent you still have 600k a year left for other living expenses agter oaying for health insurance.

 

It is a significant cost, yes. It is certainly my biggest single expense and I'm still at an age where paying well under 100k. But I would not describe it as "prohibitive" and calling it such may deter people from even looking into it as they will wrongly assume it is many hundreds of thousands of baht.

 

Ability to get insured due to significant pre existing chronic conditions (diabetes, heart disease, VOPD, cancer etc) is on the contrary a real constraint for some people. In some cases they could have averted the dilemma by getting insurance while still healthy but in others they already had one or more such conditions when they moved here.

 

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

 

 

 

 

 

 

[JLCrab]

10 minutes ago, Sheryl said:

I have no idea but will be quite interested to find out!

Well unless this 65K baht per month FTT-type deposit extension thing has been worked out solid, I'll be heading to WashDC well before my current extension is finished -- and who knows whether that insurance req. for O-A will be in force by then.

[AhFarangJa]

Last month I applied for my annual extension based on retirement. I had to provide four more pieces of paper than the previous year. I mentioned to the Wife that I wonder what more will be added to the list for next years extension. She told me I was paranoid. Then 2 weeks later they mention the insurance requirement. I believe that with any Government there is no smoke without fire, and that this will be implemented. I will wait to see how much this is going to cost before making any decisions to move or not.

As a footnote, can anyone say if we will have to use a Thai insurance company. If so I see a huge con in the making here.

[madmitch]

I am generally in favour of mandatory insurance, though someone, somewhere will have to come up with some sort of clever policy for those who have pre-existing conditions, those who are too old to get insurance or would have to pay a very high percentage of their banked 800,000 baht to get it.

 

The suggested out-patient coverage is ridiculous. I do have out-patient cover on my own insurance but plan to cut it next year as a cost-saver as I've reached the next age band. Again, any expat showing 800,000 or 400,000 baht in the bank can afford 40,000 for out-patient treatment.

 

With these reservations I haven't registered a vote. It probably won't happen anyway.

[wwest5829]

2 hours ago, sfokevin said:

If the government would require the insurance companies to cover preexisting conditions and have no age limit at a reasonable cost I would gladly buy health insurance...  

Agreed. I view a Thai medical insurance coverage on the same level as the EU Schengen requirement. Past short term “travel” type insurance for “tourists”... When I first retired here, I took out a policy but it excluded all heart/circulation issues as pre-existing sine I had by-pass surgery 6 years before coming to Thailand. So, my biggest cost risk excluded, 2nd year, they raised the premium (no claims), so I cancelled the policy. Here is yet another reality. I can get “emergency care” reimbursed through Medicare, then return to US for additional Medicare coverage in the US. My guess is all these scenarios would simply have to be ignored to come up with a one size fits all policy.

[HAKAPALITA]

Impossible to implement fairly.. Ive self insured a Thai Family for 30 years, a very decent Brit ferang friend has insured Self and Wife correctly with BUPA, 15+ years, not one claim and now all his money has gone, so have they, no money for marry extension.Lost House to her kids. Cant say about young folks, only in general they cant earn enough here to save anything yet alone pay insurance bill..realy its a place to retire when your well off and old.

[Kerryd]

The policy I have from Bangkok Bank (PA 1st VIP, Plan 2) gives me 930,000 "in patient" coverage per visit and 20,000 "out patient" per visit for 21,000 baht per year. 
If I went back to the "Plan 1" option, I'd pay 27,000 per year and the "out patient" coverage would go up to 40,000 (or more) per visit.

 

According to the bank, that plan (and the regular "PA 1st Smart" plan) go to age 65. I think the "Smart" plan is cheaper (and lower coverage limits of course). 

 

They also have a "PA 1st Senior" plan that covers ages 50-100. No idea what the coverage limits (or premiums) are like but I'll try to remember to ask the next time I'm at my local branch.

 

I also suspect that the Insurance companies will come up with (or already have) a policy that is tailor made to the requirements - which are still just a suggestion as NOTHING has been formally submitted to the Cabinet yet, let alone approved.

 

And with the upcoming election, it could be something that gets forgotten about completely, especially if the new government isn't made up of the same people currently in power. Or it could be simply set aside until a later date as the new government sets different priorities.

 

Hard to say at this point but one fact remains. I'd say that most of the expats I know are not "spring chickens" and most likely they have little - or no - medical insurance at all.
As we've seen in many stories on TV, a lot of tourists/expats are here with no coverage at all and many have the misguided idea that whatever coverage they have "back home" still covers them while here.

Misguided because in many cases, they are not covered at all (and just "assume" they are without ever actually checking).

 

Others apparently hope that "if" something happens, they'll be able to hop on a plane and fly home to be taken care of. 
If your "healthcare plan" consists of words like "I assume" and "I hope", then you are going to be in for a really bad time if something does happen.

 

Also remember - just because you may have a "pre-existing" condition does not mean you can't get healthcare coverage !! It means they won't cover you for illnesses relating to that pre-existing condition ! Most of them state that specifically - that they will not cover you for "pre-existing conditions". They do not say "if you have a pre-existing condition - piss off as we won't cover you at all".

Despite what a lot of people here seem to think (probably because they "assume" instead of actually "asking").

For example, at the bottom of the page describing the limits of my Health 1st coverage it notes:
"Note 2) This policy does not cover medical costs resulting from pre-existing conditions which are chronic diseases, illnesses or injuries that are not completely cured before the policy takes effect for the first time."

But we all know the real reason why so many don't want to have to have any healthcare coverage at all, don't we ?
 

[Jingthing]

Health insurance requirements are hard to manage for any nation especially for shorter term visits or visas. The Thai government should offer a basic easy to purchase plan for O-A visa applicants and also annual extension applicants (even though the latter aren't currently being discussed). It's not fair to require insurance if they make it too hard to get the insurance or don't account for people that can't reasonably be accepted by insurers. That's why I suggest the keep it simple basic Thai government plan and people can purchase additional if they choose and can get it.

[Pedrogaz]

For me this is an important issue. If they enact it, I will leave Thailand. I am in the very happy position whereby if I get a 2 or 3 million baht medical bill one year I can manage it. I have looked at insurance rates and exclusions by age and concluded that taking insurance out for me was foolish, I would only enrich the insurance company. I have been 'bare' more than 10 years. Paying outrageous premiums for limited coverage is a fools game. I have saved enough already for a really major medical expense but not having insurance....probably a million baht ahead.

 

You all do know that the lobbyists for insurance companies are lobbying for this, don't you? You don't think that the issue just arose spontaneously?

 

If the government were to ask for a two or three thousand baht a year, added to the visa extension, to allow farangs to access the public health system I would support that.....but I resent feeding the vultures in the insurance industry

[Pedrogaz]

I am wondering if anyone knows about Medicare in the US. I am eligible but have not yet enrolled. My cost would be between $400 and 500 per month for Basic Medicare plus gap insurance and Part D coverage. 

I have been told that they will not cover overseas citizens....is that correct? Is there a way around it?

[Kerryd]

3 minutes ago, Jingthing said:

Health insurance requirements are hard to manage for any nation especially for shorter term visits or visas. The Thai government should offer a basic easy to purchase plan for O-A visa applicants and also annual extension applicants (even though the latter aren't currently being discussed). It's not fair to require insurance if they make it too hard to get the insurance or don't account for people that can't reasonably be accepted by insurers. That's why I suggest the keep it simple basic Thai government plan and people can purchase additional if they choose and can get it.

I'm sure they could do it very easily. Think about it, when you take your scooter/car/whatever in every year for the Road Tax/Registration, you pay for the compulsory government insurance which provides basic coverage and you can usually have it done that day.

 

All they'd have to do is come up with a basic policy and when you go into Immigration to renew/extend/whatever, you'd pay for the basic coverage at the same time (or you pay for it when you purchase your Visa at an Embassy). (Sheesh - I'm sure they could even set up a kind of ticket dispenser where you'd punch in some information and swipe your debit card and it would spit out a little "policy" ticket with the details on it that you could then show the IO.)

 

If they made it for a reasonable fee (along the lines of the compulsory vehicle insurance say) then it wouldn't be that onerous. I'm sure they'd still make far more from that than they'd stand to lose from actual medical expenses incurred by expats.

 

 

[Enoon]

 

None of the above.

 

It should be compulsory to pay direct into the Thai healthcare system for those who intend their visa arrangements to extend beyond a certain time/"for the duration".

 

Those paying taxes in Thailand should be considered as already having done so.

 

A definition of "basic" treatment to be arrived at.

 

"Complex" treatments to be paid for according to what "provision" (savings or insurance) the individual has made for themselves.

 

No money?.........no treatment, basic or otherwise.

 

That seems like a reasonable "deal" for what we "get" from Thailand.

 

A deal for people who don't want to go "Full Thailand" (Citizenship).

 

 

 

 

[abrahamzvi]

3 hours ago, nong38 said:

This seems to me all about   increasing revenues for Thai insurers who want their cut. Is it really that big a problem the health issue? How much does it cost the country? Is it a problem in other countries?

I entirely agree that people entering Thailand, as tourists or otherwise, should have health insurance, sufficient to cover health costs in Thailand. I can't say that the limits required by the suggested regulation are the right ones, as I do not know the average costs incurred by hospitals and clinics in the last few years. However, where I think the regulation is wrong is that it requires the insurance to be with a Thai insurance company. Surely, a person entering Thailand with a proof of an insurance with adequate limits by an insurance company from her/his home country (e.g. Travel insurance, or a short term health cover), valid in Thailand and other countries, should be sufficient. This is a practice valid in most countries in Europe. For Thais to get a Schengen visa, a certificate of insurance from a Thai insurer is fully acceptable. Why should Thailand insist on Thai insurers?

[connda]

First O-A and then all long-stay Non-O extension.  If they do one, the other isn't much of a leap.

 

The problem with this 'scheme' is that it is an absolute 'gift' for Thai insurance companies.  Heck, what's not to like if you're a Thai insurance company?  65, 70, 75, and older foreigners being forced by law to purchase a 40k THB out-patient/400k THB in-patient policy for anywhere between 70k THB to 250k THB per year for the 'privilege' of staying in Thailand for either retirement, or even better, for the privilege of supporting a Thai family.  As I told my wife, if they do this for Marriage or Retirement extensions as well as O-A visa, what they are doing is taking the money that I give to support her and my extended family and forcing me to give it to a Thai insurance company.  Imho, it's a scam.  With either 400k THB to 800 THB sitting in the bank (for those of us with that money in a Thai bank) I'm essentially able to cover medical expenses based on the Thai government's proposed 'minimums'.  But I don't rely on that money as I have an in-patient only international health insurance policy and I cover my own out-patient coverage out-of-pocket.  So I neither need nor want that insurance.
So, if forced to purchase a Thai government mandated insurance policy - I'll leave the country after moving my funds back to the US.  There will be two train-wreaks: one being the life I had built here with over 1/2 of my retirement savings in the form of real estate and home and other assets for my wife and my own use during our retirement years (I'll never recoup that), and two, my Thai wife who does not want to move to the US.  And after living here for 12 years with no avenue toward permanent residency even though I've supported my wife and her son including putting him through school - forcing me to buy insurance I don't need will be the straw that breaks the camel's back.  I'll walk away, numb, and not look back.