April Insurance

[Sheryl]

14 hours ago, Ray394 said:

Hi Sheryl, so April came back with the offer and they will cover my existing conditions with higher quote but there's a condition saying '50% increased Medical expenses' do you know what does this mean? I emailed back to April but they takes more than 3 weeks to reply.... ???? just want to know if it's a common terms in insurance world, cause I don't know if that's benefit to us or them. 

 

No idea what that means, might help to see it in context

 

You really, really should be doing this through a broker. They would then be able to explain ti to you.

 

Using a broker does not cost more, and has the advantage that the broker can help afterwards if there are any issues with claims

[Ray394]

1 hour ago, Sheryl said:

 

No idea what that means, might help to see it in context

 

You really, really should be doing this through a broker. They would then be able to explain ti to you.

 

Using a broker does not cost more, and has the advantage that the broker can help afterwards if there are any issues with claims

I am going through this with AA broker, but somehow April always replied me back directly... So then I include my broker again.  I already messaged back to both April and my broker about this. 

 

And there was no context at all but just new offer says, here's a condition "50% increased Medical expenses" that's it ????

 

[Sheryl]

No idea what it means. Ask AA

[BestB]

On 8/29/2020 at 7:02 PM, Sheryl said:

No idea what it means. Ask AA

i think he means extra loading on premium, ie extra 50% on top of the premium to include his pre conditions

[Sheryl]

12 hours ago, BestB said:

i think he means extra loading on premium, ie extra 50% on top of the premium to include his pre conditions

 

Could be but they usually word it more clearly than that

[Ray394]

On 9/6/2020 at 12:30 AM, BestB said:

i think he means extra loading on premium, ie extra 50% on top of the premium to include his pre conditions

Yeah that's what AA broker explained to me. However when I calculated it's actually more than 50% of charge of my original premium. So we are still waiting for reply from April....they are really really late on reply......

[prb]

On 2/6/2020 at 3:09 PM, pontious said:

I am also in April International. I have just spoken to AA Brokers in Hua Hin to clarify the Terms and Conditions dates . They confirm that when new T and C's are issued [ latest are 2020[ the new T and C,s apply to ALL members in April irrespective of the year  they joined April.

Regarding the 'private rooms' situation, as there are so few Twin room  private hospitals in Thailand it has little practical effect. The 75$ would only apply if you were say in Bhumigrad [spelling[ in Bangkok which does have twin rooms then if you went to a private room that 75$ would come into play. Even then they will use the room price and not all the ancillaries that may take it to 8000 Baht. 75$ may mean you will have to maybe pay 700 Baht top up for instance..

"Regarding the 'private rooms' situation, as there are so few Twin room  private hospitals in Thailand it has little practical effect." 

If no Twin available, you will get private room at no extra cost, even if > 75$. Is it written in the policy

 

"Even then they will use the room price and not all the ancillaries that may take it to 8000 Baht. "

So there is a standard price hospital use for room and any extra medical equipement (eg for pneumonia intensive care) is charged on an other part of the bill? 

[prb]

On 7/30/2020 at 9:59 PM, Sheryl said:

 

Pretty much all insurers require pre-approval for hospitalizations. In an emergency can inform them after arrival at the hospital but should be within 24 hours.

 

Also, for direct billing (payment of the hospital by the insurer, leaving you out of it except for any deductible - definitely the preferred arrangement) the hospital has to submit some paperwork (treatment plan,  estimated cost etc) to the insurer which then provides them with a "Guarantee of Payment" and most private hospitals  will not want to treat - at least not for anything costly - until they get the GOP. This process takes a few hours at least (and speediness may depend on the hospital at least as much as the insurer i.e. some are better than others at churning out the paperwork).

 

Should you be in a government hospital it will usually nto be possible to get a GOP and you'll have to pay and be reimbursed afterwards, not because of the insurer but because the hospitals don't have the capacity and staff to handle it and set up diorect billing. Possibly the really big ones in Bangkok differ in this regard, I don't know.

 

In my case the hospital took care of contacting the insurer. We got the go-ahead in about 4-6 hours (on a Sunday). As I needed immediate surgery the hospital gave me the option of making a deposit with my credit card  pending the insurance authorization or else delaying the surgery by several hours,  I chose the former (turned out to have been a wise move, medically) and when the insurance OK came through they tore up the credit card deposit.  For a planned hospitalization of course no problem.  In an emergency  the hospital might ask you to front a deposit to cover the initial costs pending the insurance OK especially if something costly like surgery is needed right away.

 

 

They don't have a 24/7 hotline to confirm you are insured?

What happen if you are not conscious and unable to make the deposit?

[Sheryl]

Just now, prb said:

They don't have a 24/7 hotline to confirm you are insured?

What happen if you are not conscious and unable to make the deposit?

 

They have a 24 hour number but it still takes some time as the hospital has to submit paperwork in order to get a GOP (Guarnatee of Payment)

 

As far as I know, the case with all insurers.

 

Hospitals usually want a GOP for a specific amount of money, not just a confirmation that you are insured.

 

As to what if you are unconscious...hopefully you will have someone with you able to make a deposit or at least convince the hospital the bill will be paid. If no one with you it will be up to the hospital what to do. But you will still be better off having an insurance card in your wallet than being there without that.

[Sheryl]

4 hours ago, prb said:

"Regarding the 'private rooms' situation, as there are so few Twin room  private hospitals in Thailand it has little practical effect." 

If no Twin available, you will get private room at no extra cost, even if > 75$. Is it written in the policy

 

"Even then they will use the room price and not all the ancillaries that may take it to 8000 Baht. "

So there is a standard price hospital use for room and any extra medical equipement (eg for pneumonia intensive care) is charged on an other part of the bill? 

 

Actually my understanding with April is that there is no special provision for a hospital that has only private rooms. But it will depend on how the room charge appears on the bill.

When I was hospitalized last year it was at a hospital with only private rooms., I expressed my concern re insurance covering only semi private and was told "we don't classify rooms by private/semi - private. Your insurance  will be billed  for a 'Standard Room" and that will be OK. And it was. No guarantee same will hold true for you, or for me in the future -- this was at a hospital in Phnom Penh that is much more savvy about insurance billing than the hospitals in Thailand seem to be (they are surprisingly bad at it, even the top "international" ones). But that's how it went for me.

 

The next level up of April cover will pay for private room. I considered upgrading but after doing the math decided that even if I had to pay the excess on a private room it would still be less than the extra premium given that there was no other meaningful advantage to the next level of cover. .  They will pay up to 75 USD for a private room, just not the actual full cost (whereas semi private will be covered up to the total charge). It is aggravating, I agree

 

Hospital room charges are just that and not inclusive of any treatment costs. which is why looking at room charges will not give any idea of total bill.

 

There are 3 elements to room charge: the room itself, meals and nursing charge and this will be (or can be) split out on your bill. Only the room charge part is limited to 75 USD if a private room under April. They'll cover the meals and nursing.

[prb]

4 hours ago, Sheryl said:

 

Actually my understanding with April is that there is no special provision for a hospital that has only private rooms. But it will depend on how the room charge appears on the bill.

When I was hospitalized last year it was at a hospital with only private rooms., I expressed my concern re insurance covering only semi private and was told "we don't classify rooms by private/semi - private. Your insurance  will be billed  for a 'Standard Room" and that will be OK. And it was. No guarantee same will hold true for you, or for me in the future -- this was at a hospital in Phnom Penh that is much more savvy about insurance billing than the hospitals in Thailand seem to be (they are surprisingly bad at it, even the top "international" ones). But that's how it went for me.

 

The next level up of April cover will pay for private room. I considered upgrading but after doing the math decided that even if I had to pay the excess on a private room it would still be less than the extra premium given that there was no other meaningful advantage to the next level of cover. .  They will pay up to 75 USD for a private room, just not the actual full cost (whereas semi private will be covered up to the total charge). It is aggravating, I agree

 

Hospital room charges are just that and not inclusive of any treatment costs. which is why looking at room charges will not give any idea of total ill.

 

There are 3 elements to room charge: the room itself, meals and nursing charge and this will be (or can be) split out on your bill. Only the room charge part is limited to 75 USD if a private room under April. They'll cover the meals and nursing.

Yes, the cover seems quite sufficient for me as well with the Essential fomula. It's just this detail with the room that is a bit annoying.

As almost everyone else i guess, if it's just a matter of paying few hundreds baht a day because there are no twin rooms, the hospital specify it's private in the bill and it's a bit more than 75$ i wouldn't worry too much. Just want to avoid any nasty surprise.