How much to put aside for major health issue (self insure)

[Lazy Sod]

Aetna quoted me for health insurance, but excluded heart disease, stroke, and any vascular related diseases because I have high cholesterol (controlled by statins). I've told them to stick it and will probably self insure.

I am wondering how much I would need to put aside for a major event like heart attack/stroke/cancer treatment at a good hospital such as Samitivej.

A friend had a heart attack recently with a few stents fitted, it was about THB 200K, somebody had a serious stroke and it was about THB400K with a week in ICU, I think one of the highest is triple bypass at around THB800K. So I'm thinking if I put aside THB1M I should be OK for most major events. If the money ever runs out I could always use government hospitals (been paying social security here for 20+ years), and I could go to my home country in Europe as I've continued to pay for government cover there as well.

Any thoughts? Is THB1M enough for most things?

[Pilotman]

You will get a lot of contrary opinions here.  It's a risk assessment exercise, much like an actuary would do, a balance of probabilities if you will.  Do the maths.  You know your medical history/existing conditions, family history, lifestyle and therefore the probability range of experiencing the conditions you mention.  Research today's treatment costs and then inflate those figures to give you a longer term answer to the question, how much do I need to bank.  My own view is that I don't budget for the worst, but budget for the most likely and inflate as the years go by and as I get older. You will then come up with a number.  I also insure separately against accident only, a relatively cheap option to cover unlikely accident events.

 

My own reserve figure, held in Thailand, is 2 million Baht.  Sheryl will no doubt disagree, politely of course, as ever. 

[lopburi3]

My one week visit to Bangkok Hospital 3 years ago for bladder removal/ileal conduit was more than a million but if willing to use government hospitals one million should cover most things but without a means to replenish it is far from insurance - cancer treatment, if wanting to use drugs, can become extremely costly.

 

But it really is one of those 'how long is a piece of string' questions.

[BestB]

At least 3 million , but depends which hospital you willing to be treated. If public then half or third that.

 

just the other day know someone was in an accident, 3 days in Bangkok hospital , in ICU, 1.2 million 

 

i had minor surgery , one night stay, same hospital 130000 baht

 

had shoulder surgery, 2 nights stay 400000 baht 

[kingofthemountain]

Between 1 and 2 millions bths seems to be a good option for me.

And at least in case of something go wrong with your health, you can use it as you want and decide what to do, you do not have to fight and argue with a greedy private insurance which have an exact opposite interest to your in this case.

Private hospital like Bangkok hospital is the most costly choice

if you can go to public hopitals they are much affordable and some are excellents like the queen Sirikit hospital in Sattahip

Edited September 13, 2019 by kingofthemountain
additional information

[wgdanson]

I just paid Bht 1.25k to Cigna for up to Bht 12M cover at 71 years old. It seems like enough.

[Pilotman]

21 minutes ago, BestB said:

At least 3 million , but depends which hospital you willing to be treated. If public then half or third that.

 

just the other day know someone was in an accident, 3 days in Bangkok hospital , in ICU, 1.2 million 

 

i had minor surgery , one night stay, same hospital 130000 baht

 

had shoulder surgery, 2 nights stay 400000 baht 

I would not myself be worried about none urgent conditions. Any conditions that are not emergencies, I would return to the UK and use the NHS. I am still registered there with my local GP,  as I am only on: 'an extended travelling holiday in Asia'. 

[VocalNeal]

I caught a virus. The immunoglobulin alone cost 500,000 baht. The actual hospital was reasonable as I didn't opt for the "best" rooms.

[lopburi3]

42 minutes ago, kingofthemountain said:

Private hospital like Bangkok hospital is the most costly choice

if you can go to public hopitals they are much affordable and some are excellents like the queen Sirikit hospital in Sattahip

True but may not always be the best option.  For my bladder cancer original biopsy was low grade and advised to use govt hospital as team does many - queue in government hospital was 10 weeks and when unable to operate due no ICU room and estimate would have been another 3-4 months wait (although check on eve of operation showed cancer much worse than expected).  Operation next week at Bangkok Hospital found cancer testing high grade after removal.  Have had one operation since due spread which might not have happened with more timely treatment.  Post above as a caution - although government doctors are often first rate and they do their best private hospitals can be a positive option for some. 

[Lazy Sod]

Wow, these numbers are shocking. Lesson learned for newcomers...if you go for a "health check up package" at one of the major health centers here it could cost you THB2M in exclusions just for simple things like high cholesterol. I suggest you get health insurance before you do any health check ups here.

[Momofarang]

My figure, if I wanted to leave my cover and self insure, would be in the range of 5 to 10 million Bahts. And I'd still worry. So I keep paying my 8000 Bahts a month (no age increase, 60000 Bahts yearly max co-payment, unlimited coverage) and enjoy my quarterly DREs at Bumrungrad.

[essox essox]

1 hour ago, BestB said:

At least 3 million , but depends which hospital you willing to be treated. If public then half or third that.

 

just the other day know someone was in an accident, 3 days in Bangkok hospital , in ICU, 1.2 million 

 

i had minor surgery , one night stay, same hospital 130000 baht

 

had shoulder surgery, 2 nights stay 400000 baht 

my friends travel insurance paid out 3.2 million for his big op at BKK Pattaya Hospital......he had the op Feb 8 this year !!!

[Lazy Sod]

I just found this which provides a good summary

https://trafalgar-intl.com/company-health-insurance-need-know/

 

[1FinickyOne]

3 hours ago, Lazy Sod said:

A friend had a heart attack recently with a few stents fitted, it was about THB 200K,

That does not sound like a recent price... I would expect that one stent, no complications would be double that... 

 

Most hospitals provide lists of costs

 

but don't forget, you might not be insuring for one event, but many... 

Edited September 13, 2019 by kenk24

[wgdanson]

2 hours ago, Lazy Sod said:

Wow, these numbers are shocking. Lesson learned for newcomers...if you go for a "health check up package" at one of the major health centers here it could cost you THB2M in exclusions just for simple things like high cholesterol. I suggest you get health insurance before you do any health check ups here.

Unless the Insurance Company (say Pacific ) want check-ups first.

[BestB]

2 hours ago, Pilotman said:

I would not myself be worried about none urgent conditions. Any conditions that are not emergencies, I would return to the UK and use the NHS. I am still registered there with my local GP,  as I am only on: 'an extended travelling holiday in Asia'. 

And what if unable to fly?

[Spike1938]

I don't know what hospitals you all are using but I had an angioplasty done at Pitsanuvej Hospital in Phitsanulok for just over 200000 THB. In 2006 I had spinal stenosis surgery at Bangkok Hospital in Bangkok for roughly 600000THB.

So I don't know where these multimillion baht figures are derived from.

[Pilotman]

34 minutes ago, BestB said:

And what if unable to fly?

'None urgent', to me,  means able to fly. 

[Lazy Sod]

Well, well, well...I just followed Sheryl's advice from another thread and applied online at cignaglobal. I declared the high cholesterol, it then asked me if I have any symptoms of heart disease, neurological, etc. (no), and is the condition controlled (yes). The next page listed exclusions...nothing related to cholesterol. So I paid with my credit card and it's done.

[abrahamzvi]

3 hours ago, BestB said:

At least 3 million , but depends which hospital you willing to be treated. If public then half or third that.

 

just the other day know someone was in an accident, 3 days in Bangkok hospital , in ICU, 1.2 million 

 

i had minor surgery , one night stay, same hospital 130000 baht

 

had shoulder surgery, 2 nights stay 400000 baht 

All the above figures seem highly exaggerated. I broke a hip and had  surgery with 2 nights in ICU and a total of 2 weeks in hospital, including a few sessions of physiotherapy, and the total bill including 3 months supply of expensive medicines, amounted to just over BHT 1 Million, all in Bangkok hospital. I again stayed 4 nights in the same hospital with  a serious infection and the bill amounted to just over BHT 120,000, including a supply of expensive medications.

I know one pays a lot at the Bangkok hospital, but one gets the best treatment, at costs which compared to USA and other western countries, are still reasonable.

[bprhodes]

I was diagnosed with a rare kind of cancer at BKK hospital in Chiang Mai. Standard protocol for this cancer is weekly injections that cost 120,000 baht each jab.  Then every 4-6 months I get a Pet scan for another 100k baht (have to got to BKK for that).   These costs are likely to continue for the long term, potentially for the rest of my life.  Fortunately I’m covered by group insurance that was part of my retirement package.  Government hospitals would have sent me home with paracetamol.   2-3 million baht in the bank wouldn’t last me more than a year and a half.  Going into this I thought myself healthy and invincible.  Lesson is that if you don’t have good insurance, better have a quick and well planned exit strategy.  That could be a difficult option if your home, family, friends, and all worldly possessions are here, as are mine.

[Pilotman]

1 hour ago, Lazy Sod said:

Well, well, well...I just followed Sheryl's advice from another thread and applied online at cignaglobal. I declared the high cholesterol, it then asked me if I have any symptoms of heart disease, neurological, etc. (no), and is the condition controlled (yes). The next page listed exclusions...nothing related to cholesterol. So I paid with my credit card and it's done.

at what age and at what cost. It's not available to everyone, even if the individual is willing to pay an inflated premium. 

[Lazy Sod]

I'm early 50's. It was USD1,450 for Gold package but I selected deductable of USD10,000 and 30% of cost paid by me. I selected this for 3 reasons, my local employer's insurance covers up to USD 12,000, I have savings to pay the 30% myself, and this reduced the premium significantly.

Edited September 13, 2019 by Lazy Sod
% typo

[gamesgplayemail]

Still better to waste $1000 yearly on insurance and hoping to never need it...

[BritManToo]

I've put a loop of rope and a stick to wind it with aside as my major health insurance.

The little problems cost almost nothing to fix at the government hospital.

[BritManToo]

2 hours ago, abrahamzvi said:

I broke a hip and had  surgery with 2 nights in ICU and a total of 2 weeks in hospital, including a few sessions of physiotherapy, and the total bill including 3 months supply of expensive medicines, amounted to just over BHT 1 Million, all in Bangkok hospital.

Guy I know broke his hip, NokornPing government hospital charged 16Kbht for the plastering and initial recovery (3 nights), paid direct by his government minimum m/c insurance and another 25Kbht for a month in a fully inclusive Chiang Mai care home, paid by him.

 

Hope you feel the 960Kbht extra you paid for 'expensive medicine' and a private room was worth it.

Edited September 13, 2019 by BritManToo

[DFPhuket]

I had the same situation. Because I am proactive, have annual health checks, and take medications to keep my cholesterol and hypertension low, Aetna's quote excluded anything heart or stroke related - just like the OP. Had I never had health checks and didn't know about or treat these, they would have covered me without exclusions - even though I'd likely cost them more in the long run.

 

I submitted the same health information to Cigna and their Silver worldwide plan covered me for USD 1,000,000 (excluding USA) with no exclusions. I'm 62 and the premium was USD 3200. You might try them. 

[Lazy Sod]

2 minutes ago, DFPhuket said:

I had the same situation. Because I am proactive, have annual health checks, and take medications to keep my cholesterol and hypertension low, Aetna's quote excluded anything heart or stroke related - just like the OP. Had I never had health checks and didn't know about or treat these, they would have covered me without exclusions - even though I'd likely cost them more in the long run.

 

I submitted the same health information to Cigna and their Silver worldwide plan covered me for USD 1,000,000 (excluding USA) with no exclusions. I'm 62 and the premium was USD 3200. You might try them. 

Just did the same (see post 19 & 23). Thanks

[bkk6060]

5 hours ago, Lazy Sod said:

Wow, these numbers are shocking. Lesson learned for newcomers...if you go for a "health check up package" at one of the major health centers here it could cost you THB2M in exclusions just for simple things like high cholesterol. I suggest you get health insurance before you do any health check ups here.

Yes.

I know an insurance guy and he said all the hospitals are connected and know your history of anything done in Thailand.

So, if you do one of those executive health screening deals or even a blood draw and something shows, you could well be denied in the future if you make a claim for a related issue.

I do have insurance here but my biggest concern is a motorbike accident if serious could mean significant time in a hospital.  The only thing Aetna told me is that I would not be covered if I had been drinking and crashed.

For self I think 2 million is a good number.  

 

Edited September 13, 2019 by bkk6060

[BestB]

2 hours ago, abrahamzvi said:

All the above figures seem highly exaggerated. I broke a hip and had  surgery with 2 nights in ICU and a total of 2 weeks in hospital, including a few sessions of physiotherapy, and the total bill including 3 months supply of expensive medicines, amounted to just over BHT 1 Million, all in Bangkok hospital. I again stayed 4 nights in the same hospital with  a serious infection and the bill amounted to just over BHT 120,000, including a supply of expensive medications.

I know one pays a lot at the Bangkok hospital, but one gets the best treatment, at costs which compared to USA and other western countries, are still reasonable.

Yes I exaggerated it for fun, would you like to see the bills?