"Cheat Sheet" for Longstay Insurance Policies

[Sheryl]

Got it, thanks

[TallGuyJohninBKK]

BTW, here's why the acceptance or not for O-A purposes of deductibles is a significant premiums cost issue, along with their no claims discount, in regards to Pacific Cross:

 

 

 

 

 

[Momofarang]

On the LMG page they state "This plan can either be your primary or secondary plan e.g. as a supplement to your company's benefits", if this was actually applicable to their OA offer, it would be a step in the right direction for those who have a foreign coverage that they can't drop.

I can't imagine why neither the Ministry of health nor Immigration haven't requested the participating companies to offer secondary insurance offers. They probably thought that ALL foreigners are reckless enough not to have health coverage.

[Sheryl]

5 minutes ago, Momofarang said:

On the LMG page they state "This plan can either be your primary or secondary plan e.g. as a supplement to your company's benefits", if this was actually applicable to their OA offer, it would be a step in the right direction for those who have a foreign coverage that they can't drop.

I can't imagine why neither the Ministry of health nor Immigration haven't requested the participating companies to offer secondary insurance offers. They probably thought that ALL foreigners are reckless enough not to have health coverage.

 

More than that, why they haven't insisted all the companies listed have plans available to the target age group. Some have no health insurance at all, or so they say. Others target only those under 60/65. Few provide guaranteed renewal for life/99.

 

Re LMG they do nto make it onto the short chart pinned due to "The underwriting team considers the renewal premium for policyholders who are more than 70 years old on a case by case basis".

 

I do agree there is a great untapped market for a secondary insurance scheme.

[Momofarang]

19 minutes ago, Sheryl said:

I do agree there is a great untapped market for a secondary insurance scheme

Not only would it soothe the frustration of having to pay for a totally unnecessary policy, but would address issues concerning preexisting conditions.

[Sheryl]

26 minutes ago, Momofarang said:

Not only would it soothe the frustration of having to pay for a totally unnecessary policy, but would address issues concerning preexisting conditions.

 

Absolutely.

 

I know my broker, at AA, is helping people sort of put something like this together ad hoc, by increasing the deductible on their foreign insurance then buying a second local policy, idea being that the local policy would pay the deductible amount. Of course only possible if below age 75 since none of the insurers on the supposed retirement insurance list of TI see fit to insure people beyond that age, at any price.

.

 

Something like that, since not specifically designed to work that way by the insurer, you would definitely want to do through a broker who understands the idea and will help with the claims.  I recently used a local Personal Accident policy to pay the deductible on my foreign policy after I had an accident  leading to large expenses (>600,000 baht worth).  It eventually worked but was like pulling teeth to get the local insurer to understand the documentation and why the claim was a different, lower amount than the full hospital bill and how it related to the other insurer. Took 4 full months to resolve. (Local policy had not been purchased through the broker who I used for my main foreign policy. Lesson Learned!).

[KeeTua]

Since Immigration will only grant an entry date until the date of your policy expiration I was wondering how the dates would sync to get a full year out of an extension, assuming the rules will at some point apply to extensions.

 

Answered by Martyp in a post in the visa forum.

"My insurance company, Pacific Cross, said they would sync the dates of my insurance coverage with my extension dates. My insurance currently runs Jan - Jan and my extension expires in mid-November. I could back up my insurance to Dec 1. They said they would sync the dates and reimburse any unused premiums in the process which would be 1 month if I moved it to December"

[Sheryl]

Yes.

And most insurers let you select an effective date.

 

It will take some planning and juggling and people may lose a day or two here and there but hopefully not more than that.

[ukrules]

This whole insurance thing seems to be some kind of nonsense.

 

Considering the cover required is pretty low and the premiums are so high when compared to the cover amount there should be a way to self insure via some sort of 'medical use only' escrow account which will only pay medical expenses.

 

Siam Legal talk about escrow accounts for property purchases but given the choice of paying those fees which are a large percentage of the miserly cover offered and putting the money aside somewhere that can't be touched I think a lot of people would go with the self insurance option should it be allowed.

 

Something like this would also allow people who are already over the age at which they can start a new policy an option.

 

One other point, lets say you're two months into a years extension and you make a claim that uses up all of your yearly claim allowance - what then? Effectively you're uninsured......the whole thing sounds pretty much unworkable if it's done by private companies.

[amexpat]

30 minutes ago, ukrules said:

Considering the cover required is pretty low and the premiums are so high when compared to the cover amount there should be a way to self insure via some sort of 'medical use only' escrow account which will only pay medical expenses.

 

Wasn't that the rationale for the 800k then 400k reserve?

 

But after they took care of the banks, the insurance cos said "hey what about us!"

 

 

[Sheryl]

1 hour ago, amexpat said:

 

Wasn't that the rationale for the 800k then 400k reserve?

 

 

 

 

No. It was not. Had nothing to do with medical expenses.

Note that people using the income method don't keep 400K reserve.

 

It is absolutely true that 400K is insufficent insurance; this was very, very badly designed to put it mildly. One needs a minimum of 1 million if using only government hospitals, 3-5 million if you want the option of using private. And one does not need OPD.

 

If you aren't over 75  you can get a policy with that level of protection which also meets Imm requirements. If under 65, more than one company option.

 

The big problem will be for people over 75 or with pre-existing conditions.

 

And then there are those who are abundantly insured but via foreign policies, or who have access to unlimited free health care in Thailand through SS or Tricare. Currenlty no provision for these.

[amexpat]

8 minutes ago, Sheryl said:

No. It was not. Had nothing to do with medical expenses.

It has been said so repeatedly.  Not the official statement?

[pontious]

3 hours ago, Sheryl said:

I know my broker, at AA,

They seem to have left as sponsors to TV - is that correct.?

Of topic I know - just interested.

 

[Sheryl]

15 hours ago, amexpat said:

It has been said so repeatedly.  Not the official statement?

Thete was never any statement from Imm linking the 800/400 in the bank to medical or any other expense.

Pure expat barstool speculation and clearly not the case since no comparable requirement for people using income methid.

The seasoning and minimum balance rules are intended to close loopholes as people without 800k have been getting extensions based on 800k. Won't work of course but that is the original idea.

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

[amexpat]

800K and income both indicate some ability to pay.

 

Maybe the govt is just concerned we won't have enough money for beer, girls, and green fees. 

[TallGuyJohninBKK]

20 hours ago, Sheryl said:

Yes.

 

 

Sheryl, I spoke on the phone this afternoon with one of the expat reps at Pacific Cross, trying to answer a couple of the looming questions about their policies and compliance with the O-A insurance requirement. Here are the answers I got:

 

1. Regarding policies with deductibles, the Pacific Cross rep indicated that any particular deductible level that a person chooses for their policy should NOT in any way impact its eligibility for O-A compliance. So as long as the policy limits themselves meet or exceed the O-A 400K/40K requirements, any chosen level of deductible is fine.

 

2. Regarding which Pacific Cross policies are going to be eligible for O-A certification, the rep there indicated that among their general policies, an O-A holder must have their Standard Extra or higher level policy. The rep specifically said their Standard and Standard Plus policies are NOT O-A certified.

 

So that means their O-A certified policies would include the three Platinum, O-A specific policies linked to on the TGIA website, as well as their general public policies including Standard Extra, Premier and Premier Plus, Maxima and Maxima Plus, and Ultima and Ultima Plus.

 

Also, for their Standard series policies, and specifically for the Standard Extra policy where the outpatient coverage is expressed as a maximum of 2000 baht per visit X a maximum of 30 outpatient visits per year, the Pacific Cross rep indicated that kind of coverage has been deemed to meet the O-A outpatient coverage requirement. Meaning they will issue an O-A insurance certificate for it, and the others, that should be accepted by Thai Immigration.

 

Overall, the answer above about being able to apply deductibles to the various Pacific Cross policies, and still maintain O-A eligibility, is really good news IMHO, because their premium discounts can be quite substantial depending on the policy deductible level chosen, which provides a good way to make the policy premiums much more affordable, along with their option for additional "no claims" discounts. Put the two together, and you can cut their standard premium rates by almost half or more.

  

[albertik]

Thanks Sheryl...…...Just took a look at your cheat sheet posting. Helpful info there.

[Sheryl]

28 minutes ago, TallGuyJohninBKK said:

 

Sheryl, I spoke on the phone this afternoon with one of the expat reps at Pacific Cross, trying to answer a couple of the looming questions about their policies and compliance with the O-A insurance requirement. Here are the answers I got:

 

1. Regarding policies with deductibles, the Pacific Cross rep indicated that any particular deductible level that a person chooses for their policy should NOT in any way impact its eligibility for O-A compliance. So as long as the policy limits themselves meet or exceed the O-A 400K/40K requirements, any chosen level of deductible is fine.

 

2. Regarding which Pacific Cross policies are going to be eligible for O-A certification, the rep there indicated that among their general policies, an O-A holder must have their Standard Extra or higher level policy. The rep specifically said their Standard and Standard Plus policies are NOT O-A certified.

 

So that means their O-A certified policies would include the three Platinum, O-A specific policies linked to on the TGIA website, as well as their general public policies including Standard Extra, Premier and Premier Plus, Maxima and Maxima Plus, and Ultima and Ultima Plus.

 

Also, for their Standard series policies, and specifically for the Standard Extra policy where the outpatient coverage is expressed as a maximum of 2000 baht per visit X a maximum of 30 outpatient visits per year, the Pacific Cross rep indicated that kind of coverage has been deemed to meet the O-A outpatient coverage requirement. Meaning they will issue an O-A insurance certificate for it, and the others, that should be accepted by Thai Immigration.

 

Overall, the answer above about being able to apply deductibles to the various Pacific Cross policies, and still maintain O-A eligibility, is really good news IMHO, because their premium discounts can be quite substantial depending on the policy deductible level chosen, which provides a good way to make the policy premiums much more affordable, along with their option for additional "no claims" discounts. Put the two together, and you can cut their standard premium rates by almost half or more.

  

 

It is good news re the deductibles. But why on earth is he saying Standard Plus is not compliant. It is 450/45 so should be. Regular standard of course not, but plus should be. (Though I would advise people to go for a higher level of cover if this will be their only policy and if they can afford to).

[TallGuyJohninBKK]

10 minutes ago, Sheryl said:

 

It is good news re the deductibles. But why on earth is he saying Standard Plus is not compliant. It is 450/45 so should be. Regular standard of course not, but plus should be. (Though I would advise people to go for a higher level of cover if this will be their only policy and if they can afford to).

 

I asked that exact same question, Sheryl, since as you noted, the limits of the Standard Plus policy DO fit within the 400/40K limits. The guy's answer was, the Standard Plus policy hadn't been certified by the government...

 

And it presumably isn't because of its XXXX baht X 30 OPD visits provisions, since the Standard Extra has similar OPD language but with a higher per visit limit. And that kind of OPD language apparently isn't a problem. So where's the logic in it?  I have no clue.

 

[Mango Bob]

On 10/14/2019 at 11:24 AM, TallGuyJohninBKK said:

 

According to the Pacific Cross rep's recent post here, originally, only the policies specifically listed on the TGIA O-A page were going to be deemed acceptable for O-A compliance, not their regular policy line. And even now, the Immigration language says the complying policies must be purchased online via the TGIA website.

 

 

However, the rep's post indicated PC ended up going and persuading the government to allow all of their policies that met the coverage minimums to be deemed in compliance -- not just the 3 O-A policies they currently have listed on the O-A website.  Originally, that was not going to be the case.

 

My follow-up question I posed to them -- which they have not answered as yet -- is whether or not the government's permission to Pacific Cross also extended to all the other insurers listed on the O-A website, meaning, are all of their policies also available now provided they meet the minimums.

 

 

I think that is for someone applying for an O/A from outside of Thailand.  

[TallGuyJohninBKK]

24 minutes ago, Mango Bob said:

I think that is for someone applying for an O/A from outside of Thailand.  

 

Since that post 11 days ago, it's become reasonably clear that, at least in theory, the Thai Embassies and Consulates who take O-A applications are going to be willing to accept either foreign or Thai insurance policies that meet the 400K IPD / 40K OPD minimums in their rule.

 

But significant problems/issues remain for both the foreign and Thai policies:

 

--For those with existing foreign/home country policies, it's appearing very difficult if not impossible to get those insurers to sign the required Thai legalistic "foreign insurance certificate" that the Thai government is requiring in order to accept such policies.

 

--And for those who might look to a Thai insurance policy instead, a lot of the participating Thai insurers either won't write new policies at all for older folks and/or won't renew existing policies beyond varying ages. And at the moment, there's no alternative/workaround except to insure with the 1 or 2 Thai carriers who will write new policies and renew existing ones for older folks.

 

 

[Tuvoc]

Regarding the comment on Aetna guaranteeing lifetime coverage if purchased before 60 - all well and good, but do the premiums head to the stratosphere at higher ages ?

[Sheryl]

All insurance companies raise premiums eith age, usually in 5 year incrrments. The "cheat sheet" indicates rates at 65 and 75 and you will see that there is a big difference. For rates at 80 and beyond contact the companies.

Definitely if planning to settle permanently in Thailand need to factor this into your long-term financial planning..along with continued rise in cost of living in Thailand.

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

[KKr]

On 10/13/2019 at 4:11 PM, OneMoreFarang said:

 .... and I think it would be good to add the following things to .... 

hi there, thank you for the clear explanation.

I would like to point out that with some companies, whereas they top-line do insure 400.000 in-patient cover, according to the information sheets, there seems to be a significantly lower limit on the maximum payment per disability/time/year.
Further to what was already mentioned, I am being told by someone handling a lot of claims that, in an international perspective, it would be prudent to have about 1 million USD cover to be relatively well protected
But, having said that, a local senior head of department in a respected hospital mentioned that medical bills of about 500.000 THB or over are rare in regular (i.e. not up-market) Hospitals here.

[Momofarang]

On 10/25/2019 at 6:12 PM, TallGuyJohninBKK said:

--For those with existing foreign/home country policies, it's appearing very difficult if not impossible to get those insurers to sign the required Thai legalistic "foreign insurance certificate" that the Thai government is requiring in order to accept such policies.

Indeed, and as so many things Thai the wording on the "Foreign Insurance Certificate" is pathetically unprofessional: "in accordance with the Cabinet Resolution, dated 2 April B.E. 2562(2019)". This doesn't mean frakk all. I'd expect them to quote a gazetted article of new legislation, but these "jeurks" work like seven year olds.

What if I would want to submit their official legal requirements to my ex employer so that they get the certificate signed from our insurer?

[Sheryl]

1 hour ago, Momofarang said:

Indeed, and as so many things Thai the wording on the "Foreign Insurance Certificate" is pathetically unprofessional: "in accordance with the Cabinet Resolution, dated 2 April B.E. 2562(2019)". This doesn't mean frakk all. I'd expect them to quote a gazetted article of new legislation, but these "jeurks" work like seven year olds.

What if I would want to submit their official legal requirements to my ex employer so that they get the certificate signed from our insurer?

 

Yes, that clause is a killer. Especially since as far as I can tell no copy of that resolution exists in English. (I actually have not been able to find it in Thai either but assume it is somewhere).

 

Can hardly expect an insurance company to soign that they are in compliance with something they've never read.

[OJAS]

On 10/21/2019 at 2:02 PM, Sheryl said:

Update: I just got reply from them confirming all policies available up to age 75. And deductibles are an option for all plans inc the Platinum.  Chart edited accordingly.

This is at complete variance with what Pacific Cross have just told me today - namely, that deductibles are NOT an option for the 3 Platinum plans.

[TallGuyJohninBKK]

29 minutes ago, OJAS said:

This is at complete variance with what Pacific Cross have just told me today - namely, that deductibles are NOT an option for the 3 Platinum plans.

 

I see Pacific Cross has redone their webpage linked from the TGIA website since the last time I looked, with better information, explanation, and a handy little chart:

 

 

The divergence between the policies the govt. has OK'd for the O-A program vs. the only one line for the O-X program is a bit odd, though....

 

They appear to have taken down the details re the Platinum policies on the O-A page. But as best as I recall, there were no deductible options on the Platinum plans that were specific to the O-X visa program and lately to the O-A.

 

However, AFAIK, all of the other general public Pacific Cross health plans such as the others listed in the chart above all have deductible options. And likewise, Pacific Cross has told me that those policies are O-A approved regardless of what deductible level a policyholder may choose.

 

 

 

 

[Sheryl]

26 minutes ago, TallGuyJohninBKK said:

...AFAIK, all of the other general public Pacific Cross health plans such as the others listed in the chart above all have deductible options. And likewise, Pacific Cross has told me that those policies are O-A approved regardless of what deductible level a policyholder may choose.

 

This is what I was told in writing (email) from a rep there:

 

" Dear Sheryl,

 

In the insurance certificate there will be no mention of deductibles. This is one of our strong points, no other company that is approved by immigration has deductibles in their plans."

 

and

 

" *2. For the Platinum Plan that can enrol up to age 75, is therean option

  for taking a deductible to reduce premium?  *

 " Yes, we have 40,000, 100,000, 200,000 and 300,000 deductibles"

 

[TallGuyJohninBKK]

16 minutes ago, Sheryl said:

2. For the Platinum Plan that can enrol up to age 75, is therean option

  for taking a deductible to reduce premium?  *

 " Yes, we have 40,000, 100,000, 200,000 and 300,000 deductibles"

 

Thanks Sheryl... Google has a cached version of the prior Pacific Cross webpage where they listed all the details of that visa-specific Platinum policy range... At least on that page, there was no mention of deductibles being available for that policy range.  Even though on all their other policy range web pages, deductible options are very clearly spelled out...  So dunno how to reconcile that with the info you received...

 

https://webcache.googleusercontent.com/search?q=cache:8rZzdqVhz7UJ:https://www.pacificcrosshealth.com/en/health-insurance/longstay-visa/+&cd=1&hl=en&ct=clnk&gl=us

 

But it did include several other details in small print at the bottom, including:

 

 

Quote

 

Applicant must be aged 6 – 75 years old.

 

Elective treatment for North America, Japan, HongKong, EU countries and Switzerland – This benefit is permitted only on a case by case basis with no guarantee of acceptance. In all others countries pre-approval of treatment is required.

 

The applicant must be Thai resident or reside in Thailand at least 6 months in 12 months period.

 

The insured has the ability to continuously renew the policy up to age 99 years, premium and coverage may be adjusted following the claim experience, health condition, increasing age.

 

Information in this brochure is only preliminary information provided for the applicant to consider for applying for health insurance coverage from the company, all insuring conditions shall be referred to Definition, General Definition, General Exclusions, and Insuring Agreement of the health insurance policy of the company.