Money in the Bank Vs Health Insurance

[Mike Teavee]

Came across a link to this in one of my regular newsletters...  https://www.expatden.com/thailand/mandatory-health-insurance-rules-for-retirees/?utm_source=ActiveCampaign&utm_medium=email&utm_content=A+Guide+to+Thailand+s+Mandatory+Health+Insurance+Rules+for+Retirees&utm_campaign=Published%3A+A+Guide+to+Thailand+s+Mandatory+Health+Insurance+Rules+for+Retirees

 

Mainly stuff we've read before (though the article seems a lot more certain that the new requirements will apply to existing Non-OA holders when they come to renew) but one part stood out which I haven't seen mentioned before... 

What if I Can’t Buy Health Insurance?

The Thai government is changing the financial requirements and will soon update retirement visa holders.

But if you can’t buy health insurance for whatever reason, you should expect to have to show more money in your bank account when you apply for your new retirement visa.

This is to make that you have enough money to pay for your medical bills if you don’t have health insurance.

This rule is not set in place yet. Soon, we may see changes in retirement visa requirements. Visa requirements may be separated between those who have health insurance and those who don’t.

 

This seems like a reasonable thing to do (& similar to the way Malaysia does it as part of MM2H), though the comment about "Changing the Financial Requirements" sounds a little ominous.  Has anybody come across any other articles about this?

 

 

[tgeezer]

More rumours but logical if Insurance is just a means of supporting insurance companies. However if it to provide for the cover they demand 40,000THB out-patient and 400,000THB in-patient care, where is the logic in increasing the 800,000THB which we already hold ? 

[ubonjoe]

That appears to be more of a opinion piece than anything else that is not entirely correct.

[Matzzon]

22 minutes ago, tgeezer said:

More rumours but logical if Insurance is just a means of supporting insurance companies. However if it to provide for the cover they demand 40,000THB out-patient and 400,000THB in-patient care, where is the logic in increasing the 800,000THB which we already hold ? 

Because that is money you have to be sure to can live and stay in Thailand, as well as have a buffer to quickly go home if something change. If you take a part of that money, you will not be considered to have enough funds for stay in Thailand. Simple logic, isn´t it?

[tgeezer]

1 minute ago, Matzzon said:

Because that is money you have to be sure to can live and stay in Thailand, as well as have a buffer to quickly go home if something change. If you take a part of that money, you will not be considered to have enough funds for stay in Thailand. Simple logic, isn´t it?

No, it isn’t logical.  Insurance only pays out 400,000THB how will Immigration ensure that we can remain if the bill comes to 800,000THB? In fact unlike you, I don’t think that Immigration feels it their duty to protect us from spending below the limits they set.    

[Sheryl]

It sounds like it was written prior to the new police order and also last Aoril's Cabinet Resoltion. 

 

Also I may be wrong but I think a change to the amount tequired for a retirement extension would require either a change to the Immigration Law or a special Cabinet Resolution. Immigration can't just do it on their own.

 

There just was a Cabinet Resolution passed regarding health insurance and retirees but limited to O-A visas.

[Mike Teavee]

1 hour ago, Sheryl said:

It sounds like it was written prior to the new police order and also last Aoril's Cabinet Resoltion. 

 

Also I may be wrong but I think a change to the amount tequired for a retirement extension would require either a change to the Immigration Law or a special Cabinet Resolution. Immigration can't just do it on their own.

 

There just was a Cabinet Resolution passed regarding health insurance and retirees but limited to O-A visas.

Hi Sheryl,

 

The article references RTP Order #548/2562 dated September 27th 2019 so would seem to be fairly recent... 

 

To my mind it makes perfect sense to allow people to self-insure by keeping the equivalent money in the bank in lieu of the Insurance, something along the lines of:-

1. Must keep 1,240,000 THB for 2 months prior to extending (800,000 + 400,000 to cover inpatients & 40,000 to cover outpatients)
2. Must keep same 1,240,000 THB for 3 months after extending
3. Must keep 840,000 THB for the remainder of the year (obviously this is the 400,000 you have to keep now + 400,000 Inpatients & 40,000 Outpatients)

... for those using the Income method, must keep 440,000 THB in an account all year round

 

I personally wouldn't have such a low level of "Cover" but it would seem to meet the minimum set by RTP & for those guys who choose (or have to) Self Insure, it sets a baseline to ensure there's always something there if needed

Edited October 30, 2019 by Mike Teavee

[Jano22]

5 hours ago, tgeezer said:

More rumours but logical if Insurance is just a means of supporting insurance companies. However if it to provide for the cover they demand 40,000THB out-patient and 400,000THB in-patient care, where is the logic in increasing the 800,000THB which we already hold ? 

What you mean by supporting insurance companies ? You think they make those rules for supporting them ? In every civiliced country i know, you have to show proof of insurance if you want to visit. My healthinsurance in Thailand cover up to 5 mill.Baht , used it once, last month whent to BP hospital because of pain in my left upper leg. Examination by doctor number 4 last month,replacement of hip (whitch was the problem) number 17, hospital took care of everything with the insurance company, all i showed them was a copy of my passport/valid visa and the insurance card. The bill was 419000 Baht, i covered a pair of sticks (4500Baht) wrote my name and went home.

The 800000 you already hold is a guarantee for your living expences here, not including healtcare, wich can be far away more expensiv than 800.000.

[Balance]

Speaking for the Americans, as I don't have any firsthand knowledge of insurance details for other nationalities, if you are over 65 you are eligible for Medicare,and you can go back to the states to take care of non emergent issues. I did this in 2014 when my afib became very symptomatic. I was in the US for 3 months going through the protocols and getting the ablation done.

 

 

 

 

[4MyEgo]

To insure or not to insure, I took out health insurance, emergency cover only, the cover being up to 1.2mil USD, which also covers a pre-existing condition, now in my 2nd year, and then took out health insurance for the family with a different company, again emergency cover only as outpatient is cheap enough to pay out of pocket.

 

The cost for the two is around 110,000 baht per annum ATM, and will no doubt increase soon when I turn 60, so thinking to self insure and put that 110,000 + per annum aside and see how things go, I mean if you look at the slide in the AUS $ the 110,000 baht per annum is actually 123,855 baht or an increase of 11.18% since a year ago.

 

Healthwise we are all good, and as the cover is emergency cover only, it's a gamble, but if there are no emergencies within 4-5 years, I think we will be in a good position as anything major can cost around 400k-500k baht and upwards of course, and I just have this thing about insurance companies coughing up ?

 

Anyone else have any thoughts on this ? 

Edited October 30, 2019 by 4MyEgo

[UncleMhee]

45 minutes ago, 4MyEgo said:

I just have this thing about insurance companies coughing up ?

I've had that thought all of my life since they screwed my dad over when I was five year old. He drilled it into us kids; don't trust any of those bastards.

[MRToMRT]

I think the source is this forum, this "theory" (400/800 covers med) has been raised in many posts here by multiple posters. 

The basis of many articles and writings on the entire web is by gleaning bits of information from various online sources and putting them together as a "guide". Theres also a "lawyer" on YouTube who just seems to read this forum and Facebook and then make bite sized videos "clarifying" the "situation".

 

It's hard to trust much online these days as being grounded in truth. Would be nice of it were true though. 

[jesimps]

6 hours ago, Mike Teavee said:

Hi Sheryl,

 

The article references RTP Order #548/2562 dated September 27th 2019 so would seem to be fairly recent... 

 

To my mind it makes perfect sense to allow people to self-insure by keeping the equivalent money in the bank in lieu of the Insurance, something along the lines of:-

1. Must keep 1,240,000 THB for 2 months prior to extending (800,000 + 400,000 to cover inpatients & 40,000 to cover outpatients)
2. Must keep same 1,240,000 THB for 3 months after extending
3. Must keep 840,000 THB for the remainder of the year (obviously this is the 400,000 you have to keep now + 400,000 Inpatients & 40,000 Outpatients)

... for those using the Income method, must keep 440,000 THB in an account all year round

 

I personally wouldn't have such a low level of "Cover" but it would seem to meet the minimum set by RTP & for those guys who choose (or have to) Self Insure, it sets a baseline to ensure there's always something there if needed

I self insure, but as well as my lump sum I keep in the Thai bank for my extension, I keep the rest of my savings in my UK bank. If I ever need a lump to pay for hospital treatment, I'll bring it from the UK. No need for extra in a Thai bank. For fit over 75s, self insurance is the way to go in my opinion.

[Thaidream]

10 hours ago, Mike Teavee said:

This seems like a reasonable thing to do (& similar to the way Malaysia does it as part of MM2H), though the comment about "Changing the Financial Requirements" sounds a little ominous.  Has anybody come across any other articles about this?

There is a provision in the Malaysian program that waives insurance if a person cannot get it.

 

In Mexico when a foreigner retires- after a perior in the country- one then becomes eligible to buy into the Social Security Scheme at a rate similar to what a Meican citizen pays per month.

 

Thailand could easily allow  various schemes-  Insurance coverage; waiver for those uninsurable; extra funds in bank;  certification that one can self insure; buy into the Thai Social Security System/  Thailand should have all these options if it really wants retirees.  There is no way I will ever put an extra 800K into a Thai bank for medical or for that matter anything.  After purchasing a home; several condos;  several cars and sending children to university- I have done enough .

[Gilltom]

10 hours ago, tgeezer said:

More rumours but logical if Insurance is just a means of supporting insurance companies. However if it to provide for the cover they demand 40,000THB out-patient and 400,000THB in-patient care, where is the logic in increasing the 800,000THB which we already hold ? 

What is the 800.000 bt for we keep in bank  its not like we can go to social and get money like in uk???? can.t that be used instead of insurance often wandered why we need to do that 

[tgeezer]

10 minutes ago, Gilltom said:

What is the 800.000 bt for we keep in bank  its not like we can go to social and get money like in uk???? can.t that be used instead of insurance often wandered why we need to do that 

800,000THB is an arbitrary figure set to satisfy the powers that be that we are not impecunious. The insurance requirement is to protect hospitals from Long-term visitors who run up medical bills and don’t pay them. The average Unpaid bill was a little over 400,000THB and coincidentally Immigration recently required retirees using the 800,000THB for extensions to not touch 400,000THB of that money. They also dictated that A-O visa holders with no money here must have insurance to the value of 400,000THB.  It is all so strange isn’t it? One would be forgiven for believing that there was a policy at work here.  I may be jumping to conclusions but I believe that if you have the cash you are self insured. 

[tgeezer]

2 hours ago, jesimps said:

I self insure, but as well as my lump sum I keep in the Thai bank for my extension, I keep the rest of my savings in my UK bank. If I ever need a lump to pay for hospital treatment, I'll bring it from the UK. No need for extra in a Thai bank. For fit over 75s, self insurance is the way to go in my opinion.

At our age, I am 74, it will be difficult to find an insurance company to cover us so that is a “load off”. I hope to drop dead which is the cheapest way to go, I work on it like you do probably, by trying to keep physically fit. Also I only spend the winter here so it is 7to5 that I will get sick in UK.  I can transfer cash from UK if the bill is more than the 1Mill. My bills are my responsibility and if I default it will be because the Western financial system has collapsed. 

[The Man Who Sold the World]

Well, this "piece" kinda lost credibility when I read this; "In 2018, 680,000 out of 3,420,000 expats who visited the hospital didn’t pay their bills. The total unpaid amount was estimated at 305 million baht. 

The majority of unpaid bills were from retirees." 

 

Really need to provide some supporting documentation for this claim.

[Max69xl]

12 hours ago, tgeezer said:

No, it isn’t logical.  Insurance only pays out 400,000THB how will Immigration ensure that we can remain if the bill comes to 800,000THB? In fact unlike you, I don’t think that Immigration feels it their duty to protect us from spending below the limits they set.    

Immigration didn't come up with the insurance numbers. Health Department did. 

[madmen]

4 hours ago, jesimps said:

I self insure, but as well as my lump sum I keep in the Thai bank for my extension, I keep the rest of my savings in my UK bank. If I ever need a lump to pay for hospital treatment, I'll bring it from the UK. No need for extra in a Thai bank. For fit over 75s, self insurance is the way to go in my opinion.

I dont get it. Keeping your cash in the UK has cost you dearly

 

For those in their 70"s it makes no sense to stay here if you have cheap cover back home (unless stuck with a family) . Forget 400k a serious health issue emergency will set you back millions. For those from OZ with nearly free medicare and meds would have to be nuts even if they had several million to spare ..why wipe out your life savings just because of a single medical emergency and once you hit 70 you better believe they will be around the corner somewhere

Edited October 30, 2019 by madmen

[gk10002000]

5 hours ago, Balance said:

Speaking for the Americans, as I don't have any firsthand knowledge of insurance details for other nationalities, if you are over 65 you are eligible for Medicare,and you can go back to the states to take care of non emergent issues. I did this in 2014 when my afib became very symptomatic. I was in the US for 3 months going through the protocols and getting the ablation done.

 

 

 

 

Yes and that was and still is my plan and goal.  I have no desire and do not see a big need to carry insurance in two countries.  As I coast into semi or permanent retirement I want things to be simple!  There is some risk that I may be debilitated and unable to fly home to accident or injury or whatever.  But paying for this Thai minimum insurance, especially at my older age and that home care provision really does make things more expensive.

[WhatupThailand]

Maybe Too many Lawyers and those that wanabe.

 

Why is it so hard to use common sense, and do the simplest thing,

Just allow anyone staying in Thailand long term, to Join the Thai Social Security system,

pay their premiums and be done.

 

PS: And stop Medical Price Fixing @2-3 times the normal rates.

Edited October 30, 2019 by WhatupThailand
ps added

[Max69xl]

24 minutes ago, WhatupThailand said:

Maybe Too many Lawyers and those that wanabe.

 

Why is it so hard to use common sense, and do the simplest thing,

Just allow anyone staying in Thailand long term, to Join the Thai Social Security system,

pay their premiums and be done.

 

PS: And stop Medical Price Fixing @2-3 times the normal rates.

Every hospital in western countries charges much more than 2-3 times for non-citizens outside the EU, for example. A lot more. 

[tgeezer]

10 hours ago, Max69xl said:

Every hospital in western countries charges much more than 2-3 times for non-citizens outside the EU, for example. A lot more. 

That is difficult too understand. The National Health System in UK charges me nothing, 2-3 times that is how much? 

[Mike Teavee]

6 minutes ago, tgeezer said:

That is difficult too understand. The National Health System in UK charges me nothing, 2-3 times that is how much? 

Technically if you've been out of the UK for > 6 months, unless you're returning to settle in the UK you're no longer eligible for free (non-emergency) treatment on the NHS & as a British Citizen the NHS will charge you 1.5x what it would charge a non-British citizen.  

 

How messed up is that!

 

Edit to Add link to Telegraph Article: https://www.telegraph.co.uk/news/health/expat-health/11571256/British-expats-from-outside-Europe-must-pay-for-NHS-hospital-care.html

Expats from outside Europe who return to the UK to use NHS hospitals will be billed for 150 per cent of the cost of treatment if they don’t have sufficient insurance.

Treatment remains free for those with a European Health Insurance Card (Ehic) and UK state pensioners living in the European Economic Area (EEA).

The charges only apply to hospitals – appointments with GPs and accident and emergency treatment remain free. Patients should expect to be asked questions about their residence status in the UK.

 

Edited October 31, 2019 by Mike Teavee

[Sujo]

I hate the idea of any insurance for anything being imposed, isnt that a kind of socialism?

 

i have never had anything insured in my life unless it is compulsory through a govt, again thats not being an open market capitalsm but socialism.

 

but i have made a nice earner by paying cash for everything and putting what it would cost me in insurance away in a nice nest egg.

[tgeezer]

12 minutes ago, Mike Teavee said:

Technically if you've been out of the UK for > 6 months, unless you're returning to settle in the UK you're no longer eligible for free (non-emergency) treatment on the NHS & as a British Citizen the NHS will charge you 1.5x what it would charge a non-British citizen.  

 

How messed up is that!

 

Edit to Add link to Telegraph Article: https://www.telegraph.co.uk/news/health/expat-health/11571256/British-expats-from-outside-Europe-must-pay-for-NHS-hospital-care.html

Expats from outside Europe who return to the UK to use NHS hospitals will be billed for 150 per cent of the cost of treatment if they don’t have sufficient insurance.

Treatment remains free for those with a European Health Insurance Card (Ehic) and UK state pensioners living in the European Economic Area (EEA).

The charges only apply to hospitals – appointments with GPs and accident and emergency treatment remain free. Patients should expect to be asked questions about their residence status in the UK.

 

Thanks Mike, I am being selfish I guess because I am not out of the country for six months. However it does show how unjust the NHS could be but that being the case why would a doctor ask a native born Brit with a Nationals Insurance number if he is entitled?  

[tgeezer]

13 minutes ago, Sujo said:

I hate the idea of any insurance for anything being imposed, isnt that a kind of socialism?

 

i have never had anything insured in my life unless it is compulsory through a govt, again thats not being an open market capitalsm but socialism.

 

but i have made a nice earner by paying cash for everything and putting what it would cost me in insurance away in a nice nest egg.

I am with you there, socialism is to deny facts. There is a Thai expression, Born, old, pain, death.  That is the cycle of life, it has to be accepted.  I gave up my medical insurance when I retired fifteen years ago when it cost 1000GBP. A friend who is now about the age that I was then, pays 4000GBP a year, I can’t imagine how much I have saved by not paying. 

One thing to do is to have a medical, if the result makes you insurable then you don’t need insurance. 

[MRToMRT]

13 hours ago, The Man Who Sold the World said:

Well, this "piece" kinda lost credibility when I read this; "In 2018, 680,000 out of 3,420,000 expats who visited the hospital didn’t pay their bills. The total unpaid amount was estimated at 305 million baht. 

The majority of unpaid bills were from retirees." 

 

Really need to provide some supporting documentation for this claim.

Good spot!

 

If these number are right then thats an average bill of less than 500 baht per non-payer. So are they not paying the bill or is the hospital simply not billing them? Anyone can afford an "average" price of 500 baht!

 

 

[LivinLOS]

4 hours ago, MRToMRT said:

Good spot!

 

If these number are right then thats an average bill of less than 500 baht per non-payer. So are they not paying the bill or is the hospital simply not billing them? Anyone can afford an "average" price of 500 baht!

 

 

But those number are not right.. Does anyone with an ounce of brain think 1 in 5 expats who visited a hospital didnt pay ?? 

 

The numbers have ranged from 100 million unpaid to 300 million unpaid.. For ALL non Thai visitors.. Consider 40 million arrive per annum thats a range of 2.5 baht to 7.5 baht per visitor !!!