Medical Insurance Disabled, Home Country Insurance, Military

[JimmerJJ]

I hope the Thai Authorities are giving a thorough vetting of the complicated issues of who needs Thai Health Insurance.  It's not as simple and cut and dried that all Ex-Pats need insurance from Thai Insurance providers.   Many have disabilities that like me are covered by ny Military Tricare Overseas.  Others have insurance in their home countries (I pay $135 a month into Medicare in case I have a catastrophic illness, otherwise I just pay out of pocket).  Also those who have military service frequently are covered by insurance in their home countries.

 

The gist of this new law is that many farangs stiff the hospitals for care they received. I'm not a lawyer but it seems that on the Visa application they could include a clause stating that in the event of unpaid hospital bills the applicant will be immediately deported to their home country. Plus they could require a 50,000 baht deposit to be held in escrow for any emergency care and flight back to home country. This would cover the vast majority of unpaid bills.

 

I fear that those writing the regulations are just doing so to make it as easy as possible in the interest of expediency to accept or deny applications with no consideration to extenuating circumstances.  Or in the worst case o benefit the Health Insurance Industry,

 

Alo there should be an open public forum of say 60 days for people to come forward and voice their concerns about these regulations. Health care is  very complicated issue that needs to be thoroughly discussed before implementing requirements that can have disastrous consequence that upheave peoples lives.Hopefully these issues can be brought to the attention of Thai Immigration Authorities.

[Bruce Aussie Chiang Mai]

I agree with your comments re health insurance industry will benefit most, poor insurance for high fees.

Maybe that good idea 50k to 100k in trust account totally locked till leaving country.

What about dome of policies with excesses that amount also needs to be available to pay, unlikely insurance will settle a claim if excess not paid.

It already know fact majority of debts left are tourists and neighbouring country visitors not people on retirement and marriage visas.

❤????????????

 

[UKresonant]

2 hours ago, JimmerJJ said:

Plus they could require a 50,000 baht deposit to be held in escrow for any emergency care and flight back to home country. This would cover the vast majority of unpaid bills.

It would be substantially greater than zero provision!

 

2 hours ago, Bruce Aussie Chiang Mai said:

Maybe that good idea 50k to 100k in trust account totally locked till leaving country.

What about dome of policies with excesses that amount also needs to be available to pay, unlikely insurance will settle a claim if excess not paid.

I agree that an account for excess and outpatients cover would be a great idea, and that account could be opened and maintained by non-residents. Could run it like  a Mutual fund/cash & bond OEIC(s) and buy units at 5k a pop, open with 40k and add at least 5k a year or as much as you wish. Not everyone that applied for a O-A ME (in the past) necessarily was using it to stay here in Thailand all the time. Buy it through the banks for a small fee. Add a listed beneficiary, doubles as a small insurance provision, if no medical incident and the such. (Could get it SWIFTed to yor bank, if you have no intention of coming back)

 

I always remember a story, many years ago, by an aquaintance that observed someone they new die of a heart attack, as he could not get treatment fast enough, though he had $5000 in his hotel room safe! Some sort of standard recognisable card you could carry, recognised by all hospitals would be a useful thing. With the card having an organisational back-up that any bill will be scrutinised for appropriate charging.

 

For the insurance component it would have appear a better option for the buyer, if it were perhaps set lower, say 200k but more flat rate pricing and a higher surety of pay out, and could be purchased in smaller 97 day chunks.  Always pays for claims in Thailand first, don't have to be resident in Thailand to buy the cover etc.

 

But the above would be useful to the customer. and reduce the unpaid hospital bill risk threshold to above 240k.

 

Sequence = 40k,-compulsory insurance bit (always pays first),-other insurance(s) (with 240k deductible) and or self funding, - remainder of funds in the account if still required.

 

The objective they state, would perhaps  be better addressed if they had insured themselves against unpaid hospital bills! Rather than this indirect method implemented so far. health does not recognise policy periods of visa and extension periods it is continuous...but being in Thailand may not be...

Edited December 4, 2019 by UKresonant

[Momofarang]

2 hours ago, JimmerJJ said:

I fear that those writing the regulations are just doing so to make it as easy as possible in the interest of expediency to accept or deny applications with no consideration to extenuating circumstances.  Or in the worst case o benefit the Health Insurance Industry,

 

Yep, laziness and corruption go hand in hand.

[Sheryl]

" I hope the Thai Authorities are giving a thorough vetting of the complicated issues of who needs Thai Health Insurance.  "

 

That is exactly what they have not done.

 

They also do not remotely understand the limitations of Thai insurance policies and who can and cannot get them at any price.

 

Hence the diplomatic briefs forwarded by various Embassies and all the fuss.

 

" there should be an open public forum of say 60 days for people to come forward and voice their concerns about these regulations"

 

Dream on.

 

"Hopefully these issues can be brought to the attention of Thai Immigration Authorities."  No avenue for doing so except through your Embassy and hope they in turn pass it on, 

[JimmerJJ]

26 minutes ago, Sheryl said:

" there should be an open public forum of say 60 days for people to come forward and voice their concerns about these regulations"

 

Dream on.

I know Sheryl it is a dream but still people shouldn't give up to improve things just because the situation seems hopeless. There are a lot of things that seemed futile like civil rights but forward thinking people persevered and change happened. Another hopeless but worthy idea is for Thailand to have 'town halls' where Thai Officials would stand up before constituents who would put tough questions to them that they would naturally try to duck but a good questioner wouldn't let them of the hook and make them answer the question. It's a way of holding them accountable.

[JimmerJJ]

There's are a myriad of things to consider regarding health care insurance coverage and Thailand is really opening up a can of worms with this insurance requirement that is so basic and fails to address so many issues. It seems like they thought about it for about half an hour and then put it out.

Edited December 4, 2019 by JimmerJJ

[Sheryl]

What is truly disheartening is that they thought about and discussed it for many months and still this result....????????

 

Matters were made more complicated by the interministerial nature of this. 3 different govt entities plus the local  private insurance sector involved.  None of them with a good understanding of health insutance (and that does include the last group).

[4MyEgo]

4 minutes ago, JimmerJJ said:

There's are a myriad of things to consider regarding health care insurance coverage and Thailand is really opening up a can of worms with this insurance requirement that is so basic and fails to address so many issues.

Look for a loophole as others have and are doing, e.g. changing from non O/A to marriage non O, and or retirement.

 

I get what your saying, but look at the TM30 fiasco, I hear a few immigration officers are not interested in farangs reporting unless they go overseas, then requiring them to report via the TM30 when they return to their province, perhaps this is on the quiet so as not to lose face ?

 

I have yet to confirm the above, only heard this on TVF so when I visit my IO next month will ask if there have been any changes to the TM30 requirement, if not, I will keep updating online.

[LivinLOS]

41 minutes ago, JimmerJJ said:

I know Sheryl it is a dream but still people shouldn't give up to improve things just because the situation seems hopeless. There are a lot of things that seemed futile like civil rights but forward thinking people persevered and change happened. 

Your seriously comparing the issues wealthy western retirees face with the civil rights era ?? LOL

 

Quote

Another hopeless but worthy idea is for Thailand to have 'town halls' where Thai Officials would stand up before constituents who would put tough questions to them that they would naturally try to duck but a good questioner wouldn't let them of the hook and make them answer the question. It's a way of holding them accountable.

What could possibly be in it for them ?? Being held accountable ?? By a bunch of grumpy nit picking non Thais.. Oh true LOLz

[thailand49]

I hate to bash the Thai authorities, but this all comes from the lack of critical thinking in their education system which we westerner take for granted back home?

 

As we live here  tough not to noticed they come up with a lot of rules and ideas put them forward but never thought out causes more confusion that providing solutions. 

 

As we know Immigration is a prime example.  This is surely a place " the light is on but no one is home "

[Langsuan Man]

If it ain't broke don't fix it

 

There have never been any reports of "non immigrant visa holders " not paying hospital bills, it has always been the tourists yet O-A Visa holders are the low hanging fruit right now.

 

If you really think that it is not going to come to "O" Visa holders your living in a fantasy world, not Thailand

 

I have a year to decide if I wan't to continue to come to Thailand for the winter and right now, unless I can use my US health insurance,  I won't be coming back  

[gk10002000]

56 minutes ago, Langsuan Man said:

If it ain't broke don't fix it

 

There have never been any reports of "non immigrant visa holders " not paying hospital bills, it has always been the tourists yet O-A Visa holders are the low hanging fruit right now.

 

If you really think that it is not going to come to "O" Visa holders your living in a fantasy world, not Thailand

 

I have a year to decide if I wan't to continue to come to Thailand for the winter and right now, unless I can use my US health insurance,  I won't be coming back  

Spot on.  Expats or long stay visa holders are getting targeted because they are vulnerable and presumably the Thais think they have a captive audience.  If that is their mentality then yes it will flow over to Marriage visa expats as they probably are more attached to Thailand.  But the authorities are playing with fire and are going to lose much more money and business than they gain.  Foreigners will leave. 

[Sheryl]

56 minutes ago, Langsuan Man said:

If it ain't broke don't fix it

 

There have never been any reports of "non immigrant visa holders " not paying hospital bills, it has always been the tourists yet O-A Visa holders are the low hanging fruit right now.

 

If you really think that it is not going to come to "O" Visa holders your living in a fantasy world, not Thailand

 

I have a year to decide if I wan't to continue to come to Thailand for the winter and right now, unless I can use my US health insurance,  I won't be coming back  

There have in fact been a number of "GoFundMe" type appeals from longtime resident expats. It does happen. Previous TVF polls indicate as many as a third are uninsured and from my discussions with TV members I would say not one in ten "self insured" person is adequately self insured. Many have nothing put by at all (they seem to think "self pay" means "self insured. It does not) and the rest, way too little.  Many people coming from countries where medical care is not paid for at point of service have absolutely no idea what medical care can cost.

 

It is not that the problem doesn't exist. It is that the "solution"  is horribly designed, not thought through and will not solve the problem while at the same time causing a lot of collateral damage.

[rwill]

Didn't the Thai government used to offer a low cost health insurance plan for expats but later scrapped it?  Perhaps they should come up with some government option for expats (with no exclusions).  

[MadMuhammad]

21 hours ago, Bruce Aussie Chiang Mai said:

I agree with your comments re health insurance industry will benefit most, poor insurance for high fees.

Maybe that good idea 50k to 100k in trust account totally locked till leaving country.

What about dome of policies with excesses that amount also needs to be available to pay, unlikely insurance will settle a claim if excess not paid.

It already know fact majority of debts left are tourists and neighbouring country visitors not people on retirement and marriage visas.

❤????????????

 

Oh my. Imagine the stink from those that 'Don't trust thai banks' at having to put 100K in a locked account

[LivinLOS]

15 minutes ago, MadMuhammad said:

Oh my. Imagine the stink from those that 'Don't trust thai banks' at having to put 100K in a locked account

100k.. So able to fund an ingrown toenail then !! 

 

 

[MadMuhammad]

9 minutes ago, LivinLOS said:

100k.. So able to fund an ingrown toenail then !! 

 

 

I spent 7 days in hospital on an IV including antibiotics not long ago. No critical care just a nurse doing obs twice a day. 200Kthb. Ouch 

[Jeffkp]

I have a non-o visa and private insurance from the U.S. I use it currently with Bangkok Hospital Chiang Mai. Is this sufficient for immigration?

Thanks.

[ubonjoe]

2 minutes ago, Jeffkp said:

I have a non-o visa and private insurance from the U.S. I use it currently with Bangkok Hospital Chiang Mai. Is this sufficient for immigration?

If you used a non-o visa to get the permit to stay you have been extending you do not need to worry about insurance.

[Jeffkp]

Just now, ubonjoe said:

If you used a non-o visa to get the permit to stay you have been extending you do not need to worry about insurance.

Thanks!

[evadgib]

I have never understood why long term residents cannot be given PR status that entitles them to local rates at a govt hospital. I cannot understand this 'skin tax' (dual pricing/gouging, call it wot yer like) at all.

Edited December 5, 2019 by evadgib

[Sheryl]

3 minutes ago, evadgib said:

I have never understood why long term residents cannot be given PR status that entitles them to local rates at a govt hospital. I cannot understand this 'skin tax' (dual pricing/gouging, call it wot yer like) at all.

1. Most government hospitals charge the same fee to foreigners as they do to self-pay Thais. Just a few exceptions , all of them hospitals receiving a larger than average volume of foreign patients.

 

2. However few Thais have to self pay as all have free health care cover. They have to pay only if they choose to go to a hospital other than the one they are registered at under the SS or universal cover schemes and withput a letter of referral from it.  Not too unusual in Bangkok (middle class Thais often willing to pay to access the top hospitals rather than go whete they are registeted, especially if it is far away) bit pretty rare in most of the country.

 

2. PR does not entitle one to coverage under the national health care system. Only citizenship would do that. 

[chilly07]

As preexisting conditions and over 75s are never covered this 'insurance' is junk and will do nothing for expats. Tourists and Itinerant workers will continue to run up the majority of unpaid bills and leave! 

[JimGant]

2 hours ago, MadMuhammad said:

I spent 7 days in hospital on an IV including antibiotics not long ago. No critical care just a nurse doing obs twice a day. 200Kthb. Ouch 

When we are given huge cost numbers attributed to farang deadbeats, please lets look at actual costs, not huge profit margins. Yes, the cost of medicines paid by the hospital, and disposables, such as panty liners, plus wear and tear on equipment, etc. can be put in the real cost column. But don't add a huge doctor's fee, simply because he checked your pulse during his eight-hour shift. Certainly hospitals deserve to be reimbursed for costs -- just make sure, however, these are costs that, unpaid, would affect their bottom line. But don't scream "deadbeat farang" when the majority of the "cost" is padding that could be relegated to the "mandatory pro bono" column in the cost accounting ledger.

 

Yes, there's a problem; but it ain't as big as advertised!

[khunPer]

On 12/4/2019 at 6:29 AM, JimmerJJ said:

I hope the Thai Authorities are giving a thorough vetting of the complicated issues of who needs Thai Health Insurance.  It's not as simple and cut and dried that all Ex-Pats need insurance from Thai Insurance providers.   Many have disabilities that like me are covered by ny Military Tricare Overseas.  Others have insurance in their home countries...

So far it's only for the so-called "retirement visa" non-immigrant "O-A" and "X" (X = 10-year visa) that a health insurance is mandatory for, and if you have an insurance from your home country, there is a pdf-form to download from the "long-stay" homepage that the insurance company can sign, and thereby state that the person is covered within the Thai demands, as proof of insurance.

 

Government hospitals on Phuket – or is it only one, and the same director...???? – has for a couple of years complained about unpaid bills from foreigners. With the new government hospital prices, where tourists pays more, and retired expats even more, that should in principle cover the unpaid bills...????

 

The original news article from November 29th is here...

According to the facts given in the article I calculated in my reply post that half of 9,000 is 4,500 – mainly Russian, Chinese and French – not paying their bill, out of 14 million visitors to Phuket, i.e. 0.065 percent.

 

It has always been my impression that the 800k baht deposit, and especially after the latest adjustment with not less than 400k baht in balance, generally should cover expenses that a retired long-term visitor might have.

 

Those staying based on Work Permit can be included in the Social Security's health coverage, which at retirement can be extended to continued cover for a very modest voluntary SS-fee.

 

A deposit method of 400k baht – like it's demanded for non-immigrant "O" based marriage/family – could be a solution instead of health insurance, for those that cannot be covered due to for example age, or other reasons, or don't have a health insurance for various reasons; including age compared to a way too high insurance cost that can be around 25 percent of the maximum insured amount. Could be 450k baht to include outpatient, or something around that level to equal the insurance coverage. And by the way, reading the small text in the mandatory long-stay insurance it has various limitations, so it not just a plain 400k baht coverage.

 

A mandatory tourist insurance for short term visitors might be a good idea, it's both (very) affordable and covers repatriation and lots of other issues – that would also safe a number of go-fund-me pages and especially worrying families.

????

[WhatupThailand]

Just put anyone coming into Thailand on the National Health system, for the duration of their stay.

Add a Monthly Fee to their visa or extension Fee, Problem solved.

Why is it they can never use common sense ?

 

 

[JimHuaHin]

I cannot but agree that the restrictions of the new policy have not been thought out.

 

Those of us who have comprehensive international health insurance with large companies are now forced to either take on an expensive extra health insurance with one of 12 companies, of which only 4 are foreign, or stop our current health insurance and just go with one of the 12 'accepted' companies.

 

The problem with the latter course is that if we leave Thailand we may be too old to get a NEW health insurance policy in another country.

 

Why is the new policy only restricted to using 12 approved companies - corruption?  Even the large BUPA company is not in the approved list.

 

Thai planning?  What planning?

 

 

[LivinLOS]

47 minutes ago, JimHuaHin said:

Why is the new policy only restricted to using 12 approved companies - corruption?  Even the large BUPA company is not in the approved list.

Because apparently these are the only ones who even showed any interest in insuring over 50s without a wider pool to spread it.. 

The immigration view was they wanted domestic insurers who would admistrate the backed / database so IOs just have to log in and check.. These ones are the only ones interested in the bureaucracy hurdle. 

[MadMuhammad]

3 hours ago, JimGant said:

When we are given huge cost numbers attributed to farang deadbeats, please lets look at actual costs, not huge profit margins. Yes, the cost of medicines paid by the hospital, and disposables, such as panty liners, plus wear and tear on equipment, etc. can be put in the real cost column. But don't add a huge doctor's fee, simply because he checked your pulse during his eight-hour shift. Certainly hospitals deserve to be reimbursed for costs -- just make sure, however, these are costs that, unpaid, would affect their bottom line. But don't scream "deadbeat farang" when the majority of the "cost" is padding that could be relegated to the "mandatory pro bono" column in the cost accounting ledger.

 

Yes, there's a problem; but it ain't as big as advertised!

While I understand your point of view the bill forwarded to the patient is the bill, like it or not. Actual costs never come into the equation unfortunately. 
If you owe 200K you owe 200K. I don’t see a way around it