Keep employer sponsored health plan in home country (USA) or take the extra money?

[Hal65]

I have the option of keeping an employer sponsored health plan in the US or taking the extra money. I'm asking for an extra $3,000. Researching this, I've read that in the tech industry $0-3,000 extra income to forgo health insurance is typical, with the employer often agreeing to around $1,000 extra salary.

 

I'm in Thailand about 360 to 364 days per year. I occasionally go back to the US, but not every year. I'm 35 and believe I'm in good health.

 

As far as I can tell, the benefit of keeping employer sponsored health insurance would be in case I needed a major operation. My choice, if I had the plan, would be to fly to the US for the operation. Or go to a private hospital in Bangkok like Bumrungrad.

 

Without the employer insurance I'd have only the 2nd option. But my self funded HSA should also be larger, and probably cover most everything. So the main question then is where the better quality of care is.

 

What would you guys do?

 

[timendres]

I had an HSA combined with insurance that had a $10,000 deductible. The best possible combination, in my opinion. Racking up $3k per month (~100,000 THB) will quickly put enough aside to cover most issues you might have to pay for here in Thailand. However, I would be more concerned about something that absolutely required your return to the US, meaning that the expertise required simply did not exist there. That is the specific case where you would not be even close to being able to afford the bill in the US, and would be wishing you had the coverage.

 

As an aside, I would choose Samitivej over BumRunGrad for anything that was serious.

[Sheryl]

At your age, for the same money $3000 you can get an excellent expat policy that will cover you in Thailand and many other countries  plus cover emergencies during trips to the US. 

 

 

[Hal65]

33 minutes ago, timendres said:

I had an HSA combined with insurance that had a $10,000 deductible. The best possible combination, in my opinion. Racking up $3k per month (~100,000 THB) will quickly put enough aside to cover most issues

Thanks, to be clear though, the salary bump would be a max of $3,000/yr, and more likely around $1,000/yr.

[sirineou]

5 minutes ago, Hal65 said:

Thanks, to be clear though, the salary bump would be a max of $3,000/yr, and more likely around $1,000/yr.

If it was $1,000 per month  yes, but per year No. 

Keep the company medical coverage. For $80 a month it is not worth it to be without insurance , one trip to the doctor and you will wipe out any extra income you had. 

[tweedledee2]

  So you are 35 yrs old, healthy, have a company paid health plan, but would get an increase in annual salary if you voluntarily exit the coverage. Does the company pay 100% of the premium? If yes, keep the coverage, as that's a company benefit at no cost to you. Drop it and you're responsible for your own health insurance premiums plus any co-pays.

  From experience never voluntarily give up a company paid benefit, because in doing so it will benefit the company more than you. Heath insurance costs will continue to increase but your opt-out money won't. By accepting $1-2,000 to opt-out, the company is saving a lot more than that in their present and future costs.  

   Although you consider yourself healthy now, ones health can change suddenly. An unforeseen and unplanned event can change ones life instantly.  

[Sheryl]

He seemed to be saying the health cover is for the US only. Which seems o=dd if he is working in Thailand.

 

Op can you clarify? Medical care costs in Thailand are nto cheap, a hospitalization can easily run to many millions of baht. If the plan covers you both in US and here in Thailand, you should keep it.

[Hal65]

Yes, it is from a US company and I believe the plan only covers US medical care. Would be odd if it covered Thailand. I am only able to work out here because it is a remote work position. Technically I need a work permit for Thailand as well.

[Sheryl]

I see. Well in that case it would make sense to forego it and use the extra income to get a good expat policy that covers you in Thailand.

 

Are you aure you will be able to live most of the year in Thailand? Withoit a work permit visa will be an issue.

[Hal65]

33 minutes ago, Sheryl said:

I see. Well in that case it would make sense to forego it and use the extra income to get a good expat policy that covers you in Thailand.

 

Are you aure you will be able to live most of the year in Thailand? Withoit a work permit visa will be an issue.

 

There are arrangements that can be made. It will cost money.

 

I could also take the risk and continue to use a fallback (ED visas) which still work despite suggestions to the contrary recently.

[gk10002000]

$3,000 more in salary would be taxable, Federal tax, Social Security Tax, maybe State tax also depending on how you declare residency.  Unless somehow you are getting paid in such a way that this salary as an overseas earned income exemption.

[gk10002000]

7 hours ago, tweedledee2 said:

  So you are 35 yrs old, healthy, have a company paid health plan, but would get an increase in annual salary if you voluntarily exit the coverage. Does the company pay 100% of the premium? If yes, keep the coverage, as that's a company benefit at no cost to you. Drop it and you're responsible for your own health insurance premiums plus any co-pays.

  From experience never voluntarily give up a company paid benefit, because in doing so it will benefit the company more than you. Heath insurance costs will continue to increase but your opt-out money won't. By accepting $1-2,000 to opt-out, the company is saving a lot more than that in their present and future costs.  

   Although you consider yourself healthy now, ones health can change suddenly. An unforeseen and unplanned event can change ones life instantly.  

Well stated.  I would add that on one's W-2 down in box 12 area, there is an amount of money that shows how much the company asserts it paid for your health insurance.  That number is useful for calculating what your COBRA insurance cost might be if you leave the company and want to maintain the same general health insurance plan.  I just left a big aerospace company and am on COBRA for 18 months and my new plan costs were in line with those numbers, although they jacked up the 2020 costs more than the 2019 W2 would suggest.