Health Insurance: Local vs International vs Immigration

[SooKee]

Though I'd prefer the world situation to be much different, one thing the current crisis has done is spur me into action for something that's been in 'Next Month' tray for way too long.  Currently shopping around for health insurance and trying to juggle the various considerations.  First are the provider / cover issues with international policies seeming to be more favourable than local ones (e.g. no risk profile increases, guaranteed renewal etc) followed by the lesser consideration of how regulations may change in the future where current O-A provisions may be extended.  I know there's a point of view that the second consideration should not be a priority (e.g. move country) but the local competition don't really appeal much as places to live, at least not yet!

 

For international coverage I'm looking at Cigna Global (probably coming out on top) with their new(er) Close Care plan that carves out much (I'll have to check that the whole SE Asia region is not excluded) of the worldwide cover for a lower premium and also MyHealth International but the latter seem quite steep cover wise even with OPD factored out.

 

I'm 61 now and in good health at the moment but no longer want to leave health issues to luck, you never know!  Within the next 6 months the whole world may look a lot different and places that seem attractive now might not in the future, I'm thinking that really would be worst case scenario though and that once things stabilise, staying in Thailand might still be the best option.  One thing that is clear is that a fair degree of notes small print is required with regard to all these policies and, despite having left it 10 years or so without any, I'm probably looking to pull the trigger on something ASAP just to get cover in place.  To that end I might even go with something from a local provider like Pacific Cross on the basis that, unless things change, a local policy would likely only be a short term (1 year) option, giving me time to go through the international policies with a degree more leisure.  I'm already in contact with AA Insurance (I'm hoping they're busy at the moment and that their current service isn't an example of the norm as so far they have been pretty <deleted> at replying to emails and that's with trying to BUY a policy!) and it may be I can things sorted out sooner than expected and end up buying from a company like Cigna or MH International straight away.

 

I'm thinking to leave out OPD cover (although I understand that that is actually needed for O-A insurance) as it can always be added back in mid life if needed (at least it can with Pacific) but will likely end up buying some accident (PA) cover as a separate policy rather than call on my main health policy for an accident.  The cover on the local PA policies is dismally low though (around 50K max from what I've seen so far) but even 50K for a minor accident is 50K I wouldn't have to pay.  However with the Bangkok Bank PA 1st Senior Plan 4 for instance, while you get up to 60K of cover per accident for "broken bones", what if you don't break bones but still 30k of other treatment, need stitches or whatever?  I guess it would only be for broken bones that you'd get into the 10s of thousand but say there were no broken bones and 8,000 of treatment, can you claim?  I saw a lot of mentions of World Nomads for accident cover but they only seem to offer travel insurance so it surely wouldn't apply if you live in Thailand and have an accident in Thailand.  Still in the early stages of the PA search and while I was considering the Bangkok Bank PA 1st Senior I might look around for better but likely not from the same provider as my health insurance.  

 

If I consider a local policy for now it would likely be with either Pacific Cross or April (Thailand).  It will just depend on whether for not much more premium I can go straight to international cover.

 

Pacific Cross seem to be highly recommended and have a no claims bonus of up to 20% (after 3 years, less before) which is a bonus (albeit I will most likely not benefit from that if I switch to an international provider).  Just one thing that puts me off a little is that I've seen numerous posts regarding the speed and amount by which PC will up the premium if you ever need to claim?  That said, I'm not sure that would apply to just PC unless there are instances of premiums not being increased with companies like Aetna and April.  I guess I'll likely be looking for a level of cover around the Maxima level of plan with Pacific.  Along with Aetna and April (Th) I'm guessing PC will be on the list if Immigration approved providers IF anything changes in the future and another country doesn't appeal.

[trawler]

I have had Cigna for a couple of years (Silver),however they have averaged 10% increase each nd every renewal.They did cover a knee replacement late last year with my Us$ 1500 deductible,so no complaints that they do not pay for stuff,however at 65 extrapolating forward the premiums seem to be in the unobtainium range in the future.I contacted them re the increase being higher than most other providers but got no reponse and after 4 weeks(plus chaser emails) got fed up waiting.So cancelled the insurance for end of this month.

I also looked at Pacific Cross but  last year they wanted me to do a full health check at a hospital with full blood/stool/xrays etc etc at my own cost for underwriting,however when I queried them what happens if I dont like your 'quote/exclusions if any' then I would end up wearing the cost.As you mentioned the small print allows them to hike the premiums up to 25% per year depending on your claim status/age.........

Seems most local insurers the same hence my wish to stay with overseas providers who are more strictly regulated.

I have changed to another provider but at 65 it is getting harder even if in good health.

My advice is stay with overseas provider if you can.

 

[mrmicbkktxl]

2 hours ago, trawler said:

I have had Cigna for a couple of years (Silver),however they have averaged 10% increase each nd every renewal.They did cover a knee replacement late last year with my Us$ 1500 deductible,so no complaints that they do not pay for stuff,however at 65 extrapolating forward the premiums seem to be in the unobtainium range in the future.I contacted them re the increase being higher than most other providers but got no reponse and after 4 weeks(plus chaser emails) got fed up waiting.So cancelled the insurance for end of this month.

I also looked at Pacific Cross but  last year they wanted me to do a full health check at a hospital with full blood/stool/xrays etc etc at my own cost for underwriting,however when I queried them what happens if I dont like your 'quote/exclusions if any' then I would end up wearing the cost.As you mentioned the small print allows them to hike the premiums up to 25% per year depending on your claim status/age.........

Seems most local insurers the same hence my wish to stay with overseas providers who are more strictly regulated.

I have changed to another provider but at 65 it is getting harder even if in good health.

My advice is stay with overseas provider if you can.

 

So which insurance are you using now?

[TigerandDog]

To my surprise nobody has mentioned the fact that if you have international health insurance you need a certificate ( each time you extend your O-A based on retirement ) signed by directors of the insurance company. The odds on that happening are not great, so to do an O-A extension based on retirement you need to be insured by one of the approved health insurers, of which Pacific Cross imho is the best option.

[thailand49]

You don't need to go to AA, Pacific Cross has an office now on Sukhumvit as you head to Pattaya Nua it is on the left.

Pacific Cross is expensive if not getting more expensive, they required you to have a full physical anything wrong you can still buy if offer but it won't be covered. 

 

I threw all their flyers away, went without for the once time in 15 years,  due to complaints? they have adjusted some of their policies offered and now offer policies with deductibles which lower the premium. I'm now 68 a basic policy runs me 72-75,000 once I get into the 70-75 range it jumps again to near 100,000 unless I opt for a huge deductible?

 

If money is no object I would go with a International policy but the cost is as if your were buying in the U.S. if that is where you come.  If you O-A and not living here majority of the year I would go with International being 61, at 65 you got Medicare? 

[stouricks]

On 3/22/2020 at 11:17 AM, SooKee said:

For international coverage I'm looking at Cigna Global (probably coming out on top) with their new(er) Close Care plan that carves out much (I'll have to check that the whole SE Asia region is not excluded) of the worldwide cover for a lower price

I was 71 when I took Cigna Close Care last year. They excluded ANY prostate cover even though I had no problems down there. Paid £3134 (Bht 120,000) for 12 months for up to £325,000 (Bht 10M) cover.. Customer support is on and off. If I call at 'nightime' in UK get to talk to a Romanian or some other Eastern European person. The ones in Scotland are OK so time it correctly. They have paid out on two recent admittances to hospital I had, but NOT the easy procedure they promise. They did send me an email assuring me that they would cover COVID. I shall not renew next year, will 'self insure' !

[iaminwa]

I went through this a year ago.

 

I was sick of the Thai Health Care companies jacking up the price just because I was a foreigner and their <deleted> and low hospital cover - and in 10 years I never made one claim.

 

I decided to look into overseas companies that would cover an Expat living in Thailand and when I traveled out of Thailand for holidays or back to my home country.

 

I went with A+ out of Hong Kong - I am over 50 years old and the policy without dental care or extras was US$1400 with much higher coverage (and they emailed me last week to re-assure me I was covered for COVID-19 without me even asking them). Another advantage of this product was that I said to the Broker I eventually wanted to return to living in my home country and would this cover me - yes they would.

 

Avoid the useless Thai products.

 

 

[Max69xl]

10 hours ago, trawler said:

I have had Cigna for a couple of years (Silver),however they have averaged 10% increase each nd every renewal.They did cover a knee replacement late last year with my Us$ 1500 deductible,so no complaints that they do not pay for stuff,however at 65 extrapolating forward the premiums seem to be in the unobtainium range in the future.I contacted them re the increase being higher than most other providers but got no reponse and after 4 weeks(plus chaser emails) got fed up waiting.So cancelled the insurance for end of this month.

I also looked at Pacific Cross but  last year they wanted me to do a full health check at a hospital with full blood/stool/xrays etc etc at my own cost for underwriting,however when I queried them what happens if I dont like your 'quote/exclusions if any' then I would end up wearing the cost.As you mentioned the small print allows them to hike the premiums up to 25% per year depending on your claim status/age.........

Seems most local insurers the same hence my wish to stay with overseas providers who are more strictly regulated.

I have changed to another provider but at 65 it is getting harder even if in good health.

My advice is stay with overseas provider if you can.

 

As far as I know PC requires a health check from 66 years of age. 

[SooKee]

10 hours ago, iaminwa said:

I went through this a year ago.

 

I was sick of the Thai Health Care companies jacking up the price just because I was a foreigner and their <deleted> and low hospital cover - and in 10 years I never made one claim.

 

I decided to look into overseas companies that would cover an Expat living in Thailand and when I traveled out of Thailand for holidays or back to my home country.

 

I went with A+ out of Hong Kong - I am over 50 years old and the policy without dental care or extras was US$1400 with much higher coverage (and they emailed me last week to re-assure me I was covered for COVID-19 without me even asking them). Another advantage of this product was that I said to the Broker I eventually wanted to return to living in my home country and would this cover me - yes they would.

 

Avoid the useless Thai products.

 

 

Interesting.  What's their hospital network like here?  Do they have a card and direct pay policy?  Any pre-approval required (and if so by who?).

[SooKee]

Having sifted through all this at length with the help of Matt from AA Insurance (Hua Hin office) I'm slowly coming round to going with MyHealth (April) International.  

 

One of the reasons I was considering a Thai company is that it would be accepted by Immigration if they change the regulations and extend the current insurance requirements beyond O-As.  Given that a policy for this can be had for around 7,700 baht that's less of a consideration now and not enough of an issue to draw me into a Thai policy with all the negatives that entails.

 

The Thai policies have also always been considerably cheaper when I looked at them before too. Shouldn't be a deciding factor but you can't help but notice it.  While attractive at first, the age band premium increases (common to all companies, Thai and international) and risk / claim related premium hikes (NOT a thing with international policies) make them much less attractive long term for me.  Currently though, the strength of the Thai Baht means those savings are much less now, indeed a policy with April International for me at the moment is actually cheaper, with much higher levels of cover, than April Thailand.