Pacific Cross Cover Reviews

[JimmyGreaves]

Thinking of moving away from being self insured and getting some cover with Pacific Cross, I'm 66 and in good health with no previous health issues apart from the odd bone fracture.

 

Can I get some feedback/ reviews on any of the following:

 

Paying out when you have to make a claim

PC paying direct to hospital without you having to claim back

Increases in yearly premiums 

Increases in premiums after making a claim

Having to copay for certain ailments that they think you may get (read about back issues)

Hidden small print that can cause problems.

 

Many thanks

 

 

 

[scubascuba3]

A friend of mine is currently having problems with them getting the go-ahead for an eye operation and it's urgent... 

[JimmyGreaves]

Many Thanks

Edited October 6, 2020 by JimmyGreaves
Could not delete!

[JimmyGreaves]

35 minutes ago, scubascuba3 said:

A friend of mine is currently having problems with them getting the go-ahead for an eye operation and it's urgent... 

Please let me know how this progresses

[Swiss1960]

Increases in yearly premiums can be found in their documentation,  they occur every 5 years and get very steep in your coming age groups. 

 

Increase after claim up to 25% (happened to my wife after meniscus surgery), no coming down ever and of course, this is now a pre-existing condition for next renewal and any future problems with that knee are excluded.

 

Pre-payment works ok, if not to urgent. One surgery was 50% prepayment to hospital as the authorization did not arrive in time, the other surgery (knee) was pre-planned and fully authorized before we arrived at the hospital. Just let the hospital deal with the insurance, they have all the experience necessary.

 

Last point: careful what you put in the medical questionnaire. I am slightly overweight,  blood pressure little too high (150/85), so when I applied,  they excluded everything with heart, blood pressure,  cholesterol,  diabetes etc. Reading their exclusions list, I thought "will they pay if I break my leg or not?"

[Sheryl]

For age related premium increases you can get a chart from them that shows it so you know what to expect. All insurances raise premiums as you age.

 

PC has   direct payment arrangements with most Thai private hospitals, I don;t think that would be an issue once they approve the hospitalization.

 

You will be told upfront after your application is reviewed whether there are any exclusions and if so, what.

 

PC can and will raise premiums based on claims history. The only way to avoid that is to get a policy issued in a western country rather than Thailand as the insurance regs in most Western countries do not allow this whereas Thailand does..The combo of claims based increases and age related increases can  price you out if you are unlucky, it is definitely something to be concerned about. . (on the other hand, there is also an annual no claims bonus from PC). As you are 66, might like to look at Cigna Global and Cigna Close Care. UK issued, no premium increase based on claims, only on age.

 

With PC or any other company, there is no "small print", perfectly legible policy document. You can ask to see a sample in advance. Usual exclusions for self inflicted injuries, cosmetic procedures etc

 

I strongly advise working with a broker, they can give you franker feedback than is possible in public forums and a list of all the options. They can also help with any problems that may arise with claims or pre-approvals. I use AA brokers  www.aansure.net  Expat staff, specialize in expat health policies.

 

 

[Disparate Dan]

Maybe check out Aetna, which used to be BUPA and awful but has more recently been very good on a couple of claims I had to make. They have real people to talk to, including good (medical) English speakers, and advised me, as well as arranging payments etc surprisingly painlessly.

I think they do new busness up to age 70, although I imagine joining at your age may not be cheap.

[Sheryl]

2 minutes ago, Disparate Dan said:

Maybe check out Aetna, which used to be BUPA and awful but has more recently been very good on a couple of claims I had to make. They have real people to talk to, including good (medical) English speakers, and advised me, as well as arranging payments etc surprisingly painlessly.

I think they do new busness up to age 70, although I imagine joining at your age may not be cheap.

AFAIK they issue new policies only up to age 65. And they do nto guaranatee lifetime renewal unless you enrol before age 60.

[Disparate Dan]

7 minutes ago, Sheryl said:

The combo of claims based increases and age related increases can  price you out

Not spruiking Aetna, but in my experience they have not hiked my premiums after a (very substantial) claim in the previous year. Only the age-band increase.

[scubascuba3]

A friend of mine who has had Pacific Cross for a few years says that if your cover is exceeded in medical costs, PC will then cover 90% of the costs. I recommend you look into that, sounds too good to be true

[Sheryl]

7 minutes ago, scubascuba3 said:

A friend of mine who has had Pacific Cross for a few years says that if your cover is exceeded in medical costs, PC will then cover 90% of the costs. I recommend you look into that, sounds too good to be true

 

Not correct, for either PC or any other insurer. They will cover only up to the maximum stated in your policy. Anything over that, is yours to pay.

 

Which is why it is important to be sure to have an adequate level of cover.

 

Your friend may be describing instead how a policy with a deductible (excess) and copay operates. I don;t think PC domestic policies have any copay options but possible some of their internationally issued  plans do. Their domestic plans do have deductible options. With a deductible you pay up to that amount and then they pay anything in excess of it.

 

 

[scubascuba3]

11 minutes ago, Sheryl said:

 

Not correct, for either PC or any other insurer. They will cover only up to the maximum stated in your policy. Anything over that, is yours to pay.

 

Which is why it is important to be sure to have an adequate level of cover.

 

Your friend may be describing instead how a policy with a deductible (excess) and copay operates. I don;t think PC domestic policies have any copay options but possible some of their internationally issued  plans do. Their domestic plans do have deductible options. With a deductible you pay up to that amount and then they pay anything in excess of it.

 

 

I suspected the 90% thing was wrong, I get the feeling many people don't understand the cover they have

[offset]

15 hours ago, Sheryl said:

 

Not correct, for either PC or any other insurer. They will cover only up to the maximum stated in your policy. Anything over that, is yours to pay.

 

Which is why it is important to be sure to have an adequate level of cover.

 

Your friend may be describing instead how a policy with a deductible (excess) and copay operates. I don;t think PC domestic policies have any copay options but possible some of their internationally issued  plans do. Their domestic plans do have deductible options. With a deductible you pay up to that amount and then they pay anything in excess of it.

 

 

I have PC and have co pay on 1 segment of my cover ( my cloistral was high) but not on the total cover

[JimmyGreaves]

Thanks all went with PC

[siam dreamers]

I hate to leave a negative review of anyone but pacific Cross deserves this. Dealing with Pacific Cross  been the most negative experience I have ever had  with an insurance company. I am not going to get into details but be warned that simple things like keeping  their word on their contract, replying to my inquiries about questions with my policy, and getting paperwork back to me in a timely manner has been non existent. Both my broker and I have gotten no where with them and I personally am disgusted with even trying to do the simplest business with them never mind trying to submit a claim. Be warned and look else where if you can.

[richard_smith237]

17 minutes ago, siam dreamers said:

I hate to leave a negative review of anyone but pacific Cross deserves this. Dealing with Pacific Cross  been the most negative experience I have ever had  with an insurance company. I am not going to get into details but be warned that simple things like keeping  their word on their contract, replying to my inquiries about questions with my policy, and getting paperwork back to me in a timely manner has been non existent. Both my broker and I have gotten no where with them and I personally am disgusted with even trying to do the simplest business with them never mind trying to submit a claim. Be warned and look else where if you can.

 

Thanks for the review. I am currently in the market to renew Health Insurance for my family and I. 

 

I’ve been equally unimpressed with the communication from April Health and don’t wish to renew with them.

 

Pacific Health were looking the most cost effective but a coupe of lukewarm reviews made me question whether they are just going to be too difficult to deal with when needed at a stressful time.

 

 

Its looking like VUMI, LUMA 

 

 

 

[scubascuba3]

5 hours ago, siam dreamers said:

I hate to leave a negative review of anyone but pacific Cross deserves this. Dealing with Pacific Cross  been the most negative experience I have ever had  with an insurance company. I am not going to get into details but be warned that simple things like keeping  their word on their contract, replying to my inquiries about questions with my policy, and getting paperwork back to me in a timely manner has been non existent. Both my broker and I have gotten no where with them and I personally am disgusted with even trying to do the simplest business with them never mind trying to submit a claim. Be warned and look else where if you can.

A friend recently had retina surgery with Pacific cross, it caused a cataract which they wouldn't pay for...

[Sheryl]

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