Health care for over 65.

[7by7]

Sorry if this has been asked before; please bear with me.

 

I am 65, married to a Thai currently living in the UK.

 

I am epileptic, controlled by Epilim (Sodium Valproate); although I did have my first seizure after nearly 13 years a couple of weeks ago. I am also taking prescribed medicine for an enlarged prostate.

 

I was in Thailand February 2020 with my wife for my sister in law's funeral, and our return was delayed until the end of April due to the numerous flight cancellations because of Covid. All Thai and BA flights cancelled, EVA down to one very other day! This meant my medication ran out. However, I was able to register with and get free treatment from our local hospital in Dusit; paying just a relatively small fee for the pills.

 

My questions are:-

 

When I move indefinitely to Thailand with a spouse visa, will I still be entitled to any free treatment, or was this a one off? If I am entitled, I still have the hospital registration card which has a commencement date but no expiry date on it. So do I simply go to the hospital and present it if required? Should I go and see if I am still registered and re register if not?

 

Would I still be able to obtain free treatment, or was that I received last year a one off for some reason? It was, after all, merely a doctor asking me about my condition and what medication I was taking before she issued me a prescription.

 

What about insurance? I'll be at least 66 when we move so expect it will be expensive. I'm also concerned about coverage for my pre existing conditions.

 

I've had a quick search online and there are many options. But before I start getting quotes, any recommendations?

 

Thank you.

[Sheryl]

As a foreigner you are not (and were not) entitled to free treatment. I have no idea why you were not charged previously (and also can't figure out which hospital it was). May have simply been a mistake.

 

You can register at any hospital, but it does not entitle you to free treatment. Registering just means your details are on file and you have a hospital number that links to you medical records. it does save time on subsequent visits but that's it.

 

Re insurance, a company would definitely exclude anything related to epilepsy and prostate.  A Thai company would likely make the exclusion much broader (e.g. anything neurological) or even refuse to insure you altogether but   international companies are usually better able to make sophisticated medical judgements.  Even with exclusions, you should definitely get insurance. It is bets to get through a broker, a good one will not only help you choose but help with any claims issues that arise afterwards.

 

AA Insurance brokers are very good, specialize in health insurance for expats and have expat staff

www.aainsure.net

 

Premiums at 66 will run the equivalent of US$2500-$3000 annually, can reduce a bit by taking a deductible (excess)

 

Make sure to get a  policy that guarantees lifetime renewal, does not raise rates based on claim history (in itself this criteria rules out a Thai-issued policy) , and has direct payment arrangements with Thai hospitals.

 

Off hand for your age and with these criteria, Cigna Global or Cigna Close Care come to mind but see what the broker suggests.

[bert bloggs]

The one good thing here is if you are registered with a good govt hospital,charges are not anywhere near the private hospitals.

I have heart problems and to be honest the prices they charge me are very low and my treatment good 

[7by7]

Thanks, guys.

[BritManToo]

I know we have extreme political differences BUT,

As a person having similar prostate problems in Thailand at the same age, I can only say ....... Don't do it!

I know several other people (4) in Thailand with prostate problems, three posting on this forum.

Three have had surgery in Thailand, and essentially post it has ruined their lives,varying levels of  constant pain, erectile dysfunction and incontinence. 

One is a neighbour and is completely impotent after his Thai TURP but at least appears fairly happy that he isn't constantly weeing himself (at 59 he is married to a Thai woman his own age so no urgent desire for sex).

 

I'm at the stage of daily medication (2-3 pills of 2mg doxazosin), which is cheap from the government hospital, about 130bht/month inc hospital fees.

But if you want any other drug, expensive but available from most Thai pharmacies. I think Flowmax was about 1,500bht/month.

 

BPH is a medical problem which will only get worse, and the long term prognosis for sufferers is bleak (especially in Thailand).

If you have a home, a woman, and free medical care in the UK don't give it up for a fairly quick death in Thailand.

I wouldn't, but in the UK I would be a homeless single guy living in a shelter, so I choose early death.

At age 65 in Thailand with BPH, I don't expect to make 70.

 

As a sufferer  of BPH, your health insurance will likely exclude all prostate, bladder, kidney, and probably cancer claims.

As BPH medicine (long term) affects your blood pressure (decreased) and heart rate (increased), I'd assume they will also exclude any heart and circulation claims.

So probably not worth buying, as everything is excluded.

 

Government hospital charges me 50bht (foreigner fee) plus medication @1bht/pill.

And will issue me medications for 6 weeks.

Edited February 6, 2021 by BritManToo

[simon43]

[quote]

At age 65 in Thailand with BPH, I don't expect to make 70....

[/quote]

 

Well, BPH isn't prostate cancer, so I'm not sure why you are so pessimistic about your lifespan.  I also have BPH (so many men do!).  It can take 15 minutes to wee in the morning in little dribbles!  But I take no medication at all, preferring to follow a healthy diet and exercise.  My BPH was first noticed by my doctor some 15 years ago and my lifestyle keeps it 'at bay' - it certainly doesn't interfere greatly with my day-to-day living.

 

[ivor bigun]

52 minutes ago, simon43 said:

[quote]

At age 65 in Thailand with BPH, I don't expect to make 70....

[/quote]

 

Well, BPH isn't prostate cancer, so I'm not sure why you are so pessimistic about your lifespan.  I also have BPH (so many men do!).  It can take 15 minutes to wee in the morning in little dribbles!  But I take no medication at all, preferring to follow a healthy diet and exercise.  My BPH was first noticed by my doctor some 15 years ago and my lifestyle keeps it 'at bay' - it certainly doesn't interfere greatly with my day-to-day living.

 

yes i had it diagnosed 20 yrs ago , hardly any difference now than then(i did lose weight) always pee quite slowly but only takes a minute or two,also these days i take a diuretic for heart problems . so pee quite often .

[7by7]

@BritManToo, I appreciate your concern, but as @simon43 and @ivor bigun both say, Benign Prostatic Hyperplasia is not as terminal as prostate cancer.

 

As the frequency of my having to get up to pee in the night had increased, my GP recently ordered blood tests and an ultra sound scan to ensure that I was suffering from BPH only; all came back as ok. 

 

I have been taking Tamsulosin for some time, and she also added Finasteride as well; which has helped.

 

But apart from having to get up in the night, the greatest effect it's had is that I now pee sitting down and give a good shake to ensure it's all out and the last drops don't go down inside my trousers!

 

It is not so much my BPH which concerns me as my epilepsy. Particularly as I had my first seizure in over 10 years in January. I have yet to see a neurologist, but the doctor I saw in A7E thought it was either because I was getting older, or it may have been triggered because I had contracted Covid 19.

 

I know I can continue to get my Epilim, or other brand of Sodium Valproate, but it's what happens if I have a seizure which worries me.

 

Thanks to all for your comments. They will all help us make the decision when the time comes.

[BritManToo]

Good luck whatever you decide,

Glad to hear you BPH isn't as bad as mine.

I was diagnosed in 2019, after getting off a plane from Saigon, no previous symptoms, couldn't wee at all ...... 1 month catheter + 5mg Doxazosin/day + 5mg Finesteride/alternate days seem to have temporarily sorted me out (but hematuria once a week after exercise for a few hours worries me). I'd prefer to be back in the UK, but accept my death whenever it happens. 

Edited February 11, 2021 by BritManToo