Crohns in Thailand

[Samfoz]

Hi, 

I am hoping to move to Thailand this summer from the UK. I just have a few questions about the healthcare. 

I have Crohn's disease and need infusions every 6 weeks. Any insurance I get won't cover me for my pre existing conditions. Presuming I get a job will I be covered under the Universal Coverage Scheme?

Thankyou in advance for any advice you can give, I just really want to make sure I can continue the treatment I need one way (private insurance through work) or another (UCS) 

 

 

[blackcab]

You will be covered if you make Social Fund contributions. As far as I am aware, teachers in private schools are not part of the Social Fund system, so you would probably need to find a job in the commercial sector.

 

@Sheryl is away for a few days, but I have tagged this post so that she can reply to you in her return.

[CMoldie]

I have Crohn's and have lived in Thailand full time for some years. I am fortunate in that I have responded best to Methotrexate which is cheap, readily available and can be taken in tablet form.

Crohn's is a very rare condition among Asians. It would almost certainly be treated at the Provincial, or even regional level. If you were registered under the UCS, you would have to go through the government  hospital where you are registered, then to the Provincial and then, quite possibly, on to a regional hospital such as Maharaj in Chiang Mai. It will not be quick to get through that process.

If you are being treated by the NHS, you may not be aware of the cost of these "infusions" which I assume to be biologic therapies. When I was on Infliximab/Remicade here, it was costing me around 90,000 baht pr 6 weeks - around 1 million baht or£20,000 to £25,000 pr year depending on exchange rate. Don't assume that you will get that as a matter of right in a government hospital here. They will probably treat you with other medications, such as Methotrexate, or some other immuno suppressive.

Private hospitals that have a large expat client base possibly have more expertise than government hospitals. This is because the condition is much more prevalent in Westerners. However, I would be surprised if you could find any insurer, whether sponsored by a commercial company or wholly private, who would not exclude Crohn's as a pre-existing condition. In fact, many will not accept people with auto-immune diseases on any terms at all, because of the long term implications for your general health of both the condition and the treatment for it.

I am sorry if I sound negative. What you  want to do is difficult and, if not carefully thought out, dangerous to you. Good luck.

[Sheryl]

The above post sums it up. Not at all common here, few doctors with expertise in treating it and biologic therapy is prohibitively expensive.

If you are employed (and not in a a private school) you will come under the Social Security system (not the USC, that is for Thais only).  There are no exclusions for pre-exisitng under that but I am >95% sure it will not cover these infusions. Would cover doctor visits, diagnostics and treatment with anti-inflammatories and immunosuppressants, but if you are already on infusions then likely those did not work for you.

Even if anti-inflammatories or immunosuppressants worked for you, you might have some difficulty under SS getting care from a doctor with much experience. Your coverage is limited to one hospital and requires a written referral from them to go elsewhere. They are supposed to provide this if you need care they can't provide but in practice it can be difficult especially if not clear cut e.g. they have a GI specialist just not one wioth much (or any) experience with Crohn's.