Health insurance age bracket increase 60-64 Ouch !!!

[gearbox]

20 hours ago, 4MyEgo said:

 

 

 

The fact that you have a 12 month extension based on retirement to live in Thailand makes you a non resident of Australia, THAT IS MY WHOLE POINT.

 

 

 

Technically that's not quite true. The retirement extension is a "non-immigrant" visa, which doesn't give you any extras than the normal tourist visa, except the longer period of stay. It says it in the name - "non-immigrant", you are not migrating to another country and changing abode. It doesn't automatically show an "attachment" to a different country in regards to losing Australian residence. If you travel around a lot you can argue that you got the visa for convenience and have a base for travel. I have 5 years tourist visa for India which allows me to spend 6 months per year there, it doesn't make me an Indian resident.

 

Of course if you have 15 of these yearly extensions and no stamps in your passport for significant stay in other countries you might find it harder to prove that you are an Australian resident.

[madmen]

23 minutes ago, gearbox said:

 

 

I agree it depends on your circumstances.  Every travel insurance provider requires that you are "resident" of some country where they can repatriate you...as soon as you get repatriated their job is done, no more payments.

The "resident" means two things - first whether "resident" is in the wording of the insurance policy. Some policies don't have this requirement in the wordings and implicitly assume the if you are citizen you are a resident too, or if you have PR visa you are eligible too. Sounds logical as say Australia would never refuse you entry if you get repatriated for medical reasons, and once you are within Australia you are off the insurer's books.

Secondly, and probably much more important is if you are getting dumped in the country you are citizen whether you have the "residency" to get free or low cost care.  AFAIK in Australia if you don't have Medicare card you need to pay. Other countries don't have these restrictions. So if one relies on travel insurance the possession of a valid Medicare card is a must.

 

For all intents and purposes I'm still an Australian resident although I spend most of my time overseas...I am "traveling".  I still have a private company there, bill Australian customers and pay taxes. I even have Medibank private insurance, although it is of little use to me, but I'll pay more tax than premiums if I don't have a private health insurance. I also have Australian phone number, pay broadband bills and have a car registered, plus tons of bank accounts and credit cards. I also spend in Australia 2 X 2 weeks every year (have many things to do ).

 

But even if you don't have the circumstances above, one can still be a resident.  We are allowed to travel and still be residents, but if required we may need to prove that we travel. It means for example that you don't have a PR or work visa from another country, and spending 99% of your time there. For myself it is easy to prove it, as I usually never spend more than 7 months in a single country per year.

 

 

 

 

 

Good post. Ozzies need to get back every 5 years for Medicare to stay active. I just returned after 4 years and coincidentaly got very sick and spend lots of time in hospital having several procedures. 

If it happened in Thailand I would be broke 

Travel insurance for 12 months is $1500 not including covid but still cheaper than thai full insurance, I can pay for outpatient myself it's not expensive and travel insurance covers the big stuff eg heart and stroke, hit by a tuk Tuk 

 

However one must return to country of origin once a year to renew the policy so its good for people that want to go back to visit 

Edited March 24, 2021 by madmen

[4MyEgo]

11 hours ago, Sheryl said:

 

Good outcome and kudos to AA brokers for doing that. Any conditions to get that 15% discount?

 

None that I am aware of.

[4MyEgo]

11 hours ago, scubascuba3 said:

You should definitely get a $1k+ deductible, you'll save $500+ a year, so two years of not claiming will pay for it

 

No deductibles with this mob.

[4MyEgo]

14 hours ago, Sheryl said:

The only people who can actually self-insure (real self-insurance, not the nonsense some people talk about) are comparatively well off. (And they will often choose to nonetheless have insurance in order to protect their assets).

 

That's exactly my point.

 

No assets = no insurance

 

Assets require insurance for protection, regardless if the assets are you, your family, your wife's house, car, bike, or personal wealth, it just takes one even and that could be life changing for those with or without assets, those without out still have a choice if they can afford it.

 

To sum up, it's all about choices and biting the bullet, as much as it may hurt.

 

Those that "self insure" know the risk, personally I don't like risks, so by paying someone else to take the risk, is insurance for me.

Edited March 24, 2021 by 4MyEgo

[4MyEgo]

3 hours ago, Why Me said:

Good for you and your broker. I too started with David Shield a few years ago and was happy with their service, never made a claim though, till a couple of years in when I got some data from AA Insurance which suggested a possible stupendous premium increase at the next age band which I was approaching. Your experience seems to bear that out but it's great negotiations limited the damage.

 

I didn't wait. Because I didn't want to risk crossing into a new age band and then finding other insurers giving me a hard time for wanting to join late. So I fled to April France a couple of year ago which you were considering as well. Again, haven't made a claim yet. But from what Sheryl said about her experience no worries dealing with them.

 

Yes, for me the paperwork involved to change with any provider, let alone April which my broker suggested, that and whether they would accept my pre-existing condition was my biggest concern.

 

Increases are anticipated, and now with the broker having negotiated the 15% discount with them, means the increase of around 25,000 baht is out of the way, it's something that I accept now being into that new age bracket 60-64, if the broker didn't come through with it, it would mean paperwork and fingers crossed, sometimes better the devil you know as they say.

 

At the ned of the day, I just need to know I am covered and hopefully for the next 5 years the increase are just the usual annual ones, once we reach the next bracket, I guess I should worry to much, because the use by date might expire not too long after that....lol 

[Sheryl]

7 hours ago, madmen said:

Good post. Ozzies need to get back every 5 years for Medicare to stay active. I just returned after 4 years and coincidentaly got very sick and spend lots of time in hospital having several procedures. 

If it happened in Thailand I would be broke 

Travel insurance for 12 months is $1500 not including covid but still cheaper than thai full insurance, I can pay for outpatient myself it's not expensive and travel insurance covers the big stuff eg heart and stroke, hit by a tuk Tuk 

 

However one must return to country of origin once a year to renew the policy so its good for people that want to go back to visit 

 

You will also usually have to return anytime you need medical care that can't wait for the annual planned visit. So that $1,500 isn't buying you all that much if you normally go back just once a year for a short time.

[Sheryl]

4 hours ago, 4MyEgo said:

 

Yes, for me the paperwork involved to change with any provider, let alone April which my broker suggested, that and whether they would accept my pre-existing condition was my biggest concern.

 

Increases are anticipated, and now with the broker having negotiated the 15% discount with them, means the increase of around 25,000 baht is out of the way, it's something that I accept now being into that new age bracket 60-64, if the broker didn't come through with it, it would mean paperwork and fingers crossed, sometimes better the devil you know as they say.

 

At the ned of the day, I just need to know I am covered and hopefully for the next 5 years the increase are just the usual annual ones, once we reach the next bracket, I guess I should worry to much, because the use by date might expire not too long after that....lol 

 

65 is the cut off for enrolling in April (and many other plans) so I suggest that come age 64 you give yourself some lead time to figure out what the next increase will be and if necessary change providers.

 

By age 65 one wants to have a policy one can keep for life as after that changing becomes very difficult.

[Sheryl]

7 hours ago, gearbox said:

 

Technically that's not quite true. The retirement extension is a "non-immigrant" visa, which doesn't give you any extras than the normal tourist visa, except the longer period of stay. It says it in the name - "non-immigrant", you are not migrating to another country and changing abode. It doesn't automatically show an "attachment" to a different country in regards to losing Australian residence. If you travel around a lot you can argue that you got the visa for convenience and have a base for travel. I have 5 years tourist visa for India which allows me to spend 6 months per year there, it doesn't make me an Indian resident.

 

Of course if you have 15 of these yearly extensions and no stamps in your passport for significant stay in other countries you might find it harder to prove that you are an Australian resident.

 

Agree that the type of extension is not an issue, I have not heard of anyone  having an issue with a travel policy claim because of the type of non-immigrant visa or extension they had.

 

But you will certainly need to return to Australia (or other home country) regularly every year so as to begin a new trip that originated from there and have a consistent Australian address.  Might or might not still get an issue if your passport history shows that you spent say 11 out of the past 12 months, every year, in Thailand for several years in a row - would depend on the wording of the policy and how much the insurer wanted to get out of the claim (which in turn usually depends on the size of the claim, the larger it is the more likely to draw in-depth scrutiny).

 

Where travel policies are ideal is for "snow birders" who spend say around 6 months of the year in Thailand and people who go back and forth several times a year between Thailand and their home country.  in such cases a residence in the country is clearly maintained and not difficult to get all non-emergency care in the home country, also not a big problem to have to make an unscheduled trip back due to illness. So ravel policy is perfect fit.

 

Using it to cut costs when living in Thailand 11 out of 12 months of the year and not really having a home in the home country is dicier and not what I would recommend unless there is no choice (e.g. unable to get regular policy due to pre-0existing conditions).

[4MyEgo]

16 minutes ago, Sheryl said:

 

65 is the cut off for enrolling in April (and many other plans) so I suggest that come age 64 you give yourself some lead time to figure out what the next increase will be and if necessary change providers.

 

By age 65 one wants to have a policy one can keep for life as after that changing becomes very difficult.

 

Very good points, thanks for that Sheryl.

 

Lets see how we go from here, if I end up with an event and they pay up, all and good, if no event when the next age bracket comes my way, we might just have to opt for April, the clincher for me is the per-existing condition, April might cover that, but who knows at what cost, hence the reason I always say, better the devil you know than the one you don't.

 

But great advice, will keep it on board for when the time comes, if alzheimer's hasn't set in by then, that or I have croaked it ????

 

[GregTN]

I am researching and planning on changing to APRIL international France “basic” next month.  The information as I understand it on age restrictions is actually 71 for the hospitalization part and the 65 applies to some of the add on modules.  I am still trying to get a clear answer on how the two bed hospital room is paid, if at all, at a facility that only offers private rooms as that is all that is available in my area.  I am awaiting a reply from my broker before I proceed forward with the purchase.

 

Edited March 25, 2021 by GregTN

[Sheryl]

14 minutes ago, GregTN said:

I am researching and planning on changing to APRIL international France “basic” next month.  The information as I understand it on age restrictions is actually 71 for the hospitalization part and the 65 applies to some of the add on modules.  I am still trying to get a clear answer on how the two bed hospital room is paid, if at all, at a facility that only offers private rooms as that is all that is available in my area.  I am awaiting a reply from my broker before I proceed forward with the purchase.

 

Let me know what you find out as I have the same concern.

 

I actually had a hospitalization fully paid for by them in a hospital that has only private rooms, when admitted I expressed concern to the hospital and they in effect told me "we don't list our rooms as private or semi-private, just standard or (some higher level)" and assurred me there would be no problem and there wasn't. But this was at Royal Hospital in Phnom Penh where they are very savvy about dealing with insurance, oddly enough despite higher volume none of the Thai hospitals seem to be so still a potential issue if no semi-private room available.

[JetsetBkk]

23 hours ago, Sheryl said:

The only people who can actually self-insure (real self-insurance, not the nonsense some people talk about) are comparatively well off.

 

I rarely read topics about health insurance, and I am particularly intrigued by your statement above.

 

Could you please expand on what you mean by "real self-insurance" and by "the nonsense".

 

Is it really just about the amount of ready cash available (if so, how much), or is it something else?

[Sheryl]

11 minutes ago, JetsetBkk said:

 

I rarely read topics about health insurance, and I am particularly intrigued by your statement above.

 

Could you please expand on what you mean by "real self-insurance" and by "the nonsense".

 

Is it really just about the amount of ready cash available (if so, how much), or is it something else?

 

it is the amount of cash always available for medical costs i.e. set aside solely for that purpose. And having some way to replenish it or else an alternative plan of what to do once it goes below a certain level.

 

Needs 3-5 million baht if want to be able to use private hospital, at least 1 million if will only use government hospitals, and these amounts need to be maintained i.e. topped off if partly spent as they are the amount that one single catastrophic accident or illness could cost.

 

What I mean by "nonsense" is people with no such fund, no savings to speak of, and no insurance saying they are "self insured".

[JetsetBkk]

2 minutes ago, Sheryl said:

 

it is the amount of cash always available for medical costs i.e. set aside solely for that purpose. And having some way to replenish it or else an alternative plan of what to do once it goes below a certain level.

 

Needs 3-5 million baht if want to be able to use private hospital, at least 1 million if will only use government hospitals, and these amounts need to be maintained i.e. topped off if partly spent as they are the amount that one single catastrophic accident or illness could cost.

 

What I mean by "nonsense" is people with no such fund, no savings to speak of, and no insurance saying they are "self insured".

 

Thanks, Sheryl.  I was hoping that was what you meant. A friend of mine had half his stomach removed because of cancer and he reckoned it cost him about 3 million baht. So, to be on the safe side, I'll aim for a bit more than that. I do have the 400k/40k insurance for my visa, but I know that wouldn't be enough to cover anything serious.

 

[4MyEgo]

20 minutes ago, JetsetBkk said:

 

Thanks, Sheryl.  I was hoping that was what you meant. A friend of mine had half his stomach removed because of cancer and he reckoned it cost him about 3 million baht. So, to be on the safe side, I'll aim for a bit more than that. I do have the 400k/40k insurance for my visa, but I know that wouldn't be enough to cover anything serious.

 

 

I thought I would weigh in on this as well, I know of a guy who just retired here, built his house and was really happy, then he got sick with Pneumonia, and went to hospital, he spent two weeks there and they went over him like a fine tooth comb before allowing him to leave as he was about to check out, then they found that he had a narrowing in one of his arteries, in went the stent, and another week in hospital.

 

Surprise surprise, 1.6 mil later, which I thought was cheap considering he had a room for himself, fortunately for him he had private cover.

 

Now some might say 1.6 mil isn't that bad, but I don't know any other expats that have private cover, they live off of their pensions, and you can tell they are living month by month, and I hear the stories of some going to public hospitals, not that I have anything bad to say about them, it's long ques and little if any interest in my experience, except for a university hospital that I went to which was good, albeit it an all day event as there are so many people waiting, bit like a war zone, beds in corridors, not enough seating, cramped conditions, but the privates, well like going to a 5 star hotel, yes please and I will gladly pay for not having to wait and speak to a doctor who speaks good English and is thorough, even as an outpatient were I pay as it's not part of the coverage on my policy, cheap enough, but each to their own, you have to go through it to appreciate it.

Edited March 25, 2021 by 4MyEgo

[JetsetBkk]

39 minutes ago, Sheryl said:

it is the amount of cash always available for medical costs

 

After reading 4MyEgo's post above, I was reminded that having cash "always available" is critical (literally) when dealing with some private hospitals. I had the money in my account but had no way to pay - in advance - the operation cost for my kidney stone operation. I had no "app" on my phone to transfer the money to the hospital.

 

So I was drugged up to kill the pain, showed to the taxi rank and sent to my bank to withdraw about 200,000 baht.

 

Only then, would they operate. Thanks Bangkok Phuket. Nice.

[how241]

What are members thoughts on whether or not you get better treatment with insurance compared to people who self insure ?  Sometimes when the hospital knows you have good insurance,  they might be fast to order a lot of tests knowing that they will get paid from the insurance company.  I guess it can be hard to determine if some tests are unnecessary and that the doctor/hospital are just trying to jack up the bill... Do you think the treatment would be the same if your paying cash compared to having a good insurance policy ??

[scubascuba3]

6 hours ago, 4MyEgo said:

 

Very good points, thanks for that Sheryl.

 

Lets see how we go from here, if I end up with an event and they pay up, all and good, if no event when the next age bracket comes my way, we might just have to opt for April, the clincher for me is the per-existing condition, April might cover that, but who knows at what cost, hence the reason I always say, better the devil you know than the one you don't.

 

But great advice, will keep it on board for when the time comes, if alzheimer's hasn't set in by then, that or I have croaked it ????

 

People should check future affordability also, expect 200k-300k a year if over 75, in fact many insurers don't even show how much premiums would be if over 80 (source AA summary)

[Sheryl]

1 hour ago, how241 said:

What are members thoughts on whether or not you get better treatment with insurance compared to people who self insure ?  Sometimes when the hospital knows you have good insurance,  they might be fast to order a lot of tests knowing that they will get paid from the insurance company.  I guess it can be hard to determine if some tests are unnecessary and that the doctor/hospital are just trying to jack up the bill... Do you think the treatment would be the same if your paying cash compared to having a good insurance policy ??

 

i don't think there is the least difference in treatment. the doctor ordering the treatments often doesn't know what sort of insurance you do or do not have.

As for hospitals, their main concern is getting paid. But given the choice they'd rather a self-pay patient (who has sufficient funds) anytime over an insured one simply because it saves them a lot of paperwork and also some uncertainty (insurers may dispute certain charges etc). In fact I have known some hospital staff to attempt to pressure patients into paying up front themselves first on one pretext or another, merely for their (the staff)'s own convenience.

[Nemises]

15 hours ago, Sheryl said:

it is the amount of cash always available for medical costs i.e. set aside solely for that purpose.

 

Why must it be set aside, always available cash solely for medical costs?

 

Can one not withdraw and pay for medical costs from a "cash always available" investment portfolio which is not solely for healthcare?

 

Edited March 26, 2021 by Nemises

[Sheryl]

2 hours ago, Nemises said:

 

Why must it be set aside, always available cash solely for medical costs?

 

Can one not withdraw and pay for medical costs from a "cash always available" investment portfolio which is not solely for healthcare?

 

 

As long as the balance is always maintained, you could. the problem is that if it is not designated solely for health care it tends to get spent on other things. If the minimum balance is always maintained except when/as needed for health care, amounts to the same thing. I think semantics. The point is, to be self-insured you need immediate access, all the time, to funds in that amount (and have a plan for how to replenish or what to do next if balance drops below the minimum level). How someone arranges this is really not the issue. The issue is that, in my long experience advising people on this board, easily 95% of the so-called "self-insured" do not have access to such funds, in fact majority have virtually no savings at all.  Which makes them uninsured, not self-insured.

[GregTN]

20 hours ago, Sheryl said:

Let me know what you find out as I have the same concern.

 

I actually had a hospitalization fully paid for by them in a hospital that has only private rooms, when admitted I expressed concern to the hospital and they in effect told me "we don't list our rooms as private or semi-private, just standard or (some higher level)" and assurred me there would be no problem and there wasn't. But this was at Royal Hospital in Phnom Penh where they are very savvy about dealing with insurance, oddly enough despite higher volume none of the Thai hospitals seem to be so still a potential issue if no semi-private room available.

I received an email from APRIL. via my broker today concerning the room reimbursement policy for two bed room coverage at hospitals with only private rooms and it stated that the private room would be covered if the cost was reasonable and customary for the area.  That might eliminate my option for Bangkok hospital at 5000/day but is good news for the other private hospitals at less than 2000/day.

[Why Me]

On 3/25/2021 at 6:54 PM, Sheryl said:

As for hospitals, their main concern is getting paid. But given the choice they'd rather a self-pay patient (who has sufficient funds) anytime over an insured one simply because it saves them a lot of paperwork and also some uncertainty (insurers may dispute certain charges etc).

Sheryl, I see where you are coming form. But I've always thought another plus of being insured is that the hospital is confident of being paid and will proceed with treatment without hesitation. Now, this might be the case too for a familiar patient.

 

However, if an unknown person is wheeled in after a serious health event and the doctor says we need these tests done right away and have to prepare him or her for surgery, I can see the manager of a private hospital (quite reasonably from their point of view) asking if we can't tread water for a few hrs. till we know how it's all going to be funded. And I would hate to be in the fellow above's situation if I am sick, drugged and in barely coherent state of mind:

 

On 3/25/2021 at 5:25 PM, JetsetBkk said:

So I was drugged up to kill the pain, showed to the taxi rank and sent to my bank to withdraw about 200,000 baht.

 

[madmen]

On 3/25/2021 at 2:08 PM, Sheryl said:

 

You will also usually have to return anytime you need medical care that can't wait for the annual planned visit. So that $1,500 isn't buying you all that much if you normally go back just once a year for a short time.

I have a couple of health issues, peripheral neuropathy and non Hodgkins lymphoma which is a type that never completely gets cured but is managed for life. 

I doubt I can even get insurance in Thailand or it would be very expensive 

 

You have any suggestions for me? 

[The Fugitive]

On 3/25/2021 at 5:25 PM, JetsetBkk said:

 

After reading 4MyEgo's post above, I was reminded that having cash "always available" is critical (literally) when dealing with some private hospitals. I had the money in my account but had no way to pay - in advance - the operation cost for my kidney stone operation. I had no "app" on my phone to transfer the money to the hospital.

 

So I was drugged up to kill the pain, showed to the taxi rank and sent to my bank to withdraw about 200,000 baht.

 

Only then, would they operate. Thanks Bangkok Phuket. Nice.

Wow! Thanks for the advice. Absolutely charming behaviour from Bangkok Hospital, Phuket. I guess the only safe option is to keep a 'substantial' balance in an instant access internet account, ensure you have the correct APP installed on your mobile and kept up-to-date. Plus an 'always on' SIM card allowing unlimited data in case of WiFi problems. Then carry a second phone with the same in case your battery goes flat! 

[Sheryl]

4 hours ago, madmen said:

I have a couple of health issues, peripheral neuropathy and non Hodgkins lymphoma which is a type that never completely gets cured but is managed for life. 

I doubt I can even get insurance in Thailand or it would be very expensive 

 

You have any suggestions for me? 

 Consult a broker.  You might not be able to get insured due to the Hodgkins but possibly there is a company who would take you with exclusions.

 

Otherwise your best recourse is (1) get a personal accident policy with as high a medical cover as possible (broker can advise) so that you have some coverage at least for anything related to an accident  and (2) put aside as much money as you can, continuously until it reaches at least 1 million baht (and then use only government hospitals) or about 4 million baht (your choice of hospitals).

 

Another option you might look at if it is feasible for your situation (i.e., you can go home for medical care) are policies that provide emergency repatriation only

[JetsetBkk]

2 hours ago, The Fugitive said:

On 3/25/2021 at 5:25 PM, JetsetBkk said:

So I was drugged up to kill the pain, showed to the taxi rank and sent to my bank to withdraw about 200,000 baht.

 

Only then, would they operate. Thanks Bangkok Phuket. Nice.

Wow! Thanks for the advice. Absolutely charming behaviour from Bangkok Hospital, Phuket. I guess the only safe option is to keep a 'substantial' balance in an instant access internet account, ensure you have the correct APP installed on your mobile and kept up-to-date. Plus an 'always on' SIM card allowing unlimited data in case of WiFi problems. Then carry a second phone with the same in case your battery goes flat! 

 

That just about covers it!

 

Actually, maybe I was a little harsh on Bangkok Phuket Hospital. I just checked my bank records and hospital bills and now remember the precise timeline: 

 

At the hospital, I withdrew 20,000 baht from an ATM so they would perform a CT scan to find out why I was previously in so much pain. I didn't have enough cash on me to pay for that - about 16,000 baht. At this point in time I had little pain thanks to the injection they gave me. Then, after they proposed the kidney stone operation, that's when I had to go to the bank and withdraw 200,000 to cover the operation and anything else.

 

I also remember that I took my bank book with me in the ambulance in case I needed a lot of money. Thank God I did that! I also remember showing the bank book to the finance person who was not willing to accept that I clearly had the money available and could pay for the operation. She wanted the funds actually transferred to the hospital before she would authorise the operation. I thought that was pretty disgusting. 

 

Of course, the staff and doctors were great. Except maybe for one nurse who came into my room after a couple of days, lifted up the sheet, grabbed my ding dong and yanked out the catheter without so much as a bye-your-leave.

 

[NancyL]

On 3/25/2021 at 5:25 PM, JetsetBkk said:

 

After reading 4MyEgo's post above, I was reminded that having cash "always available" is critical (literally) when dealing with some private hospitals. I had the money in my account but had no way to pay - in advance - the operation cost for my kidney stone operation. I had no "app" on my phone to transfer the money to the hospital.

 

So I was drugged up to kill the pain, showed to the taxi rank and sent to my bank to withdraw about 200,000 baht.

 

Only then, would they operate. Thanks Bangkok Phuket. Nice.

At least my friend in her 80s had a slightly better experience where someone from CM Ram drove her back to her condo so she could get her passport, bankbook and ATM card after she fell out of the back of a songthaew that took off before she had fully disembarked, and left her lying in the road. 

 

They wouldn't even give her any painkiller for her broken arm before she turned over the passport, bankbook and ATM card.

 

In all fairness, they did give her the option of transporting her to the government hospital where they take on "charity cases", but she had enough money to pay, but she just didn't have her ATM card with her because she'd gone out to lunch with friends with just a few items in her handbag and sadly, none of her friends were answering their phones.

[madmen]

3 hours ago, Sheryl said:

are policies that provide emergency repatriation only

Thanks I never heard of that but what if I'm hit by a bus I will still end up in intensive care for weeks. 

I'm currently in Oz getting free Medicare for a hip replacement and the lymphoma which is in remission. 

I will try all the options you gave, thanks.