International health insurance in Thailand

[timoti]

Hi,

 

I want to get an international health insurance in Thailand, and I saw a few that were mentioned here a lot like April Global. My question is, in another SEA country when I was asking for quotes from Pacific Prime, they told me for a preexisting kidney stone operator that happened 4 years ago, it would cost an additional 30% of regular rate, forever.

 

Is this normal? I am mid 30s so I thought many people here sign up first time much older than that and so preexisting condition in these cases become much more common. So can anyone please tell me if any of you have similar mark ups on your premiums? If so, how much?

 

One of my friend is also using April in Singapore, and he told me they are very good but not sure. Pacific Prime said they recommend Cigna likely coz of the kickbacks they get.

 

When I compared their full benefit listing, April seems to have more benefits like unlimited scans vs 10K if I remember right, for their mid plans.

 

I would appreciate any help on this because I want to have international health insurance for life, so it's important I choose the best one I can.

 

 

Thanks a lot in advance.

[scubascuba3]

Thai insurers go back a long time sometimes since birth to find pre existing conditions. Foreign companies go back 2\5 years depending. The more you know about Thai insurers the more you'll want to avoid.

 

April France very different to April Thailand

Edited November 4, 2021 by scubascuba3

[timoti]

Yes I am talking about global intl insurance companies like April or Cigna. This was in another SEA country that quoted the 30% increase.

 

So are you saying if the condition happened 2-5 years before they might not charge you extra to cover it? Because Pacific Prime told me there is no waiting period for this.

[Sheryl]

It depends entirely on the company. But usually an event within the past 5 years (10 years for some companies) will lead to either increased premium or an exclusion. Sometimes they give you a choice of which, for example when I got April global I was given option of a higher premium or excluding all thyroid conditions (I take regular medication for hypothyroidism) , I opted for the exclusion.

 

There is also often an option to later drop an exclusion if X years have passed without a recurrence but again, depends on the company and also the illness. Posisblek that for kidney stones that would nto be the case.

 

People who have had one kidney stone are indeed at higher risk of a second one, even many years later, so I would nto be surprised if all companies want either higher premium or to exclude this.

 

Broker should be explaining all this to you, if they are not, suggest you try a different broker. I have been very happy with AA www.aainsure.net

 

Personally I have April global (out of France) and have been happy with them. I had Cigna before but changed because of poor customer service (nothing sinister just really ditsy & very inexperienced  staff...they have lower premiums but seem to achieve this by cutting in admin costs). However with a good broker to run in interference for you, this should be less of a concern, I did not have AA at that time.

 

All that said, at age 30-ish you have a very wide range of choice, so examine all options. Do not forget to look at illustrative premiums as you grow older, they all increase with age but some more so that others. And make sure whatever policy you get (1() guarantees lifetime renewal and (2) will not raise rates based on claim history. I would alsoi suggets sticking to solid companies that have been in business for at least a  few decades.

 

 Whatever policy you choose,  I think you will find best approach is to accept exclusion of kidney stones (stones only, not all kidney disease!) and put some funds aside to self-fund that, within 5-10 years will likely pay for itself in premium savings.

[timoti]

Thanks a lot for replying. I don't remember if they gave me the ability to exclude I think they did, but they said there was another type of underwriting moratorium but they said if you already applied to one you can't apply to the other one. Some weird rules.

 

The big worry is if you exclude kidney stones, they come and claim some other complication is a result of that and avoid paying.

 

Here also they say they this:

https://globalhealthasia.com/aboutus-expat-medical/frequently-asked-questions.html

 

"We will always make an attempt to cover your pre-existing conditions and may require a premium loading or a cap on benefits.  We believe this is a more straightforward and honest approach than offering a pre-existing waiting period/moratorium."

 

Because I got screwed by my employer insurance, I am trying to make sure I choose a good one that won't screw me down the line.

 

I will ask the brokers you mentioned. Did you have any other intl. health insurance besides Cigna and April that you heard is good? There are so many listed on pacific prime website for example that it's a bit overwhelming but I did compare to almost all of their plans roughly in terms of caps, benefits, etc.

[Sheryl]

28 minutes ago, timoti said:

Thanks a lot for replying. I don't remember if they gave me the ability to exclude I think they did, but they said there was another type of underwriting moratorium but they said if you already applied to one you can't apply to the other one. Some weird rules.

 

The big worry is if you exclude kidney stones, they come and claim some other complication is a result of that and avoid paying.

 

Here also they say they this:

https://globalhealthasia.com/aboutus-expat-medical/frequently-asked-questions.html

 

"We will always make an attempt to cover your pre-existing conditions and may require a premium loading or a cap on benefits.  We believe this is a more straightforward and honest approach than offering a pre-existing waiting period/moratorium."

 

Because I got screwed by my employer insurance, I am trying to make sure I choose a good one that won't screw me down the line.

 

I will ask the brokers you mentioned. Did you have any other intl. health insurance besides Cigna and April that you heard is good? There are so many listed on pacific prime website for example that it's a bit overwhelming but I did compare to almost all of their plans roughly in terms of caps, benefits, etc.

I can't really say re other insurers as, being much older than you, I have focused on those who will ensure at older ages.

 

April will offer you the alternative of an exclusion. If by some chance they do not, ask about it. As long as the exclusion clearly says kidney stones (and not "kidney disease") you should be OK.

 

What they mean by what you quote is that all exclusions will be stated up front and no moratorium or waiting period (rather than do full medical underwriting, some companies just exclude claims in the first X months or years...and Thai companies seem to decide after the fact what is and is not "pre-existing").

 

The only way to be certain what a company will do regarding your medical history is to apply. Even the most experienced broker cannot predict with certainty. And what one company does, will likely not be the same as what another will do.

 

In my case the offer was either exclusion or a 15% premium surcharge (not 30% - I think that would be very unlikely unless the pre-existing condition were something very expensive to treat).

[timoti]

Thanks a lot for replying. That makes sense.

 

If you get an insurance from AA brokers you mentioned, when you move, then you have to change your brokers also?

 

As for 30%, it might be because this was April Singapore so I assume their mark ups are higher and maybe coz like you said kidney stones have higher chance to come back.

 

I just liked the listed benefits of April more than others it seemed a lot better from what I could tell, that's why I want to get them if possible.

[Sheryl]

40 minutes ago, timoti said:

Thanks a lot for replying. That makes sense.

 

If you get an insurance from AA brokers you mentioned, when you move, then you have to change your brokers also?

 

As for 30%, it might be because this was April Singapore so I assume their mark ups are higher and maybe coz like you said kidney stones have higher chance to come back.

 

 

More likely the broker was just estimating based on  the highest possible premium from their experience. I can assure you that not all pre-exisitng conditions get a 30% surcharge. A sophisticated company with real medical advisors (like April) does not treat all conditions the same. Having had kidney stones in the past, your odds of having them again are certainly above average, but kidney stones are not on par with things like heart disease and cancer in terms of cost.

[timoti]

Yes that also shocked me because we are not talking about 30% for a few years but forever, so it becomes huge.

 

Pacific Prime did quote 30% in the final stage of approval though. Then I submitted another application myself via April's website and they contacted me, and I assume not knowing it's the same person also quoted 30%.

 

I just checked the email to be sure, and I was wrong it was 35%. Here is their writing:

 

"Kidney stones are excluded as you have wished. If you'd like to include them, a 35% loading would apply. Let me know if you want to change it, otherwise kindly send signed offer letter back to me."

 

This was directly from April employee.

[Sheryl]

Just now, timoti said:

Yes that also shocked me because we are not talking about 30% for a few years but forever, so it becomes huge.

 

Pacific Prime did quote 30% in the final stage of approval though. Then I submitted another application myself via April's website and they contacted me, and I assume not knowing it's the same person also quoted 30%.

 

I just checked the email to be sure, and I was wrong it was 35%. Here is their writing:

 

"Kidney stones are excluded as you have wished. If you'd like to include them, a 35% loading would apply. Let me know if you want to change it, otherwise kindly send signed offer letter back to me."

 

This was directly from April employee.

 

That certainly surprises me. Anyway I would definitely take the exlcusion instead and put money aside in case of stones.

[timoti]

Yes me too. Seems like a crazy mark up. My time here is gonna end soon (contract), so we will see what I get quoted for April Global using AA brokers for Thailand coverage.

 

Total annual premium is $7K SGD with exclusion. If I include you can imagine how much more expensive it is. It includes IP and OP though.

 

If it's this expensive now, how much it would be when I am 70s. Will certain become a major financial cost.

[WhiteBuffaloATM]

Curious exactly HOW Health Insurance Companies can actually trace ANY persons medical history, declared or undeclared, with current Privacy & Confidentiality laws. What can do they do, other than Decline, if you just say never been injured or ill, just child vaxx, no reg. doctor, etc. ? Would they find out from Medical Reports for Claimed Treatment showing Previous Surgery / Illness ?

[scubascuba3]

1 hour ago, timoti said:

Yes me too. Seems like a crazy mark up. My time here is gonna end soon (contract), so we will see what I get quoted for April Global using AA brokers for Thailand coverage.

 

Total annual premium is $7K SGD with exclusion. If I include you can imagine how much more expensive it is. It includes IP and OP though.

 

If it's this expensive now, how much it would be when I am 70s. Will certain become a major financial cost.

Look at the premiums at 70, 75, 80+

[timoti]

1 hour ago, WhiteBuffaloATM said:

Curious exactly HOW Health Insurance Companies can actually trace ANY persons medical history, declared or undeclared, with current Privacy & Confidentiality laws. What can do they do, other than Decline, if you just say never been injured or ill, just child vaxx, no reg. doctor, etc. ? Would they find out from Medical Reports for Claimed Treatment showing Previous Surgery / Illness ?

I am also not sure but one doctor told me if they ask her she has to tell everything.

 

Another doctor said they have people that can give this kind of private records if the claim is large.

 

Pay some small fee to some guy to avoid paying 100k claim for example.

 

So i am not sure exactly but i have a feeling if you use a different passport likely they wouldn't know?

 

Another thing is possibly if you claim something and they order some test they can say this is an old illness based on timing?

 

 

[internationalism]

as you are working on a contract you should get insurance from your employer, wherever you will go next.

Insist on it on your contract, if it's important for you.

if you don't have underlying and clean family record (no hereditary), save yourself money and splash on a good insurance when you need the most, after retirement. For another 30 years you can save and invest those some $sg7k per year. 

Get now the basic one, to allow yourself to travel (if you are planning) and very large accident with the biggest possible deductible

Edited November 5, 2021 by internationalism

[timoti]

My company provides insurance but they are very bad, doesnt pay anything, and no pre-existing and not only that they try to avoid paying legit claims. Company said it's put of their hands. After contract finish they will cut insurance also same day.

[Sheryl]

Thai companies are notorious for providing fairly worthless private insurance cover.

 

However if working in Thailand you should also be under the Social Security scheme which will provide free care at nominated hospital. Exception being if you work at a private school.

[Sheryl]

13 hours ago, internationalism said:

if you don't have underlying and clean family record (no hereditary), save yourself money and splash on a good insurance when you need the most, after retirement. For another 30 years you can save and invest those some $sg7k per year. 

Get now the basic one, to allow yourself to travel (if you are planning) and very large accident with the biggest possible deductible

Strongly disagree- waiting until retirement age often (in fact, usually) leads to having trouble getting insured at all, and any existing conditions will not be covered.  The time to take out a policy is while still young and healthy.

 

At his age annual premium will be more like $1k sg .

[timoti]

2 hours ago, Sheryl said:

Strongly disagree- waiting until retirement age often (in fact, usually) leads to having trouble getting insured at all, and any existing conditions will not be covered.  The time to take out a policy is while still young and healthy.

 

At his age annual premium will be more like $1k sg .

You mean I could likely get $1K annual for April Global? Because as I mentioned I got quoted $7k with exclusion, and almost $10k with full coverage.

 

So would be very good if it was that cheap.

 

Is it secret how much is your annual premium? I assume insurance companies like April charges the same for everyone for base based on age, regardless of claims (if we exclude pre existing)?

 

So that would be a good way to see how much increase there is.

[Sheryl]

1 hour ago, timoti said:

You mean I could likely get $1K annual for April Global? Because as I mentioned I got quoted $7k with exclusion, and almost $10k with full coverage.

 

So would be very good if it was that cheap.

 

Is it secret how much is your annual premium? I assume insurance companies like April charges the same for everyone for base based on age, regardless of claims (if we exclude pre existing)?

 

So that would be a good way to see how much increase there is.

There is no possible way their Essential Plan could cost that much, that is more than I am paying and I am in my late 60's. Rate for ages 35 - 39 years was under US$1k in 2018, may have gone up but not by a whole lot.

 

Must be some more elaborate plan and with special options included, and also must be worldwide coverage including US, to reach that high.

 

Try here. Do NOT select any of the add on options.

https://lp.april-international.com/th/international-health-insurance/?bodytxt=solution-designed-for-expats-and-Thai-citizens&conjoin=an&header=for-Individuals-and-Families&keyword=International-Health-Insurance&source=Website&destination=TH&pays

 

Select Essential Plan not Comfort etc. And if it then gives you an option for coverage area select Zone 3.

 

Outpatient cover is almost never worth having in Thailand, as outpatient care is quite afffordable and it at least doubles your premium.,  The Essential Plan will cover high cost outpatient things like cancer care and dialysis, and also covere day surgeries.

 

Dental cover also not worth having.

 

Should copme out around $1K and you may be able to further lower it by taking a deductible.

 

[timoti]

Oh yes this was their executive plan, which was the mid one I think? I had both IP and OP. I was just thinking it would be nice if I could see doctors proactively like I have something minor or even a mole and get it checked etc.

 

Mine was worldwide except USA. I was sent this before the preexisting conditions loading:

[bubblegum]

I have April France trough AA insurance, Cigna was way to expencive

[timoti]

4 minutes ago, bubblegum said:

I have April France trough AA insurance, Cigna was way to expencive

How much is it annually? IP and OP? Basic or Mid plan?

 

Cigna seems more expensive and less benefits but if I am not wrong larger network.

[internationalism]

there are no good or not bad policies, entirely on you how much you want to spend.

Here including inpatient - from 7.7k to 166k, so over 20x difference. Some 100 policies.

https://misterprakan.com/th/health/plans?gender=Male&age=35&lg=en&ipd=1&opdf=1&leadid=348157

The first policy with 300k deductible is pacific premier for 13k, covers 1.3mln.

 

Yearly health check ups are recommended for over 50. That's when you health might need attention. I have started later than that, and because I did not feel well for over a month. Nothing was found and not any problems in the next years.

The only scary and difficult to early detect and treat is a cancer. 

Don't run with minor ailments. Next years premiums would be higher, maybe by 35%, as with your stones. 

Select the highest possible deductible.

I got pacific cross maxima plan - with  300k deductible, unlimited outpatient (cost me only additional 7k) accident to 1mln for 1200b.

 

Edited November 6, 2021 by internationalism

[Sheryl]

18 hours ago, timoti said:

Oh yes this was their executive plan, which was the mid one I think? I had both IP and OP. I was just thinking it would be nice if I could see doctors proactively like I have something minor or even a mole and get it checked etc.

 

Mine was worldwide except USA. I was sent this before the preexisting conditions loading:

 

As I explained, it is almost never worth having outpatient cover in Thailand, and premiums will be prohibitively expensive.

 

An outpatient consultation in Thailand costs between 50 - 2000 baht depending in hospital and doctor. Even at top tier international hospital with western trained specialist, and inclusive of hospital add on charges, unlikely to  exceed 2,000 baht for the consultation. (Meds and labs would be extra, but almost all meds can be bought without prescription at a pharmacy. For that matter, labs can be gotten cheaply at stand alone labs).

 

I have the April Essential plan and pay out of pocket for outpatient. I do not feel in the least constrained in seeing a doctor whenever I want. Spend on average  about 5,000- 6,000 baht a year for that i.e. couple hundred dollars. Compared to thousands extra to have a policy that includes outpatient. When I have needed day surgery/surgical procedures, easily covered by Essential plan. For example just had an epidural injection for spine problem, fully covered as a day surgery since it required use of OR and a brief stay in recovery., Likewise cataract surgery and other day surgeries would be covered. Some policies also cover endoscopies (screening colonoscopy etc) and CT/MRI, some do not or do so only if linked to hosptalization. (Apri Essential will also cover all OPD costs that are related to a hospitalization if occurring within 30 days of it).

 

But do make certain the policy covers OPD cancer treatment and dialysis without limit as those are costly.

 

Do the math and you will see that even with multiple outpatient visits each year, it does not pay to have OPD cover.

 

Cover that includes USA will also always be very, very expensive and usually unnecessary -- even policies limited to Asia will usually cover emergency care in US during short visits. If for some reason you need cover in the US for more than 30 days in a row (or for more than emergency care) then look into Cigna Close Care, which will cover you in your home country plus Thailand.

 

Also what you are quoted here is not the April global international  plan out of France,. It is a policy specific to Singapore ("My Health Singapore"), managed by a Singapore affiliate and underwritten by a   local Singaporean insurer and coming under Singaporean insurance regs. Not what you would want or get for Thailand.

 

In Thailand you would have 2 choices: the MyHealth Thailand policy (analagous to the Singapore plan i.e. a local Thai affiliate manages it and issued/underwritten by a Thai insurer -- but likely lower premiums since health care costs are much lower in Thailand than in Singapore) OR the international policy issued out of France, which is managed and underwritten by April France and cones under EU insurance regs, this is what I have.

 

This may explain the puzzling 30% premium loading - it was not a decision by April France but rather by Liberty underwriters/Singapore. 

 

I suggest you try again but specifically for the April Global policy, Essential Plan, zone 3 and listing Thailand as where you will live.  You will get a quote of probably under US $1k a year and I'd be surprised if there was a 30% load for inclusion of the kidney stones.

[timoti]

Thanks a lot Sheryl, that's very useful!

 

That April SG vs April Global was confusing. Tbh when you google april insurance, or april intl insurance, the website directs you to all sorts of places based on which place you choose.

 

Surprised Pacific Prime didnt inform me of this. They told me this is intl insurance. But when I inquired Thailand one, they said I have to talk to PP Thailand.

 

But AA brokers will surely sign me up with April Global rather than April Thailand?

 

I will try 2 quotes from 2 emails with and with preexisting just to compare. That's really useful. Will share results.

 

Thanks a lot again!

[Sheryl]

1 hour ago, timoti said:

Thanks a lot Sheryl, that's very useful!

 

That April SG vs April Global was confusing. Tbh when you google april insurance, or april intl insurance, the website directs you to all sorts of places based on which place you choose.

 

Surprised Pacific Prime didnt inform me of this. They told me this is intl insurance. But when I inquired Thailand one, they said I have to talk to PP Thailand.

 

But AA brokers will surely sign me up with April Global rather than April Thailand?

 

I will try 2 quotes from 2 emails with and with preexisting just to compare. That's really useful. Will share results.

 

Thanks a lot again!

 

Yes, AA brokers can help you get a policy with April Global. I got my policy through them, telling them specifically that I wanted April Global not April Thailand.

 

They can't sign you up -- you have to fill out the application materials yourself, and also (if accepted) make payment directly to the company, but they can facilitate the process  and their after service (help afterwards with claims etc) is in my experience very good, something that can't be said of a lot of brokers here.

 

April France has a Medical Board which reviews the medical history. It takes time, you won't get a quick quote, but the final decision will be a medically informed, well thought out one (and I will be astonished if it comes back at 30% premium load!). Could take as much as a month. They do thorough medical underwriting (which is one of many, many differences between how western and Asian insurers operate).

[timoti]

Ok this seems strange. I submitted a quote request using this link:

https://lp.april-international.com/th/international-health-insurance/?bodytxt=solution-designed-for-expats-and-Thai-citizens&conjoin=an&header=for-Individuals-and-Families&keyword=International-Health-Insurance&source=Website&destination=TH&paysNationalite=US

 

The auto email I got is from the same person I was talking to on the April side. Basically when I submitted the application manually for SG.

 

So that link above is also not April Global then?

 

In the signature it says:

"APRIL Brokerage (Thailand) Co., Ltd., 518/3 Maneeya Center North, 10th floor, Ploenchit Road, Lumpini, Pathumwan, Bangkok 10330, Thailand"

[chaam]

This health insurance everyone is going on about. Isn't this just travel insurance that we would purchase before arriving in Thailand? My travel insurance covers me for any medical emergency and the UK company providing it say it is worldwide cover. 

I don't understand how the Thai authorities claim that all of these medical Bill's have been unpaid by foreigners? Whenever I've ever needed treatment at a Thai hospital theyve checked the policy first before providing any treatment,so they know that they will get paid. Someone is making a nice profit at the expense of foreigners,yet again!

[scubascuba3]

5 hours ago, chaam said:

This health insurance everyone is going on about. Isn't this just travel insurance that we would purchase before arriving in Thailand? My travel insurance covers me for any medical emergency and the UK company providing it say it is worldwide cover. 

I don't understand how the Thai authorities claim that all of these medical Bill's have been unpaid by foreigners? Whenever I've ever needed treatment at a Thai hospital theyve checked the policy first before providing any treatment,so they know that they will get paid. Someone is making a nice profit at the expense of foreigners,yet again!

yeah travel insurance is enough, needs to explicitly state covid 19