How do you cope with skyrocketing premiums from health insurers?

[Lucky Bones]

12 minutes ago, rumak said:

I am more terrified that one of those army helicopters will come crashing down and completely destroy my collection of original Picassos .

Would possibly have happened if Air Chief Marshall Fufu was at the wheel???? 

It's good to be terrified, keeps one alert.

[Nickelbeer]

On 7/26/2022 at 6:33 PM, 1FinickyOne said:

So, take an average 70 yr old... would you want to risk your money insuring them? 

This is EXACTLY why Thailand needs a single-payer, universal health-care system. Expats could pay higher rates (though not the insane rates that insurance companies want) and Thai people would be protected with a lower premium rate. Indonesia does this and so do many countries in Central and South America who have a lower GDP than Thailand. If a government allows insurance companies to have a lock on healthcare, as they do in the USA, that is exactly why you can expect a huge pool of uninsured and potentially bankrupt citizens.

[Excel]

On 7/28/2022 at 12:14 PM, Pumpuynarak said:

Then get transferred to your registered government hospital without delay and pay BPH for the few hours you've spent there, i have a wifey who is aware of exactly what is to happen with me in the event of an accident/illness requiring emergency treatment.

I appreciate those falang that are on their own without the help of a wife/GF its not so easy to escape the thieves. 

And ironically, Some of the private hospital "thieves" use foreign business advisors. Talk about ripping off your own, they are no more than leaches in my book.

Edited July 29, 2022 by Excel

[jerrymahoney]

1 hour ago, rumak said:

Self-insurance is a situation in which a person or business that is liable for some risk does not take out any third-party insurance, but rather chooses to bear the risk itself." 

That definition comes in part from Wikipedia https://en.wikipedia.org/wiki/Self-insurance

 

If you follow the links in that entry, you will also come up with this:

 

"Stop-loss insurance is a form of reinsurance that insures self-funded plans and their assets. 

 

Due to the limited assets at the disposal of an average employer as compared to an insurance company, an employer could easily bankrupt itself if its employees incur a large number of high-dollar claims and the employer is unable to fund them all. This risk is where the concept of stop-loss insurance comes into play, as it provides the employer with an additional source for funding to pay for catastrophic losses. 

 

from https://en.wikipedia.org/wiki/Self-funded_health_care

 

 

 

[Lacessit]

19 hours ago, Sheryl said:

 

The big barrier is not age per se but that by age 70 or so,  most people have some chronic health conditions which may make it difficult or impossible to get a policy.

 

 

I am 79, with multiple pre-existing conditions which would disqualify me from getting insurance. I am assured by the medical profession none of those conditions will kill me.

 

In any case, the last time I looked at health insurance with an international company, the premium quoted without reference to my conditions was about 200,000 baht/year.

 

I have 500,000 baht set aside for medical emergencies. My GF knows I am to be taken to a government hospital, where I am registered.

 

Six years ago, I was on five different prescribed medications. Via diet and exercise, I now only need one.

 

Health insurance in Thailand is unaffordable for people my age, so I am trying to stay healthy instead.

[Nickelbeer]

On 7/26/2022 at 6:33 PM, 1FinickyOne said:

So, take an average 70 yr old... would you want to risk your money insuring them? 

This does not seem to be an issue with single-payer universal coverage.

Edited July 29, 2022 by Nickelbeer

[jerrymahoney]

(As posted before)

 

The old Bob Hope line is: "A bank is a place that will lend you money if you can prove to them that you don't need it."

 

Much the same for health insurance.

Edited July 29, 2022 by jerrymahoney

[bkk6060]

The "self insured" seem like naive fools to me.  Just because it is free in your home country you don't want to pay for it here? Good luck.

I bet many have well under 1,000,000 b probably more like 100,000 b

and think they are covered? For what? It provides coverage "if" an incident occurs.  That is why it is called "insurance".

[Lacessit]

3 minutes ago, bkk6060 said:

The "self insured" seem like naive fools to me.  Just because it is free in your home country you don't want to pay for it here? Good luck.

I bet many have well under 1,000,000 b probably more like 100,000 b

and think they are covered? For what? It provides coverage "if" an incident occurs.  That is why it is called "insurance".

It would be even more naive to be shelling out hundreds of thousands of baht in health insurance I have not needed for 12 years here, to companies that will use every excuse in the book to avoid meeting their obligations. They have entire departments dedicated to finding loopholes.

Strike naive, that's just dumb.

[rumak]

25 minutes ago, Lacessit said:

Six years ago, I was on five different prescribed medications. Via diet and exercise, I now only need one.

It amazes me that the majority of people who i thought were intelligent turn out to be slaves

to medications that IMO  and experience are not only not needed but actually can cause other problems (just read the side effects) .

the medical establishment has the whole world on drugs.   YES,  there are of course occasions where there may be no alternative.   BUT,  as you point out...... and as i too have discovered,  a dedicated person can overcome and avoid many of the "ailments"  that come on as we age.

Diet and exercise ..... and a few "alternative"  ( or as they used to be called , Natural remedies) can indeed solve many health issues. 

 

 

 

[rumak]

20 minutes ago, bkk6060 said:

The "self insured" seem like naive fools to me.  Just because it is free in your home country you don't want to pay for it here? Good luck.

I bet many have well under 1,000,000 b probably more like 100,000 b

and think they are covered? For what? It provides coverage "if" an incident occurs.  That is why it is called "insurance".

naive fools .    always the name calling .        I feel pretty darn smart to have taken care of my own medical bills over the last 40 years.     saved me a fortune .    which,  being a naive fool,  i still have instead of some insurance mafia that i must beg and fight to pay .

[richard_smith237]

8 minutes ago, rumak said:

naive fools .    always the name calling .        I feel pretty darn smart to have taken care of my own medical bills over the last 40 years.     saved me a fortune .    which,  being a naive fool,  i still have instead of some insurance mafia that i must beg and fight to pay .

I think there is a range of experiences...

 

Between cover from work and myself, less has been spent health care than I have received out of it having been (medivacced from Indonesia to Singapore - 10 days in a Hospital in Singapore) - that bill was about $50,000

 

Another one, My Wife was covered with Bupa (which also covered child birth) 330,000 baht bill at Bumrungrad - the premium at the time was about 60,000 baht (IDP only).

She’s been in a couple of times since, with various minor but over night treatments.

 

I know a couple of people who have had 4.5 million baht bills in Thailand (one developed a very rare sudden condition (Gillain Barre syndrome), life threatening... that person spent a month in ICU, then another month in room before continuing with physio for a year. 

 

 

That said...  when I’m older and no longe working, when I have to pay elevated rates of cover for myself and Wife which could easily reach 200,000 baht per year (for the same level of cover), I may re-think my approach and self insure myself and rely on the Thai healthcare system for my Wife. 

 

 

 

 

 

 

 

[Lacessit]

21 minutes ago, richard_smith237 said:

 

 

That said...  when I’m older and no longe working, when I have to pay elevated rates of cover for myself and Wife which could easily reach 200,000 baht per year (for the same level of cover), I may re-think my approach and self insure myself and rely on the Thai healthcare system for my Wife. 

 

 

 

 

 

 

 

Exactly, it is not a case of one size fits all.

[Boomer6969]

On 7/28/2022 at 10:38 AM, Henryford said:

Self insure. I have for 18 years. If you are paying $2000 a year that's $36,000 (1.3 million baht)  to go towards any treatment.

"any treatment" ? Nope.

[jerrymahoney]

When I first decided to move full-time to Thailand almost 20 years ago, there were many people in US who were not happy at all with that decision. One thing that appeased them is that there was individual health coverage for me in Thailand that was not available at all for me in US.

 

And it would have been inconceivable to those back in US that anyone would reside full time in Thailand without that kind of coverage. If some choose to do otherwise, up to them.

[rumak]

1 hour ago, richard_smith237 said:

I think there is a range of experiences...

As in all things in life  ????  .    As i mentioned,  i broke my hip,  when i was 70 .   Looking at google one finds this tidbit :   "One in three adults aged 50 and over dies within 12 months of suffering a hip fracture. Older adults have a five-to-eight times higher risk of dying within the first three months of a hip fracture compared to those without a hip fracture."     

Let me say,  when i broke my hip the pain was incredible.  Couldn't move.   I had the surgery done at a private mid range hospital in CM .   Total cost 140 K  baht .   I was on crutches within a month... and walking without them within 3 months.  This is why i might repeat in some health threads the advantage of taking care of ones self .  

I understand what you say,  that sometimes in life unexpected things happen.  Car crashes, hit by a drunk driver,   sudden rare illness,  etc .     One person's choices will not fit all .   Health insurance for a major catastrophe such as you mention ( in the millions)  would be great.   On the other hand there are hundreds of thousands of people who have been denied or had horrible experiences trying to get insurance companies to pay.    

Working for a company or govt that gives good insurance is definitely worth it.  Self employed and retired people who pay themselves have a tough decision . (well,  for me not tough) .   Pretty sure you will make right choice for yourself when the time comes .  

[jerrymahoney]

10 hours ago, rumak said:

On the other hand there are hundreds of thousands of people who have been denied or had horrible experiences trying to get insurance companies to pay.   

While that may be true, and as long as there was no link for that statistic, I will just say there are probably millions who have had their individual policy claims routinely paid as they accurately and fully provided their medical history for the underwriters when they submitted their application for the health insurance policy.

Edited July 29, 2022 by jerrymahoney

[Sheryl]

2 hours ago, jerrymahoney said:

While that may be true, and as long as there was no link for that statistic, I will just say there are probably millions who have had their individual policy claims routinely paid as they accurately and fully provided their medical history for the underwriters when they submitted their application for the health insurance policy.

This actually is the norm worldwide..  But it is true that based insurers have a comparatively poor record and many of them engage in practices that would be unthinkable (and unallowable) elsewhere.

 

Some of the negativity  one hears from expat community here is from people whose only frame of reference are Thai policies.

[rumak]

opening google there will be many claims about how necessary and great having insurance is,  What the "copy and paste experts"  here on TV  don't have a clue is how these are all written and paid for by the insurance industry .    

 

Just to add a little spice ....... let's see if there are any "opposing"   views :

https://www.decof.com/documents/insurance-company-tricks.pdf

[rumak]

6 minutes ago, Sheryl said:

Some of the negativity  one hears from expat community here is from people whose only frame of reference are Thai policies.

seems to be worldwide  problem ..... IMO

Edited July 30, 2022 by rumak

[internationalism]

On 7/26/2022 at 6:10 PM, DUS said:

My concern is the affordability in a few years from now. I would love to remain insured for the "worst case" incidents, like cancer, a stroke or anything that includes major surgery and ICU etc. Those things that would break the bank if I had to pay everything out of pocket. But with the current rates of increases in the premiums, it will be CIGNA that will cause me to go broke, not surgery. ;-))))

 

ask cigna for pricing of your plan till 99. I have asked my insurer and they send me only till 90, but they do cover to 99. I am shocked at those prices, can't believe them. That information is very hard to get, almost never published publicly. Often they say premium will go higher than those quoted once 65 passed, those figures are just a ballpark.

So if you need only the worst case, strip your policy of all add ons, get to highest possible deductible and co-pay. Cigna is asking for $300 even if it's not your regular increase year (usually they do increase every 5 years - so your major increase suppose to be at 51). When older they will be asking much higher increase every single year.

 

Get thai based insurer (unless you are planning to go back to UK to continue your cigna).

As you have regular check ups and you are healthy, no hereditary etc maybe stop insurance for sometimes, when insurance companies are in covid turmoil. Start shopping before age 61 or 66. There are some insurers which will take before 70 (but cover only till 80 or 85) and pacific cross visa friendly before 75. 

When covid will pass, and with it "long covid" patients, cancer (and many other serious conditions) victims from covid fallout, premiums will stabilise to pre-covid situation. Premiums now are some 20% higher than pre-covid, I gave an example of April.

Find the best local governmental secondary care hospital, which is university associated. So they speak english, have equipment and doctors doing scientific research in their field, so you have a chance to meet even professors. Even, if you have to travel 100km each way several times per year for some treatment, it will well pay you back. 

Yearly check check ups you can do at any governmental hospital 2-6k (depending on chosen options).

 

Edited July 30, 2022 by internationalism

[chalawaan]

I went with Cigna then reneged during the Cool-off period. 

Use a Thai insurer like Pacific Cross they're underwritten by the "big boys" anyway. 

Also, nobody who lives in Thailand needs Medevac! To where? An inferior hospital in Aussie? 

Think through every extra, and scenarios where it can be of value, or not, injury rehab is necessary, but not in every case, consider the reasons why actuaries price and limit benefits. 

Finally, be fatalistic to a degree.

Get a DNR clause written up somewhere and witnessed by a JP. Have "DNR" tattoed on your chest in Thai and English.

Figure out if you are willing to euthanase yourself if your prognosis is a few months of agony and death ahead. And figure out how to do that effectively. At least your loved ones can prepare to farewell a lucid person and won't have a pointless hospice care bill to pay.

It's a tough call, and would mean some sorrowful and frank conversations, but the knowledge is out there and I am ready for that if necessary.  

Master of extremes, I temporarily (I hope) relocated back to my socialist homeland, so insurance is not my problem right now. I really don't know how to deal with it in my 70s if I return though. 

I guess if a hospital cost is big enough to break you in your 70s you quality of life will likely suck beyond convalescense, and then my voluntary self-euthanasia kicks in. 

Assisted euthanasia is legal where I currently live anyways. 

 

[jerrymahoney]

3 hours ago, rumak said:

opening google there will be many claims about how necessary and great having insurance is,  What the "copy and paste experts"  here on TV  don't have a clue is how these are all written and paid for by the insurance industry .    

 

Just to add a little spice ....... let's see if there are any "opposing"   views :

https://www.decof.com/documents/insurance-company-tricks.pdf

Yes and if you open Google I will cut and paste here from the Kaiser Foundation website why most (group policy) health insurance claims are denied.

 

Why do health plans deny claims?
HealthCare.gov plans also report on certain categories of reasons for in-network claims denials:

Denials due to lack of prior authorization or referral
Denials due to an out-of-network provider
Denials due to an exclusion of a service
Denials based on medical necessity (reported separately for behavioral health and other services)
Denials for all other reasons

 

And one of those 'other reason' for individual policies is that the applicant -- deliberately or otherwise -- did not provide an accurate medical history when applying for coverage and this was only found out when such person submitted a claim.

[jerrymahoney]

21 hours ago, Lacessit said:

It would be even more naive to be shelling out hundreds of thousands of baht in health insurance I have not needed for 12 years here,

Sure. But did you know that 12 years ago?

[beau thai]

like the op, I was insured with cigna.

 

after several claim free years, they increased my premium by a factor of 3!!

 

They said that at my last birthday I 'entered a higher risk pool'.

a self fullfilling prophecy as only those in doubt about their health will accept such a huge increase! Then they have a higher risk pool and prove themselves right.

 

I offered full health screen or whatever but they werent interested -pay up or go. I went.

 

So yeah, they will insure you as you get older but at a cost you find acceptable?

 

  Best option is to self insure, start young and build your own big medical fund.

 

For example, a cancer op followed by months of chemo will set you back 1m bht+, so self insurance is not for the faint hearted

 

 

[Lacessit]

1 hour ago, jerrymahoney said:

Sure. But did you know that 12 years ago?

I had a pretty good idea of what my pre-existing health conditions were, and what to do about them.

I do still have private health insurance in Australia, I pay about 15% of the normal yearly premium to maintain it. Reinstated with an email or phone call if I go back.

In any case, even then premiums in Thailand were prohibitively expensive. Even if a company would accept me.

[xylophone]

On 7/28/2022 at 8:36 PM, Sheryl said:

If by "Thai indurance" you mean insurance issued by a Thai company, they will usually not issue a new policy beyond age 75 bug many will allow renewal well past that age.

 

There are internationally based expat insurance policies that are newly  available past age 75 and will cover you kin Thailand. Internationally issued policy ls preferrable in at any age anyhow...more reliable and better regulated.

 

The big barrier is not age per se but that by age 70 or so,  most people have some chronic health conditions which may make it difficult or impossible to get a policy.

 

 

Even though my health insurance is expensive these days, and I know that because I've just renewed it for the coming year at 146,000 baht, I'm not sure that I want to do without it at the moment.

 

I was lucky enough to take it out with BUPA here just before the age of 60, and they guaranteed that the policy would cover me up to the age of 100 and I have got that in writing (if that makes any difference) and of course they have now been taken over by Aetna and they are still renewing my policy at the age of 75 this year, so hopefully it will last until I reach the ton, if indeed I want to!

 

I did try to switch when I noticed that the premiums were increasing quite markedly, but at the time I investigated the market here, including Pacific Cross, I'd had a few medical conditions which fell into the "pre-existing" category, so would have been excluded in my ongoing coverage, and I didn't want this, especially as one of them was for an enlarged aorta, so I needed future coverage, hence staying with Aetna.

 

Although my cover is for just over 1 million baht, I am fortunate enough to have some investments in NZ which I can draw on if necessary, or of course there is always the option to travel back to NZ and get medical care, given the fact that I am an NZ citizen, so I think I have got my options covered.

 

I suppose I was lucky enough back before my 60th birthday to research my options and duration of policy/coverage, so that has stood me in good stead so far.
 

[jerrymahoney]

2 hours ago, Lacessit said:

Reinstated with an email or phone call if I go back.

Just like me with Medicare in US --  It's there if I go back. But I might not be in a stable sufficient condition to fly to Bangkok let alone back to USA.

[Sheryl]

11 hours ago, rumak said:

seems to be worldwide  problem ..... IMO

The populations of France, Germany and many Scandinavian countries -- all with well functioning universal health care access systems based on  insurance and a well regulated insurance sector  -- would likely disgree.

[Sheryl]

4 hours ago, beau thai said:

 

 

For example, a cancer op followed by months of chemo will set you back 1m bht+, so self insurance is not for the faint hearted

 

 

Easily 3 - 5 million in a private hospital (depending on type of operation needed etc).