How do you cope with skyrocketing premiums from health insurers?

[Sheryl]

4 hours ago, jerrymahoney said:

Sure. But did you know that 12 years ago?

Of course he did not. None of us knows if or when we will need insurance, and having had no claims till now in no way means you won't have a major claim tomorrow.

 

The statistical likelihood of a claim rises exponentially  as you age Which is why insurance premiums do. 

[Lacessit]

4 minutes ago, jerrymahoney said:

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.

Medicare in Australia has devil in the detail. True, healthcare is free. However, if the condition is classed as elective surgery, a patient could be waiting in pain for 1-2 years before getting the surgery done.

OTOH, with private health cover, I can be on the operating table within 2 - 4 weeks of landing.

[Lacessit]

8 minutes ago, Sheryl said:

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

 

 

I don't know what the statistics are now, years ago survival rates after surgery were no better than tossing a coin, because the surgery tended to spread the cancer cells elsewhere.

Personally, at my age, rather than facing surgery plus chemo for an uncertain outcome and huge expense, I would rather pull the plug for the sake of my heirs.

[Sheryl]

23 minutes ago, Lacessit said:

I don't know what the statistics are now, years ago survival rates after surgery were no better than tossing a coin, because the surgery tended to spread the cancer cells elsewhere.

Personally, at my age, rather than facing surgery plus chemo for an uncertain outcome and huge expense, I would rather pull the plug for the sake of my heirs.

There are not,  and never have been,  statistics on survival rates for "cancer surgery" per se . Cancer is not one disease, but many, and it exists in different stages ranging from completely localized to regional spread to distant metastasis. Survival rates differ greatly according to type of cancer and also its stage.  In most types if cancer,   prognosis for full cure with surgery is high if the cancer is still localized. 

 

Benefits of chemo also vary enormously depending on type and stage  of cancer. There are some types of cancer which are completely  curable by chemo alone . Others where chemo given at certain stages together with surgery significantly improve chances of full cure.  And yes, cases of advanced cancer where the benefit is just a fews months more of life. In which case one might indeed want  to consider  carefully whether worth it. 

 

Certainly no readon to assume that any cancer treatment you might need would be of uncertain  benefit.

 

And, of course, cancer is just one of many, many, many things that might lead to significant medical expense.

 

 

 

 

[beau thai]

1 hour ago, Sheryl said:

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

 

 

not my experience sheryl. colon resection at BCH less than 1m as was chemo programme at ram chiang mai. 

Burst appendix emergency op this new year at Ram Chiang Mai plus 7 days inpatient recovery, 150k. Seemed good value to me.

[Richard 2020]

I was also insured for the first 20 years in Thailand.
And very well!
Had unfortunately, also some hospitalizations, but all went well.
But when with over 60 years the insurance companies increased the premiums partly exorbitant, I canceled the last!
It was the AETNA.
On my written request, I got the information that it would be usual to adjust the premiums by about 5% annually & a surcharge if an unfavorable damage history.
So for me from 75 years no longer affordable! From 80 years even less!
In addition, in the event of damage everywhere information is obtained! Hospitallers / doctors and previous insurance!
So that in a for the insurance, more expensive case of damage can be assumed that is not regulated!
The secret is called: "Not made pre-contractual health data".
And there can be found almost always something to which the last disease is due ????
In addition, some large international health insurance have terminated all contracts in Thailand years ago and are no longer here on the market!
So now I have the Non O/A health insurance,which although only covers 600.000.-THB with 200.000.-THB excess!!!
The advantage is', 24/7 available, all in Thai!
In addition still an accident insurance over 300.000.-THB
That should be enough for an emergency!?
In the last 10 years I have saved a good 1.8 million THB, which I have just not paid to health insurance, which should possibly be enough?
Thai KV,s can increase your premiums after each claim up to 35% and also exclude this disease from the insurance in the future!!!
So in old age without previous illness is simply almost impossible, and these are just generally excluded !

 

[Lacessit]

1 hour ago, Sheryl said:

There are not,  and never have been,  statistics on survival rates for "cancer surgery" per se . Cancer is not one disease, but many, and it exists in different stages ranging from completely localized to regional spread to distant metastasis. Survival rates differ greatly according to type of cancer and also its stage.  In most types if cancer,   prognosis for full cure with surgery is high if the cancer is still localized. 

 

Benefits of chemo also vary enormously depending on type and stage  of cancer. There are some types of cancer which are completely  curable by chemo alone . Others where chemo given at certain stages together with surgery significantly improve chances of full cure.  And yes, cases of advanced cancer where the benefit is just a fews months more of life. In which case one might indeed want  to consider  carefully whether worth it. 

 

Certainly no readon to assume that any cancer treatment you might need would be of uncertain  benefit.

 

And, of course, cancer is just one of many, many, many things that might lead to significant medical expense.

 

 

 

 

You may be right. However, if I was to have Stage 4 esophageal cancer, which usually is not detected until it has reached that stage, I doubt surgery and chemo would do much more than fatten the wallets of hospitals and doctors.

I also remember reading somewhere metastasis of smaller tumors is promoted by removal of a primary tumor. Perhaps chemo is supposed to address that eventuality.

OTOH, I have been a bladder cancer survivor for 16 years, so it depends, as you say, on the type of cancer. And luck of the draw.

[Boyn]

2 hours ago, Lacessit said:

I don't know what the statistics are now, years ago survival rates after surgery were no better than tossing a coin, because the surgery tended to spread the cancer cells elsewhere.

Personally, at my age, rather than facing surgery plus chemo for an uncertain outcome and huge expense, I would rather pull the plug for the sake of my heirs.

Big talk but i can assure you when the big C diagnosis comes things look different its a basic human instinct to want to survive, I know cos i have been there which is why people talking rubbish annoy me.

[Lacessit]

3 minutes ago, Boyn said:

Big talk but i can assure you when the big C diagnosis comes things look different its a basic human instinct to want to survive, I know cos i have been there which is why people talking rubbish annoy me.

Perhaps you missed out on reading skills, I have been there too. Continue to be annoyed, because I don't give a damn about your opinion.

You'd rather suffer from terminal cancer for months, than end your life peacefully? Be my guest.

[Chris.B]

7 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

The Chemo can be administered at a state hospital.

 

[david555]

On 7/28/2022 at 10:52 AM, Chris.B said:

Don't worry about being insured over 70. You will either be priced out of the market or you will be refused cover for health reasons. ☹️

 

1 of the reasons i return to my E.U. country .....and as no longer a Thai resident i can have 3 months full  covering insurrance from my home country as a tourist, including repatriation dead or alive ..., for max period of 3 months, ...this just included for the normal 86 euro a year .....

A Calculation quick made ...to become back  just only tourist to Thai

Thanks to my nanny state country...????

Edited July 30, 2022 by david555

[Hummin]

27 minutes ago, david555 said:

1 of the reasons i return to my E.U. country .....and as no longer a Thai resident i can have 3 months full  covering insurrance from my home country as a tourist, including repatriation dead or alive ..., for max period of 3 months, ...this just included for the normal 86 euro a year .....

A Calculation quick made ...to become back  just only tourist to Thai

Thanks to my nanny state country...????

For 500 euro, I have one year policy, 180 days cover travel home, come back new 180 days, full cover and repatriation as well. No age restriction,

 

travel insurance applies to everyone, regardless of age. The only limitation is the accident cover (one-off payment in the event of medical disability and death), where the cover is adjusted with age. After the age of 70, the compensation is reduced, and after the age of 75, coverage ceases

[david555]

11 minutes ago, Hummin said:

For 500 euro, I have one year policy, 180 days cover travel home, come back new 180 days, full cover and repatriation as well. No age restriction,

 

travel insurance applies to everyone, regardless of age. The only limitation is the accident cover (one-off payment in the event of medical disability and death), where the cover is adjusted with age. After the age of 70, the compensation is reduced, and after the age of 75, coverage ceases

Lile i said 1 of the reasons....i am on my way to 75 ....however in good health ...but that does not change the Thai insurrances policy's ....????

Edited July 30, 2022 by david555

[gk10012001]

It has surprised me as I get older now at 65.  I am an American just started Medicare, which itself is not dirt cheap, but OK once I stop making money as they base premiums on income.  Having spent a lot of time in Thailand and planning to semi retire there very very soon, I have kept an eye on Thai health insurance.  It can come in very hand when abroad for 6 months and unable to get back to the States for treatment.  Medicare supposedly reimburses emergency services if over seas, but not much knowledge about that from anybody that every got that to work.  I wanted to have some Thai insurance while abroad, but am still pondering it.  I would never rely or have to rely on Thai health insurance so not a big issue at this point, but I have read enough to believe that having thai insurance can come in very handy.  Feelings for full retiree and expats that have to rely on Thai insurance. 

 

Mandatory or not, living in another country without insurance is a dangerous game.  the old days of self insuring are very risky, and if serious conditions arise, will break you.

 

My best suggestion is take the highest deductible possible as an attempt to lower the premiums.  The idea is to avoid cataclysmic massive expenses and catastrophic costs. 

[gk10012001]

1 hour ago, Lacessit said:

You may be right. However, if I was to have Stage 4 esophageal cancer, which usually is not detected until it has reached that stage, I doubt surgery and chemo would do much more than fatten the wallets of hospitals and doctors.

I also remember reading somewhere metastasis of smaller tumors is promoted by removal of a primary tumor. Perhaps chemo is supposed to address that eventuality.

OTOH, I have been a bladder cancer survivor for 16 years, so it depends, as you say, on the type of cancer. And luck of the draw.

my dad got bladder cancer.  He had been peeing blood and finally went to the doctor.  quick diagnosis on Friday.  Doctor said it is one of the most aggressive cancers.  had surgery through his Penis on Monday.  All good.  No conditions or symptoms the rest of his life 14 years on

[Sheryl]

4 hours ago, beau thai said:

not my experience sheryl. colon resection at BCH less than 1m as was chemo programme at ram chiang mai. 

Burst appendix emergency op this new year at Ram Chiang Mai plus 7 days inpatient recovery, 150k. Seemed good value to me.

As I said, depends on type  of surgery.  Lung resections etc cost considerably more than simple hemicolectomy. Chemo costs depend on the drug with newer agents bring especially expensive.  What your specific treatment for one type of cancer cost  does not represent the upper limit of what treatment for any type of cancer can cost.

[Sheryl]

2 hours ago, Chris.B said:

The Chemo can be administered at a state hospital.

 

And can still be very costly. How much, depends on the drug needed. Some of the newer drugs may not even be available at a govt hospital.

[Lacessit]

2 hours ago, gk10012001 said:

my dad got bladder cancer.  He had been peeing blood and finally went to the doctor.  quick diagnosis on Friday.  Doctor said it is one of the most aggressive cancers.  had surgery through his Penis on Monday.  All good.  No conditions or symptoms the rest of his life 14 years on

You don't say whether your dad had BCG immunotherapy, which with a more than 90% success rate is still one of the most effective cancer treatments. I remember the procedure well.

[jerrymahoney]

After 18 years of private insurance in Thailand, my paid claims are roughly 40% of my total paid-in premiums.

 

I know that would not square with the  I-am-way-ahead-of -the-game self-insured folks, but given all the other advantages of a million US$ per year coverage, it's good enough for me.

Edited July 30, 2022 by jerrymahoney

[Pumpuynarak]

22 hours ago, internationalism said:

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.

This.........????

[Chris.B]

9 hours ago, Sheryl said:

And can still be very costly. How much, depends on the drug needed. Some of the newer drugs may not even be available at a govt hospital.

Some of the older Chemo drugs could still be effective while being cheaper?

 

[gk10012001]

10 hours ago, Lacessit said:

You don't say whether your dad had BCG immunotherapy, which with a more than 90% success rate is still one of the most effective cancer treatments. I remember the procedure well.

no chemicals.  Just a pure cut out.  Some post surgery pain meds that's about all.  This was back in 2006

[Lacessit]

2 hours ago, gk10012001 said:

no chemicals.  Just a pure cut out.  Some post surgery pain meds that's about all.  This was back in 2006

Coincidentally, that was when I had my first surgery. I have had a couple since; however, the urologist did not seemed to be concerned about the recurrences.

[GinBoy2]

This is the problem with health insurance.

If you look at it logically, of course the older you get the chances of you actually needing it increase, hence insurance policy costs will escalate.

 

Even in the US with our f><?ed up system we call it quits at 65 and you get Medicare and you're out of the insurance market.

 

In Thailand as an expat you just gotta suck it up, that insurance is based on risk, andthe older you get that risk increases, as do the premiums

[gk10012001]

17 hours ago, GinBoy2 said:

This is the problem with health insurance.

If you look at it logically, of course the older you get the chances of you actually needing it increase, hence insurance policy costs will escalate.

 

Even in the US with our f><?ed up system we call it quits at 65 and you get Medicare and you're out of the insurance market.

 

In Thailand as an expat you just gotta suck it up, that insurance is based on risk, andthe older you get that risk increases, as do the premiums

yeah.  not many other options.  If reasonably healthy and have not chronic recurring conditions, go for the largest imaginable deductible to reduce your premiums.  My goal always was just to insure against the  bankroll busting major illnesses.  Knock on wood, now at 65 literally have never been to a hospital when I was paying for medical.  In the Air Foce they yanked my wisdom teeth and that's been about it.  Broke an arm as a kid. 

[jerrymahoney]

8 hours ago, gk10012001 said:

yeah.  not many other options. 

The standard Part B premium amount in 2022 is $170.10

 

https://www.medicare.gov/your-medicare-costs/part-b-costs

 

If you don't take Part B, and are willing to put up with a possible Part B enrollment penalty, or have a waiver for such penalty, you have $2040 per year to put toward health insurance in Thailand.

[Sheryl]

15 hours ago, gk10012001 said:

 Knock on wood, now at 65 literally have never been to a hospital when I was paying for medical.  In the Air Foce they yanked my wisdom teeth and that's been about it.  Broke an arm as a kid. 

I was exactly the same at age 65. Never an insurance claim except for some really minor day surgeries.

 

Now had 5 claims in just the past 3 1/2 years. Didn't see it coming and thought it unlikely  I'd make much use of my insurance any time soon, but I was wrong. 

 

2 of the 5 were accident related so totally unpredictable (and no, there was no negligence or risk taking in my part that contributed). The other 3 related to spinal degeneration I was blissfully unaware I had until suddenly severe symptoms struck. Similar to what happens to many with their hips or knees (and for all I know, though feeling fine now, those could go on me too at any time).

 

The likelihood of claims really does shoot up as you age and previous state of good health is no guarantee against it.

 

[internationalism]

pacific cross has published now new premiums, which in broker's slang they call them "new normal" - a slight reference to covid. So they are old policies with higher premiums.

For plan "premier plus" (that one for 3ml):

for age 56 jumped from 59k to 63k

61 from 70k to 75k

66 from 96k to 103k

71 from 144 to 154k

 

for 300k deductible there is 50% discount in premiums.

Until age 76 they have also 20% discount for not claiming.

So those premiums can be lowered by up to 70%.

After a large claim they increase premium by 25% for 2 years and no claim benefit is lost.

Their accident part of this plan covers only to 200k, but can be upgraded to 5mln at rate 145b for an additional 100k cover, so to 5 mln that would be additional 7k.

 

Broker wrote to me that they don't have all data from the PC: "We apologize as they only release the up to 75 premiums to us as after 75 it will be based on renewal of the client".

The PC has also stopped issuing Visa Friendly plan (it appears it was better value, just my broker was not offering any deductible).

 

the old quotation, send to me recently in July was age 76 from 194k, age 81 from 241k, 86 from 304k. They did not include from 91 - probably around 400k, and from 96 - probably below 500k 

Edited August 2, 2022 by internationalism

[GinBoy2]

The other thing I think you need to consider is what they will exclude.

 

Now things may have changed, but me and my wife signed up for what was then BUPA in the disclosures we told them she had had a previous ruptured ovarian cyst which had required surgery and hospitalization.

The policy was then written to exclude coverage for any gynecological issues, which for any woman, especially a middle aged woman is a risk.

 

I always wondered after that, have a heart attack and a stent, next year do they exclude any heart issues as a pre-existing condition?

 

Of course you could not disclose anything, but my experience of insurance companies the world over is they are are rather adept at finding ways not to pay!

[richard_smith237]

The exclusions insurance companies apply for non-symptomatic issues is often ridiculous... 

 

I often wonder if I had a broken leg would they exclude me from cover for further broken legs !!!...