Self insure v health insurance

[Adelphi]

I am 62 and planning on trying out living permanently (retired) in Thailand.  I now need to decide whether to buy health insurance or self insure.  My preference is to self insure as I instinctively dislike insurance companies.  Two friends have suggested that I should have at least 4M THB immediately available should I need emergency treatment.  I would be grateful to know the views of others on this subject.   Thanks in advance for all helpful contributions.

[scubascuba3]

I self insure, 1m baht in the bank should be enough to get them treating you, in fact they have to treat you, keep you alive etc i also have personal accident insurance which covers 250k baht, again that gets you treated. You will need access to more money if need be, from abroad ok as long as can move it quickly

[4MyEgo]

47 minutes ago, Adelphi said:

I am 62 and planning on trying out living permanently (retired) in Thailand.  I now need to decide whether to buy health insurance or self insure.  My preference is to self insure as I instinctively dislike insurance companies.

From my experience having moved here in 2015, I started looking for health insurance, why, to protect my life's savings which will keep me going here till I'm 101 ????

 

I found out real fast in the 1st two years no one would touch me with a pre-existing condition dating back as far as 2007 with no issues.

 

The above said, I had no option but to self insure, took it on the chin, then a broker reached out and said, he had found one, so did all the paperwork, gave them the letters from Dr's & Specialist and all good approved, it cost me about $60 US monthly to over the pre-existing condition, and then I had the annual cover to pay for suffice to say in the 3-4 years that I was with them, no claims, but the policy kept going up and when I turned 61 last year it went up double, and I negotiated a 15% discount, but when I turned 62 and the policy was due again, it went up again to about 150k, the reason was they had a new underwriter, so I said, enough is enough and for that kind of annual outlay I will self insure so declined to renew the policy. 

 

Don't get me wrong, the money they received in that time, I paid because I knew I was covered, that was the game plan, but when they kept raising the stakes, my pair of Jack's so to speak weren't worth the bluff, so I now transfer 250k baht a year to an online account which I have named Health Insurance funny enough and a reminder to transfer the same annually.

 

I do have enough to cover a major emergency is need be, that said there are also some pretty good university type hospitals which are much cheaper then the privates, and when the time comes, i.e. if it does, I will see what my options are, considering that I'm in good health, eat right, exercise and drink in moderation, should not expect to see myself in a hospital, and think of those $'s back in my pocket rather than theirs, fully knowing that every year the policy would be going up, and especially with every 5 year age bracket, e.g. 59-64, 65-69 etc etc.

 

The decision is ALL yours, that said, if you have enough to fall back on, 4 million is conservative, but with that kind of Baht, you should be fine for major stuff, excluding the big C, if you were ever so unfortunate.

 

I know of a couple of lads who went into privates, one for a quadruple by-pass, 750k, another a stent and pneumonia, had to return a 2nd time for a 2nd collapsed lung, was in and out in total for a about 4 weeks, 2.5 mil baht. 

 

Good luck.  

Edited August 21, 2022 by 4MyEgo

[jaywalker2]

I self insure but be aware, the older you get, the harder it will be for you to get insurance. At 62, you should be able to get a policy that you can hopefully keep for your lifetime but once you edge towards 70, buying insurance will become more and more difficult.

 

4 million does seem like a lot. You're talking a major illness. The best thing is to get a complete physical and review your family history to see if you're likely to have any major problems in the future and then decide.

[KannikaP]

4 minutes ago, jaywalker2 said:

I self insure but be aware, the older you get, the harder it will be for you to get insurance. At 62, you should be able to get a policy that you can hopefully keep for your lifetime but once you edge towards 70, buying insurance will become more and more difficult.

 

4 million does seem like a lot. You're talking a major illness. The best thing is to get a complete physical and review your family history to see if you're likely to have any major problems in the future and then decide.

I reviewed my family medical history to find that neither my Mum nor my Sister had Enlarged Prostate. !   555

[The Hammer2021]

Get insurance  while you  can. You can also get insurance  here. There is no such thing  a self insurance- it's just a fantasy.

It's not just serious  illness like a stroke or haemorrhage but minor  illness that require  treatment. If you have  insurance  you will look  after  yourself  better

[rumak]

Keep in mind that all responses are "subjective" .    We are all different.   I think people that work the same job for 30 years ,  people who spend money to support bigger and" better" lifestyles, people who climb Mt Everest,  people who jump out of planes to skydive,  ......are nuts.   

 

I do not like Insurance companies. To me the reasons are well known,   I do like living a pretty active lifestyle which minimizes my "risk"  of serious medical expenses .    For me the "reward" of saving money for many years instead of handing it to a third party to hopefully pay for something THEY say they will do , written by them...... has worked out very well.   Others of course strongly disagree.     

 

I also think that one million baht will cover most healthy people if a true emergency .... sure, there are some that could require a lot more.   Good to be prepared if that should happen.  But I have known lots of guys here over thirty years and the 2 worst cases ( heart issues)  came to a lot less than a million.   

 

People who say that there is no such thing as "self insurance"  are definitely mistaken .   The definition can be looked up .   

[OneMoreFarang]

Do you like to gamble?

How is your health?

What is your lifestyle?

 

If you want 1st grade medical treatment, then it can get very fast very expensive. 

If you accept a government hospital, maybe with several people in one room, and nobody speaking English, then you can get away with paying a lot less.

 

Personally, I think if you can afford a health insurance then get one, maybe with a high deductible.

If you can't afford that then you are anyhow in trouble.

 

And if you have millions of dollars in the bank then you could self-insure. But why? You could easily afford to pay an insurance which will cover a lot and you don't have to worry about paying a fortune to hospitals. 

[rumak]

17 minutes ago, 4MyEgo said:

3-4 years that I was with them, no claims, but the policy kept going up and when I turned 61 last year it went up double, and I negotiated a 15% discount, but when I turned 62 and the policy was due again, it went up again to about 150k, the reason was they had a new underwriter, so I said, enough is enough

Yes,  enough is enough.    Fortunately I said that over 30 years ago.   Doubt anyone reading this is very young........ but if you are:    start saving what you can for old age  ????

[4MyEgo]

10 minutes ago, rumak said:

start saving what you can for old age 

Agree 110%, invest, invest and keep investing in property and shares and any other vehicle, because savings on their own don't grow as much as the above, then when you get to retirement age, you keep investing while earning from the fruits of your labour. 

[Robin]

I have always taken the risk.  now 78 and probably could not get insurance.  I keep 2M baht in my bank which serves for visa and medical emergencies.  Thinking that if I need all the money for medical treatment i will not be needed a visa for long.

[scubascuba3]

36 minutes ago, OneMoreFarang said:

Do you like to gamble?

You realise having insurance is a gamble? will they pay the claim or find a pre-existing, will premiums become unaffordable when i could have been saving for all those years, both health insurance and self insuring are gambles

[4MyEgo]

3 minutes ago, scubascuba3 said:

You realise having insurance is a gamble? will they pay the claim or find a pre-existing, will premiums become unaffordable when i could have been saving for all those years, both health insurance and self insuring are gambles

Well said, you do the right thing and pay your premium nd hope they do the right thing.

 

With self insuring, if we are fortunate to have saved up enough to cover the costs, we know it's a sure bet, that and if we don't have any issues, we are richer for it.

 

Like you said, it's a gamble by choice.

[proton]

Thought about insuring a few years ago, saved 250k now by not doing so and now the premiums would be about 100k a year at my age. No brainer, don't give your money to insurance companies, who may go bust by the time you need them anyway.

[internationalism]

this 4mln is a max at the top private hospital.

So the governmental one some 1mln.

That is for a major event, series of operations, months in hospital, including weeks in ICU.

Average operations at the governmental hospitals are some 150k, with some 1 week on the bed. I have stayed in such hospital for 4 nights in a common 6 bed room and it was good enough, 1/3rd of private room.

 

Get registered at the secondary care governmental hospital, they are more expensive, than primary one, but shorter waiting time for treatments and specialists.

Think about insurance with the highest deductible. Pacific cross has 50% lower premiums with 300k deductible. For your age 3mln cover with 300k deductible is some 30k/year. They give up to 20% reduction for not claiming.

It's inevitable that at some stage you will have to get self-insured. Insurance premiums are rising sharply because of covid and undetected/untreated chronic diseases it caused. For the next 20 years patients will be draining insurance companies for treating cancer and the other major. 

Edited August 21, 2022 by internationalism

[PJ71]

36 minutes ago, proton said:

Thought about insuring a few years ago, saved 250k now by not doing so and now the premiums would be about 100k a year at my age. No brainer, don't give your money to insurance companies, who may go bust by the time you need them anyway.

The 250K you've saved will not go far.

 

Someone i knew spent 3 nights in ICU at 150K per night.

 

 

[The Hammer2021]

1 hour ago, rumak said:

Keep in mind that all responses are "subjective" .    We are all different.   I think people that work the same job for 30 years ,  people who spend money to support bigger and" better" lifestyles, people who climb Mt Everest,  people who jump out of planes to skydive,  ......are nuts.   

 

I do not like Insurance companies. To me the reasons are well known,   I do like living a pretty active lifestyle which minimizes my "risk"  of serious medical expenses .    For me the "reward" of saving money for many years instead of handing it to a third party to hopefully pay for something THEY say they will do , written by them...... has worked out very well.   Others of course strongly disagree.     

 

I also think that one million baht will cover most healthy people if a true emergency .... sure, there are some that could require a lot more.   Good to be prepared if that should happen.  But I have known lots of guys here over thirty years and the 2 worst cases ( heart issues)  came to a lot less than a million.   

 

People who say that there is no such thing as "self insurance"  are definitely mistaken .   The definition can be looked up .   

When you get  cancer of the bowel you might think differently  about medical  insurance.

[PJ71]

I used to think to self insure was clever due to money saved and thinking i was bullet proof.

 

Now i have insurance at about 80K per year, i'm <50.

 

4MB may sound like a lot of money but in reality for a serious condition or accident it won't go far.

[scubascuba3]

5 minutes ago, PJ71 said:

The 250K you've saved will not go far.

 

Someone i knew spent 3 nights in ICU at 150K per night.

 

 

where was 150k a night? Bangkok Pattaya was 50k a night ICU.

 

I was chatting to a guy the other day who recently spent 6 months in a coma in govt hospital, paid 600k bill when he woke up

[scubascuba3]

7 minutes ago, The Hammer2021 said:

When you get  cancer of the bowel you might think differently  about medical  insurance.

Not sure whether it's worth getting treated here, if a Brit head back to UK and yes you can do it, someone i know just did it

[PJ71]

3 minutes ago, scubascuba3 said:

where was 150k a night? Bangkok Pattaya was 50k a night ICU.

 

I was chatting to a guy the other day who recently spent 6 months in a coma in govt hospital, paid 600k bill when he woke up

this was bkk / ptty yes, it was a good few years ago too. 

 

600K for a 6 month coma ain't too bad.

[rumak]

1 hour ago, 4MyEgo said:

With self insuring, if we are fortunate to have saved up enough to cover the costs, we know it's a sure bet, that and if we don't have any issues, we are richer for it.

exactly .    for me, peace of mind has always been not worrying about having to deal with insurance companies !     

[The Hammer2021]

4 minutes ago, scubascuba3 said:

Not sure whether it's worth getting treated here, if a Brit head back to UK and yes you can do it, someone i know just did it

Currently the NHS is in chaos with  cancer referrals over a year behind.

It's not fit for  purpose.  If you are British- all the  more reason to have real medical  coverage - to have good medical  insurance.

AnE waiting  time is 4 hours if you're  lucky. It's 4 minutes here  and 30 minutes  to see a specialist.

Two to three months to see a specialist on the No Health Service Britain.

 

[proton]

25 minutes ago, PJ71 said:

The 250K you've saved will not go far.

 

Someone i knew spent 3 nights in ICU at 150K per night.

 

 

He was ripped off then!

[scubascuba3]

3 minutes ago, The Hammer2021 said:

Currently the NHS is in chaos with  cancer referrals over a year behind.

It's not fit for  purpose.  If you are British- all the  more reason to have real medical  coverage - to have good medical  insurance.

AnE waiting  time is 4 hours if you're  lucky. It's 4 minutes here  and 30 minutes  to see a specialist.

Two to three months to see a specialist on the No Health Service Britain.

 

Strange, guy i know went back and got treated straight away, very recently. Remember that YouTuber Kev in Thailand, had cancer, wasted  1m+ trying to get treated in Thailand, eventually went back to UK, died, maybe should have gone back sooner

[PJ71]

Just now, proton said:

He was ripped off then!

Expert on all prices at all hospitals are you?

 

Expert on ICU cases are you?

 

All ICU cases the same are they?

[PJ71]

7 minutes ago, The Hammer2021 said:

Currently the NHS is in chaos with  cancer referrals over a year behind.

It's not fit for  purpose.  If you are British- all the  more reason to have real medical  coverage - to have good medical  insurance.

AnE waiting  time is 4 hours if you're  lucky. It's 4 minutes here  and 30 minutes  to see a specialist.

Two to three months to see a specialist on the No Health Service Britain.

 

I agree.

 

I listen to the local radio stating from back home which have adverts that say you must now actually phone A and E and nont just turn up.

 

The UK is a 3rd world country now IMO.

[Excel]

6 minutes ago, PJ71 said:

I agree.

 

I listen to the local radio stating from back home which have adverts that say you must now actually phone A and E and nont just turn up.

 

The UK is a 3rd world country now IMO.

I think that may be a bit unfair. It's still a 1st world country with 1st class dedicated NHS workers. However when it comes to lies and corruption it definitely should be considered as having 3rd world politicians.

[simon43]

2 hours ago, KannikaP said:

I reviewed my family medical history to find that neither my Mum nor my Sister had Enlarged Prostate. !   555

They won't have that, but your new Thai 'girlfriend' might!!

[TravelerEastWest]

I can't get insurance do to pre existing conditions but if I could find a high deductible plan taht accepted me and gave me their wholesale rates for my deductible taht would be good.

 

As an example in America I had a plan with around a $5,000 decidable or something like that.

 

My wife had our daughter (in America) and above the deductable everything was paid for in a very nice hospital. For the first $5,000 we ended up paying a reduced rate which was the same rate that our insurer paid in effect a wholesale rate...

 

Around 15 years ago I spoke with an insurance broker in Bangkok who told me taht insurance plans where customers paid a wholesale rate were not available in Thailand. Maybe they are now?