Self insure v health insurance

[KannikaP]

2 minutes ago, simon43 said:

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

Sorry mate, same real girl for 12 years.

[The Hammer2021]

9 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.

Very sad. And possibly impossible to fix  because  it is an ideological  issue but affordable health care works in France and Germany. The problem is that 'privatisation ' is a toxic  word associated  with the  cruelest  aspects of the American  health  care system.

So you get local news?

Im amazed  at how many people  have no idea about  what is happening  in the UK.

I use a free website  that has all the UK newspapers  for free

[KannikaP]

44 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.

 

 

And someone I know got a TURP for Bht60k at the local hospital with no problems whatsoever.

[KannikaP]

2 minutes ago, The Hammer2021 said:

Very sad. And possibly impossible to fix  because  it is an ideological  issue but affordable health care works in France and Germany. The problem is that 'privatisation ' is a toxic  word associated  with the  cruelest  aspects of the American  health  care system.

So you get local news?

Im amazed  at how many people  have no idea about  what is happening  in the UK.

I use a free website  that has all the UK newspapers  for free

BBC News is free and available, as are most US news channels.

[The Hammer2021]

2 hours 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.

No amount  of medicals can predict  your health, unfortunately. 4 million is only  80 thousand  pounds.

How much is a month in ICU + Medivac?

 

[talahtnut]

Never had insurance, I just take

the cheap way out and die.

[BangkokHank]

43 minutes ago, PJ71 said:

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

 

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

That's 100,000 baht a month. That's about how much I spend when I'm NOT in a coma.

[jerrymahoney]

2 hours ago, rumak said:

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

Sure is such a word. But or the large companies or groups that self-insure, self-insure rarely means no insurance. They only self-insure a portion of the risk.

[The Hammer2021]

If the OP has 4 million- OK. Come here and check insurance  rates here. I had Thai insurance that was 25k a year at 63 and it covered me for Cambodia  etc. But it only covered for for 1.5 mil. Next time I would pay more. That's still  about 1500usd a year

[SteveBull]

Self insure - the stress of paying enormous premiums coupled with the worry they will somehow deny the claim, which happens so often made the decision for me.

 

The only problem with that is the cash needs to be readily available, ie I like to invest every penny and not have millions sat around in an interest free account. If I slipped into a coma for any reason the wife isn't going to be able to access/liquidate that cash. However with an insurance policy number.....

 

I know someone who was taken to Bangkok Hospital with his second heart attack and they told him the procedure would be circa 2m, he had the cash but couldn't access it immediately and asked how long he had to pay - they replied he wouldn't make it through the night unless he could prove he could underwrite the whole amount.

[jerrymahoney]

3 hours ago, 4MyEgo said:

I will see what my options are, considering that I'm in good health, eat right, exercise and drink in moderation,

That's funny. All my big medical expenses both in Thailand and while still in US were related to exercising.

[wwest5829]

Only addressing my own situation as retired Yank for over a decade. 1. Retirement policy paying up to $5K annually for overseas care. Pre-existing heart history. O-A Visa for retirement so, since the change in rules, required to have health insurance. So, 11,400 baht policy, excluding pre-existing conditions with a 200,000 baht deductible … a tax, I figure. Yes, plan to change to O next extension in the Spring. Heart attack, Chiang Mai 2015, my U.S. insurance paid the $5k and I paid the 6K balance.

[wwest5829]

16 minutes ago, SteveBull said:

Self insure - the stress of paying enormous premiums coupled with the worry they will somehow deny the claim, which happens so often made the decision for me.

 

The only problem with that is the cash needs to be readily available, ie I like to invest every penny and not have millions sat around in an interest free account. If I slipped into a coma for any reason the wife isn't going to be able to access/liquidate that cash. However with an insurance policy number.....

 

I know someone who was taken to Bangkok Hospital with his second heart attack and they told him the procedure would be circa 2m, he had the cash but couldn't access it immediately and asked how long he had to pay - they replied he wouldn't make it through the night unless he could prove he could underwrite the whole amount.

2 million? Pull the plug. Painkillers only, too much? OK!

[Chris.B]

2 hours ago, internationalism said:

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

What is a secondary care hospital?

 

[Sheryl]

2 hours ago, Chris.B said:

What is a secondary care hospital?

 

There is nothing by that name. From the description (less wait, higher cost)  he may mean the after hours clinics /special clinics that most larger govt hospitals have. 

[PJ71]

3 hours ago, The Hammer2021 said:

Very sad. And possibly impossible to fix  because  it is an ideological  issue but affordable health care works in France and Germany. The problem is that 'privatisation ' is a toxic  word associated  with the  cruelest  aspects of the American  health  care system.

So you get local news?

Im amazed  at how many people  have no idea about  what is happening  in the UK.

I use a free website  that has all the UK newspapers  for free

Yes i use an app called Radio Garden, free for hundreds of radio stations worldwide.

[PJ71]

3 hours ago, KannikaP said:

And someone I know got a TURP for Bht60k at the local hospital with no problems whatsoever.

TURP?

[Sheryl]

If you want to self insure I would agree re  mnot less than 4 million baht.  Note that you will need to be able to replenish it as used. 

 

You are still young enough (assuming no chronic health issues) to get a good internationally issued expat health policy but in a few years will not be so think this through carefully. 

 

Most people who can afford to truly self insure still get health insurance as a means of protecting their assets. Major exception being those who can't get insured due to pre-existing conditions. But up to you. As long as you can put adequate  funds aside and replenish them as used, it'll work. Whether you will end up ahead or behind financially that way is a roll of the dice. Odds favor coming out ahead but you could end up way, way behind and no way to know in advance. 

 

I say "truly self insure" because I have found that most of the expats who describe  themselves as self insured are actually uninsured. 

[1FinickyOne]

6 hours ago, rumak said:

People who say that there is no such thing as "self insurance"  are definitely mistaken

I agree for many of the same reasons... insurance companies can decline to pay and do you really want to be fighting w/an insurance co when you are ill? And even if covered, face rising interest rates forever and to what heights? And they do have a point, in fairness, I would not want to take the risk of insuring an 80 year old... 

 

I also see that many people here might self insure and be covered for one incident, so for example 1MM baht might cover an illness event, but what about the next time? the next illness after the $$ is gone? And costs of medical procedures are going up too. 

 

As I get older, I have been defining being elderly as a feeling of vulnerability. We are all more vulnerable both physically and financially both when we are insured and not. Insurance costs will go up as we age and even more so if we have an event... Uninsured w/savings will be depleted by an event and will evaporate entirely w/a few events and will an elderly person have the income needed to save enough to replenish their own funds? 

 

I have known over 80 year olds who lost their savings to scams - - dementia comes along slowly. Things are not the same as the world changes. 

 

ok. Sorry if this is getting depressing. But isn't this the abyss that many of us are looking into? 

 

ps - and most of us here have family connections. How much would you pay for a wife or child if they fall ill? The 30 baht plan might not provide the care needed. 

Edited August 21, 2022 by 1FinickyOne

[Lorry]

4 hours ago, scubascuba3 said:

Bangkok Pattaya was 50k a night ICU.

555

10 or 20 years ago?

It's almost 150k now, not less than 100k

 

If you are happy with the medical system of a middle-income country,  4m is way more than enough. 

Be sure you know what that means.

 

If you want Western standards,  dialysis more than in the UK, modern oncology, good ICU, the latest medicines, maybe even rehab....4m is hardly enough for a lifetime. The private hospitals who give you this standard are now more expensive than in Europe. Average lifetime medical costs there are about 200,000 € (7m baht). That's the average. 

 

I do know 2 guys who have very good insurance (1000 US per month) and who are way ahead already (one used just 3m just this year). They are not yet really old, and  not less healthy than the average Pattaya expat. 

 

Medivac by Air Ambulace to Europe about 100,000 €, to US more. 

By commercial flight not less than 20,000

[Chris.B]

3 hours ago, SteveBull said:

I know someone who was taken to Bangkok Hospital with his second heart attack and they told him the procedure would be circa 2m, he had the cash but couldn't access it immediately and asked how long he had to pay - they replied he wouldn't make it through the night unless he could prove he could underwrite the whole amount.

If this was his second heart attack, I doubt if he was insurable anyway?

 

[Adelphi]

52 minutes ago, Sheryl said:

If you want to self insure I would agree re  mnot less than 4 million baht.  Note that you will need to be able to replenish it as used. 

 

You are still young enough (assuming no chronic health issues) to get a good internationally issued expat health policy but in a few years will not be so think this through carefully. 

 

Most people who can afford to truly self insure still get health insurance as a means of protecting their assets. Major exception being those who can't get insured due to pre-existing conditions. But up to you. As long as you can put adequate  funds aside and replenish them as used, it'll work. Whether you will end up ahead or behind financially that way is a roll of the dice. Odds favor coming out ahead but you could end up way, way behind and no way to know in advance. 

 

I say "truly self insure" because I have found that most of the expats who describe  themselves as self insured are actually uninsured. 

Thank you Sheryl and others for many well balanced and thoughtful responses.  My health is good.  I tend not to trust insurance companies but I take your point about safeguarding assets.  You suggested that I consider a good international expat health policy.  Can you suggest which companies I might consider?  If you would rather not do this publicly then perhaps you might PM me.  

[peterfranks]

3 hours ago, SteveBull said:

I know someone who was taken to Bangkok Hospital with his second heart attack and they told him the procedure would be circa 2m, he had the cash but couldn't access it immediately and asked how long he had to pay - they replied he wouldn't make it through the night unless he could prove he could underwrite the whole amount.

Exactly, so those on this thread that think they can self insure with 1 million baht in the bank, and claim they have to treat you, keep you alive etc , are delusional.

[Lorry]

4 hours ago, SteveBull said:

 

I know someone who was taken to Bangkok Hospital with his second heart attack and they told him the procedure would be circa 2m, he had the cash but couldn't access it immediately and asked how long he had to pay - they replied he wouldn't make it through the night unless he could prove he could underwrite the whole amount.

Very unusual. 

Usually they will ask for  a deposit of 50,000 or 80,000 baht,  even if they know that the final bill will be much higher. 

I have once heard of a 500,000 baht deposit,  never heard of more.

 

Was it Bangkok Pattaya hospital? Due to the prevailing culture in this resort and due to their fine selection of clientele, they have less scruples.

[Sheryl]

48 minutes ago, Adelphi said:

Thank you Sheryl and others for many well balanced and thoughtful responses.  My health is good.  I tend not to trust insurance companies but I take your point about safeguarding assets.  You suggested that I consider a good international expat health policy.  Can you suggest which companies I might consider?  If you would rather not do this publicly then perhaps you might PM me.  

At age 62 I'd suggest April Global (not April Thailand). Issued out of France and governed by EU insurance regs.  https://fr.april-international.com/en/living-abroad/myhealth-international

 

Get through a broker, do not get it (or any other poljcy) directly on your own as they will help with any issues with claims. I used Jenny at AA brokers <[email protected]> Just hospitalization cover (Essential plan, includes outpt cancer treatment and dialysis ) and take at least $500 deductible. 

 

Careful if trying to get info online as once you type in Thailand it may  revert to April Thailand which is a Thai company under Thai regulation  which I do not advise. 

[The Hammer2021]

2 hours ago, PJ71 said:

Yes i use an app called Radio Garden, free for hundreds of radio stations worldwide.

http://www.wrx.zen.co.uk/britnews.htm

Excellent  for newspapers including mail, guardian,  independent, Spiked  the Red tops and many magazines

[scubascuba3]

4 hours ago, peterfranks said:

Exactly, so those on this thread that think they can self insure with 1 million baht in the bank, and claim they have to treat you, keep you alive etc , are delusional.

Maybe you're delusional, in my example further up one govt hospital kept a guy alive for 6 months while in a coma, with no proof of money from anyone, he reckons they have to take care, of course that won't mean expensive ops

[scubascuba3]

The other thing to factor in is quality of insurance, i reckon a small minority of expats have good insurance, others go for the cheap option, ignorance is bliss and all that, poor coverage, history of denying claims, premium increases, questionable financial backing 

Edited August 21, 2022 by scubascuba3

[4MyEgo]

9 hours ago, jerrymahoney said:

That's funny. All my big medical expenses both in Thailand and while still in US were related to exercising.

Everything in moderation and within your capabilities, my body loves exercise, just wants to keep going and going and going, like a horse let out of the starting gates, but I have to keep it held back, otherwise I will feel the pain for the next couple of days, joints mainly when doing cardio, i.e. if my mind wants to take over, thinking I'm still a new car and not a vintage one.

 

Edited August 21, 2022 by 4MyEgo

[jerrymahoney]

51 minutes ago, 4MyEgo said:

Everything in moderation

That isn't what causes the problems. The horse can be in a light trot and still break a leg stepping in a gopher hole.