Self insure v health insurance

[1FinickyOne]

34 minutes ago, jerrymahoney said:

The horse can be in a light trot and still break a leg stepping in a gopher hole.

is there insurance for that too?

[KannikaP]

8 hours ago, PJ71 said:

TURP?

TransUretheral Resection of the Prostate. Basically cutting part of the prostate away.

[KannikaP]

8 hours ago, Sheryl said:

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. 

Yes, I just had an ultrasound down below. Bht 850, plus Bht 400 because it was after 'office hours' Still had to wait around for a couple of hours.

[Rampant Rabbit]

12 hours ago, The Hammer2021 said:

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

"if"  you  get cancer of the bowel there  is  always the final solution, and thats MY  choice.

[Rampant Rabbit]

28 minutes ago, 1FinickyOne said:

is there insurance for that too?

Not for the gopher!

[jerrymahoney]

I  am not suggesting not to exercise but that exercise has its own risks. For me:

 

Bicycle accident shoulder dislocation capsular ligament tear that required surgery when I fell riding over a railroad track that others in group had no problem.

 

Knee meniscus tear from swimming breast stroke/whip kick Arthroscopic surgery. (Florida) Later required acl reconstruction in Thailand.

 

Bicycle injury (Florida) when hit head on by a Ford F150 pick-up. Fractured collarbone required surgery.

 

Most recent: Hip fracture and later hip replacement from fall AT a swimming pool -- not while swimming -- busted water fountain leak not visible.

[Lacessit]

13 hours ago, The Hammer2021 said:

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

If I got cancer of the bowel, I'd be thinking about an exit with some dignity left.

[Lacessit]

11 hours ago, jerrymahoney said:

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

Perhaps you should stop, you seem to be accident-prone. Or change your modes of exercise.

Given your record, perhaps you should not buy dumbbells.

[Henryford]

13 hours ago, The Hammer2021 said:

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

If you get cancer later in life you are finished anyway. Throwing millions at it won't help, just accept the fact and plan accordingly.  I worked in the NHS and even there friends of mine who got cancer were dead within a year.

Just ask Steve McQueen and Steve Jobs (with unlimited money).

Edited August 22, 2022 by Henryford

[KhunLA]

Depends on 'you', gene pool, family history, life expectancy, age now, and mainly ... 'trust in insurance companies' ... which I lack.

 

I know a few that got dropped when diagnosed terminal, or expensive treatment was obviously needed.

 

Myself, self insured, and never had health insurance.  Carried accident/health ins here for 1 yr and it was useless.  Also inexpensive.  To use had to be an accident, or admitted overnight.  One doc when asked if I could use, he said ... "yea, no prob, but I have to admit you"

 

This ... to have my ears cleaned ... what a scam as usually a 15 min office visit, for the mini pressure wash ... ????

 

Keep at least 1 mill for oops / health ins.   Far less money that I would have spent over the past 48 years of ins. premiums if I had.

 

At 67, it would be a be expensive, and they'd drop my here at 70-75-80 anyway.  So why bother, and anything I would actually need it for, would be some terminal diagnosis, which case, they'd probably drop me or find some silly excuse not to cover.

[Excel]

1 minute ago, Henryford said:

If you get cancer later in life you are finished anyway. Throwing millions at it won't help, just accept the fact and plan accordingly.  I worked in the NHS and even there friends of mine who got cancer were dead within a year.

My Father lasted 3 months so no amount of wasted money on private health insurance would have benefitted him. The only ones to benefit are the insurance companies and the brokers, the latter I suspect are amongst this forum's members judging by some of the comments.

[Lacessit]

I keep 500K baht set aside for medical emergencies. If that's not enough, so be it. I am not going to leave my GF a pauper by paying for overpriced, greedy private hospital treatment that may only give me a bit more lifespan. She is under instructions to get me to a government hospital if needed.

 

I am uninsurable, with a list of pre-existing conditions as long as my arm. Ironically, the medicos assure me none of those conditions are going to kill me.

 

What irks me is sanctimonious posters intoning if one does not have health insurance, they should not be in Thailand. Spare me your vacuous bletherings, one size does not fit all.

 

[4MyEgo]

2 hours ago, jerrymahoney said:

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.

So what's the problem my dear Watson ?

[rumak]

9 hours ago, Sheryl said:

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

I do not find that.   The different circumstances involved means that IMO  there is no right or wrong.   I think healthy people that pay exhorbitant ever increasing amounts to (in many cases) dishonest companies are nuts.    OTOH  you and some others think that in the relatively rare cases of long term drastic health issues that might crop up  for some people....... that would be into the millions of baht (no one i have known here over many many years,  but surely you will know some)  .....  tilt the table in favor of shelling out lots of money to these companies.  

Of course,  as we know,  if one has pre existing conditions AT ANY TIME  ,  even if not affecting their current insurance,   then the company can just say  bye bye.    For me,  i don't like the odds.     But certainly those who have conservative views will see insurance as the way to go,

until they have a bad experience getting paid .   When i google to find facts and figures of the number of people complaining about health insurance companies i get just the opposite.  WHY ?   Because Google is mainstream , biased

,  and naturally chooses to put pages and pages of paid for responses at the front of the que.    People who do not know this ( a few very obvious examples on every forum)   love to post links to these biased facts, studies, etc ..   

I do have one link however :https://www.decof.com/documents/insurance-company-tricks.pdf

 

Summary:   to each his own.   

[The Hammer2021]

1 hour ago, Henryford said:

If you get cancer later in life you are finished anyway. Throwing millions at it won't help, just accept the fact and plan accordingly.  I worked in the NHS and even there friends of mine who got cancer were dead within a year.

Just ask Steve McQueen and Steve Jobs (with unlimited money).

Incorrect 'Both in medical  terms and your lack of humanity. Your attitude  speaks  volumes about the  NHS not about international standards  of medicine.

If a person has medical  insurance they would not be 'throwing money away'.

Your comment  sounds cruel and almost spiteful  in its insensitivity  to all the forum readers who are fighting cancer or have loved ones fighting cancer.

The OP is 62. To suggest  somebody of his range couldn't  survive  cancer is wrong and misleading. Also very irresponsible. There are different  cancers and different DNA profiles- some cancers are treated more successfully than others.

If you have medical  insurance  you  can explore  these chances and options.

Edited August 22, 2022 by The Hammer2021

[The Hammer2021]

1 hour ago, Lacessit said:

If I got cancer of the bowel, I'd be thinking about an exit with some dignity left.

Medical  insurance  allows you to explore more options that include dignity. You don't get  more choice by no medical  insurance.

[Sheryl]

1 hour ago, Lacessit said:

If I got cancer of the bowel, I'd be thinking about an exit with some dignity left.

Colon cancer is fully curable through simple resection  if caught early. (Hence the recommendation for periodic colonoscopies).

[Chris.B]

8 hours ago, The Hammer2021 said:

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

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

I just used it clicking on The Times and a subscription notice came up!

 

[Sheryl]

1 hour ago, Henryford said:

If you get cancer later in life you are finished anyway.

 

That is not necessarily the case.

 

Likelihood of surviving cancer primarily depends on:

 

- type of cancer

 

- how early it is diagnosed

 

Bot of those matter far more than age. Plenty of older people do survive cancer (of the types with good prognosis).

[jerrymahoney]

1 hour ago, 4MyEgo said:

So what's the problem my dear Watson ?

The problem is that even though you're in good health, eat right, exercise and drink in moderation, some things could put you in the hospital regardless of the above behavior.

 

But that's OK. Lots of guys on here think self-insurance is the way to go based upon their healthy lifestyle.

Edited August 22, 2022 by jerrymahoney

[jerrymahoney]

2 hours ago, Lacessit said:

Perhaps you should stop, you seem to be accident-prone. Or change your modes of exercise.

Given your record, perhaps you should not buy dumbbells.

that's over a 40 year period. I don't buy dumbbells. And I certainly don't ride a bicycle in Thailand.

[4MyEgo]

5 minutes ago, jerrymahoney said:

The problem is that even though you're in good health, eat right, exercise and drink in moderation, some things could put you in the hospital regardless of the above behavior.

I think you would have less chances of ending up in hospital if you take care of your engine, e.g. good oils vs cra-p oils????

 

6 minutes ago, jerrymahoney said:

But that's OK. Lots of guys on here think self-insurance is the way to go based upon their healthy lifestyle.

Some of us would like to get health insurance to protect our savings, i.e. as mentioned, I was previously insured, however not at the astronomical annual increases they demand, especially when you haven't even made a claim, e.g. no reward, no reduced policy or same amount as the previous year, it's a go for the juggler attitude from the insurer, their attitude is, if they stay, good, if they don't, we have already won over the years because we (the insurer) haven't had any outlay.

[jaideedave]

15 hours 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

I had bowel cancer a few years ago and the the cost was less than 300k.3 weeks after surgery I had kidney failure and that set me back quite a bit. Insurance wouldn't pay for that because renal failure was an exclusion.This was at Queen Sirikit hospital near Sattahip. All okay for now..

[Richard 2020]

16 hours ago, internationalism said:

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. 

This is the offer from Pacific Cross to me...A joke, but a bad one!

 

I am 71 years old, except COPD, according to the findings of the hospital for my age very healthy!
I had to make the examination to be able to make a claim at all!
The examination pays the insurance, but only when the contract is signed!
But that is not important to me! 
I was, I say it kindly "Very Surprised" when I got the offer of the health insurance!
Here is the letter to this insurance, which of course I will not conclude!

 

The letter:

 

Referring to your application for insurance, the company would like to confirm your enrollment based on the completed application form.
The terms and conditions are as follows.
Does not cover the diagnosis and treatment of heart disease and abnormalities diseases and disorders of cerebrovascular disease and diseases and disorders arteriosclerosis, including hypertension and hyperlipidemia, their consequences and complications
Does not cover diagnosis and treatment of emphysema chronic obstructive pulmonary disease, asthma, bronchitis, pneumonia, disease and disorders of the respiratory system and lungs, including sequelae and complications
Does not cover examination and treatment of diseases and disorders of the prostate, urinary tract infections, urinary incontinence urinary insufficiency, lower urinary tract syndrome, including sequelae and complications
(Does not cover examination and treatment related to eye diseases and abnormalities, but does cover eye defects resulting from accidents and casualties
Waiting period(s)
Does not cover diagnosis and treatment of diseases and disorders of the bony joints of the neck and back covered by the policy, include
Complications for a period of 3 years Coverage for acute fractures. will reconsider After this waiting period, however, the requirements for 30% of the joint responsibility for the diagnosis and treatment of such disease apply 
Does not include diagnosis and treatment of moles and skin lesions, including complications, for a period of 3 years and will be reconsidered).
Waiting Period means a condition that was originally excluded from coverage because the Waiting Period was included.
Automatically covered after the expiration of the waiting period. Future coverage of previously excluded conditions is conditional.
When reviewing the customer's most recent claims and treatment history If the customer has undergone a prior examination or treatment Excluded conditions during the waiting period This condition may be considered a condition that exists and does not exist by the insurer.
Protection may be offered in the future. This review will be conducted on a case-by-case basis. Future coverage options may include co-payments.
An application for health insurance must be submitted with a certified copy of the passport or a copy of the identification card of the individuals whose names are certified
to the Company to be lawful, effective and correct.
2: This offer is valid for 30 days after the insurance application form is completed.
3: The policy will come into effect according to the terms of when the insurance premium has been paid.

 

 

My decision:

 

Thus, all possible illnesses for which there is currently no indication from the medical side 
(see hospital report) are excluded from any treatment!
These exclusions include as good as ALL diseases that could occur somehow!
So I pay in case of a hospital stay not only the ca.62.000.- THB contribution, which is the amount with 50% discount, but also 300.000.-THB deductible, and the health insurance rejects all claims, because yes 99% of all possible diseases are excluded!
And for the rest, there is certainly a causal relationship with the diseases excluded from the regulation.
OK, a fracture of the arm or leg would possibly be partially regulated as a gesture of goodwill!
In addition, the biggest uncertainty factor for the future is this passage in your contract conditions:
The insured has the possibility to extend the contract continuously up to the age of 99 years: (If i can still afford it...).
Premium and coverage can be adjusted based on claims history, health status and increasing age.
THAT means for me:
Claims history with me! Health condition that actually does not improve and increasing age, which is pretty sure will lead to exclusions and exorbitant premiums!
Now I seriously ask myself, what should I do with a health insurance that does not pay for illnesses that occur?
Now this is not meant ironically by me, but just a factual statement.
So once again thank you for your kind support and help!

 

[jerrymahoney]

8 minutes ago, 4MyEgo said:

I think you would have less chances of ending up in hospital if you take care of your engine, e.g. good oils vs cra-p oils????

 

Some of us would like to get health insurance to protect our savings, i.e. as mentioned, I was previously insured, however not at the astronomical annual increases they demand, especially when you haven't even made a claim, e.g. no reward, no reduced policy or same amount as the previous year, it's a go for the juggler attitude from the insurer, their attitude is, if they stay, good, if they don't, we have already won over the years because we (the insurer) haven't had any outlay.

If you can't get health insurance at a reasonable price and under reasonable conditions, then no- insurance is the way to go.

[AddyA]

15 hours ago, talahtnut said:

Never had insurance, I just take

the cheap way out and die.

It's a valid point. For example, not everyone wants to be revived after a severe stroke or life-changing accident. Imagine relying on other people to spoon-feed you and wipe your backside for the rest of your days. I would imagine insurance would also be cheaper if you factored that into the policy. I mean, a clause that instructs hospitals not to revive you if it would mean you're permanently incapacitated and need wet nursing 24/7.

[Lacessit]

1 hour ago, Sheryl said:

Colon cancer is fully curable through simple resection  if caught early. (Hence the recommendation for periodic colonoscopies).

My last colonoscopy was four years ago. The doctor said don't bother coming back, at your age if you haven't had cancer, it's unlikely you will get it now.

[rumak]

43 minutes ago, jaideedave said:

weeks after surgery I had kidney failure and that set me back quite a bit. Insurance wouldn't pay for that because renal failure was an exclusion

no need for me to add anything   ????           no matter how clear the writing is,  some people will always look only at the other side of the wall

[riclag]

Spot on with that amount!

 You could even go down to 3 mil!

 

Many years ago while living here,I had a friend from Wales,who was told he had cancer here ! Treatment was quoted at 2 mil! Unfortunately he didn’t have insurance or the 2 mil.

Keep up with your healthcare , you’ll be ok with self insurance imop

[rumak]

57 minutes ago, Richard 2020 said:

This is the offer from Pacific Cross to me...A joke, but a bad one!

 

I am 71 years old, except COPD, according to the findings of the hospital for my age very healthy!
I had to make the examination to be able to make a claim at all!
The examination pays the insurance, but only when the contract is signed!
But that is not important to me! 
I was, I say it kindly "Very Surprised" when I got the offer of the health insurance!
Here is the letter to this insurance, which of course I will not conclude!

 

The letter:

 

Referring to your application for insurance, the company would like to confirm your enrollment based on the completed application form.
The terms and conditions are as follows.
Does not cover the diagnosis and treatment of heart disease and abnormalities diseases and disorders of cerebrovascular disease and diseases and disorders arteriosclerosis, including hypertension and hyperlipidemia, their consequences and complications
Does not cover diagnosis and treatment of emphysema chronic obstructive pulmonary disease, asthma, bronchitis, pneumonia, disease and disorders of the respiratory system and lungs, including sequelae and complications
Does not cover examination and treatment of diseases and disorders of the prostate, urinary tract infections, urinary incontinence urinary insufficiency, lower urinary tract syndrome, including sequelae and complications
(Does not cover examination and treatment related to eye diseases and abnormalities, but does cover eye defects resulting from accidents and casualties
Waiting period(s)
Does not cover diagnosis and treatment of diseases and disorders of the bony joints of the neck and back covered by the policy, include
Complications for a period of 3 years Coverage for acute fractures. will reconsider After this waiting period, however, the requirements for 30% of the joint responsibility for the diagnosis and treatment of such disease apply 
Does not include diagnosis and treatment of moles and skin lesions, including complications, for a period of 3 years and will be reconsidered).
Waiting Period means a condition that was originally excluded from coverage because the Waiting Period was included.
Automatically covered after the expiration of the waiting period. Future coverage of previously excluded conditions is conditional.
When reviewing the customer's most recent claims and treatment history If the customer has undergone a prior examination or treatment Excluded conditions during the waiting period This condition may be considered a condition that exists and does not exist by the insurer.
Protection may be offered in the future. This review will be conducted on a case-by-case basis. Future coverage options may include co-payments.
An application for health insurance must be submitted with a certified copy of the passport or a copy of the identification card of the individuals whose names are certified
to the Company to be lawful, effective and correct.
2: This offer is valid for 30 days after the insurance application form is completed.
3: The policy will come into effect according to the terms of when the insurance premium has been paid.

 

 

My decision:

 

Thus, all possible illnesses for which there is currently no indication from the medical side 
(see hospital report) are excluded from any treatment!
These exclusions include as good as ALL diseases that could occur somehow!
So I pay in case of a hospital stay not only the ca.62.000.- THB contribution, which is the amount with 50% discount, but also 300.000.-THB deductible, and the health insurance rejects all claims, because yes 99% of all possible diseases are excluded!
And for the rest, there is certainly a causal relationship with the diseases excluded from the regulation.
OK, a fracture of the arm or leg would possibly be partially regulated as a gesture of goodwill!
In addition, the biggest uncertainty factor for the future is this passage in your contract conditions:
The insured has the possibility to extend the contract continuously up to the age of 99 years: (If i can still afford it...).
Premium and coverage can be adjusted based on claims history, health status and increasing age.
THAT means for me:
Claims history with me! Health condition that actually does not improve and increasing age, which is pretty sure will lead to exclusions and exorbitant premiums!
Now I seriously ask myself, what should I do with a health insurance that does not pay for illnesses that occur?
Now this is not meant ironically by me, but just a factual statement.
So once again thank you for your kind support and help!

 

I await the pro insurance advocates answers to this AMAZING  post .    thank you sir.     What would have been the cost of this very generous contract offered to you by the wonderful  and caring insurer ?

Edited August 22, 2022 by rumak