When does it become time to put money aside in a separate account and self insure?

[dingdongrb]

1 hour ago, scubascuba3 said:

for many heart attacks and strokes you aren't in an ICU or coma, a guy i know had a heart attack and went to a govt hospital got treated quickly, stent inserted, pretty cheap

Almost described me perfectly......  However I was in ICU for 4 days......stent placed.....government hospital..... no complaints except the food.....  ????

 

160k THB

[dingdongrb]

1 hour ago, Lacessit said:

I self insure because I have to. 80 yo, pre-existing conditions. An application from me here would probably cause merriment among insurance writers..

I do, however, have top level private health cover in Australia. If I have a heart attack or stroke, so be it. Anything else requiring hospital, I am on a plane to Australia.

 I checked health insurance premiums here when I was 72. IIRC it was 300,000 baht/year with no pre-existing conditions.

Good plan but what happens when you are too critical to be on a plane?

[bradiston]

56 minutes ago, ChrisKC said:

This is easy! NOW! start by putting a little aside per month and gradually increase as you age a bit.

 

Saving for any emergency is a wise move!

 

61 is NOT too old to have Health Insurance and for you to decide if affordable.

 

Start something now. Bangkok Bank, and others I assume, you can get Accident Insurance for less than B5,000 per year and covers you Worldwide.

Yes, but PAI covers next to nothing in medical expenses. 200k, maybe 300k, at most. Not much use in a serious RTA, for instance.

I'm 73. I only started medical insurance a year ago. I have Afib. I pay 10,401 THB pm. My heart is now covered after a 6 month moratorium ended. I thought about lowering the cover, $400,000, to $200,000, and upping the deductible to $5,000, in order to lower the premium, in theory, to about 6750 THB pm. But I'd have to reapply, and all the premiums have gone up, so it isn't worth the hassle. I haven't made a successful claim, so my premiums are locked in, so I'll continue them at 10,401 pm, a lot less than the current prices I think. It's ironic I suffered my worst fear, a fall, a claim for which was refused, as it only involved OP, and cataract surgery the same. So I had a month or so grinding my teeth, thinking what the heck am I paying for, and then thought, well, is any really useful education free? The fall only cost in all about 10k THB in hospital visits, CT scan, X ray etc. And I can live perfectly well with the incipient cataracts. $400,000 would go some way, maybe all the way, to meeting costs for chronic/catastrophic illness/injury, which is the main concern. For just over 10k pm, can I complain? No, I don't think so.

 

PS My insurers are WRLife.

[Gecko123]

Just some random comments in reaction to previous posts...

 

1. You might not be fit to fly in the event of a medical emergency, so you may not be able to return home on a timely basis to utilize home country insurance. Forum member Nancy L, RIP, pointed this out years ago.

 

2. Medical costs in Thailand appear to be rising considerably, and this should be considered if you are relying on self-insurance.

 

3. From what I've seen, life insurance and medical insurance policies in Thailand often contain clauses which are not particularly policy holder friendly. This particularly applies to sub-limits for specific types of medical conditions (like kidney disease), which are stated clearly in the policy. As unfair as these terms and conditions might seem when they are only discovered at the time a claim is made, this is not the same thing as an insurance company "looking for a way to not pay a claim."

 

4. One positive that can be said about self-insuring is that, when you know that any medical expenses will have to be paid out-of-pocket, many people will make lifestyle choices (exercise and diet) and avoid hazardous activities (drinking while driving, wearing safety belt)  that will minimize their risk of landing in the hospital.

[newnative]

    This is something I have certainly struggled with.  I moved to Thailand in 2010 and I took health insurance with April International out of Paris in 2012.  I chose the cheapest 'Essential' plan.  My only pre-existing condition was elevated cholesterol.   I can't remember what I was paying then--maybe around $1400 a quarter--but my premiums rose every year.  By 2021, I was paying around $2340 a quarter, depending on the dollar to euro exchange rate.  

    I inquired about reducing my premiums and I adjusted my plan to 80/20.  April pays 80% and I pay 20%.  At some point I had dropped outpatient coverage to save money and I think that year I added it again. I  The new premium was around $2180 a quarter for 2022.

    This year I aged up to the over 70 bracket and I had a huge jump from around $2180 to around $2900 a quarter.  Mind you, this is a quarter, not yearly.  So, $2900 times 4 quarters equals $11,600 a year.  About 412,000 baht at current exchange rates.  Yikes.  If you can afford to save that amount, and are rigorous in doing it, you'd have a fairly large amount after 4 or 5 years to help self-fund any medical bills. 

    In case you're wondering, I didn't have any major medical bills since my 2012 enrollment.  The largest 2 bills were for 2 colonoscopies in the 10 year time period, which April covered.  I didn't submit claims for routine stuff like annual physicals, trips to the doctor for shots, treatment for colds, etc.

     Around three or four years ago I investigated switching to a different western insurance company but what I found at that time was that the savings wouldn't be very much and I would be starting over with a new company regarding anything medical coming up.  I thought there was a better chance that April might cover something since I have been a customer for a number of years.  I almost switched to a local health insurance company several years ago because it was much cheaper, but I was worried about whether claims would be honored or rejected.

     At this point I will bite the bullet and continue with April--they tell me this year's huge jump won't be repeated.   In hindsight, I think I should have switched to the local company while I was still young enough to be accepted, while at the same time putting the money I would have saved in lower premiums into a savings account earmarked to help cover any medical expenses that might not have been covered.   The OP might consider doing something like this.

[JeffersLos]

Getting good insurance and getting a good insurance payout are two very different things. 

 

Could jest well be a lot of money down the toilet. 

[jesimps]

3 hours ago, bignok said:

We all die. Nobody except the top 2% have loads of money.

There's also the fact that the more elderly of us almost without exception have at least one pre-existing condition, which even if we can find a company to insure us, makes it prohibitively expensive. I've been here 16 years and self insure, that means I'd have paid out about 1.6 million baht for a small local op to remove a growth on my eye costing 8000 baht and to have my ears syringed 2000 baht. I used to have accident insurance with my bank until they refused to renew the policy when I turned 65. 

I'm fit (jog every other day), eat the right food and I'm the correct weight for my age and height. I reckon that's better insurance than being with a company that isn't guaranteed to pay out.

[scubascuba3]

58 minutes ago, Gecko123 said:

Medical costs in Thailand appear to be rising considerably, and this should be considered if you are relying on self-insurance.

There are options available such as good govt hospitals, even India only 2 hours away and apparently very good hospitals and clinics and much cheaper than Thailand, certainly worth investigating 

[scubascuba3]

1 hour ago, bradiston said:

My heart is now covered after a 6 month moratorium ended

Have they confirmed that? that 6 month thing seemed like a giant fake carrot

[Rotweiler]

3 hours ago, K2938 said:

So if you are not part of your self-defined top 2%, you should get insurance.  Simple as this.

Absolute nonsense.  Self-insurance in TH is the way to go to make sure there is sufficient to cover remediable medical events.

[1FinickyOne]

4 hours ago, bignok said:

Holiday account, health account. $50 a week into each.

He is 61.. That is way too little - unless he never ever gets sick - then he is fine... 

[1FinickyOne]

10 minutes ago, scubascuba3 said:

certainly worth investigating 

before you get sick or after?

[scubascuba3]

11 minutes ago, 1FinickyOne said:

before you get sick or after?

before or during, up to you, obviously not for emergencies

[JimTripper]

I just got a policy with a high deductible/no outpatient, just for something serious. Anything else I pay out of pocket.

 

My line in the sand is when premiums would require tapping into savings. In that case the insurance would be downgraded further or cut.

 

What you want to avoid in the present is running out of money. You never know if your going to get sick or not. The important thing is not drawing down your savings.

[jcmj]

My insurance here, which originally was BUPA Thailand and has been acquired by several companies and now is Allianz Ayudhya cannot cancel my policy. I’m not sure what age you have to have started it, for this clause, but well worth looking into. I only have IPD and they have always paid the bill, minus a few sleeping tablets or something that is not really required. I may have to pay 800 baht or when I have been in longer with a more serious condition it may be as much as 8,000 baht that they deny. I have also always been reimbursed for any appointments or required medication for the 30 days after release. You just need to read the policy and ask the important questions. I only have high blood pressure as a pre existing condition. Any that happen after I had my policy are never added to the list when I pay for the next year. They can increase it max 10%. You’re still young enough to get a good plan that will cover you if you don’t have a lot of pre existing conditions. I wouldn’t risk it. International plans are always much more expensive and most do not cover the US. The devil is in the details so just cross your t’s and dot your i’s. Good luck. 

[khunPer]

5 hours ago, Scouse123 said:

 

After seeing recent postings on this board of insurance companies doing anything to get out of paying and null and voiding accounts with ' small print clauses ' I am wondering if these premiums are a waste of time and would I be better off just putting those fees in a separate ' health account '

When I settled in Thailand in my late fifties, I decided to opt for the second best at that time of Bupa's health insurances and set the difference to the cost of the best insurance aside in a "Rainy Day-account". Also because that there might be/often are cases, where the insurance do not fully covers you, or don't covers at all.

 

When I passes 60 years the insurance increased and I stepped a level down and set more aside. Again at 65 was a mile marker, where I decided it's not worth it anymore. I've never ever used my health insurance and got a 10 percent discount when renewed, but with a until then – and also until now – good health, I decided to top up little extra in the Rainy Day-account and become self-insured. I'm still paying an "insurance fee" every month into my Rainy Day-account.

 

It's a difficult personal choice, as when self-insured and something happens, you might spend all or most of the money set aside. While when insured, you are still insured next year; as long as you can afford the premiums. Some with health knowledge have mentioned in this forum that you need to set 3 million baht aside – or have access to a larger sum of savings up around that level – so it's a question of balance between annual insurance premium, size of savings and one's health, combined with what you personally think is the right size for you. The initial insurance sum for the so-called "retirement visa" was 440,000 baht; so anything between that sum and several millions might be the right self-insurance amount.

[FritsSikkink]

4 hours ago, scubascuba3 said:

Those insured should also be self insured as a "claim denied" is likely and common.

 

Being self insured is more common than people think, some have enough money and some don't.

 

i self insure because i don't trust insurance companies to pay out on some things and if you can't be sure they will pay why bother paying premiums.

 

I don't put any money in a separate account i just know I'll need to pay for it from savings and investments. For some very serious conditions like cancer I'll probably go back to UK NHS unless over a certain age then won't bother getting treatment

Have a private Thai insurance through work and they always pay. Also have Social Security and will keep paying into that after retirement. 

[bradiston]

1 hour ago, scubascuba3 said:

Have they confirmed that? that 6 month thing seemed like a giant fake carrot

I double checked by ringing them and emailing them so I got it in writing. I outlined a scenario where I had a cardiac arrest or some other major coronary event. Would I be covered in the light of my Afib. They confirmed I would be covered.

[mudcat]

A helpful guide on travel when seriously ill from EVA.  I investigated this to reassure my wife that we would get her home if she could not manage flying without special accomodation. 

 

This may not apply in your case if you are under the care of the medical system and want to return to your home country.  Check with your carrier.

https://www.evaair.com/en-us/fly-prepare/special-assistance-and-inquiry/medical-conditions/

 

For U.S. citizens you should investigate what is necessary to get care under Medicare and how whether you have continued to pay your Part B premiums affects waiting period.

[Denim]

4 hours ago, BritManToo said:

Forget insurance, accept death when it comes! 

Agreed. I'll be 66 soon so not the worst of innings. The main thing is pain relief when the time comes.

 

I have a gut feeling that I will drop down dead immediately after I go to an ATM machine to withdraw my first State Pension payment.

[Neeranam]

50 is a good age to start saving for health insurance

 

[4MyEgo]

5 hours ago, London Lowf said:

I sometimes look at things from an unusual perpective.....

 

Insurance is gambling - the underwriter/actuary has calculated the chances of you making a claim and offers you a premium that they reckon will make them money - they are a business, after all.

 

By paying the premium you are effectively punting on the fact that they got their figures wrong and that your chances of getting sick are higher than they think - that's the only way you can "win".

 

By self-insuring you are denying the insurance industry their profits - but also taking a chance. However, the odds ARE in your favour.

 

(In much the same way, the odds of winning the lottery are stacked against you, but people still do it and some do win)

 

I don't agree that you are looking at it from an unusual prospective, and agree, insurance is gambling, however most reparable insurers will pay the claim providing you are not breaching the agreement in any way or form.

 

When I came to Thailand, no insurer would include my pre-existing condition that I had, which has never caused me an issue since I first had it in 2008 so I self insured for 2 years.

 

A broker found me an insurer that would cover it for a separate premium amount which covered that pre-existing condition, but not before they received all the paper trails that I had from my Dr and Specialist, including all the blood tests that I had annually, meaning I had a good clean file on every visit etc.

 

My premium started off at 70,000 baht per annum from age 57 and went up every year, by the 4th year it reached 150,000 baht age 61 (new bracket), when I queried the big jump in the 4th year, e.g. from 110,000 baht to 150,000 baht, I was told it was because the insurer changed underwriters.

 

I am now 63 and have self insured for the past 2 years, I put aside 250,000 baht for myself and another 100,000 baht for the family, which was also increasing every year, thus far I have 700,000 aside and due to add another 350,000 baht which will take me just over the million baht mark.

 

The above said, it's not enough, but I have savings that exceeds that 10 fold easily, (not bragging) just stating the fact, which I hope that I never have to use, but as you say, it's a gamble and short of the insurers gauging me every year with their increase (without any claims) from me or my family, I feel better that the money that would have gone to their every rising annual premiums are back in my pocket.

 

I have also found out that there are some pretty good government hospitals out there, if and when a situation arises, failing that one could bite the bullet and go to the private or go back home.

[Lacessit]

3 hours ago, dingdongrb said:

Good plan but what happens when you are too critical to be on a plane?

Then I have a problem which my GF will have to deal with. She knows to get me to a public hospital, as I have no desire to fill the pockets of a private one

 at her expense.

[1FinickyOne]

3 hours ago, JimTripper said:

The important thing is not drawing down your savings.

That would depend on how much you have in savings... 

[TravelerEastWest]

8 hours ago, bkk6060 said:

The self insured folks I know seem foolish.  100 to 500 k is very little for a major illness or accident.

Unless you have about 2 million today in an account for this, you are way under insured.  Good luck.

If your age and health prevent insurance with coverage why would it be foolish to self insure?

 

I agree that you need more than 500,000 baht put aside for care in a private hospital and after seeing teh horrible conditions in public hospitals I would not consider them for anything except a car accident when they are close by...

[London Lowf]

I have just turned 70 and take six meds a day - what are my chances of getting covered.

 

By the way, all of my pre-existing conditions are fully controlled by these pills and are of no consequence to my day-to-day living - but I'd still have to declare them.

 

I did a dummy quotation about a year ago in which I didn't declare anything and the premiums were still shocking.

 

Self-insurance is the only option for people like me.

[Sheryl]

10 hours ago, Etaoin Shrdlu said:

If you only set aside an amount equal to what you would pay in premiums each year, you would be seriously underfunded. You'd need several million baht from day one in order to address a catastrophic accident or illness, assuming you'd wish to be treated at a private hospital. Less, but still significant amounts, if treatment is sought at a government hospital. We just never know when we will fall ill or have an accident, even if we are otherwise healthy.

 

I would suggest looking into health insurance from insurers located outside Thailand. Coverage is often better as is claims-paying attitude and consumer protection laws.

This.

 

I would add you not only need to be able to immediately put aside several million baht but also have a way to replenish it as used. 

 

In my experience most of the expats who say they are "self insured" are not really. They are uninsured or under-insured. 

 

At 61 years and still healthy you can get a good policy without difficulty. That will change as you near 65 (or develop a health problem -- as you eventually will, good health does not last hmforever) ) so I would advise acting sooner rather than later. 

[Sheryl]

16 minutes ago, London Lowf said:

I have just turned 70 and take six meds a day - what are my chances of getting covered.

 

By the way, all of my pre-existing conditions are fully controlled by these pills and are of no consequence to my day-to-day living - but I'd still have to declare them.

 

I did a dummy quotation about a year ago in which I didn't declare anything and the premiums were still shocking.

 

Self-insurance is the only option for people like me.

Depending on what the conditions are for which you take medication you may be right. Especially if one of them is diabetes. 

 

The best insurer for people with stable well controlled conditions seems to be Cigna Global. 

 

[Sheryl]

31 minutes ago, TravelerEastWest said:

If your age and health prevent insurance with coverage why would it be foolish to self insure?

 

I agree that you need more than 500,000 baht put aside for care in a private hospital and after seeing teh horrible conditions in public hospitals I would not consider them for anything except a car accident when they are close by...

If your are unable to get insurance then certainly you should self insure.

 

The problem is that few can afford to self insure adequately. 

[Dan O]

8 hours ago, London Lowf said:

I sometimes look at things from an unusual perpective.....

 

Insurance is gambling - the underwriter/actuary has calculated the chances of you making a claim and offers you a premium that they reckon will make them money - they are a business, after all.

 

By paying the premium you are effectively punting on the fact that they got their figures wrong and that your chances of getting sick are higher than they think - that's the only way you can "win".

 

By self-insuring you are denying the insurance industry their profits - but also taking a chance. However, the odds ARE in your favour.

 

(In much the same way, the odds of winning the lottery are stacked against you, but people still do it and some do win)

 

The term "Self Insured" is an inaccurate term in my opinion as it implies that you have sufficient assets set aside just for Medical Emergencies. Oddly there is no guide or directive that shows how many assets you must have set aside for "Self Insurance".  Self pay is a more accurate term to be used unless you have assets segregated exclusively and sufficiently to cover the major medical expenses that could occur, which I'm betting most people dont.