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

[spidermike007]

Now is the best time. Just say no to the insurance mafia. It feels good. 

[scubascuba3]

1 hour ago, VirgoSG said:

With a GBP2,000 (voluntary) deductible, aged 75, my annual (worldwide excluding USA) premium this year is GBP5,300 (about THB230,000)

Out of interest at what premium level (baht) would you cancel? most people have probably got an upper limit

[Yellowtail]

3 minutes ago, scubascuba3 said:

Out of interest at what premium level (baht) would you cancel? most people have probably got an upper limit

If I could get the same Cigna policy I had when I was working for US$12,000 a year, I would take it. 

[Sheryl]

3 hours ago, save the frogs said:

What I'm getting from this thread ...

 

Having no insurance or bad insurance will bankrupt you.

 

And paying for proper insurance eliminates the lower cost of living in Thailand. 

 

Reduces, but certainly does not eliminate.

 

And many of us would have as much or even  higher medical expense if back in oud home countries. 

[TravelerEastWest]

On 7/5/2023 at 9:11 AM, Yellowtail said:

Do you not have a credit card? 

I do - maybe that is the answer - just charge the first expenses... Good thinking

[TravelerEastWest]

On 7/5/2023 at 11:20 AM, scubascuba3 said:

That's where the 800k in the bank non Imm O might come in useful for a medical emergency, will get them to treat you. Waiting to sell shares etc is too long

You are right, but at the most I have been asked by immigration for 400,000 and that's only for I think two months before the annual extension - not sure but is retirement 800,000? I have two kids in high school so until college is done I will be working... maybe longer as I like to work.

[Sheryl]

3 hours ago, TravelerEastWest said:

You are right, but at the most I have been asked by immigration for 400,000 and that's only for I think two months before the annual extension - not sure but is retirement 800,000? I have two kids in high school so until college is done I will be working... maybe longer as I like to work.

Yes 800 for retirement, 400 is for marriage.

[jerrymahoney]

10 hours ago, spidermike007 said:

Now is the best time. Just say no to the insurance mafia. It feels good. 

What is referred to on here as self-insurance is really self-pay.

Insurance involves the sharing of risk and at least the possibility of getting back in paid claims more than you put in as premiums.

With self-insurance, as used on here, what you got is what you got.

[Yellowtail]

8 hours ago, TravelerEastWest said:

I do - maybe that is the answer - just charge the first expenses... Good thinking

And if you die you don't have to pay the bill. 

[mania]

13 hours ago, save the frogs said:

What I'm getting from this thread ...

 

Having no insurance or bad insurance will bankrupt you.

 

And paying for proper insurance eliminates the lower cost of living in Thailand. 

 

Maybe somewhat true about reducing the lower cost of living in Thailand but......

 

I wish I was there now. I am here in the US & in a State that is expensive cost of living & yet you get almost nothing for your insurance

 

When we visit Thailand 3 months a year I am happy to pay for diagnostics I may want & can just get them NOW

 

We often think of moving back full time to Thailand but then say ...yeah but insurance is free here (Medicare)

But truthfully it is crap

 

For instance just today ...

Tried to see a doctor & am told soonest will be Late August maybe early Sept!

I am in great health eat well, exercise no smoking etc but I have had a nagging dry cough for a few weeks.

 

I tried a few different ways & at various locations to get seen & always the same reply...Late Aug.

If I were in Thailand now I would walk into a fine hospital & be seen & diagnosed today I'm certain & at a fair price

 

So yes you pay there but at least are served nicely/promptly

 

At this rate I may as well wait till Oct when we are back there. But hate to think of having a cough that long.(If that is the case)

 

I think that is why so many here are seen then diagnosed with something serious as it festers so long

Edited July 7, 2023 by mania

[scubascuba3]

4 hours ago, mania said:

Maybe somewhat true about reducing the lower cost of living in Thailand but......

 

I wish I was there now. I am here in the US & in a State that is expensive cost of living & yet you get almost nothing for your insurance

 

When we visit Thailand 3 months a year I am happy to pay for diagnostics I may want & can just get them NOW

 

We often think of moving back full time to Thailand but then say ...yeah but insurance is free here (Medicare)

But truthfully it is crap

 

For instance just today ...

Tried to see a doctor & am told soonest will be Late August maybe early Sept!

I am in great health eat well, exercise no smoking etc but I have had a nagging dry cough for a few weeks.

 

I tried a few different ways & at various locations to get seen & always the same reply...Late Aug.

If I were in Thailand now I would walk into a fine hospital & be seen & diagnosed today I'm certain & at a fair price

 

So yes you pay there but at least are served nicely/promptly

 

At this rate I may as well wait till Oct when we are back there. But hate to think of having a cough that long.(If that is the case)

 

I think that is why so many here are seen then diagnosed with something serious as it festers so long

Presumably they don't think it's anything serious hence next appointment August.

 

Truth is Drs don't want to work anymore, in UK 3 days a week is enough for them, hence big wait for an appointment 

Edited July 7, 2023 by scubascuba3

[Yellowtail]

11 minutes ago, scubascuba3 said:

Presumably they don't think it's anything serious hence next appointment August.

 

Truth is Drs don't want to work anymore, in UK 3 days a week is enough for them, hence big wait for an appointment 

Almost no one wants to work. If people wanted to work, they would pay their employer, not the other way around. 

[scubascuba3]

2 minutes ago, Yellowtail said:

Almost no one wants to work. If people wanted to work, they would pay their employer, not the other way around. 

Being a doctor is more of a vocation, helping people and all that, they actually enjoy their job unlike most others, well they did until covid hit

[Yellowtail]

7 minutes ago, scubascuba3 said:

Being a doctor is more of a vocation, helping people and all that, they actually enjoy their job unlike most others, well they did until covid hit

I enjoyed almost every job I had, and I had plenty, but if they quit paying me I'd be out of there so fast you'd be able to shoot-dice on my shirt-tail...

 

The only job I hated was at a commercial laundry in Las Vegas. Even it would have been okay had it not been so f'n hot and stinky. Table linen was the worst. Uniforms were great, but you had to be there years to work them.

[VirgoSG]

22 hours ago, scubascuba3 said:

Out of interest at what premium level (baht) would you cancel? most people have probably got an upper limit

Fortunately, I am financially in a position not to have to ask myself that question.  But, given that AXA International only increases premiums based on total claims experience and medical cost inflation, I find it hard to imagine a stage where the question would arise 

[TravelerEastWest]

10 hours ago, mania said:

Maybe somewhat true about reducing the lower cost of living in Thailand but......

 

I wish I was there now. I am here in the US & in a State that is expensive cost of living & yet you get almost nothing for your insurance

 

When we visit Thailand 3 months a year I am happy to pay for diagnostics I may want & can just get them NOW

 

We often think of moving back full time to Thailand but then say ...yeah but insurance is free here (Medicare)

But truthfully it is crap

 

For instance just today ...

Tried to see a doctor & am told soonest will be Late August maybe early Sept!

I am in great health eat well, exercise no smoking etc but I have had a nagging dry cough for a few weeks.

 

I tried a few different ways & at various locations to get seen & always the same reply...Late Aug.

If I were in Thailand now I would walk into a fine hospital & be seen & diagnosed today I'm certain & at a fair price

 

So yes you pay there but at least are served nicely/promptly

 

At this rate I may as well wait till Oct when we are back there. But hate to think of having a cough that long.(If that is the case)

 

I think that is why so many here are seen then diagnosed with something serious as it festers so long

Best post in this thread by far!

 

I am used to seeing an expert specialist with no appointment in Chiang mai at a cost that is probably the same or less than a US copay.

 

I think if I went home I would experience reverse culture shock...

 

But if my kids settle down in the US i will have no choice but to move back.

[Phulublub]

11 hours ago, mania said:

Tried to see a doctor & am told soonest will be Late August maybe early Sept!

I am in great health eat well, exercise no smoking etc but I have had a nagging dry cough for a few weeks.

Keep trying...a long lasting cough can be an early symptom of some quite serious ailments.

 

PH

[Sheryl]

5 hours ago, VirgoSG said:

Fortunately, I am financially in a position not to have to ask myself that question.  But, given that AXA International only increases premiums based on total claims experience and medical cost inflation, I find it hard to imagine a stage where the question would arise 

They will also raise by age bracket.

 

You can get a chart now showing current rates by age group which will give you an idea of what magnitude of increase to expect and at what age. 

 

The increases are most marked after age 65. For the simple reason that need for medical csre and thus size and frequency of claims substantially increases at that poinh and keeps doing so. 

 

It makes zero sense IMO  to opt out of a policy because of these higher rates in old age since you are at that point quite likely to have a large claim in the forseeable future...and anyone who can't afford insurance premiums certainly can't afford to self pay that.  If unable to afford continued insurance it may be  time to consider a move back home. All of which should have been thought through/planned years in advance, since there is nothing unknown or unpredictable about age related changes in premium.

 

Previous or current state of health and prior use of policy (or lack thereof) is not a good   predictor of   future need for health care  once you are elderly.

 

 

 

 

[Mark Nothing]

I cancelled my health insurance 25 years ago taking personal responsibility for my own affairs.

 

My intuition agrees with natural health practices.  So that has been fully implemented. 

 

One of the important strategies I follow is to pray daily for health, vitality and perfect health which leads to the right books, videos, friends, and strategies to magically appear.  Which results in the right diet, exercise, and hobbies appearing into my life.  This negated my need for doctors, hospitals or insurance.

 

Good luck in your decision.

 

 

[save the frogs]

3 hours ago, Mark Nothing said:

Which results in the right diet, exercise, and hobbies appearing into my life.  This negated my need for doctors, hospitals or insurance.

the inverse is also true.

in countries where health care is free (ie paid by taxes), most people make no effort in maintaining a decent diet / exercise regime.

the free healthcare provides a sense of security. 

so it's a valid philosophy. 

 

Edited July 7, 2023 by save the frogs

[scubascuba3]

11 hours ago, VirgoSG said:

Fortunately, I am financially in a position not to have to ask myself that question

The guy i bought my condo from says he doesn't need insurance, he can pay whatever if the bill comes, he had 17 condos when i bought mine

[mokwit]

6 hours ago, Mark Nothing said:

I cancelled my health insurance 25 years ago taking personal responsibility for my own affairs.

 

My intuition agrees with natural health practices.  So that has been fully implemented. 

 

One of the important strategies I follow is to pray daily for health, vitality and perfect health which leads to the right books, videos, friends, and strategies to magically appear.  Which results in the right diet, exercise, and hobbies appearing into my life.  This negated my need for doctors, hospitals or insurance.

 

Good luck in your decision.

 

 

I did all the right things for 20+ years and then had a tumor the size of a golfball in my colon. I also have mild hypertension despite doing all the things you do to lower blood pressure for years.

 

I had no need to go to a Doctor for 20 years and so I was always putting off the colonoscopy and tests I knew I needed to have. I wasn't thinking if I exercised enough and ate enough vegetables I wouldn't get sick. Fact is I didn't, but I did get older and that is when things start in previously healthy people.

[mania]

17 hours ago, scubascuba3 said:

Presumably they don't think it's anything serious hence next appointment August.

 

Truth is Drs don't want to work anymore, in UK 3 days a week is enough for them, hence big wait for an appointment 

Actually I did get into a urgent care place today & did get the chest x-ray I wanted

Happy it was all clear

 

But I did ask the LPNR I saw about why the long waits. Was it more patients or less doctors.

She said less doctors for sure + increased population here

 

She said majority of doctors we had were all baby boomers & now they are all retiring leaving a vacuum

[mania]

9 hours ago, Phulublub said:

Keep trying...a long lasting cough can be an early symptom of some quite serious ailments.

 

PH

Thanks & yes I agree & did get a chest x-ray today from a urgent care clinic.

They said No radio graphic evidence for acute cardio pulmonary disease

(Which I was happy to hear as I was worried it may be a cardiac cough)

Lungs expanded & clear no pneumothorax

everything normal so that is good.

 

 I do live part time in a active volcanic area & exercise daily 60% outdoors for hours at a time

So after years of this it may just be affecting me more now.

 

Wonder which is worse volcanic gasses or Chiang Mai air during burn season? ????

Edited July 7, 2023 by mania

[VirgoSG]

On 7/7/2023 at 9:15 PM, Sheryl said:

They will also raise by age bracket.

 

You can get a chart now showing current rates by age group which will give you an idea of what magnitude of increase to expect and at what age. 

 

The increases are most marked after age 65. For the simple reason that need for medical csre and thus size and frequency of claims substantially increases at that poinh and keeps doing so. 

 

It makes zero sense IMO  to opt out of a policy because of these higher rates in old age since you are at that point quite likely to have a large claim in the forseeable future...and anyone who can't afford insurance premiums certainly can't afford to self pay that.  If unable to afford continued insurance it may be  time to consider a move back home. All of which should have been thought through/planned years in advance, since there is nothing unknown or unpredictable about age related changes in premium.

 

Previous or current state of health and prior use of policy (or lack thereof) is not a good   predictor of   future need for health care  once you are elderly.

 

 

 

 

Interestingly, I think AXA International calculate age premiums based on total claims for each age in their customer base, meaning you don't get any sudden big increases in premium when (for example) you go from 60-65 into 65-70 -- which a lot of companies do.

I couldn't agree more with your view regarding opting out of coverage when you get older.  Very sage advice...

[mania]

On 7/7/2023 at 4:15 AM, Sheryl said:

It makes zero sense IMO  to opt out of a policy because of these higher rates in old age since you are at that point quite likely to have a large claim in the foreseeable future...and anyone who can't afford insurance premiums certainly can't afford to self pay that. 

Lot of truth in that ????

[Sheryl]

17 hours ago, VirgoSG said:

Interestingly, I think AXA International calculate age premiums based on total claims for each age in their customer base, meaning you don't get any sudden big increases in premium when (for example) you go from 60-65 into 65-70 -- which a lot of companies do.

 

Calculating age premiums based on expected claims for each  age in the customer base is exactly what all insurers do. It does, however, lead to a big increase between 60 - 64/ 65-69, 70-74/75-79 etc because claims (both frequency and cost) go up significantly as people are older. There is no getting around this.

 

The very big mistake people seem to make is to look at their need for health care (and hence utilization of insurance) until now and assume it predicts what will be the case going forward, despite the fact that they are aging.

[mania]

16 minutes ago, Sheryl said:

The very big mistake people seem to make is to look at their need for health care (and hence utilization of insurance) until now and assume it predicts what will be the case going forward, despite the fact that they are aging.

 

Very True & sad to say I also was one who once thought I was safe due to my endurance type training most of my life. Now I am in my 60's & still doing quite well but my eyes have now seen many endurance type athletes suddenly have heart attacks or worse drop dead. Plus many other unrelated problems

 

I also have become aware that endurance athletes can have CAD as much or more than non athletic folks due to the tearing down nature of high intensity over time.

 

"Previous studies have documented the higher prevalence of coronary atherosclerotic plaques among highly trained endurance athletes compared with non athletes"

 

Don't get me wrong I think & so does the cardiologist that I speak with that I am better off overall for it (exercising)

 

But I think those who judge their future needs for health care based on the exemplary diet & exercise they now have may be in for a surprise.

 

Yes of course clean living beats a bad diet/smoking/lack of exercise but it is not a impenetrable shield for possible future problems which may or may not be down to genetics or sheer luck. We age & things are subject to wear & tear self inflicted or not.

 

 

 

Edited July 9, 2023 by mania

[scubascuba3]

On 7/7/2023 at 9:15 PM, Sheryl said:

It makes zero sense IMO  to opt out of a policy because of these higher rates in old age since you are at that point quite likely to have a large claim in the forseeable future

Of course, so people should work out whether they will be able to pay the premiums in 70s and 80s, they'll need to increase the published premiums based on how many years ahead

[Sheryl]

1 minute ago, scubascuba3 said:

Of course, so people should work out whether they will be able to pay the premiums in 70s and 80s, they'll need to increase the published premiums based on how many years ahead

It is possible to get an age chart showing premiums for all age groups. Just gave to ask for it.

 

Of course what you see in a chart now will have increased some due to inflation (for all age groups) by the time you reach the later ages but the magnitude if increase between age brackets will be about the same.