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

[Gottfrid]

9 hours ago, Scouse123 said:

So, it's a calculated risk.

Ok. What is it they say. Let me think......Up to You! 

[Yellowtail]

18 hours ago, scubascuba3 said:

Early days though, premiums start spiralling out of control later

Not sure what you mean by this. Dude was claiming insurance companies were regularly cheating people out of paying claims. I was only pointing out that that had not been my experience, and had nothing to do with premiums. 

 

The premium has to go up with the risk or it is not insurance. It is not fair for a heathy 25-year-old to be paying the same rate as a 70 year-old with preexisting conditions. 

 

 

[scubascuba3]

47 minutes ago, Yellowtail said:

The premium has to go up with the risk or it is not insurance. It is not fair for a heathy 25-year-old to be paying the same rate as a 70 year-old with preexisting conditions

I'm not so sure, there's a gap in the market for a shared premium that doesn't go up with age, which incentives people to get health insurance from a young age, pointless being priced out when you need it the most

[Yellowtail]

49 minutes ago, scubascuba3 said:

I'm not so sure, there's a gap in the market for a shared premium that doesn't go up with age, which incentives people to get health insurance from a young age, pointless being priced out when you need it the most

It's only a gap in the market to old people, young people have no interest in paying for old people they do not know, that is why the state has to compel them to do so. 

 

In the US, most all people are insured either though their employer or by the state. In many other countries, people are most all insured by the state. Where is the market? 

 

What I would like is inexpensive catastrophic coverage with a US$10K deductible and US$2M coverage, these used to be easy to get but (as I understand it) have been made "illegal", at least in the US. 

 

Unfortunately, many people feel cheated if their insurance does not pay more for their coverage than they pay in premiums. They think it's smart to get all the "free" care they can get. It cannot work that way.

 

There are also people who expect a $50 policy to cover the same things a $1,000 policy covers, and moan about exclusions and call the insurance companies greedy cheaters when their uncovers claims are not paid, or when they lie about preexisting conditions. 

 

Look at the bright side, we're getting older, a lot of people don't. 

 

 

[simon43]

Although I recently took out a new medical insurance policy with WR Life, I am considering whether it is worthwhile to have such a policy in my own circumstances viz:

 

- I live in north Laos in a small village some 20km away from the nearest town (Luang Prabang).  The hospital facilities in that town are very basic.  If I were to have a serious medical event, such as a motorbike accident, heart attack or stroke, then I would probably be dead long before I get to the hospital, and even at the hospital only the most basic care can be provided.

 

If I have some minor medical issue then I can pay cash for outpatient treatment.

 

If I have some chronic illness, cancer etc, then I can return to the UK for free treatment on the NHS (long waits for treatment for most things if it's not cancer).

 

Yes, I can pay for medical insurance, but I'm not sure such insurance would be of any help to me if I collapse at home (no-one would even know - I live alone).

[jaideedave]

On 6/29/2023 at 1:31 PM, Chivas said:

No amount of saving in an account will cover serious Trauma, Strokes or Heart attacks whereby you're in an Intensive Care Unit for a long period of time

 

The question always remains as to just HOW you get that money out of the account in the first place.

 

Remember you're in a coma....

In my case I'm a 72 yo cancer survivor plus I had quad bypass surgery 12 years ago.I've probably used up my (9) lives by now.I had my wife sign the DNR forms and gave them to my Dr.

I don't want my family's inheritance eaten up in a ICU and they have to pull the plug when the insurance and money is gone.No issue for me at all.Its been a good ride!

[jaideedave]

On 6/29/2023 at 1:54 PM, BritManToo said:

Forget insurance, accept death when it comes! 

I agree BMT:In my case I'm a 72 yo cancer survivor plus I had quad bypass surgery 12 years ago.I've probably used up my (9) lives by now.I had my wife sign the DNR forms and gave them to my Dr.

I don't want my family's inheritance eaten up in a ICU and they have to pull the plug when the insurance and money is gone.No issue for me at all.Its been a good ride!

[Chivas]

9 minutes ago, jaideedave said:

In my case I'm a 72 yo cancer survivor plus I had quad bypass surgery 12 years ago.I've probably used up my (9) lives by now.I had my wife sign the DNR forms and gave them to my Dr.

I don't want my family's inheritance eaten up in a ICU and they have to pull the plug when the insurance and money is gone.No issue for me at all.Its been a good ride!

Fair play. I had to sign those forms for mother back in 2021. I was not particulary "close" to my mother it would be fair to say but the Dr explaining the process in her home with myself present (and fortunately another brother lol) was not a pleasant experience once the GP had left !

Most "difficult" day I ever had with mother and there were literally 100's down the decades

[Expat68]

On 6/29/2023 at 11:53 AM, 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.

Disagree with several million baht. I had a operation in the most expensive hospital in Bangkok, stayed 4 days in my own private room, everything covered and it only came to 400,000 baht

[skorts]

On 6/29/2023 at 11:44 AM, Jingthing said:

This is a hard question. You could develop a condition that would exclude you from decent coverage or coverage at all tomorrow. It sounds like right now you can have a clean application. If I were you I would do lots of research on the best agents and best companies and apply for the insurance. No guarantees but it would be a fair enough bet if your record is really as clean as you present it here.

I totally agree. I have had a personal medical plan with my international insurer for 8 years after switching on a moratorium from a group/employer plan with them. I considered switching to another insurer recently to lower my premiums (using a broker) but all of the insurers wanted to exclude things that are covered by my current insurer. 
Biggest lesson I learnt is to find an insurer whilst you are in still in good health and stick with them. 
If you are in good health you can always look to increase the annual excess which keeps the premium down but still provides cover if something major happens. 
This can provide significant savings on premiums over the years if you are in good health. 
As you can select the excess each year it means if something came along during the year which you know needs expensive surgery/treatment but isn’t urgent you could wait until the plan renewal and select a lower excess the following plan year. 
And at the next plan renewal switch back to a lower excess if all is looking OK. 

[Dene16]

On 6/29/2023 at 8:04 AM, sirineou said:

If you are over 60 I would say self insure. 

   First, they don't cover preexisting conditions and by that age a case can be made that pretty much everything is a pre-existing condition. (except car accidents of course LOL) 

You have hit the nail on the head. There is probably very little, in any pre-existing conditions, that cannot be used as a contributing factor(however small) of a heart attack or stroke and thus a refusal to pay out.

Health Insurance over 60, in itself, is a gamble on whether they will pay out or not

However the actual costs if treated in a government hospital are quite affordable, I have been led to believe from previous posts.

If it's cancer then maybe it's better to except your fate as you are unlikely to be remaining on the planet much longer with or without treatment

 

[rwill]

I'd say if you really want to self insure you should have at least 5 million in reserve.  You also would need the ability to replenish it if you have to use it.

[scubascuba3]

14 minutes ago, rwill said:

I'd say if you really want to self insure you should have at least 5 million in reserve.  You also would need the ability to replenish it if you have to use it.

I'd like to see your workings for that? must have carefully thought it through 

[TravelerEastWest]

6 hours ago, Yellowtail said:

 

 

"What I would like is inexpensive catastrophic coverage with a US$10K deductible and US$2M coverage, these used to be easy to get but (as I understand it) have been made "illegal", at least in the US. 

 

====

 

There are also people who expect a $50 policy to cover the same things a $1,000 policy covers, and moan about exclusions and call the insurance companies greedy cheaters when their uncovers claims are not paid, or when they lie about preexisting conditions. 

 

Look at the bright side, we're getting older, a lot of people don't. "

Great post!

 

Let me add one detail I want teh wholesale rate teh insurance companies get for my deductible.

 

Example when my daughter was born the total bill may have been $10,000 (not sure a long time ago...) and my deductible was $2,000 but my $2,000 was already discounted from the public rate to the rate Kaiser pays. This is good - I could not find taht type of insurance in Thailand.

 

 

6 hours ago, Yellowtail said:

 

 

 

[VirgoSG]

On 6/29/2023 at 11:35 AM, Scouse123 said:

Guys, I am at the 61 years old mark. I don't smoke, I do drink but not for the next few months as I am on a health kick. I only drink wine or beer and not heavy stuff or spirits.

 

I get regular health checks which I pay for. A recent one, the doctor stated my vitals and bloods were good as were all my organs.

 

I also get annual health check at Bangkok hospital, Khonkaen and try to stay in a reasonable condition. My check last year was a decent result considering my age and just a few age related areas to keep an eye on.

 

I need to be a bit more active exercise wise, which I will be doing this week and get back into a health routine.

 

I have a number of long term friends in Thailand that basically self insure, this is mainly due to the fact that they are late seventies and early eighties and they tell me they are in fact not insurable, due to age or premiums that are simply unaffordable.

 

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 '

Before you decide to self-insure, take a look at AXA International health insurance (based in the UK, not the local AXA branch in Thailand)  [ Search for "axa global healthcare" ].  I have been with them for many years, and had an excellent claims experience.  Doesn't matter where you live in the world, they will cover you, and you can choose where you get treatment (e.g. if I elect to go to Singapore for treatment, no problem). 

Contrary to what many people say, reputable (and likely non-Thai) insurers do not jack up the premium based on your personal claims record.  AXA increase their premiums based on the company's total claims experience and medical-related inflation.  In some years my premium has increased as little as 2%, in others up to 17%.  

They certainly insure Thais as well as expats, because we recently switched my partner's insurer to AXA International -- her own policy, not added onto mine.  Her premium aged 39 is about THB40,000 -- roughly the same as the appalling Thai insurance policy she had before, and vastly superior coverage.

With a GBP2,000 (voluntary) deductible, aged 75, my annual (worldwide excluding USA) premium is GBP5,300 (about THB230,000).  And that includes emergency evacuation and repatriation cover.  There is no age limit that I am aware of. And there should be no problem getting cover at your young 61 years!  They also have a very reasonable policy regarding pre-existing conditions.  

If you are interested after reading their website, I would suggest calling their health advisers or their sales team.  Their staff are well-trained (sales people not pushy at all), personable and helpful.  

[Rotweiler]

Well, here's my experience.

When we were building out home in Thailand (2008), I was bombarded with insurance offers; the worst seemed to be BUBA who somehow got my email address.  We (my wife and I) decided to allow one of those companies to visit and give us their spiel. 

Based on that, we decided to "self-insure" (regards to Sheryl, but her posts here on this topic are one-sided and obtuse).  Self-insure for us meant having enough money in an account that would cover (most) medical emergencies.

A couple of days ago, we decided to sit down and calculate the win/loss of that decision.  In spite of a major surgery and several less dramatic issues, the following:

SUMMARY

Total Insurance costs since 2008 (had we gone with that company – all rates based on their rate schedules each year which we religiously kept - rounded to the nearest 100 B).  (It should be clear to everyone that the coverage during that period of time would have decreased substantially while the premiums would have increased exponentially):

1,653,900 B (probably closed to 2,700,000 B based on increased rates based on age)

My actual medical costs (yes, including major surgery with associated 6 days in a major private hospital (again, rounded to the nearest 100 B)

1,137,400 B (actual)

Interestingly enough, the medical emergencies account still has the original 3 Million B in it, a factor of interest and tax return savings).

[sirineou]

2 hours ago, Dene16 said:

 

However the actual costs if treated in a government hospital are quite affordable,

 

I had an echocardiogram and a consultation with a cardiologist  to review my meds. (BP too low in the morning) at the Queen Sirikit Heart hospital in Khon Kaen the days ago. The whole thing about 600 haht ($19 usd). In the US , with good insurance , my deductible would had  been 60 usd. 

[PJ71]

On 6/29/2023 at 1:54 PM, BritManToo said:

Forget insurance, accept death when it comes! 

Death is not the problem, pain and suffering is.

 

I'm ready to check out any time, i've had a great life ( just turned 50 ).

 

Pain and suffering scares the <deleted> outta me!

[Sheryl]

12 hours ago, scubascuba3 said:

I'm not so sure, there's a gap in the market for a shared premium that doesn't go up with age, which incentives people to get health insurance from a young age, pointless being priced out when you need it the most

Not a feasible business model. 

 

If all ages paid same premium almost no younger  people would get it as their premiums eould be absurdly high relative to their medical risk. 

 

Premiums do not "spiral out of control" due to age. Age related increases are fully  knowable in advance. Where rates do really spiral is with Thai issued policies where clams based increases are tacked on as well. Those, you cannot predict in advance and they can be considerable. This can be avoided by getting an internationally issued policy.  

[scubascuba3]

7 hours ago, Sheryl said:

Premiums do not "spiral out of control" due to age.

Guys here complain about their premiums being 60k+, when they get to their 80s and it's 300k more to complain about

[tomacht8]

At 61 you can easily get private Thai health insurance. The most important thing is to check that there will be no age limit for health insurance to kick you out in the future. Most health insurance policies are valid globally, with the exception of the United States. You can start with a basic health insurance without dentist and out patient service. Only for the case of a serious illness that requiring hospitalization. In order to find the best solution for you, you cannot avoid reading the fine print carefully.

[mokwit]

16 hours ago, Expat68 said:

Disagree with several million baht. I had a operation in the most expensive hospital in Bangkok, stayed 4 days in my own private room, everything covered and it only came to 400,000 baht

'catastrophic accident or illness' will be more than an emergency surgery. Also things can be ongoing, operation after operation, long stays in hospital.

 

I paid Bt141,000 for emergency surgery and 8 days. Now I am looking at another 330k, and maybe more down the road.

[sirineou]

4 minutes ago, mokwit said:

'catastrophic accident or illness' will be more than an emergency surgery. Also things can be ongoing, operation after operation, long stays in hospital.

 

I paid Bt141,000 for emergency surgery and 8 days. Now I am looking at another 330k, and maybe more down the road.

Not sure of the options in other countries , I can only talk of the US. 

But I am sure most of the countries we are from have some sort of universal health insurance, In the US all those over 65 are entitled to medicare, 

So, In thailand I would self insure, Medical care here is relatively inexpensive, but for anything major I would go back to the US. If it's an emergency then I guess I would have to bite the bullet and spend some of my cash, but if it is ongoing and I am able to travel, I will still go to the US.

Does such option exist in your home country?

[mokwit]

26 minutes ago, sirineou said:

 

Does such option exist in your home country?

Should have added "assuming you cannot travel".

 

Yes, and that is what I intend to do for end of life care  However, It is not certain I can just go back for surgery - they changed the rules to prevent non residents doing that - it is pot luck whether you get treated. Some may have to reestablish ourselves in the country to get that treatment. I should be able to stay with family, but being sick and looking for somewhere to live and all the necessary visits to various agencies and all the paperwork won't be easy. Seems B&B in Blackpool is an option.

 

If you still retain an official presence/property in your own country then it is a "no brainer", but some of us came here with $1,000 and the clothes on our back 25+ years ago.

[Fat is a type of crazy]

I have full cover in Australia for about 77000 baht per year including extras like dental which will only go up a few per cent per year. Lets say I spend 6 months in Thailand. Keep my home policy. I wish there was a top up policy one could buy for emergency treatments only i.e. for accidents and things whereby you can't get back to your home country. I assume it is not a thing. 

[jerrymahoney]

35 minutes ago, sirineou said:

In the US all those over 65 are entitled to medicare, 

Yes. And if you go back to US for treatment under Medicare, it makes a big difference whether you still maintain Plan B while living in Thailand.

 

Plan B this year almost $2000 per year whether you use it or not. Some doctors, it seems, will only take on new Medicare patients who have Plan B.

[Expat68]

36 minutes ago, mokwit said:

Should have added "assuming you cannot travel".

 

Yes, and that is what I intend to do for end of life care  However, It is not certain I can just go back for surgery - they changed the rules to prevent non residents doing that - it is pot luck whether you get treated. Some may have to reestablish ourselves in the country to get that treatment. I should be able to stay with family, but being sick and looking for somewhere to live and all the necessary visits to various agencies and all the paperwork won't be easy. Seems B&B in Blackpool is an option.

 

If you still retain an official presence/property in your own country then it is a "no brainer", but some of us came here with $1,000 and the clothes on our back 25+ years ago.

Not absolutely certain but I do not think UK NHS would turn you away, I know quite a few have been treated for serious illnesses 

[sirineou]

7 minutes ago, jerrymahoney said:

Yes. And if you go back to US for treatment under Medicare, it makes a big difference whether you still maintain Plan B while living in Thailand.

 

Plan B this year almost $2000 per year whether you use it or not. Some doctors, it seems, will only take on new Medicare patients who have Plan B.

As I understand it, unless you enroll when you become eligible, there is a big fine if you need to enrollee later on.

And you never know when you might have to go back when you get older and all the old age associated problems start to happen. $165 a month for insurance that covers preexisting conditions does not sound to me that much, but I also have my trade union pension, I understand and sympathise that others might not be so fortunate, but if you can afford it I think it is a good deal. and a good strategy. .   

[mokwit]

1 minute ago, Expat68 said:

Not absolutely certain but I do not think UK NHS would turn you away, I know quite a few have been treated for serious illnesses 

Yes, I am hearing stories of people being treated and none of being turned away, but you can't know for sure.

[mania]

34 minutes ago, jerrymahoney said:

Yes. And if you go back to US for treatment under Medicare, it makes a big difference whether you still maintain Plan B while living in Thailand.

 

Plan B this year almost $2000 per year whether you use it or not. Some doctors, it seems, will only take on new Medicare patients who have Plan B.

Yes but they also have Medicaid which will pay your Medicare part B & also part D for you if you fall under $X amount of income which is nice benefit for those who do.