Health Insurance for the over 70’s

[jerrymahoney]

On 6/19/2024 at 10:46 AM, scubascuba3 said:

Sounds sensible but shouldn't you be self insuring anyway in case of claim denied?

So now following 2 'confused':

 

OK since this is a 'When did you stop beating your wife' type question I will add the following.

 

This is a 2 part question: 

1 -- Can a claim be denied? Sure a claim can always be denied.

2-- Do you have a self-insured reserve in case of a claim denied?

 

No. As typified on here, self-insured would mean a set-aside or reserve amount that is segregated and can only be used for medical requirements.

 

A claim denied is usually because of some pre-existing condition not fully detailed in the application. Just months before taking out my new policy, I had a life insurance policy granted at age 70 which had a more detailed medical underwriting than most if not all health insurance policies and required extensive follow-up of records. And I had a 15 year no claim experience with BUPA-Thailand and CIGNA Global.

 

And unless it's a claim related to heart attack or aneurysm etc., I have full Medicare coverage in USA for the not-immediately requiring treatment events.

 

Lastly I have a no-credit limit American Express card that I have had for 40 years -- I never leave home without it.

[jerrymahoney]

On 6/19/2024 at 10:46 AM, scubascuba3 said:

Sounds sensible but shouldn't you be self insuring anyway in case of claim denied?

As you wrote previously:

 

 On 1/19/2024 at 4:58 PM, scubascuba3 said:
Not heard from you in a while, you still a WRLife fan based on other views above?

https://aseannow.com/topic/1268153-wrlife-medical-insurance-experiences/?do=findComment&comment=18630037

 

Now you have.

[Henryford]

Typical insurance scam. They are happy to take your premiums when you are young and healthy but as you get older they force you out with unaffordable premiums. Better to self insure, but maybe too late if you don't start until your 70s. If the OP had just saved his 100k a year premium from the start he would have 1-2 million baht saved for any treatment.

[Sheryl]

3 hours ago, Henryford said:

If the OP had just saved his 100k a year premium from the start he would have 1-2 million baht saved for any treatment.

 

Assuming he had no significant medical costs from then to now. A big assumption. You cannot self insure by putting an amount aside each month.  You must have a significant amount if capital put aside from day one (3-5  million, see below). 

 

1-2 million baht is not much. A single catastrophic illness or accident will cost that much in a government hospital and more in a private hospital.

 

And once this saved amount is spent, it's gone. What then? 

 

Some people have no choice but to self-insure as pre-existing conditions make it impossible for them to get cover. But those who can get health cover, should -- and while still healthy. 

[oldcpu]

On 5/29/2024 at 11:09 AM, Ben Zioner said:

I was talking about about keeping the cover from your employer once you retire.

 

I think this is available to most US civil servants, many large corporation and the UN. I belong to the last group. The way is works is quite simple: the underwriter assesses the whole group of employees and retirees instead of assessing individuals. The premium (millions) is paid by the organisation and fully or  partly recovered from the employees and retirees.

 

This is not uncommon at all.

 

Yes - this is the sort of Health Insurance that I have (from a European government controlled/run organisation), and it covers both myself (now age-70) and my Thai wife (age-57).  I pay about 240-euros/per month for 'Health Insurance' plus 'Long Term Care' insurance. This is deducted from my European pension and further, my former employer contributes over 200-euros per month to this as well (as part of a pension perk) where the former employer's amount increases as I get older, while my contribution does not increase.  So overall the Health Insurance costs ~440 to 450 euros/month.  Expensive, but its very good.

 

As noted, the global health coverage that comes with this is excellent.  Currently this is provided by Cigna, but every few years, the European 'government' organisation I used to work for, renegotiates the pension for the entire organisation (~800 or more employees and  ~200 or more retirees), so to ensure competitive rates and 1st class health coverage.

 

It is a nice pension perk, and this Health Insurance was one of the main reasons (2 decades ago) I went to work for this organisation, in the knowledge that I would get great health insurance when I retired.

 

The 'downside' was the Health Insurance was not accepted by Thai immigration for the Type-O/OA visas, nor did I know enough how to get it accepted by BoI for the LTR visa (even thou coverage is unlimited).  (I now know the 'trick' thou for the LTR visa - which is getting a letter from Cigna saying coverage exceeds $50k US$ equivalent coverage - which I may use when I go for the 2nd part of my 5-year permission to stay on my LTR visa).

 

Of course this information on one should keep their Health Insurance upon retirement, does not help those who are already age-70 and hunting for new health insurance, BUT for those in the age of 30s to 40s, if looking for a different job, take special note if there is a pension and also in particular if there is subsidized health insurance that may come as part of a retirement package.

 

 

[Mike Lister]

I just covered my bases and checked to see how much CIGNA (Close Care) from CIGNA International will cost me, in case somebody springs new rules on me. Aged 74 with a $1,500 deductible and 30% co-pay ($5,000 out of pocket max) is quoted at USD 430 per month. Increasing the deductible to $5,000 reduces the premium to USD 363 per month. I know from experience that a further discount may be available, probably 5% or 7%.

 

We haven't begun talking about pre-existing conditions, which I have in abundance, one of the downsides of having regular health exams and fixing even minor things as you go. But I'm hopeful that potentially, 50% of my body might be covered! 

 

I might start looking around to see what inexpensive options the Thai insurers have, TBH I'm only interested in the policy for visa extensions purposes, if it comes to that, hence a 400k insured limit with a 400k deductible, at a low price, works for me. This is not for everyone of course and I wouldn't recommend it to others, unless you have options and some capital to back you up.

 

 

 

 

[Raindancer]

10 minutes ago, Mike Lister said:

 

 

I might start looking around to see what inexpensive options the Thai insurers have, TBH I'm only interested in the policy for visa extensions purposes, if it comes to that, hence a 400k insured limit with a 400k deductible, at a low price, works for me. This is not for everyone of course and I wouldn't recommend it to others, unless you have options and some capital to back you 

 

10 minutes ago, Mike Lister said:

Post deleted by user.

 

 

 

[Mike Lister]

Just now, Raindancer said:

But happy to be corrected.

 

 

Usually very reliable sources inform me that there a review of visa terms and conditions underway with results and changes expected to be implemented by September. There is, by all accounts, a mismatch in expectations between the Foreign Office and Immigration, the former wanting a relaxation of the rules, the latter wanting health insurance as a prerequisite for all long stay visa's. Since I wasn't in the room whilst the debate was being had I can't comment further with certainty. I've long believed however that a mandatory requirement for health insurance will be imposed at some point, the only questions are when and whether or not existing visa holders will be grandfathered. So I'm just covering myself by anticipating what might happen and making myself aware of options and costs. 

[Raindancer]

1 minute ago, Mike Lister said:

 

Usually very reliable sources inform me that there a review of visa terms and conditions underway with results and changes expected to be implemented by September. There is, by all accounts, a mismatch in expectations between the Foreign Office and Immigration, the former wanting a relaxation of the rules, the latter wanting health insurance as a prerequisite for all long stay visa's. Since I wasn't in the room whilst the debate was being had I can't comment further with certainty. I've long believed however that a mandatory requirement for health insurance will be imposed at some point, the only questions are when and whether or not existing visa holders will be grandfathered. So I'm just covering myself by anticipating what might happen and making myself aware of options and costs. 

Thanks for clarifying that.

 

I made a hash of replying to your previous post, but you obviously got sight of it before I deleted it 🤣

 

I thought that the " health insurance"  for expats only applied to those on non imm O-A visa/extensions, and not to other categories of visas/ extensions.

[Mike Lister]

12 minutes ago, Raindancer said:

Thanks for clarifying that.

 

I made a hash of replying to your previous post, but you obviously got sight of it before I deleted it 🤣

 

I thought that the " health insurance"  for expats only applied to those on non imm O-A visa/extensions, and not to other categories of visas/ extensions.

That is the current scenario but I am told there are attempts underway to expand the scope, I do not know how reliable they are.

[Raindancer]

1 minute ago, Mike Lister said:

That is the current scenario but I am told there are attempts underway to expand the scope, I do not know how reliable they are.

Many thanks Mike.  If they do impose it carte blanche, I will look at your 400k option with me paying the first 400k of any claim

 

[Mike Lister]

Just now, Raindancer said:

Many thanks Mike.  If they do impose it carte blanche, I will look at your 400k option with me paying the first 400k of any claim

 

It would be premature to fret at this stage but it's worth being aware of. I'm only looking into it now because of timing, my visa extension is due in November so I don't have a lot of reaction time, in a worst case scenario.

[Raindancer]

3 minutes ago, Mike Lister said:

It would be premature to fret at this stage but it's worth being aware of. I'm only looking into it now because of timing, my visa extension is due in November so I don't have a lot of reaction time, in a worst case scenario.

Well, I hope it doesn't affect your extension renewal or anyone else.

 

 

[Presnock]

15 hours ago, oldcpu said:

 

Yes - this is the sort of Health Insurance that I have (from a European government controlled/run organisation), and it covers both myself (now age-70) and my Thai wife (age-57).  I pay about 240-euros/per month for 'Health Insurance' plus 'Long Term Care' insurance. This is deducted from my European pension and further, my former employer contributes over 200-euros per month to this as well (as part of a pension perk) where the former employer's amount increases as I get older, while my contribution does not increase.  So overall the Health Insurance costs ~440 to 450 euros/month.  Expensive, but its very good.

 

As noted, the global health coverage that comes with this is excellent.  Currently this is provided by Cigna, but every few years, the European 'government' organisation I used to work for, renegotiates the pension for the entire organisation (~800 or more employees and  ~200 or more retirees), so to ensure competitive rates and 1st class health coverage.

 

It is a nice pension perk, and this Health Insurance was one of the main reasons (2 decades ago) I went to work for this organisation, in the knowledge that I would get great health insurance when I retired.

 

The 'downside' was the Health Insurance was not accepted by Thai immigration for the Type-O/OA visas, nor did I know enough how to get it accepted by BoI for the LTR visa (even thou coverage is unlimited).  (I now know the 'trick' thou for the LTR visa - which is getting a letter from Cigna saying coverage exceeds $50k US$ equivalent coverage - which I may use when I go for the 2nd part of my 5-year permission to stay on my LTR visa).

 

Of course this information on one should keep their Health Insurance upon retirement, does not help those who are already age-70 and hunting for new health insurance, BUT for those in the age of 30s to 40s, if looking for a different job, take special note if there is a pension and also in particular if there is subsidized health insurance that may come as part of a retirement package.

 

 

Totally agree, I a retired US govt employee have a policy since employment in which the government pays a large portion of the policy and another portion is taken out of my annuity.  I have family coverage and once I depart this world, my wife will most likely give up the policy unless our daughter is still a student (college now).  Since this marriage I have never really used it very much as we are all healthy but during COVID, we took out COVID insurance with a local insurer (500 baht each for 50K coverage) but only wife really needed (5 days in hospital).  Previously 1st wife died of breast cancer and fortunately we had that insurance (but I was working then) but it all worked out.  Yeah I could save a lot of money per year maybe but IF something serious came up with me or my family, I feel confident that we would not end up broke nor would any savings need to be spent so I can afford it and it allows me to confidently RELAX on the health insurance coverage concerns.  Now if the Thai Revenue Dept would let us know the latest on their 2024 tax program in relations to expats though I confidently feel that I can get through this year with absolutely no problems but would like to know and sure that folks looking at 180 days in country this calendar year would appreciate something new too.  Best regards to all..hopefully a healthy year.

[Raindancer]

Interesting thought on if they force all retirees to have a 400k health plan in place.

 

Example:  If your passport has more than a year to run at extension renewal, they will give you a years extension.

 

So, let's assume that you have health insurance that is renewable 9 months after your annual extension is granted for one year, and therefore runs out 3 months before your extension requires renewal.

 

Will they then only give you a 9 month extension??  Or will they compel you to return at the 9 month point with your health insurance proof of renewal?

 

Methinks, the health insurance idea is fraught with problems.

 

Just a thought or two.

[Presnock]

5 hours ago, Raindancer said:

Thanks for clarifying that.

 

I made a hash of replying to your previous post, but you obviously got sight of it before I deleted it 🤣

 

I thought that the " health insurance"  for expats only applied to those on non imm O-A visa/extensions, and not to other categories of visas/ extensions.

BTW for the BOI LTR, although my insurer's yearly benefits "book" included "unlimited" in coverage for hospitalization, the BOI reps sent me an note that they needed a letter from my insurer that indicated my hospitalization covered at least 50K US dollars and needed to be good for 1 year - insurer supplied the letter for 50K and indicated policy was good for the next 10 years.  Glad they were so helpful.

[hotchilli]

On 5/29/2024 at 9:54 AM, Ben Zioner said:

Why do some many people drop their cover when they retire?

Finances don't keep up with the premiums.. 

[Ben Zioner]

41 minutes ago, hotchilli said:

Finances don't keep up with the premiums.. 

For some maybe, but many are from countries where they can benefit from excellent social security and leave this behind when they chose live in Thailand... IMHO they not allowed to complain when things go wrong.

[The Fugitive]

7 minutes ago, Ben Zioner said:

For some maybe, but many are from countries where they can benefit from excellent social security and leave this behind when they chose live in Thailand... IMHO they not allowed to complain when things go wrong.

The irony is that many leave their home country because they cannot afford to pay Council Tax and astronomical Winter heating bills. If those essential expenses are unaffordable for them, how do they expect to pay medical bills when outside their totally free National Health Service?

[Raindancer]

4 minutes ago, The Fugitive said:

The irony is that many leave their home country because they cannot afford to pay Council Tax and astronomical Winter heating bills. If those essential expenses are unaffordable for them, how do they expect to pay medical bills when outside their totally free National Health Service?

Mmmmm.  That's a very strange generalisation.   I think there are numerous and varied reasons, and your suggestion might fit a very small minority.

[jerrymahoney]

44 minutes ago, Ben Zioner said:

For some maybe, but many are from countries where they can benefit from excellent social security and leave this behind when they chose live in Thailand... IMHO they not allowed to complain when things go wrong.

For any Medicare-enrolled US citizen, Medicare is available (to varying degrees and at varying expense) upon return to the US. For myself, however, I would have zero support for any long-term care type situation which is a major reason I am here in Thailand faults and all.

 

 

[hotchilli]

10 minutes ago, The Fugitive said:

totally free National Health Service?

That's the biggest mis-conception of all time

Not free, paid for from every monthly salary for those who care to work for a living.

NHS tax is deducted from your pay packet.

Of course the non-working spongers and immigrants come over and get free treatment.

For those who have made contributions and are unemployed then fair play, for those who have never paid a single penny... you want treatment, you pay for it.

 

[Sheryl]

1 hour ago, hotchilli said:

Finances don't keep up with the premiums.. 

 

That is sometimes the case.

 

In others, they can afford it but would have to cut other expenses, or it just seems to them  like too much to pay for health care- an impression often based on comparison to what has been received in payouts to date.

 

People make the huge mistake of assuming their past health history is an indication of what will happen in years to come, despite now being in old age.

 

Premiums sky rocket in old age becomes claims sky rocket in old age Insurers are keeping up with their anticipated outlays.

 

 

[Sheryl]

23 minutes ago, jerrymahoney said:

For any Medicare-enrolled US citizen, Medicare is available (to varying degrees and at varying expense) upon return to the US. For myself, however, I would zero support for any long-term care type situation which is a major reason I am here in Thailand faults and all.

 

 

Medicare does not, unfortunately, pay for long term care. A huge problem in the US.

[jerrymahoney]

1 minute ago, Sheryl said:

Medicare does not, unfortunately, pay for long term care. A huge problem in the US.

Yes -- but I mostly meant in terms of family or collegial support.

[unblocktheplanet]

On 5/29/2024 at 1:39 PM, BE88 said:

 

Not if every month you deposit the money you pay to your insurance in the bank and you have between 3 and 5 million, it is clear that if you start at 70 and then later reach these sums, or simply if you have some previous savings and therefore You say you are self insured which I think is the majority on this forum who claim to be self insured

 

For many expats, the nut is retirement visa money.

[xylophone]

As I stated in an earlier post of mine: "Some decisions to be made on my part and I will post my decisions here for the benefit of others".

 

I stayed with Allianz Ayudhya because I have a 15 year policy history with them and my agent has been very good over the years, answering my questions/queries. Also as I have had an uninterrupted tenure (cover) with them, then as all of my pre-existing conditions were stated at my policy start, then any later health issues should also be included in my cover now.

[mania]

On 6/24/2024 at 2:43 PM, Mike Lister said:

I've long believed however that a mandatory requirement for health insurance will be imposed at some point, the only questions are when and whether or not existing visa holders will be grandfathered.

 

I have also thought so for a long time.

It does not even seem outrageous at all for a country the size of Thailand to not be willing to support all who retire there should a medical crisis occur & thus would eventually require medical coverage for anyone getting a long term visa extension

 

But the problem is many are retirees & many with preexisting conditions so insurance may or may not even be available. I guess one thing they could do is put a full time freeze on your 800k & have you sign an agreement that in an emergency your 800k would be used by the hospital for emergency treatment should you be unable to leave Thailand for treatment in your home country.

 

About grandfathering in this case of medical insurance I do not think so. They would be shooting themselves in the foot but..... If for instance they raise the visa funds requirement from 800k to 1 million etc then yes that I could see being grandfathered as it has in the past

[shdmn]

On 5/28/2024 at 8:48 PM, Doctor Tom said:

I self insure, no health cover, bar accident cover on my car insurance. In 7 years I have spent circa 80,000 Baht in hospital fees, including for Wet AMD treatment and a carcinoma removal and after care.  I am quite comfortable with no insurance.  In both cases I was given a good discount by the consultant because I was self financing. To be honest, with the state of the UK NHS, I would be going private if I was living in the UK, and it would be massively more expensive.  My friend had a hip replacement in Thailand and he opted for a Thai government hospital. He had to wait for treatment, but the costs were considerably lower than in an international hospital.  My view is that unless you have an underlying serious condition, and none of us really knows if we will develop one in older age, there comes an obvious cut off point, where the cost of insurance, against the cost of private treatment, makes it much more practical to self insure.  

Most of the time it's not worth it, until it is.  That is just how insurance works.

 

There is a fairly well known travelling vlogger that just got diagnosed with a brain tumor. It caused him to suddenly lose the use of one side of his body.  Also seems to be having some mental problems.  He just got medevac'd back to the UK after weeks in a Sriracha Hospital in ICU, including a brain operation to take a sample.  If he didn't have good travel medical insurance paying for it all it probably would have wiped him out financially.

[scubascuba3]

3 hours ago, shdmn said:

Most of the time it's not worth it, until it is.  That is just how insurance works.

 

There is a fairly well known travelling vlogger that just got diagnosed with a brain tumor. It caused him to suddenly lose the use of one side of his body.  Also seems to be having some mental problems.  He just got medevac'd back to the UK after weeks in a Sriracha Hospital in ICU, including a brain operation to take a sample.  If he didn't have good travel medical insurance paying for it all it probably would have wiped him out financially.

Travel insurance is very good value, anyone who doesn't get that must be crazy. Health Insurance is relatively expensive and continues to go up until it's unaffordable for many