Health Insurance for the over 70’s

[howerde]

11 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.

Yes i was following that story, i remember the intensive  care was 80 000 baht a day who knows what the total cost was including all the tests etc, he was flown back to the  UK earlier this week

[rumak]

23 minutes ago, howerde said:

Yes i was following that story, i remember the intensive  care was 80 000 baht a day who knows what the total cost was including all the tests etc, he was flown back to the  UK earlier this week

and................ what was the limit on his policy ?

and... we don't know how much was covered ( exclusions, etc ) 

 

the thing about "insurance"  is .....   the actual risk/reward of getting it doesn't work out for many .   Of course, if you have lots of money or have worked for lots of years for a major company (not what i did, nor wanted to ) or govt. (also not my thing) ,  then insurance is ok. ( remember ... "good"  policies cost a LOT )

"normal" people spend ever increasing premiums ,  always with the very real RISK that when MOST healthy people ( gotta stay healthy folks.... not what i observe , and is confirmed by the staggering obesity rates , especially in western societies) ....

well, when the issues start popping up after 20 years of paying for "insurance" .... then they're excluded from coverage HAHA.

Nah.... i don't like those conditions.    

Get healthy.   Save your money starting in your 40's .   Worked for me .  No major problems.  No exclusions.   No stress being told no,  then waiting on hold for someone to tell you ..... errr,  you need to ......................."

 

Edited Thursday at 05:34 AM by rumak

[Sheryl]

17 hours ago, mania said:

 

But the problem is many are retirees & many with preexisting conditions so insurance may or may not even be available. 

 

Not just this. The way the  requirement is likely to be structured, based on past experience  (e.g. the O-A visa) is unrealistic and unreasonable.

- limited to Thai companies, despite the facts that most will not enroll people over age 65, and that  many retirees hold excellent foreign policies that cover them in Thailand (and remit hundreds of millions of baht each year to Thai hospitals)

- requiring outpatient as well as inpatient cover, utterly unnecessary and substantially increasing premium cost

- requiring an unrealistically low level of total cover (related to the above).

- no self insurance option for those who cannot get insurance. 

 

Net result is the requirement will  solve nothing, but place an immense - and often insurmountable   -- burden on retirees.

 

I have US $1million (36 million baht) cover from a foreign company with direct payment arrangements with scores of Thai hospitals. In the past 5 years alone, this insurance policy has  paid out over 1.8 million on my behalf to Thai hospitals. (I've had an unlucky 5 years!). But it would not be accepted under the rules in place for extension based on  an O-A visa and I much fear same would be true of any new requirement based on non-O. Add to that,  my age and at this point pre-existing conditions would make it impossible for me to get a Thai policy. So despite being very well insured  I'd be denied extension of stay. Thousands of other retirees in same situation. 

 

17 hours ago, mania said:

 

II 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 

 

The 800 is already frozen. Completely for 5 months of the year and then 400 for the rest of the year.  But not all retirees use the 800k method, 400/800k will not be enough for a catastrophic illness, and then there is the problem of what to do once the money is gone...for someone likely at that point to be  very old, weak and having lived in Thailand so long that they do not have ties back home to help them to repatriate. 

 

17 hours ago, mania said:

 

About grandfathering in this case of medical insurance I do not think so. They would be shooting themselves in the foot 

 

Not really. The cohort of people already here with retirement status will die out naturally over the next 20 years or so. Indeed  even within 5-10 years, their numbers will be much  reduced.  This group  includes many very old people i.e. 70+, 80+, 90+ years old. 

 

If they don't already have insurance, they in most cases simply cannot get it at any price. (and those that do have insurance may hold foreign policies that won't meet Imm requirements, see above).

 

These elderly  people have made lives in Thailand, having come here based on a set of rules then in place. Many have been here for decades and would have great difficulty repatriating.

 

People newly getting a retirement visa, on the other hand, tend to be younger and would know the requirement in advance of committing themselves to settling down here. 

 

A strong case can be made for grandfathering any new insurance requirement. 

[BritManToo]

20 hours 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?

I don't see health insurance as necessary, I accept at some point in my life I will die.

Hit an run got me last year while driving my m/c, 6 broken bones, collapsed lung, many cuts and bruises, total cost over 4 months (government hospital) was just over 13kbht (including physiotherapy for a month). Surprisingly completely paid for by my m/c government minimum insurance.

 

Nobody forces a foreigner to use the most expensive private hospital.

 

[simon43]

19 hours ago, xylophone said:

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.

It seems that as regards this situation, you are between a rock and a hard place.  How much is your insurance likely to increase over the next few years?

 

For me, although my insurance premiums are well within my finances right now, that might not be the case in the future.  Such is life! 🙂

[rumak]

34 minutes ago, BritManToo said:

Nobody forces a foreigner to use the most expensive private hospital.

 

  You can take the westerner out of their first world country.... but you can not take their conditioning away.     Very small percentage manage to live here , not necessarily "going native" ,  but just learning, adapting, and enjoying Thailand for what it is. Not what they want it to be ( so odd that they often don't like where they left.... but then

compare things here to things there .   baffling ) 

   do to conditioning i doubt they will be heading to govt  hospitals .   Heck,  most can hardly ask directions to the bathroom.

Nope:  gotta be BKK Hospital or Ram ,  little cute nurses smiling and speaking english.

 

Edited Thursday at 07:11 AM by rumak

[Sheryl]

4 hours ago, BritManToo said:

I don't see health insurance as necessary, I accept at some point in my life I will die.

Hit an run got me last year while driving my m/c, 6 broken bones, collapsed lung, many cuts and bruises, total cost over 4 months (government hospital) was just over 13kbht (including physiotherapy for a month). Surprisingly completely paid for by my m/c government minimum insurance.

 

Nobody forces a foreigner to use the most expensive private hospital.

 

Do not take the cost of your recent accident as indicative of what care at a government hospital always costs.

 

Bills for a single admission can easily reach 1 million or more in case of catastrophic accident or illness. 

[Mike Lister]

A bit more anecdotal info regarding the alleged review of visa's and the need for health insurance across the board.

 

I saw my long standing, highly regarded and well connected visa agent today who normally gets to hear about any changes in the pipeline, before anyone else I know. When asked about he review of visa's  he responded, "what review, the tourists visa's have been changed and that's it".

 

When asked about the broader application of health insurance across all visa types, he responded, "they've just reduced the requirement from 3 mill to 400k, why would they expand it". 

 

Also, now that Big Joke is no longer in role, the risk appears to have been lowered.

 

Maybe something, maybe nothing, like I said, anecdotal.

[shdmn]

11 hours ago, rumak said:

and................ what was the limit on his policy ?

and... we don't know how much was covered ( exclusions, etc ) 

 

the thing about "insurance"  is .....   the actual risk/reward of getting it doesn't work out for many .   Of course, if you have lots of money or have worked for lots of years for a major company (not what i did, nor wanted to ) or govt. (also not my thing) ,  then insurance is ok. ( remember ... "good"  policies cost a LOT )

"normal" people spend ever increasing premiums ,  always with the very real RISK that when MOST healthy people ( gotta stay healthy folks.... not what i observe , and is confirmed by the staggering obesity rates , especially in western societies) ....

well, when the issues start popping up after 20 years of paying for "insurance" .... then they're excluded from coverage HAHA.

Nah.... i don't like those conditions.    

Get healthy.   Save your money starting in your 40's .   Worked for me .  No major problems.  No exclusions.   No stress being told no,  then waiting on hold for someone to tell you ..... errr,  you need to ......................."

 

The minimum plan limit is five million pounds.  He's obviously not going to be anywhere close to that but I am sure the brain operation was not cheap.  The medevac included a doctor and a nurse accompanying him in business class. So that's not going to be cheap either.

https://www.postoffice.co.uk/travel-insurance

Edited Thursday at 04:31 PM by shdmn

[rumak]

9 hours ago, Mike Lister said:

"they've just reduced the requirement from 3 mill to 400k, why would they expand it". 

 

yes.   and why do some expats (i'm speaking in general) speculate on things they have no idea about?  As your agent says above ,  "they've just reduced the requirement from 3 mill to 400k, why would they expand it". 

 

Edited Thursday at 07:25 PM by rumak

[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 was this a helpful suggestion or just another one of your zingers supposedly at my expense?

[scubascuba3]

28 minutes ago, jerrymahoney said:

So was this a helpful suggestion or just another one of your zingers supposedly at my expense?

If people are with insurance companies who could deny claims and some are more likely than others then of course it would be sensible to self insure for that eventuality 

[jerrymahoney]

On 6/27/2024 at 4:09 AM, scubascuba3 said:

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

So in other words, those without health insurance should self-insure, and

 

Those with health insurance should self- insure. Thanks.

[Mike Lister]

3 hours ago, rumak said:

 

yes.   and why do some expats (i'm speaking in general) speculate on things they have no idea about?  As your agent says above ,  "they've just reduced the requirement from 3 mill to 400k, why would they expand it". 

 

Part of the answer is that decisions about these things emanate from Bangkok and not Chiang Mai, so when reasonably well connected people from Bangkok speak, it's a reason to pay attention. Wherever there's smoke there's something going on so I don't think I'd dismiss either answer completely, at this stage. 

[EVENKEEL]

17 hours ago, rumak said:

 

  You can take the westerner out of their first world country.... but you can not take their conditioning away.     Very small percentage manage to live here , not necessarily "going native" ,  but just learning, adapting, and enjoying Thailand for what it is. Not what they want it to be ( so odd that they often don't like where they left.... but then

compare things here to things there .   baffling ) 

   do to conditioning i doubt they will be heading to govt  hospitals .   Heck,  most can hardly ask directions to the bathroom.

Nope:  gotta be BKK Hospital or Ram ,  little cute nurses smiling and speaking english.

 

So, what do you call the Thais (customers) at a BKK Hospital? If given the choice do you honestly believe a Thai would choose a Gov hospital over a BKK Hospital? Me, I was able to keep my good Int Insurance after retirement. 

[jerrymahoney]

1 hour ago, scubascuba3 said:

If people are with insurance companies who could deny claims and some are more likely than others then of course it would be sensible to self insure for that eventuality 

And some people are likely the kind of people who are loose as to the application information they supplied to the insurance companies that catches up with them when they file for a claim as in topics here on AN/TV here as to "how can they find out?"

[rumak]

55 minutes ago, Mike Lister said:

Part of the answer is that decisions about these things emanate from Bangkok and not Chiang Mai, so when reasonably well connected people from Bangkok speak, it's a reason to pay attention. Wherever there's smoke there's something going on so I don't think I'd dismiss either answer completely, at this stage. 

well,  i am in Chiangmai .   And the world would be a lot better off if it listened to things emanating from around here. 😆    

 

  

Edited Friday at 12:22 AM by rumak

[Ben Zioner]

On 5/29/2024 at 11:23 AM, scubascuba3 said:

Most people don't have that luxury of continuing employer cover

In most EU countries most people keep their cover once their retire, often it is Social Security with a Semi private complementary cover which employer subsidised. It is true that such cover isn't always transferable overseas, but my point was that this should weigh heavily in the expatriation decision. 

[Ben Zioner]

On 5/29/2024 at 2:46 PM, sandyf said:

And some us never had a pension or health cover from employer in the first place.

Salary should not be the sole criterion when choosing an employer.

[Mike Lister]

15 minutes ago, Ben Zioner said:

In most EU countries most people keep their cover once their retire, often it is Social Security with a Semi private complementary cover which employer subsidised. It is true that such cover isn't always transferable overseas, but my point was that this should weigh heavily in the expatriation decision. 

I've read many of your posts on this subject and said very little but I don't think it's reasonable to be so critical of older expatriates that don't have health insurance. When they expatriated twenty and thirty years ago, many with quite large sums of money, reasonable/good quality health care was available at a low cost. In the past ten years, things have changed and in addition to health care costs increasing by a far higher percentage than most other things in Thailand, those expats have grown older and now have fewer assets. Being critical of the decision they took twenty to thirty years ago to expatriate and self finance their health insurance, is not helpful, many decisions can be challenged when using hindsight. Neither people nor the decisions they make are perfect, rubbing in those imperfections even less so! New expatriates should take the lesson onboard I agree but let's not be too harsh on those that made flawed decisions so long ago.

[Ben Zioner]

12 minutes ago, Mike Lister said:

New expatriates should take the lesson onboard I agree but let's not be too harsh on those that made flawed decisions so long ago.

Where was I harsh Mike? Hope I didn't call anyone names, again.

 

If I did feel free to call me "Harsh Loch".

[newnative]

3 hours ago, scubascuba3 said:

If people are with insurance companies who could deny claims and some are more likely than others then of course it would be sensible to self insure for that eventuality 

      Maybe I'm missing something but I'm filing this in my 'Duh' folder.  Anybody with health insurance and monetary assets available is already doing both.   Although I don't have a pile of cash earmarked 'health self-insurance', I have money I can easily get to if I ever have a health expense that is not covered by my insurance.  Ditto if my car is totaled in an accident and my car insurance only pays half.  No 'car self-insurance' fund but the money is there to make up the difference, if needed.  SOP.

[jerrymahoney]

22 minutes ago, newnative said:

  Maybe I'm missing something but I'm filing this in my 'Duh' folder.

'Duh' folder is good. I sometimes just think of this quote from Good Morning, Vietnam for certain persons:

 

General Taylor: (Sgt. Major Dickerson), I've covered for you a lot of times cause I thought you were a little crazy. But you're not crazy, you're mean. And this is just radio.

 

 

Edited Friday at 02:26 AM by jerrymahoney

[scubascuba3]

3 hours ago, newnative said:

      Maybe I'm missing something but I'm filing this in my 'Duh' folder.  Anybody with health insurance and monetary assets available is already doing both.   Although I don't have a pile of cash earmarked 'health self-insurance', I have money I can easily get to if I ever have a health expense that is not covered by my insurance.  Ditto if my car is totaled in an accident and my car insurance only pays half.  No 'car self-insurance' fund but the money is there to make up the difference, if needed.  SOP.

Yeah but many don't have a separate fund of money that can cover it, they just get a regular pension most likely

[scubascuba3]

4 hours ago, Ben Zioner said:

In most EU countries most people keep their cover once their retire, often it is Social Security with a Semi private complementary cover which employer subsidised. It is true that such cover isn't always transferable overseas, but my point was that this should weigh heavily in the expatriation decision. 

In UK the NHS was generally good so most people didn't want or need private health insurance, i had it up to 35 with employers but it's not something you continue usually

[rumak]

6 hours ago, Mike Lister said:

I've read many of your posts on this subject and said very little but I don't think it's reasonable to be so critical of older expatriates that don't have health insurance. When they expatriated twenty and thirty years ago, many with quite large sums of money, reasonable/good quality health care was available at a low cost. In the past ten years, things have changed and in addition to health care costs increasing by a far higher percentage than most other things in Thailand, those expats have grown older and now have fewer assets. Being critical of the decision they took twenty to thirty years ago to expatriate and self finance their health insurance, is not helpful, many decisions can be challenged when using hindsight. Neither people nor the decisions they make are perfect, rubbing in those imperfections even less so! New expatriates should take the lesson onboard I agree but let's not be too harsh on those that made flawed decisions so long ago.

 

Well,  i find myself agreeing with you... on this one.    🙂 .   The number of variables in peoples lives makes black and white judgements of others silly.  Surely mature and experienced people should know that.  (will pointing that out have a beneficial outcome on AN  posters ? )   HA... HA .   I expect not, but eagerly await the confused emoji or two coming from the peanut gallery.

Anyway,  (seriously) ...  the causes and intentions of the catastrophic inflation within the monetary system ,  with the medical field being the highest and most life destroying of all..... is a huge topic that would fill pages and pages of debate. 

Whether a proponent of buying "insurance"  ( the terms are certainly not insured for future years,  are they ? ) ,   OR  deciding (by choice or necessity)  to go it on ones own ...... we can make those decisions ,  BUT we , in reality,   can never foresee what the future costs will be to cover our butts.   

 

Edited Friday at 08:03 AM by rumak

[sandyf]

7 hours ago, Ben Zioner said:

Salary should not be the sole criterion when choosing an employer.

Try and stay in context.

[Presnock]

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. Then of course the question is wether this cover works in Thailand. In my case, being from a UN organisation, obviously the cover had to be international. And very honestly, if that hadn't been the case I wouldn't have retired here. As you get older having to face massive medical expenses isn't a possibility anymore, it becomes a damn certainty.

Yes, as a govt employee one can opt to keep insurance through the govt group - I did so, my premium was not too high but I added my family to the policy too many years ago - now my share of the premium for the family is about 9600 USD, I am 77 and can easily afford the premium.  My daughter will finish college and will be off the policy but then I can do a 1 plus 1 (my self and wife) and the premium would drop by about a third.   But, US insurers increase yearly so in a few years I will see (if I am still here) and my policy covers me anywhere in the world. I can't imagine never having insurance - but I myself have never had a charge against the policy but my first wife died of breast cancer so the insurance saved us a lot of money for treatment in the US which was too late in any case.

[Sheryl]

Cost of living in general, and health care costs even more so,   have increased exponentially over the past couple of decades in Thailand. More than would reasonably have been forecast 20-30 years ago (though any reasonable person would have prepared for some inflation).

 

Meanwhile currency exchange rates have altered unfavorably for some nationalities.

 

And of course the UK Old Age pension is frozen for those living in Thailand.

 

A perfect storm, especially for Brits.

 

Granted, there was often a lack of contingency planning and definitely a failure to anticipate health care costs as a significant expense as one ages. We see people on this board  all the time talking about retiring in Thailand on a fixed income based on budget calculations that assume 0 inflation going forward and totally omits health care.  Not realistic.

 

Anyway the result is a lot of elderly farang  having to live very close to the wire here, barely making their rent snd food needs and with certainly no way to handle a major health expense. Yes, they should have gotten health insurance when they first arrived...but if they had, by now they'd be unable to afford the premiums.

 

 

 

 

 

[how241]

I have followed the insurance threads for years with interest.  I last was covered under my ex-wifes policy back in the USA until 2009.  Since then, living in Thailand I have self insured following Sherly's financial  recommendations.  There seems to be a lot of confusion and conflicting info on what insurance company to buy and what Pattaya agent can handle this.   The only thing I am sure of is not to go with a Thai company.

As a 70 year old,  can anyone recommend a Pattaya agent and a good non-Thai company.  I am not concerned about the cost but want to be sure of getting paid if-when I put in a claim.  Please respond if you have actually gotten paid as I have read many posters talking good about their company but later mention that they have never put in a claim.  Thank for any info.