Request recommendations of medical insurance companies

[Cutty Shark]

Hi.  I’d appreciate your recommendation of medical insurance companies.  I plan to retire here in Thailand.  I’m American, male, age 73, living in Bangkok. Thank you!

[Sheryl]

Do you take any medications? Have any chronic health conditions? Any prior surgeries?

 

 

[Cutty Shark]

I take Losartan and Amlodipine for high blood pressure, Atorvastatin for cholesterol, and Omeprazole for acid reflux.  No other problems.  I have had operations on appendix and gall bladder more than 30 years ago.  Thank you.

[Sheryl]

1 hour ago, Cutty Shark said:

I take Losartan and Amlodipine for high blood pressure, Atorvastatin for cholesterol, and Omeprazole for acid reflux.  No other problems.  I have had operations on appendix and gall bladder more than 30 years ago.  Thank you.

 

With documented hypertension (even though controlled on medication) and elevated lipids (ditto), combined with your age, it will be very difficult to get insured. Forget Thai issued policies, which are anyway better avoided (weak regulatory environment,  track record for denying claims) as you are very unlikely to be able to get one.

 

AFAIK the best international insurer for people with chronic. but well controlled, health problems is Cigna International (based in UK, not to be confused with Cigna US).  Should always get insurance through a broker and even more so with Cigna Global, they are ultimately reliable in payouts but their admin is very inefficient so you often need someone to run interference.

 

You can see  rates for different deductible and copay scenarios on their website

https://www.cignaglobal.com/

Do NOT enter your phone number or you will be plagued by calls from sales people (really, really plagued).  Suggest just a string of 9's or the like.

Their lowest plan (Silver) is fine and for Thailand I suggest to skip optional OPD, it will greatly increase premiums  and OPD care here is quite affordable.

 

Besides what you see on that website, Cigna has something called "Close Care" which is cheaper and insures you only in Thailand and US. I have never found a website where you can get quotes for that, need to go through a  broker. Which you should do anyhow

 

The broker I use is  https://www.aoc-insurancebroker.com/

Based in France.  Can be communicated with via email or WhatsApp. I have been happy with their support (but be warned, thick accent when speaking can make it hard to understand, so email or WhatsApp messaging may be better than live chat).

 

Ask specifically about Cigna and (unless planning to spend time in other countries besides Thailand) Cigna Cose Care.

 

You will not know for sure until you submit application, whether or not you will be accepted by Cigna and whether they will apply any exclusions.

 

Possible broker will have other suggestions as well. Good luck.

 

Should you have to self insure, for using private hospitals need to set aside at least 5 million baht and have means to replenish as used.

[Cutty Shark]

Thank you for your information and advice, Sheryl.  It's very helpful.

[JBChiangRai]

Research any insurance company recommended, at least one of them is a Ponzi scheme with no underwriter.

[newnative]

    Hello.  I looked into Cigna Close Care when it was mentioned some weeks ago on another thread.  I am male and 72, close to your age.  The quote I got for Close Care, with coverage in Thailand, was $397 a month with $3000 deductible, 10% cost share, and $2000 out of pocket max.  If I remember correctly, there are several options to change the deductible to reduce the monthly cost.  At that point in the application process, which is as far as I got, they did not ask for any of my medical conditions.

    I currently have hospitalization insurance with April International insurance, out of Paris, and I am paying considerably more than the Cigna quote, although with no deductible, which is not available with my plan.  The Close Care was tempting but I decided to stick with April, mainly because I have been with them since around 2011.  

    One thing possibly of interest, when I did not immediately sign up for Cigna, a few days later they sent me an email offering a 10% lifetime discount if I signed up befoe the end of June.  Should you decide to go with them, you might wait a few days and see if you get the same 10% dicount offer.  Good luck with your health care search.

[jerrymahoney]

I had CIGNA Global out of UK for 5 years with no claims. Then I moved to an area where they had no direct payment hospital. They said that's OK and then gave me some Rube Goldberg alternative that maybe they can pay the hospital and then move me to a hospital where they do have direct pay which would be about a 5 hour drive away.

 

I canceled and went elsewhere.

[Yellowtail]

I had Cigna Global for work, and it was great. Pay the bill, submit the receipt and get reimbursed, and I had a lot of claims. 

[jerrymahoney]

8 minutes ago, Yellowtail said:

I had Cigna Global for work, and it was great. Pay the bill, submit the receipt and get reimbursed, and I had a lot of claims. 

That's OK for the small stuff but I was wasn't paying their monthly premiums and still have to have the cash for the big stuff.

[Yellowtail]

7 minutes ago, jerrymahoney said:

That's OK for the small stuff but I was wasn't paying their monthly premiums and still have to have the cash for the big stuff.

I just paid with my US credit card. I would scan and submit the bills online, and the money would almost always be in my US bank account in less than two weeks. 

 

One think that was cool, what that the exchange rate I got on my card, was better than the rate Cigna used, so I netted a bit on every claim. 

[jerrymahoney]

6 minutes ago, Yellowtail said:

I just paid with my US credit card. I would scan and submit the bills online, and the money would almost always be in my US bank account in less than two weeks. 

 

One think that was cool, what that the exchange rate I got on my card, was better than the rate Cigna used, so I netted a bit on every claim. 

Yours was a work sponsored coverage -- I was paying the annual premium myself.

 

And I wasn't interested in being told just pay the 25,000 USD hospital bill and we will reimburse you.

[Yellowtail]

3 minutes ago, jerrymahoney said:

Yours was a work sponsored coverage -- I was paying the annual premium myself.

 

And I wasn't interested in being told just pay the 25,000 USD hospital bill and we will reimburse you.

It seemed easier to me that way. Go anywhere you want and no need to get any approval. 

[jerrymahoney]

5 minutes ago, Yellowtail said:

It seemed easier to me that way. Go anywhere you want and no need to get any approval. 

As you said, this is what you had. Past tense. Group policy.

Edited July 2 by jerrymahoney

[Yellowtail]

1 minute ago, jerrymahoney said:

As you said, this is what you had. Past tense.

Yeah, I self-insure now. It works the same way, but I don't get the money back....

[jerrymahoney]

12 minutes ago, Yellowtail said:

Yeah, I self-insure now. It works the same way, but I don't get the money back....

That's nice.

 

I only replied to suggest that the OP checks that what ever insurance he might choose, make sure that there is direct pay to his hospital choice although in Bangkok that shouldn't be a problem.

Edited July 2 by jerrymahoney

[Yellowtail]

1 minute ago, jerrymahoney said:

That's nice.

 

I only replied to suggest that the OP checks that what ever insurance he might choose, make sure that there is direct pay to his hospital choice.

I only replied because I had a great experience with Cigna. 

 

 

[jerrymahoney]

1 minute ago, Yellowtail said:

I only replied because I had a great experience with Cigna. 

Group policy.

[Yellowtail]

Just now, jerrymahoney said:

Group policy.

It was, but it was not a typical group policy, because only expats were on it. The US personal were on a different plan. I could have continued on with them when I retired had I wanted to. 

 

 

[jerrymahoney]

4 minutes ago, Yellowtail said:

It was, but it was not a typical group policy, because only expats were on it. The US personal were on a different plan. I could have continued on with them when I retired had I wanted to. 

 

 

So the OP has to make his choice from non-group policies.

[bear9]

On 7/1/2024 at 9:33 AM, Sheryl said:

 

With documented hypertension (even though controlled on medication) and elevated lipids (ditto), combined with your age, it will be very difficult to get insured. Forget Thai issued policies, which are anyway better avoided (weak regulatory environment,  track record for denying claims) as you are very unlikely to be able to get one.

 

AFAIK the best international insurer for people with chronic. but well controlled, health problems is Cigna International (based in UK, not to be confused with Cigna US).  Should always get insurance through a broker and even more so with Cigna Global, they are ultimately reliable in payouts but their admin is very inefficient so you often need someone to run interference.

 

You can see  rates for different deductible and copay scenarios on their website

https://www.cignaglobal.com/

Do NOT enter your phone number or you will be plagued by calls from sales people (really, really plagued).  Suggest just a string of 9's or the like.

Their lowest plan (Silver) is fine and for Thailand I suggest to skip optional OPD, it will greatly increase premiums  and OPD care here is quite affordable.

 

Besides what you see on that website, Cigna has something called "Close Care" which is cheaper and insures you only in Thailand and US. I have never found a website where you can get quotes for that, need to go through a  broker. Which you should do anyhow

 

The broker I use is  https://www.aoc-insurancebroker.com/

Based in France.  Can be communicated with via email or WhatsApp. I have been happy with their support (but be warned, thick accent when speaking can make it hard to understand, so email or WhatsApp messaging may be better than live chat).

 

Ask specifically about Cigna and (unless planning to spend time in other countries besides Thailand) Cigna Cose Care.

 

You will not know for sure until you submit application, whether or not you will be accepted by Cigna and whether they will apply any exclusions.

 

Possible broker will have other suggestions as well. Good luck.

 

Should you have to self insure, for using private hospitals need to set aside at least 5 million baht and have means to replenish as used.

Hi Sheryl,

 

Apparently Cigna has just moved out of the Uk market. Just saw this on their website last week.

 Following the completion of a strategic review, Cigna Healthcare has ceased selling UK medical and dental products. Quotes will no longer be provided for these products.

[Sheryl]

2 hours ago, bear9 said:

Hi Sheryl,

 

Apparently Cigna has just moved out of the Uk market. Just saw this on their website last week.

 Following the completion of a strategic review, Cigna Healthcare has ceased selling UK medical and dental products. Quotes will no longer be provided for these products.

Not relevant to their international expat policies.

 

Talking about private  insurance in the UK.

[bear9]

9 minutes ago, Sheryl said:

Not relevant to their international expat policies.

 

Talking about private  insurance in the UK.

Hi,

 

Sorry yes you are correct i thought they had removed international insurance for uk customers but different part of their website still lets you purchase international health insurance

[Sheryl]

Just now, bear9 said:

Hi,

 

Sorry yes you are correct i thought they had removed international insurance for uk customers but different part of their website still lets you purchase international health insurance

Yes, they are talking about domestic UK insurance. A small market so probably they found it not worthwhile.

[roamer]

Hi Sheryl,

 

" With documented hypertension (even though controlled on medication) and elevated lipids (ditto), combined with your age, it will be very difficult to get insured. "

 

So the same age, no heath issues now or prior, can pass any physical but take a low dose statin as recommended by doctor in UK. Would that affect my insurance quote ?

[Sheryl]

11 hours ago, roamer said:

Hi Sheryl,

 

" With documented hypertension (even though controlled on medication) and elevated lipids (ditto), combined with your age, it will be very difficult to get insured. "

 

So the same age, no heath issues now or prior, can pass any physical but take a low dose statin as recommended by doctor in UK. Would that affect my insurance quote ?

 

If no health issues now or prior, why was a statin recommended?

[roamer]

Levels would hover around 4.8-5.5 mmol/L so not a health issue, but the QRISK program used in the UK took into account my fathers death at 60 from a heart attack. Didn't take into account he smoked 40+ a day, very unhealthy diet and heavy drinker.  Low dose statin use not uncommon in such circumstances.

[Sheryl]

33 minutes ago, roamer said:

Levels would hover around 4.8-5.5 mmol/L so not a health issue, but the QRISK program used in the UK took into account my fathers death at 60 from a heart attack. Didn't take into account he smoked 40+ a day, very unhealthy diet and heavy drinker.  Low dose statin use not uncommon in such circumstances.

Levels of what? LDL, or total cholesterol? (latter not useful).

 

While I understand why you are on a statin,  many insurance companies will take one look at it and assume you have elevated lipids.

 

If your father was a heavy smoker and you have never smoked, you might try repeating the QRISK answering no to family history and see what happens.

 

FYI that program gave me a greater than 10% risk and assessed my heart health as that of a 95 year old -- but recent Coronary Calcium Scan was 0, and detailed cardiac assessment including echo found my heart health to be excellent and much better than average for someone by age. Like you, a single "yes" for a family member (brother who had diabetes, which I do not, and chain smoked, while I do not smoke - meanwhile both parents lived far into old age without a single cardiac event)  was a factor.

 

These sorts of tools are made for mass screening and some would argue (and I agree) that before starting an otherwise healthy person with no history of heart disease, normal lipid profile,  and non- diabetic  on lifelong statins based on such a score, an individualized  clinical  assessment should be done eg Calcium Score, maybe echo. (NHS isn't going to say that because it costs more and they are basing recommendations on financial cost benefit. But in an individual level, it makes good sense).

 

You might consider having such tests and consulting a cardiologist to decide whether you need to stay on statins -- assuming your LDL and triglycerides are both  well within in normal range and you are not diabetic.

 

Reverting back to the insurance issue -  you would certainly be more insurable if you could truthfully answer no to any regular medications.  May not make sense but that's how it is.

 

Of the insurers, an international one that does a thorough medical screening/full is best bet. They'll likely ask for supporting documentation (lab tests, physician reports etc).

 

[roamer]

Thanks Sheryl. There is certainly some food for thought there. I totally agree that the Q risk programme is a very rough tool at best. I think I will take a look at a proper cardiac screening and see where we go from there.

If I do take out any insurance I would certainly want it to be with a reputable company and to be able to answer questions truthfully so as not to leave any loopholes. I'm very much a dot the i’s  and cross the t's type of person when it comes to things like insurance!

Thanks again, much appreciated.