Senior healthcare cost issues

[Goattee]

I realize that I am opening a discussion that contains a lot of variables. And I am not expecting hard numbers or generalizations. But I am hoping you all can share all the considerations that you have encountered or are currently considering. We're a Thai / US couple currently living in the US. Both of us currently are on the US Medicare system.

 

• We own a modest home in Bangkok free and clear (no monthly rental or mortgage costs). It's a convenient short walk from BTS so getting around is fairly easy.
  We've lived together in that home for 8 years full time before returning to the US.
• We're 73 and 65. 
• No debilitating chronic conditions.
  We're both in reasonably good health with fine mobility and energy. (When traveling, we like to do sightseeing on foot and can easily manage 5-10 km a day.)
   

Obviously none of us can predict how our health will develop as we age-- and we don't even know each other-- so I wouldn't ask anyone to speculate. But we are trying to anticipate what to expect when/if we decide to re-occupy in Bangkok. Our experience with healthcare providers and systems in Bangkok has been positive so we don't have to be convinced about that. (Bangkok Christian Hospital, Bangkok Hospital, Samitivej Thonburi, Samitivej Sukhumvit), Bumrungrad).

 

Our concern will be managing costs if we are sacrificing Medicare coverage when living abroad. Naturally we are thinking about health insurance-- at least for the American in the couple. For a few years I did have a Thai health insurance policy. That was about 10 years ago. The policy seemed to offer pretty sparse coverage but my health was rather good and never really needed to make claims.

 

There were substantial exclusions for pre-existing conditions. Even taking statins was considered tantamount to heart disease-- even though we never had been diagnosed with such. Do today's policies carry the same severe restrictions?

 

Restrictions for pre-existing conditions matter: During 2024 I was diagnosed with a very low-risk case of prostate cancer and I underwent the shortest protocol for radiation therapy. Fortunately, this was successful. I will need to monitor this for the rest of my life-- although doctors generally tell people in my position that we are far likely to die from other causes.

 

I hope I haven't put you to sleep! I'd be very grateful for any observations and anecdotes you might have to offer that we can consider as we decide whether to return to Bangkok full-time.