Health Insurance in Thailand After Leaving Employment

[Globenauta]

Hi everyone,
 

I’m looking for advice or insights from others who’ve faced similar challenges with health insurance in Thailand.

 

I’m originally from the EU, where public healthcare is the standard, and private insurance plays a minor role. I’ve been living and working in Thailand for the past 8 years, during which my employer provided comprehensive private health insurance and enrolled me in the Thai SSO system.

 

At the end of last year, I left my job, and I’m now figuring out my next steps. One of my main concerns is how to maintain health coverage moving forward.
 

I’ve been in touch with the private insurance company that provided my previous policy, and they’re willing to let me continue paying for the same plan independently. However, this has raised some questions for me:
 

1. I’ve realized I might not have much flexibility to negotiate premiums or compare other insurance options. My age and some pre-existing conditions developed during my previous policy would likely lead to exclusions or very high premiums with a new insurer. This feels restrictive - almost like I’m “locked in” with my current provider. Is this a common experience? How do others handle this?
 

2. I plan to continue coverage through the SSO public healthcare system. However, I’ve never used public hospitals in Thailand before, so I’m unsure about the quality of care, especially for serious procedures. I also understand you need to select a specific hospital for treatment - how do you go about choosing one if you’re unfamiliar with the options?

3. Are there any protections in Thailand for private insurance customers? For instance, regulations on premium adjustments or exclusions for pre-existing conditions?

I’d really appreciate hearing about your experiences with:

- Continuing private health insurance after leaving employment
- Using the SSO system, particularly outside Bangkok
- Managing pre-existing condition exclusions or negotiating with insurers

Thank you in advance for any advice or tips!

[Presnock]

20 hours ago, Globenauta said:

Hi everyone,
 

I’m looking for advice or insights from others who’ve faced similar challenges with health insurance in Thailand.

 

I’m originally from the EU, where public healthcare is the standard, and private insurance plays a minor role. I’ve been living and working in Thailand for the past 8 years, during which my employer provided comprehensive private health insurance and enrolled me in the Thai SSO system.

 

At the end of last year, I left my job, and I’m now figuring out my next steps. One of my main concerns is how to maintain health coverage moving forward.
 

I’ve been in touch with the private insurance company that provided my previous policy, and they’re willing to let me continue paying for the same plan independently. However, this has raised some questions for me:
 

1. I’ve realized I might not have much flexibility to negotiate premiums or compare other insurance options. My age and some pre-existing conditions developed during my previous policy would likely lead to exclusions or very high premiums with a new insurer. This feels restrictive - almost like I’m “locked in” with my current provider. Is this a common experience? How do others handle this?
 

2. I plan to continue coverage through the SSO public healthcare system. However, I’ve never used public hospitals in Thailand before, so I’m unsure about the quality of care, especially for serious procedures. I also understand you need to select a specific hospital for treatment - how do you go about choosing one if you’re unfamiliar with the options?

3. Are there any protections in Thailand for private insurance customers? For instance, regulations on premium adjustments or exclusions for pre-existing conditions?

I’d really appreciate hearing about your experiences with:

- Continuing private health insurance after leaving employment
- Using the SSO system, particularly outside Bangkok
- Managing pre-existing condition exclusions or negotiating with insurers

Thank you in advance for any advice or tips!

several friends here have used the goverment hospital for some serious health events/accidents and have praised the service that they receive at a much lower cost than the private hospitals.  Just saying as I haven't had that service myself.

[Globenauta]

1 hour ago, Presnock said:

several friends here have used the goverment hospital for some serious health events/accidents and have praised the service that they receive at a much lower cost than the private hospitals.  Just saying as I haven't had that service myself.

Thanks for sharing, Presnock!
 

It’s good to hear positive feedback about government hospitals. Do you know if your friends experienced long waiting times for treatment?

[JoePai]

2 hours ago, Presnock said:

several friends here have used the goverment hospital for some serious health events/accidents and have praised the service that they receive at a much lower cost than the private hospitals.  Just saying as I haven't had that service myself.

If you are under the SSO then treatment is free

[JoePai]

40 minutes ago, Globenauta said:

Thanks for sharing, Presnock!
 

It’s good to hear positive feedback about government hospitals. Do you know if your friends experienced long waiting times for treatment?

Yes always long queues for treatment - you will first seen by a regular Doctor then, depending on ailment, fix an appintment with a specialist 

[Presnock]

38 minutes ago, Globenauta said:

Thanks for sharing, Presnock!
 

It’s good to hear positive feedback about government hospitals. Do you know if your friends experienced long waiting times for treatment?

well one of those fell off a ladder that collapsed (if yu hae ever seen them you could understand why they collapse - anyway he broke his leg right at the socket of his hip plus some other problems so needed emergency response.  He got that and at first was worried until he chatted with the doctors after the xrays showed the damage.  they explained that at his agfe he might not get 100% total use again, several screws in the socket and within less than 6 months was fully recovered! cost was really cheap and he was super happy that he didn't go to a private hospital.  In addition several that have used government care, they indicate that several of the doctors work not only at the government hospital but the private hospitals too.  They never complained about any waiting times.  I think that may depend on the locations in relation to larger cities or not.  But like I said Ionly have 2nd hand knowledge and my insurance covers totally in a private hospital so that is where I go or take members of my family for treatment.  Always has been great care and covered by the policy so lucky in that respect.

[Sheryl]

"1. I’ve realized I might not have much flexibility to negotiate premiums or compare other insurance options. My age and some pre-existing conditions developed during my previous policy would likely lead to exclusions or very high premiums with a new insurer. This feels restrictive - almost like I’m “locked in” with my current provider. Is this a common experience? How do others handle this?"

 

Yes, common and you just have to choose between accepting new exclusions or staying with same insurer
 

"2. I plan to continue coverage through the SSO public healthcare system. However, I’ve never used public hospitals in Thailand before, so I’m unsure about the quality of care, especially for serious procedures. I also understand you need to select a specific hospital for treatment - how do you go about choosing one if you’re unfamiliar with the options?"

 

Post your choices here. If you are in Bangkok, may not be many (note that lists from SS often contain hospitals that are no longer accepting new enrollment).  Quality of care varies by hospital.  Where in Thailand are you?

"3. Are there any protections in Thailand for private insurance customers? For instance, regulations on premium adjustments or exclusions for pre-existing conditions?"

 

There are some but pretty weak, much weaker than in Western countries.  There is no regulation that prevents exclusion of pre-existing conditions.  Thai insurers are allowed to set their premiums by age pretty much as they want (and rates at older age are higher than in the west) and also allowed to raise premiums on an individual basis based on claim history by up to 25% annually.  This is why it is best to get an internationally issued expat policy where possible. But if you have significant pre-existing conditions that may be a problem. What exactly are these conditions?

[Presnock]

13 minutes ago, JoePai said:

If you are under the SSO then treatment is free

My friends paid out for their treatment and were pleased with the actual costs.

[Sheryl]

23 minutes ago, Presnock said:

My friends paid out for their treatment and were pleased with the actual costs.

This will depend be very much on the nature of the problem/treatment.

 

They will not be so pleased with the cost if they require speciliazed surgery followed by extended ICU stay...even at a government hospital.

[Globenauta]

34 minutes ago, Presnock said:

well one of those fell off a ladder that collapsed (if yu hae ever seen them you could understand why they collapse - anyway he broke his leg right at the socket of his hip plus some other problems so needed emergency response.  He got that and at first was worried until he chatted with the doctors after the xrays showed the damage.  they explained that at his agfe he might not get 100% total use again, several screws in the socket and within less than 6 months was fully recovered! cost was really cheap and he was super happy that he didn't go to a private hospital.  In addition several that have used government care, they indicate that several of the doctors work not only at the government hospital but the private hospitals too.  They never complained about any waiting times.  I think that may depend on the locations in relation to larger cities or not.  But like I said Ionly have 2nd hand knowledge and my insurance covers totally in a private hospital so that is where I go or take members of my family for treatment.  Always has been great care and covered by the policy so lucky in that respect.

Thanks for the detailed reply, Presnock!

It sounds like the government hospital handled the emergency very well. It’s also interesting that some doctors work in both public and private hospitals.
 

I guess location does make a difference when it comes to waiting times. I live in in the Samut Prakan province, but  I’m not sure about the gvt. hospitals here - I guess, I’ll have to check my options at the SSO office.
 

It’s good to hear that your private insurance has been so reliable for you and your family.

[Etaoin Shrdlu]

Even if you decide to obtain private medical insurance, don't give up the social security coverage. Continue to pay the monthly premiums so that you'll have this scheme to fall back on.

 

Private insurers will exclude pre-existing conditions, so that coverage will have holes in it depending upon your medical situation and history.

 

Thai regulations are not as consumer-friendly as in the West and policies here are often not as broad in coverage. You may find better coverage and better underwriting and claims-paying attitudes with offshore insurers.

 

Don't mistake the local operations of multinational insurers for the operations of offshore insurers. They may be part of the same company with the same branding, but operate under different regulations, have different approaches to underwriting and claims, and use different policy forms.

[Presnock]

11 minutes ago, Globenauta said:

Thanks for the detailed reply, Presnock!

It sounds like the government hospital handled the emergency very well. It’s also interesting that some doctors work in both public and private hospitals.
 

I guess location does make a difference when it comes to waiting times. I live in in the Samut Prakan province, but  I’m not sure about the gvt. hospitals here - I guess, I’ll have to check my options at the SSO office.
 

It’s good to hear that your private insurance has been so reliable for you and your family.

Yeah I was a civil service employee and had one of the govt insurance co. so kept that as I retired, expensive as I have never used it for myself or wife but daughter did have some event...price keeps going up but soon daughter will depart from that policy and then wife and I can basically cut the price in half.   Daughter will be yuoung though so cheaper policy anyway.  Not sure if Trump & co. want to change any of these benefits to save money ..

[Globenauta]

46 minutes ago, Sheryl said:

"1. I’ve realized I might not have much flexibility to negotiate premiums or compare other insurance options. My age and some pre-existing conditions developed during my previous policy would likely lead to exclusions or very high premiums with a new insurer. This feels restrictive - almost like I’m “locked in” with my current provider. Is this a common experience? How do others handle this?"

 

Yes, common and you just have to choose between accepting new exclusions or staying with same insurer

It’s unfortunate to hear that this is a common situation... it does seem like a “locked-in” scenario where the insurance company has all the leverage. Essentially, it feels like I have no choice but to accept their conditions or go without (private) coverage altogether, which doesn’t leave much room for negotiation or alternatives.

 

48 minutes ago, Sheryl said:

"2. I plan to continue coverage through the SSO public healthcare system. However, I’ve never used public hospitals in Thailand before, so I’m unsure about the quality of care, especially for serious procedures. I also understand you need to select a specific hospital for treatment - how do you go about choosing one if you’re unfamiliar with the options?"

 

Post your choices here. If you are in Bangkok, may not be many (note that lists from SS often contain hospitals that are no longer accepting new enrollment).  Quality of care varies by hospital.  Where in Thailand are you?

 

I’m based in Samut Prakan, not far from Bangkok. I haven’t received the list of SSO hospitals yet, but I’ll share the options here once I have them.
 

 

49 minutes ago, Sheryl said:

"3. Are there any protections in Thailand for private insurance customers? For instance, regulations on premium adjustments or exclusions for pre-existing conditions?"

 

There are some but pretty weak, much weaker than in Western countries.  There is no regulation that prevents exclusion of pre-existing conditions.  Thai insurers are allowed to set their premiums by age pretty much as they want (and rates at older age are higher than in the west) and also allowed to raise premiums on an individual basis based on claim history by up to 25% annually.  This is why it is best to get an internationally issued expat policy where possible. But if you have significant pre-existing conditions that may be a problem. What exactly are these conditions?

 

The system here seems to lean much more in favor of the insurers compared to Western countries, especially with the flexibility to increase premiums and impose exclusions. I hadn’t thought about expat policies as an option, but as you say my pre-existing conditions might complicate things.
For context, I have hypercholesterolemia, a family history of heart disease, and I’ve been on rosuvastatin for the past seven years. I’m not sure how these would affect eligibility or premiums for international policies, but I might look into it further.

Thanks again for taking the time to explain these points. Your insights have been really helpful!

[Sheryl]

Family history eon't be a factor but your hyperlipedemia probably will be. Though if you can show it is well controlled (recent lab test results etc) , might help. 

 

I suggest you contact a broker specializing in international expat polcies  and explain your situation, see what they suggest. I use 

https://www.aoc-insurancebroker.com/

 

Tell them you dpecifically want a Western based insurer. Where the indurer is based detrrmines whst regulatory framework applies. 

 

Until you actually submit an application with health history to an insurer, won't know what they will offer in terms of  premium liad or exclusions.

 

[lepik]

On 1/8/2025 at 8:44 AM, Sheryl said:

Thai insurers are allowed to set their premiums by age pretty much as they want (and rates at older age are higher than in the west) and also allowed to raise premiums on an individual basis based on claim history by up to 25% annually. 

Sherly this information is out of date, since 2022 there is a new health insurance regulation in thailand called "New Health Standard".

-It guarantees contract renewal (so the insurancy company can't kick you out if you make a big claim)

-Forbids premium increases based on individual claim history (company can only increase premiums based on age, occupation and if there were lot of claims on a portfolio level so they have raise everyone's premium equally) 

 

These are pretty much the same as european regulations . This only affect new contracts so if you bought insurance in 2021 for example then still the horrible old rules apply.

 

sources:

in english SCB bank: https://www.scb.co.th/en/personal-banking/stories/protect-my-family/new-health-standard.html

in thai AIA insurance: https://www.aia.co.th/th/health-wellness/new-health-standard

in thai blog post: https://www.msmany.com/TH/product/newhealthstandard.html

 

The only "catch" is in the "New Health Standard" that the insurance company can put you on copayment but only if the company reserves this right in the policy when you buy it (so read the renewal terms of your contract in thai). And copayment is limited to 30% per criteria but it can go up to 50% if you meet multiple criteria but can't go up higher than that. And if the company puts you on copayment then they have to give you the same amount of discount on your premium (so 50% copayment means 50% discount on your premium) and if you do not meet any copayment criteria the next year then the company has to remove the copayment.

[Globenauta]

On 1/8/2025 at 3:26 PM, Etaoin Shrdlu said:

Even if you decide to obtain private medical insurance, don't give up the social security coverage. Continue to pay the monthly premiums so that you'll have this scheme to fall back on.

 

Private insurers will exclude pre-existing conditions, so that coverage will have holes in it depending upon your medical situation and history.

 

Thai regulations are not as consumer-friendly as in the West and policies here are often not as broad in coverage. You may find better coverage and better underwriting and claims-paying attitudes with offshore insurers.

 

Don't mistake the local operations of multinational insurers for the operations of offshore insurers. They may be part of the same company with the same branding, but operate under different regulations, have different approaches to underwriting and claims, and use different policy forms.

 

Thank you for the advice, Etaoin!
 

I definitely plan to keep my SSO coverage - it seems like an important safety net here in Thailand. I also understand that private insurers can be quite restrictive about pre-existing conditions, leading to coverage gaps. Plus, from what I’ve read on this forum, paying or renewing a private policy can become harder as we age and develop more health issues. That’s one of my biggest worries about staying in Thailand long term.
 

Thanks again for your insights!