Health insurance in Thailand: What’s not included?

[CharlieH]

 

Health insurance in Thailand comes with important limitations that everyone should understand. Many policies exclude pre-existing conditions, motorcycle accidents, extreme sports, and specific treatments. These gaps can lead to unexpected expenses during emergencies, so it’s crucial to understand, and be aware of insurance exclusions. 

Common exclusions in Thai health insurance

• Pre-existing conditions: Most plans do not cover pre-existing conditions or impose a waiting period before coverage begins.

• Cosmetic procedures: Treatments aimed at improving appearance, such as plastic surgery, are typically not covered unless medically necessary.

• Alternative therapies: Acupuncture, homoeopathy, and other non-traditional treatments are usually excluded from standard plans.

• Sexually transmitted diseases (STDs): Coverage for conditions like HIV/AIDS varies, with many policies excluding them entirely.

• Fertility treatments: Procedures such as in vitro fertilisation (IVF) are rarely covered.

• Obesity treatment: Weight-loss surgeries and related treatments are often excluded unless medically necessary.

Lifestyle-related exclusions

• High-risk activities: Injuries from extreme sports like skydiving, rock climbing, or motocross are not covered unless additional insurance is purchased.

• Substance abuse: Treatment for drug or alcohol addiction, including rehabilitation, is generally excluded.

• Illegal activities: Injuries sustained while engaging in illegal activities are not covered.

• Self-inflicted injuries: Most policies exclude coverage for self-harm or suicide attempts.

• Natural disasters and terrorism: Injuries resulting from floods, earthquakes, or terrorist attacks are often not included.

• Sleep disorders: Conditions like insomnia and sleep apnea are typically excluded.

• Experimental treatments: New or unproven medical procedures are rarely covered.

• Chronic lifestyle diseases: Some policies limit coverage for conditions such as diabetes or hypertension if linked to unhealthy habits.

Specific limitations on coverage

• Dental and vision care: Routine dental procedures, braces, and corrective eyewear often require additional coverage.

• Maternity care: Prenatal visits, childbirth, and postnatal care are usually not included unless explicitly covered.

• Mental health services: Some plans provide limited or no coverage for counselling or psychiatric treatment.

• Preventive services: Vaccinations and screenings may have restrictions or require co-pays.

• Outpatient services: Some plans limit the number of visits or exclude certain treatments.

• Emergency services: Pre-authorization or coverage caps may apply to emergency medical care.

International coverage considerations

Many Thai health insurance plans do not cover medical treatment abroad. This means that travellers may face high medical expenses if they need care outside of Thailand. 

Opting for a plan with international coverage ensures access to medical providers in other countries, though these plans often come with higher premiums. Even with international coverage, exclusions for pre-existing conditions or high-risk activities may still apply.

For frequent travellers or those who are living abroad, a health insurance plan with international coverage may prove to be invaluable. For this demographic, it may also be helpful to understand the claims process for receiving treatment outside of Thailand.

Optional add-ons for enhanced coverage

• Maternity coverage: Includes prenatal care, childbirth, and postnatal services.

• Dental care: Covers routine check-ups, cleanings, and major procedures.

• Extreme sports coverage: Provides protection for high-risk activities.

Cigna offers flexible add-ons to enhance coverage, allowing policyholders to tailor their insurance plans. Discounts and promotions are available, making comprehensive coverage more accessible to all.

Verifying your health insurance coverage

To avoid unexpected expenses, policyholders should carefully review their health insurance documents. Before seeking treatment, contacting hospitals and insurance providers about any required documents such as insurance cards or IDs can help clarify coverage details. 

Key features of Cigna health insurance for expats

 

When choosing a health insurance plan, expats should consider features that provide comprehensive protection:

• Hospital stays: Coverage up to $1,000,000 annually for major health conditions.

• Doctor visits: Up to $25,000 per year for check-ups and specialist care.

• Chronic illness care: Full coverage for long-term treatments.

• Emergency evacuation: Global emergency assistance.

• Preventive care: Screenings, vaccinations, and routine check-ups to detect and manage health issues early on.

• Custom add-ons: Additional coverage for dental, vision, or maternity care.

 

Health insurance in Thailand often excludes pre-existing conditions, high-risk activities, and cosmetic procedures, creating potential coverage gaps. However, optional add-ons can help individuals tailor their policies for more comprehensive protection. 

 

Understanding exclusions and verifying coverage details can prevent financial surprises during medical treatment. Expats and frequent travellers should consider international coverage for added peace of mind while overseas.

 

 

 

Original article by The Thaiger