Health insurance-foreign policy or local one

[neytil]

Seen a few posters recently refer to local issued health insurance policy versus foreign issued .  Could someone please explain the main differences? Thank you

[CharlieH]

Some general facts to consider. (Not a personal opinion or advice.)

 

In Thailand, the key differences between local and foreign-issued health insurance policies generally come down to coverage, claims processing, cost, and acceptance. Here’s a breakdown:

Local Thai Health Insurance

✅ Easier acceptance & claims processing – Hospitals and clinics in Thailand are more familiar with local policies, so claims are often processed directly (cashless) rather than requiring reimbursement.
✅ More affordable premiums – Local policies are often tailored to Thai healthcare costs, making them more cost-effective compared to international policies.
✅ Regulated under Thai laws – Subject to the Office of Insurance Commission (OIC) regulations, ensuring compliance with local standards.
❌ Limited international coverage – Most local policies focus on treatment within Thailand, with little or no coverage abroad.

Foreign-Issued (International) Health Insurance

✅ Global coverage – Ideal for expats or frequent travelers, as coverage extends beyond Thailand.
✅ Higher coverage limits – Generally provides better coverage for major medical expenses, including private hospitals with international standards.
❌ Reimbursement-based claims – Many Thai hospitals require out-of-pocket payment first, with reimbursement afterward, which can be inconvenient.
❌ Higher premiums – Often more expensive due to wider coverage and higher benefit limits.

If you plan to stay in Thailand long-term and primarily use local hospitals, a Thai policy might be more practical. If you want global flexibility, an international policy may be worth the extra cost.

 

 

[jayboy]

Fair summary but , having had personal experience of both local and foreign issued insurance, I have the following comments.

 

The main hospitals in Thailand's large cities are very well geared up to process claims under foreign policies.In many cases claims are settled directly.

 

Foreign policies definitely tend to be more expensive but it can be a false economy to opt for a cheaper local package, not least because the financial cover tends to be less.

 

I do not see how "compliance with local standards" is relevant if the foreign provider is a blue chip outfit.

[Etaoin Shrdlu]

There are a few things I'd like to add to Charlie's analysis:

 

1) Consumer protection laws in other countries are often more favorable than Thailand's. This, to a certain extent, can negate the supposed advantage of being under the OIC's regulations and oversight. Being under the OIC is better than not being able to determine who regulates your offshore insurer or having an offshore insurer that is regulated in a small, remote tax haven with lax oversight. The OIC is relatively consumer-friendly and anyone with a complaint will get a fair hearing.

 

2) While it can be somewhat difficult to measure, there is the issue of underwriting and claims-paying attitudes. Sometimes these attitudes are influenced by the environment in which an insurer operates. Insurers in low-trust societies may see things differently than those operating in higher-trust ones. However, insurers are generally a cynical lot and a policyholder in Thailand may face more scrutiny from an offshore insurer than a policyholder in some other countries.

 

3) There are too many insurers in Thailand vying for what is still a fairly small market. Because of this, they tend not to get the full benefit of the law of large numbers and economies of scale, making their portfolio more volatile and operating costs a higher percentage of premiums written. As a result, they are more conservative in their approach to underwriting and claims and charge higher premiums for the cover they do provide. 

 

4) Many large foreign insurers are rated by the major rating agencies such as Standard and Poor and AM Best, making it easier to determine their financial ability to pay claims. Few Thai insurers are rated by S&P or AM Best, although some are rated by Fitch Thailand. Fitch Thailand's ratings are valid to compare Thai companies with other Thai companies, but may be a less reliable measure of absolute financial security. If you think it is difficult to get a claim paid in full and promptly by a large, well-reserved insurer, just try to get one paid by a small one that is financially on the edge.

 

5) The OIC regulates both policy forms insurers may issue and premiums that they can charge. While this can benefit the policyholder in that it helps prevent some sharp practices, it also stifles competition and innovation. It could be suspected that part of the reason for this type of regulation is to prop up some of the smaller and weaker insurers who would struggle to compete if rates and forms had more flexibility. The consumer may be deprived of better coverage and lower premiums as a result.