Be aware of this even if you have Health insurance cover!!!

[xylophone]

I have had health insurance cover here in Thailand for about 15 years, and every year it comes up for renewal, so I renew it! And of course every few years the premium payable gets more expensive, and it is due this month.

 

About three years ago when I was undergoing a medical check, the electrocardiogram discovered a bulge in my aorta so I had another scan and the heart doctor said it was small and not to worry too much about it, however it needed "watchful waiting" with checks every year, or less.

 

I didn't disclose it because I had no treatment for it and as I was covered by health insurance when it was discovered, I thought that all would be fine?

However I am now doing some digging around prior to my health insurance policy renewal and although I haven't contacted them yet, it appears that many health insurance companies consider that to be a pre-existing condition when one goes to sign the policy for the next year!

 

I just thought I would sound a word of warning, although I will be in touch with my health insurance agent and report back on what I find as it appears that some companies will re-insure in spite of this, whereas others won't or will consider it a pre-existing condition which will not be covered in the new policy.

Food for thought.
 

[jwest10]

17 minutes ago, xylophone said:

I have had health insurance cover here in Thailand for about 15 years, and every year it comes up for renewal, so I renew it! And of course every few years the premium payable gets more expensive, and it is due this month.

 

About three years ago when I was undergoing a medical check, the electrocardiogram discovered a bulge in my aorta so I had another scan and the heart doctor said it was small and not to worry too much about it, however it needed "watchful waiting" with checks every year, or less.

 

I didn't disclose it because I had no treatment for it and as I was covered by health insurance when it was discovered, I thought that all would be fine?

However I am now doing some digging around prior to my health insurance policy renewal and although I haven't contacted them yet, it appears that many health insurance companies consider that to be a pre-existing condition when one goes to sign the policy for the next year!

 

I just thought I would sound a word of warning, although I will be in touch with my health insurance agent and report back on what I find as it appears that some companies will re-insure in spite of this, whereas others won't or will consider it a pre-existing condition which will not be covered in the new policy.

Food for thought.
 

They just want your money and yes hearing that if there is not sufficient equipment locally or aftercare and yes even the Thias are not covered by their own policy!!

[scubascuba3]

Probably they will say it's an undisclosed pre-existing condition which it is in terms of the premium doesn't take it into account, so you aren't paying enough. Reason for claim denied, declare it

[4MyEgo]

2 hours ago, xylophone said:

I didn't disclose it because I had no treatment for it and as I was covered by health insurance when it was discovered, I thought that all would be fine?

 

Read the fine print, you have a duty of care to inform your insurer of any changes in your condition, whether it's a growth a mur mur in your heart etc etc, etc.

 

If I were you, I would get a letter from your heart doctor when it was 1st picked diagnosed and provide that to the health insurer you are with, providing a thorough explanation as to why you didn't advise them of it when it was 1st diagnosed.

 

If they don't buy it, yes, your next health insurer will class it as a pre-existing condition.

[xylophone]

31 minutes ago, 4MyEgo said:

 

Read the fine print, you have a duty of care to inform your insurer of any changes in your condition, whether it's a growth a mur mur in your heart etc etc, etc.

 

If I were you, I would get a letter from your heart doctor when it was 1st picked diagnosed and provide that to the health insurer you are with, providing a thorough explanation as to why you didn't advise them of it when it was 1st diagnosed.

 

If they don't buy it, yes, your next health insurer will class it as a pre-existing condition.

You make a good point, so I read through the policy document and can't find anything about my "duty of disclosure" or similar wording, however it could be hidden away in some other area so I'll take time to check it out a little later.

 

In addition I contacted the agent, who is also a lawyer and told her of the situation and asked her if she would contact the company direct and get an answer for me.

 

It's highly likely that this condition I have, has been with me for many years and has never been discovered, but now it has, it puts a whole different perspective on things.

 

Having said that, my premium was becoming quite hefty, so I asked if they would include a 50,000 baht deductible (the amount which I pay for any procedure) in order to reduce the premium payable, which they did. However now I come to think about it I have 50,000 baht which I have to pay upfront, as well as a 160,000 baht premium and my total cover is only 1 million baht, so I'm wondering if it's worth renewing it???

 

I will make the final decision when I hear back from my agent, however at the moment I am 50-50 about renewing it, because I do have investments in New Zealand which I can call on (transfer) if necessary, but really didn't want to dip into these.

 

Decisions to make which I will do shortly.

 

Thank you for your input/suggestions.

 

PS. This is the same Health Insurance company with whom I am renewing my policy.

[xylophone]

Well I have just had an answer from the company representative (the lawyer who I've been dealing with since I took the policy out many years ago) and she contacted the company and she informed me that because I've been with them and had the policy for over 10 years, then I am covered for this event.

 

I suppose I should get this in writing, so I will ask her to confirm this by email, however I've always found her to be a helpful and trustworthy person in the past, so I will think about that aspect.

 

Having said that, there is a clause in the policy document which states that any pre-existing condition which existed when the policy was taken out, can be included at sometime in the future of either two or five years hence (can't recall exactly so I will look again).

 

Despite all of this, I will go ahead and renew the policy for this year, and that will probably be the last time.

[KhunLA]

That makes years of health insurance premiums a waste of money.  If having a minor incident that doesn't even need treatment, as we age, things change.   If the change causes an issue in the future, then considered pre-existing and no longer covered.  What a scam 🙄

 

Add even more reason why I'd never have health insurance.

[scubascuba3]

30 minutes ago, xylophone said:

Well I have just had an answer from the company representative (the lawyer who I've been dealing with since I took the policy out many years ago) and she contacted the company and she informed me that because I've been with them and had the policy for over 10 years, then I am covered for this event.

 

I suppose I should get this in writing, so I will ask her to confirm this by email, however I've always found her to be a helpful and trustworthy person in the past, so I will think about that aspect.

 

Having said that, there is a clause in the policy document which states that any pre-existing condition which existed when the policy was taken out, can be included at sometime in the future of either two or five years hence (can't recall exactly so I will look again).

 

Despite all of this, I will go ahead and renew the policy for this year, and that will probably be the last time.

You should still disclose it so they can't get out of paying a claim

[KannikaP]

Isn't a 'pre-existing condition' one which exists when you take out the policy, and not one which develops over the duration of the policy?

[xylophone]

12 minutes ago, scubascuba3 said:

You should still disclose it so they can't get out of paying a claim

Good idea, and I will do that, thank you.

[scubascuba3]

5 minutes ago, KannikaP said:

Isn't a 'pre-existing condition' one which exists when you take out the policy, and not one which develops over the duration of the policy?

I read an example recently, a guy was going to hospital for treatment, didn't bother to tell his insurance company because he wanted to keep his premiums down, they found out when he claimed on something, claim denied, they can also just cancel the insurance and ask for repayment if a claim has been paid previously 

[xylophone]

2 minutes ago, KannikaP said:

Isn't a 'pre-existing condition' one which exists when you take out the policy, and not one which develops over the duration of the policy?

That's where I find it confusing, because that was my original understanding, however as I have to "renew" my policy every year, it could be argued that every year, effectively I take out a new policy so therefore "should" disclose anything that has occurred prior to taking that out.

 

Having said the above, as time goes on with folk, those with yearly renewable policies would have to disclose everything that's happened to them on a year by year basis, thereby making it pointless (in some cases) having health insurance, because there would be nothing left to cover??

 

Hopefully I am covered, but as I said it will probably be the last year of me renewing my policy as it gets to a point where the cost of the policy could well cover the cost of minor/average surgery and incidents, which I could pay for.

[ChaiyaTH]

This is common sense, hence you pay what is possible in cash without insurance too. The fact you had some insurance for '15 years' does not even is relevant. They cover what they cover from the moment you are insured, loyalty is for dreamers.

[save the frogs]

12 hours ago, KhunLA said:

That makes years of health insurance premiums a waste of money.  If having a minor incident that doesn't even need treatment, as we age, things change.   If the change causes an issue in the future, then considered pre-existing and no longer covered.  What a scam 🙄

 

Add even more reason why I'd never have health insurance.

 

Yeah, so how much savings does one need to have to cover all eventualities of illnesses? 

 

Seems like it must be in the millions of baht and most people won't have it in their 70s or 80s when they need it most. 

 

[Ralf001]

12 minutes ago, save the frogs said:

 

Yeah, so how much savings does one need to have to cover all eventualities of illnesses? 

 

Seems like it must be in the millions of baht and most people won't have it in their 70s or 80s when they need it most. 

 

 

I had a few health hiccups coupla years ago.

 

Total bill for that year was 6 million.

[impulse]

2 hours ago, xylophone said:

However now I come to think about it I have 50,000 baht which I have to pay upfront, as well as a 160,000 baht premium and my total cover is only 1 million baht, so I'm wondering if it's worth renewing it???

 

You've been paying for 15 years, and your cover limit is only 6.25x the annual premium?  And you have a 50K deductible on top of that?

 

 

 

 

[KhunLA]

1 hour ago, save the frogs said:

 

Yeah, so how much savings does one need to have to cover all eventualities of illnesses? 

 

Seems like it must be in the millions of baht and most people won't have it in their 70s or 80s when they need it most. 

 

They'll have it, if they didn't waste it on insurance payments.  Of course a risk assessment of family health issues is a good idea.   Not in my family, except self induced cancers.

 

Thankfully I bounce pretty good, as done plenty of stupid sh!t in days past.  Except for one recent oops, as stated, most oops were covered by pocket change.  

 

Most people in 70s & 80s have equity in their home, and or lines of credit, if needed.  If in TH, and you sold up, before coming here, you should have a nice oops fund, or at least your 800k in the bank for Imm, if can't meet the 65k a month.   800k buys a lot in Thailand at govt hospital, or even private hosp., or Ms Google tells me ... 

 

 

Obviously if you don't have an oops fund, then simply get insurance.   It's not rocket science.

 

I've yet to have one honor their policy.  OK maybe one, the rest, I had to sue.  From Soc Sec, workman's comp (3x), home owners ins, healthcare ins I actually had for 6 months (offer I couldn't turn down).

 

[4MyEgo]

3 hours ago, xylophone said:

Having said that, my premium was becoming quite hefty, so I asked if they would include a 50,000 baht deductible (the amount which I pay for any procedure) in order to reduce the premium payable, which they did. However now I come to think about it I have 50,000 baht which I have to pay upfront, as well as a 160,000 baht premium and my total cover is only 1 million baht, so I'm wondering if it's worth renewing it???

 

I can't tell you what to do, but I can say that I hear you loud and clear.

 

When I 1st came here a decade ago, no one would cover my pre-existing condition, 2 years later I found one that did through a broker, however the policy was for emergency cover only.

 

As I was just under 60 years of age, it all started out good, 70,000 per annum, which included my pre-existing condition, then the following year it jumped to 90,000 per annum, I questioned why the sharp rise, Covid claims, oh ok, I see, (not me), the following year 110,000 per annum, I questioned the sharp rise again, oh, you are now in the 59-64 year bracket, oh, ok, the following year 140,000, again, I questioned them and they said that they changed underwriters, oh ok, that is when I decided that I was not renewing and have been without cover for 6 - 7 years. I made zero claims, and they bent me over so to speak.

 

I also had my family on private cover, so the last 6-7 years worth of premiums that I have saved has been put aside, that is well over 1,000,000 baht in premiums, allowing for increases, say 1.5 mil baht.

 

I have reserves in case of an emergency, that said, unless it is something major, it isn't going to cost an arm and a leg, and if need be, and I can fly, I will go back to the old country where we still have Medicare, because we use it every 3 years when we return, so as long as we are not out of the country for 5 years continuously, we are good.

 

I have been to a private hospital a couple of time and it hasn't cost an arm and a leg for out patient procedures, that said, the University hospitals are quite good as are the Military hospitals, I have been told.

[xylophone]

2 hours ago, impulse said:

 

You've been paying for 15 years, and your cover limit is only 6.25x the annual premium?  And you have a 50K deductible on top of that?

 

 

 

 

Yes it seems a lot now, but back then with a very small premium, it wasn't. It's just that over 15 years the annual premium has increased, as it always does.

 

I started the health insurance cover at aged 60 and because of that I wasn't able to increase the total cover in later years and it covered until the age of 99.

 

I elected to choose the 50 K deductible this time to lower the premium, but thinking about it, and that which I have already mentioned, this will be the last year, for me.

 

At 78 years old this year I won't be able to get any cover anywhere else, so it looks like I will have to draw down on my NZ investments, which will more than cover even the most horrendous hospital costs here.

 

There comes a time when weighing up the pros and cons, it becomes just about obvious that the cost/benefit doesn't balance out any more.

 

I suppose that if anything drastic happens, I could always go back to NZ and get free treatment on the government health system, not that I want to do that, but it is an option if things get desperate.

 

In summary, I have enough stashed away to cover me for even the most horrendous hospital costs here, so I will live with that. 

[couchpotato]

4 hours ago, KannikaP said:

Isn't a 'pre-existing condition' one which exists when you take out the policy, and not one which develops over the duration of the policy?

Exactly.. the other posters are wrong in their assumptions of having to declare something during your policy term or at renewal.

[couchpotato]

1 hour ago, xylophone said:

I suppose that if anything drastic happens, I could always go back to NZ and get free treatment on the government health system, not that I want to do that, but it is an option if things get desperate.

With the state of the government (public) health system in NZ, you would probably pass away before being treated. Operation and doctor waiting lists are extremely long.

[TroubleandGrumpy]

1 hour ago, xylophone said:

I started the health insurance cover at aged 60 and because of that I wasn't able to increase the total cover in later years and it covered until the age of 99.

I elected to choose the 50 K deductible this time to lower the premium, but thinking about it, and that which I have already mentioned, this will be the last year, for me.

At 78 years old this year I won't be able to get any cover anywhere else, so it looks like I will have to draw down on my NZ investments, which will more than cover even the most horrendous hospital costs here.

There comes a time when weighing up the pros and cons, it becomes just about obvious that the cost/benefit doesn't balance out any more.

I suppose that if anything drastic happens, I could always go back to NZ and get free treatment on the government health system, not that I want to do that, but it is an option if things get desperate.

In summary, I have enough stashed away to cover me for even the most horrendous hospital costs here, so I will live with that. 

Please consider that the 1 million baht coverage you have is probably not for a total of 1 million baht. It will likely be 400K for this type of medical service, and 400K for this type, and 400K for this type etc etc - and it will be up to a maximum total of 1 million baht across all types of medical services - a 400K maximum for each type up to 1 million in total. 

If you have money set aside for a medical coverage fund, them I would add the 160K to that 'fund'.  At your age there will be so many exclusions and conditions in the fine print - after 75 years of age medical insurance in Thailand is 'problematic' for Expats.

Be careful of waiting too long if you do decide to go back to NZ, a bloke I knew in his early 80s did that and then he could not return as he was medically not capable - airline refused the risk. 

The medical services in Thailand for those going through 'the end game' are just not up to 1st world standard outside of the big private hospitals in Bangkok. Ambulances are a joke, GPs are not existent and most local 'Drs' are useless, blood tests and scans are just not up to 1st world standards etc etc etc. 

If you keel over and then die soon after doing that, then here is fine. But if you are like my parents and most others who pass in their 80s, you will have ongoing problems for many years before you pass away - and here IMO is not the place to go through all that. Have a read about that poor Greek bloke in Rayong - and there are many similar stories - just ask Sheryle - and I am sure my old mate would have lived 3-5 years longer back in Oz.  His Thai wife spent a lot of money in those last few years - both in getting him treated, and then in the funeral and cremation etc. (she was ripped off by the locals big time).  Our plan is that if/when one of us gets a serious illness, then we will go back to Oz, or we will go before I am 80. 

[Etaoin Shrdlu]

5 hours ago, xylophone said:

Well I have just had an answer from the company representative (the lawyer who I've been dealing with since I took the policy out many years ago) and she contacted the company and she informed me that because I've been with them and had the policy for over 10 years, then I am covered for this event.

 

I suppose I should get this in writing, so I will ask her to confirm this by email, however I've always found her to be a helpful and trustworthy person in the past, so I will think about that aspect.

 

Having said that, there is a clause in the policy document which states that any pre-existing condition which existed when the policy was taken out, can be included at sometime in the future of either two or five years hence (can't recall exactly so I will look again).

 

Despite all of this, I will go ahead and renew the policy for this year, and that will probably be the last time.

 

The Thai Civil and Commercial Code bars insurers from denying claims for unintentional non-disclosure of pre-existing conditions at original policy formation after an insured has been covered continuously for a period of five years. Some insurers may have clauses reducing this period and some may provide for declared pre-existing conditions to be covered after a waiting period.

[Etaoin Shrdlu]

7 hours ago, 4MyEgo said:

 

Read the fine print, you have a duty of care to inform your insurer of any changes in your condition, whether it's a growth a mur mur in your heart etc etc, etc.

 

If I were you, I would get a letter from your heart doctor when it was 1st picked diagnosed and provide that to the health insurer you are with, providing a thorough explanation as to why you didn't advise them of it when it was 1st diagnosed.

 

If they don't buy it, yes, your next health insurer will class it as a pre-existing condition.

 

The duty to disclose known or suspected pre-existing conditions exists when applying for coverage for the first time. I don't think Thai insurers require their insureds to declare new conditions that arise during the currency of the policy or its replacements.

 

If a pre-existing condition was unintentionally omitted when submitting the proposal form, then it may be best to disclose it and let the insurer decide whether it warrants an exclusion or, in the worst case, cancellation of the policy. While a new exclusion or cancellation might not be a great result, it's better to do this early instead of having to deal with this issue when submitting a large claim.

[scubascuba3]

4 hours ago, Etaoin Shrdlu said:

The duty to disclose known or suspected pre-existing conditions exists when applying for coverage for the first time. I don't think Thai insurers require their insureds to declare new conditions that arise during the currency of the policy or its replacements.

 

So based on that you are saying people could go for treatment for various conditions during the policy and not tell the insurer?

[Etaoin Shrdlu]

4 hours ago, scubascuba3 said:

So based on that you are saying people could go for treatment for various conditions during the policy and not tell the insurer?

 

Here's renewal wording from a policy issued by a Thai insurer:

 

"This policy can be renewed until the insured's age does not exceed 99 years old, no supportive evidence is required at this point."

 

To my understanding, this means that the insured is not required to make any additional health declarations or disclosures at renewal.

 

Some policies will have a clause that requires prompt notification of injury or illness that may give rise to a claim under the policy. So, yes, with respect to filing claims for new conditions, there is a requirement to report. This wording often appears in the claim notification clause.

[4MyEgo]

16 hours ago, Etaoin Shrdlu said:

The duty to disclose known or suspected pre-existing conditions exists when applying for coverage for the first time. I don't think Thai insurers require their insureds to declare new conditions that arise during the currency of the policy or its replacements.

 

I wasn't aware it was a Thai insurer, that said, I would never insure with a Thai personally as I have heard some bad stories when it came to coughing up.

 

When I once insured, and going through the fine print, it did state about the duty of disclosure when applying and that the insurer MUST know of any changes to ones condition, even if they weren't making a claim, that said, I would have thought most would be the same, but then again maybe not.

[NanLaew]

11 hours ago, scubascuba3 said:

So based on that you are saying people could go for treatment for various conditions during the policy and not tell the insurer?

 

When the results of an industry medical carried out in Malaysia resulted in my being diagnosed with a very, very small kidney stone, I had the confirmation diagnostics and follow-up KUB ultrasound examinations carried out at a different hospital to that which was already listed as my primary care hospital by my insurer at my own cost here in Thailand. Nine months later, the third follow-up KUB ultrasound indicated that it was no longer visible. I didn't mention it to my insurer when I renewed. If some other renal or kidney-related issues arise as I grow older, and despite not having any invasive treatment, I should hope to avoid having any claim declined due to a pre-existing condition.

 

Back to the OP and the abdominal aorta aneurysm (AAA) detected, this is quite common in 60+ males and particularly with tall people or those with a 'long' back. My father had one and would have died if he wasn't already an in-patient at the hospital in the UK, undergoing tests after a few weeks of abdominal discomfort. A few years ago, my UK medical practice flagged me for a free AAA ultrasound examination which, due to the family history, I took seriously and had done in Liverpool as an outpatient. Since then, Bumrungrad in Bangkok have also added AAA Ultrasound examinations for the 60+ crowd, so I will be getting another check later this year.

[Lacessit]

On 7/2/2025 at 12:43 PM, xylophone said:

 

 

About three years ago when I was undergoing a medical check, the electrocardiogram discovered a bulge in my aorta so I had another scan and the heart doctor said it was small and not to worry too much about it, however it needed "watchful waiting" with checks every year, or less.

 

 

OP, you should be aware an ECG/ultrasound is not the most accurate measure of aorta distension. A CAT scan is the gold standard.

 

Having said that, an ECG every six months should be sufficient to check if there is any significant change in size, unless you are running marathons.

 

As I understand it, when distension is deemed critical, fitting of a stent is indicated.

[xylophone]

12 minutes ago, Lacessit said:

OP, you should be aware an ECG/ultrasound is not the most accurate measure of aorta distension. A CAT scan is the gold standard.

 

Having said that, an ECG every six months should be sufficient to check if there is any significant change in size, unless you are running marathons.

 

As I understand it, when distension is deemed critical, fitting of a stent is indicated.

Thank you Lacessit, and I think I did have a CAT scan a couple of years back and I get checked every six months or 12 months via echocardiogram to see if things have changed.

 

Actually I did ask the heart doctor if a stent would "fix it" and also give me peace of mind, however he said the bulge is where the aorta exits the heart, so a stent is not a possibility unfortunately so if it does get critical, then it's open heart surgery (I think) however I'm sincerely hoping I will see my time out on this planet without having to go through that ordeal!