Is your health insurance protecting you or creating more risk?

Health insurance is designed to reduce financial risk, but having a policy does not mean that all of that risk has disappeared.

In many cases, it has simply been redistributed between you and the insurer depending on the deductible, cost-sharing arrangement, hospital network and the way claims are handled when you actually need treatment.

A cheaper policy might leave you responsible for a larger share of the bill, while a more comprehensive policy can come with a higher premium. Somewhere between those two extremes is the point where the amount you pay for insurance and the amount of risk you keep for yourself actually make sense for your finances.

The cheapest policy can leave you carrying more than you think

Lower premiums can look attractive, particularly if you are healthy and rarely use private hospitals, but the trade-off is often that you agree to cover more of the cost yourself before the insurer starts paying.

A higher deductible or cost share may bring the premium down, but the saving only works in your favour if the amount left with you is genuinely manageable when you need treatment. 

A cheaper policy starts to look much less attractive if using it still means finding a large amount of money at short notice.

For example, a hypothetical 100,000-baht hospital bill feels very different if you already know that you are responsible for the first 50,000 baht.

Deductibles and cost sharing can make a policy cheaper, but they should not leave you carrying so much of the bill that the insurance stops doing the job you bought it for.

How the policy works matters too

The amount of coverage on the policy document is only part of the equation because the way the insurer interacts with the hospital can have an immediate effect on your finances.

Depending on the policy and the arrangement with the medical provider, you may have to pay the hospital yourself, submit the required documents and wait for the insurer to process the reimbursement.

That may be manageable for a smaller bill, but it becomes much more difficult if treatment costs several hundred thousand baht and the hospital expects payment before you leave.

Prior authorisation may also be required for planned inpatient or day-patient treatment, adding another practical condition to how the policy works when you use it.

A policy can therefore be perfectly valid and eventually reimburse everything it is supposed to, while still creating a serious cash-flow problem at the moment you need care, which is the exact problem insurance is supposed to solve.

Know what still comes out of your pocket

Comparing health insurance becomes much more useful once you stop looking only at the premium and start checking how much of the financial burden would still fall on you when you actually make a claim.

Cigna Global, for example, allows customers to choose different deductible and cost-share levels, with current deductible options ranging from US$0 to US$10,000 and cost sharing from 0% to 30%. 

Customers choosing cost sharing can also select an out-of-pocket maximum of US$2,000 or US$5,000, which caps the amount they pay through cost sharing during the period of coverage.

Those options change the balance between the premium and the amount you contribute when making a claim. A higher deductible or cost share can reduce the premium, while a lower one places more of the financial burden on the insurer.

Explore Cigna Global's options for expats in Thailand to compare how different deductible and cost-share choices affect what you would actually need to pay yourself.

Cigna also works with providers through direct billing arrangements, which can allow eligible and authorised treatment to be settled directly between the insurer and hospital rather than requiring the patient to fund the full bill first and claim it back later.

The important distinction is whether you have chosen to retain some of that financial risk because it suits your circumstances, or whether your policy leaves you carrying more than you realised.

The real test is what remains

Paying 3,000 or 5,000 baht for a consultation may be something you are perfectly comfortable handling yourself, while being asked for several hundred thousand baht after an unexpected admission could be enough to force you into savings, investments or money that was intended for retirement.

The opposite can also be true. Paying considerably more in premiums for benefits you are unlikely to use may not make sense if you already have enough savings to comfortably handle routine healthcare and only want protection against larger medical bills.

A sensible insurance policy is therefore not automatically the cheapest one or the one with the highest possible level of coverage. It is the one where you understand exactly which costs remain your responsibility and have made a conscious decision that those amounts are manageable.

Explore Cigna Global's options for expats in Thailand and compare how much of the financial risk would remain with you under different levels of coverage.

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