Should We Make Our Own Health Insurace?

[bipbip]

The ThaiVisa health insurance covers up to 1,5 million baht if I understand it correctly. Everthing above that we have to pay ourselves somehow.

Can't we just create our own "insurance" by reserving for example 2 million baht on a bank account?

Thereby we will get interest on the money and avoid paying a montly fee for the insurance.

But what should we do if we have an emergency and need to go to the hospital fast. I mean, we don't have an insurance card if we create our own insurance.

Thanks, bipbip

[Crossy]

"Self insurance" is just fine IF you have the lump sum from day one, just ensure you have a visa/master card to access the funds when the hospital wants proof that you can pay.

[MrSquigle]

You also have to worry about major accidents or illnesses.

A road crash where you are in ITC or a cancer related disease which goes on for years will cost big bucks, where will you it then when the 2 million runs out ??

I have insurance which covers you fully for the big illnesses/accidents, that is what it is for, a kind of insurnace and peace of mind policy.

I had thought about self insurance before, but I would bet that if I started it, something would happen. I dont mind paying out the dosh and having nothing happen, kind of a reverse phsycology kinda thing.

[vagabond48]

The ThaiVisa health insurance covers up to 1,5 million baht if I understand it correctly. Everthing above that we have to pay ourselves somehow.

Is that per health incident or for the life of the plan?

[ThaivisaInsurance]

The ThaiVisa health insurance covers up to 1,5 million baht if I understand it correctly. Everthing above that we have to pay ourselves somehow.

Is that per health incident or for the life of the plan?

Please look at  http://insurance.thaivisa.com  for details of the Thai Visa plans.

[popshirt]

The ThaiVisa health insurance covers up to 1,5 million baht if I understand it correctly. Everthing above that we have to pay ourselves somehow.

Is that per health incident or for the life of the plan?

Please look at  http://insurance.thaivisa.com  for details of the Thai Visa plans.

Yeah, great, just like all the rest, nothing for those of us over 60 yrs old.

[ThaivisaInsurance]

The ThaiVisa health insurance covers up to 1,5 million baht if I understand it correctly. Everthing above that we have to pay ourselves somehow.

Is that per health incident or for the life of the plan?

Please look at  http://insurance.thaivisa.com  for details of the Thai Visa plans.

Yeah, great, just like all the rest, nothing for those of us over 60 yrs old.

Easy - no problem - please fill in the Thai Visa quote form and we'll get back to you.

[interbrit]

I am over 60 so getting insurance is a problem but I favour the self insure approach anyway. However, I have two concerns in an emergency situation:

1. Can I get (be got?) to a hospital quickly?

2. How can I make sure that I get treatment immediately at the hospital? A credit card is no use if I am unconscious.

Does anybody have a solution?

Interbrit

[jazzbo]

'Self'-Insurance really is a misnomer in that -- at least in the USA -- it does not refer to an individual policy. Will forego the long explanation. The real equivalent for an individual is to take out a policy with a large deductible. There may be coverages that will accept a person around 60 even with pre-existing conditions if the deductible is high enough say $US 5000 per year. You are thus 'self-insuring' the amount per year below that number. Only major medical events would be covered... the premiums would also reflect the high deductible.

There are some international policies structured this way. Check in with TVI or your broker.

[ProThaiExpat]

I have been self-insured for six years in Chiang Mai and have had four operations this year for a broken leg, all healing well now. Total cost to date 230K. My premiums, quoted at 12k a month six years ago would have amounted to 720k to date.

Thaivisa quoted me 18k a month this year due to my advanced age.

Fear is what sells insurance. Yes, there is always a chance that a freak accident will occur where you will lose consciousness and not be able to take care of your hospital admission, however, when you consider an ongoing relationship with a good hospital and their patient ID card in your wallet, you are really stretching the possibilities of treatment refusal due to a coma. How about lightning strike insurance. Many people worldwide are struck my lightning but try to sell a policy specifically for this risk. Aren't we all taking a chance that we might be struck by lightning?

If you are in reasonably good health, self insurance is a viable option once you get past the fear.

My worst case scenario involves a triple by-pass heart surgery, even though I have no heart disease and meds keep my blood pressure controlled, advertised cost in BKK 450K Baht. Not many more expensive operations.

Almost all medical care can be handled on an outpatient basis and with my doctor visits billed at 200 Bah, AP and Lateral Xrays at 600 baht, a one million baht reserve fund should be more than adequate. You may have to replenish is every ten years or so, but retirees who have any meaningful nest egg would have this sum or more ready to be used in emergencies. Granted a "no heroic resuscitation" order is a good idea to prevent heirs from being deprived of their inheritance by a money grubbing hospital.

My guess is that most first rate private hospitals who encounter a unconscious falang who doesn't appear to be destitute, will render treatment until he becomes conscious as most falang can afford their treatment.

[vagabond48]

The ThaiVisa health insurance covers up to 1,5 million baht if I understand it correctly. Everthing above that we have to pay ourselves somehow.

Is that per health incident or for the life of the plan?

Please look at http://insurance.thaivisa.com for details of the Thai Visa plans.

Am I reading your website correctly that the plan would cover me for less than $45,000 (33 bht per $1US) for the life of the plan. Even for Thailand that sounds awfully low.

[ThaivisaInsurance]

The ThaiVisa health insurance covers up to 1,5 million baht if I understand it correctly. Everthing above that we have to pay ourselves somehow.

Is that per health incident or for the life of the plan?

Please look at http://insurance.thaivisa.com for details of the Thai Visa plans.

Am I reading your website correctly that the plan would cover me for less than $45,000 (33 bht per $1US) for the life of the plan. Even for Thailand that sounds awfully low.

The coverage is per year (annual policy) not for life. Please note these are 'low cost' plans but for Thailand they will get you into a hospital (important !) and help take the strain away from the final invoice.

[jazzbo]

Self-Insurance -- at least in the USA -- does not mean NO Insurance: It refers to an employer (not an individual) who retains the risk of an employee's illness up to a per incident 'attachment point' and then purchases EXCESS coverage for any expenses beyond that amount. The Insurer offering the excess coverage covers those 'outlier' incidents; It is not an open-end or unlimited exposure to the the employer. There are also tax benefits to the employer.

With some of the plans offered in Thailand, if you subscribe before a certain age, and maintain your premium payments, you are guaranteed renewal for life... for a time in life when major surgeries and treatments become more than hypothetical. An international policy with a high (say $5000) deductible would be the equivalent of 'self-insurance' for an individual.

I started to address the numbers quoted in the post above, but I will refrain. TEHO.

[ProThaiExpat]

jazzbo: What you say is true as far as it goes, however, the purchase of what you refer to as "excess insurance" or re-insurance is not always done. It largely depends on the size of the corporation and the extent of the risk.

When a corporation explores self insurance, it has actuaries estimate the worst case scenario and if the exposure is not too great to be paid out of operating funds, no insurance is bought for that risk. From there, a corporation will pass off risk over given amounts to re-insurers in layers depending on ability to absorb the cost of settling claims or paying losses.

Technically you may be right regarding the use of the word "insurance", when one chooses not to buy insurance as its cost is too high for the risk covered, one might be said to be "not-insured", that is if there is not a fund established specifically to cover that risk, as in my case. Self-insurance may well mean setting up an insurance department that follows insurance principles and acts as an in house insurance company with prudent reserves earmarked for that purpose and keeps the profits from the operation in house rather that having insurance companies benefit by your risk management.

[jazzbo]

What you say PTE is true as well. However, there are underwriters who specialize in employer health retention pools --there are also 'captive' insurers registered in Bermuda, Vermont and elsewhere -- and I would say that a healthcare self-retention without some excess cover would be the exception rather than the rule.

I think regarding your personal situation, there would be high-deductible ex-Thailand policies that would cost much less than the numbers that you quote. And these policies would also guarantee renewal im perpetuum if the premiums are maintained. Even in Thailand, there are policies with 5 million baht per incident coverages so somebody thinks this could happen.

[jazzbo]

The following info on medical costs is from the NZI website:

To give you some idea of the costs associated with various procedures and treatment provided in International Hospitals in Thailand**, we have provided a small sample list of claims that NZI has paid to our members during 2006 and 2007. Medical costs are increasing in excess of 10% per year. [** Source: IAG Insurance (Thailand) Ltd.]

Tongue Cancer (2 year treatment) 4,313,700 (all numbers in Baht)

Breast Cancer (2 year treatment) 4,200,663

Brain Aneurysm 1,857,189

Snowboarding Accident (Including Evacuation) 1,402,000

Hip Surgery 642,990

Heart Block (Pacemaker insertion) 458,667

Motorcycle Accident 393,000

Acute Appendicitis 243,000

Gastric – Colitis & Polyps 142,630

Herniated Lumbar Disc 119,400

Hernia Operation 118,000

Diagnosed with Hepatitis B, Interferon Treatment 395,244

Prolapsed Disc 658,814

Septic Arthritis 428,306

Subdural Haematoma 1,094,835

Septicaemia 4,137,925

Colon Cancer 539,541

Advanced Arthritis of Right Knee 457,123

Bilateral Inguinal Hernia & CABG Operation 1,053,124

Fractured Vertebrae - Evac from Vietnam 685,460

Colonic Polyp 426,002

SCC of the Tonsil 1,975,115

Severe Scoliosis of the TLS Spine 715,624

Active Tuberculosis 1,130,184

Heart Disease - Catheter 898,858

Trimalleolar Fracture of Right Ankle 456,160

Aortic Stenosis 746,093

**********

The most interesting fact to me is that, since NZI was only established in Thailand in 2001, all the above claims occured at a maximum within the first 7 years of coverage.

[ProThaiExpat]

I certainly would like to have a quote for a policy that would have a 200K Baht deductable.

My four operations for my broken leg including two bone grafts, a plate replacement and a second operation to stop blood ooze cost just a bit over 200K in CM so that would be a good cut off point.

A 300K deductable would also make sense, for an inpatient only policy if such would be available, however, I know of no company offering, what we used to call "major medical" in the old days.

[canopus1969]

I certainly would like to have a quote for a policy that would have a 200K Baht deductable.

My four operations for my broken leg including two bone grafts, a plate replacement and a second operation to stop blood ooze cost just a bit over 200K in CM so that would be a good cut off point.

A 300K deductable would also make sense, for an inpatient only policy if such would be available, however, I know of no company offering, what we used to call "major medical" in the old days.

Have just taken a LMG policy with Thai Visa and they offered a 200,000 deductable - also a 20% co payment

[Tufty]

What about cover for pre-existing conditions (I hear some companies will provide cover say 3 years after a heart attack etc)