Choosing Health Insurance

[aircut]

O am under thai social security health insurance.... i am looking to have a second policy, and also to have one for my maid who cant have social security because she is not a company employed (reads - pays taxes)

can someone please summarize what should someone look for when choosing health insurance companies?

do health insurance policies that cover chronic conditions exists? (i am post MI [heart attack] 4 years ago.... )

thanks for any help

[ThaivisaInsurance]

O am under thai social security health insurance.... i am looking to have a second policy, and also to have one for my maid who cant have social security because she is not a company employed (reads - pays taxes)

can someone please summarize what should someone look for when choosing health insurance companies?

do health insurance policies that cover chronic conditions exists? (i am post MI [heart attack] 4 years ago.... )

thanks for any help

Answering your last question first, I am sorry but your heart (and cardiovascular system as a whole) will not be covered under a medical insurance.

As far as knowing what to 'look for', pick any of the Thai Insurance companies and you will not go wrong -

the bottom line is your budget.

May we suggest you contact Thai Visa Insurance for further information here

[patklang]

Try Axa medical insurance,and Bupa too

[thetitan99]

Saying your heart attack cannot be covered is sadly, a lie. Maybe whatever this Dude is selling won't cover it, but he doesn't represent every company. If you have not been treated, taking medication for, or seen a doctor about a pre-existing condition, said condition WILL be covered as long as the problem was 2 years ago or longer. I had the same problem (heart attack) 2 years ago in Feb. After Feb I will be covered.

Check out William Russell for excellent expat insurance. Believe me, I've shopped around.

[BigSnake]

ING was the way to go for me. Thai life may also be another choice.

[aircut]

Saying your heart attack cannot be covered is sadly, a lie. Maybe whatever this Dude is selling won't cover it, but he doesn't represent every company. If you have not been treated, taking medication for, or seen a doctor about a pre-existing condition, said condition WILL be covered as long as the problem was 2 years ago or longer. I had the same problem (heart attack) 2 years ago in Feb. After Feb I will be covered.

Check out William Russell for excellent expat insurance. Believe me, I've shopped around.

Can you PM me with the contacts of William Russell please....

[aircut]

O am under thai social security health insurance.... i am looking to have a second policy, and also to have one for my maid who cant have social security because she is not a company employed (reads - pays taxes)

can someone please summarize what should someone look for when choosing health insurance companies?

do health insurance policies that cover chronic conditions exists? (i am post MI [heart attack] 4 years ago.... )

thanks for any help

Answering your last question first, I am sorry but your heart (and cardiovascular system as a whole) will not be covered under a medical insurance.

As far as knowing what to 'look for', pick any of the Thai Insurance companies and you will not go wrong -

the bottom line is your budget.

May we suggest you contact Thai Visa Insurance for further information here

The link takes me to a quote form... i would like to see the terms more than the price at this stage ;-))

[moviesdub]

<br />

Saying your heart attack cannot be covered is sadly, a lie. Maybe whatever this Dude is selling won't cover it, but he doesn't represent every company. If you have not been treated, taking medication for, or seen a doctor about a pre-existing condition, said condition WILL be covered as long as the problem was 2 years ago or longer. I had the same problem (heart attack) 2 years ago in Feb. After Feb I will be covered.<br /><br />Check out William Russell for excellent expat insurance. Believe me, I've shopped around.

<br /><br />Can you PM me with the contacts of William Russell please....<br />

<br /><br /><br />

Hi, can you also provide contacts for William Russell to me.

Regards

[tonydabbs]

Saying your heart attack cannot be covered is sadly, a lie. Maybe whatever this Dude is selling won't cover it, but he doesn't represent every company. If you have not been treated, taking medication for, or seen a doctor about a pre-existing condition, said condition WILL be covered as long as the problem was 2 years ago or longer. I had the same problem (heart attack) 2 years ago in Feb. After Feb I will be covered.

Check out William Russell for excellent expat insurance. Believe me, I've shopped around.

I think that you are going to be sadly disappointed when you have a claim. If you told me that they have already covered you for treatment of a heart attack, I would sit up and listen. You are accusing someone of lying. I am now accusing you of not knowing what you are talking about. William Russell has a good reputation, that is true, and it provides good coverage. It is also much more costly than the Thai-based insurance that TV was talking about. No problem, though. If it would cover a pre-existing condition that a Thai-based insurer wouldn't cover, I would highly recommend it to people who need that coverage.

BUT...I read this same kind of unknowing misinformation in various forums a few years ago; so I went out seeking this "holy grail" of health insurance. You know what I found? It doesn't exist - unless it is government subsidized. Thai-based insurance does exactly the same thing.

I am responding to you just as surely as you did to TV. Now, I will step back and ask you 2 questions. If your answer to both questions is "Yes", I will humbly apologize to you. 1) Did you put on your application you that had had a heart attack? 2) If so, they must have excluded you from coverage for your heart. Did they state in that exclusion that your heart would be covered after 2 years of no further treatment? I don't think so.

That fact is, I don't think that any insurer will cover your heart ever again. That is because having a heart attack weakens your heart and leaves you more vulnerable for future attacks, although you may never have one again.

If you didn't tell them about your heart attack, then there might be a possibility that your heart will be covered after you have had the policy for over 2 years. But your heart attack was such a short time ago, they might be able to refuse coverage do to fraud on your part.

Fact: All private health insurers (including Thai-based) have up to 2 years to find and exclude any pre-existing condition that existed prior to applying for the insurance. After that, they have to cover any pre-existing conditions not already excluded.

Edited June 28, 2009 by tonydabbs

[WholeHearted]

It's easy to google up "William Russell" exoat health insurance, and read about their exclusion of pre-existing conditions.  It doesn't sound so good if you've had heart attacks or cancer. I'm looking at the website for HTH insurance, and it might be better.  You can google up "HTH global citizen expatriate insurance."  As I read it, there's only a 6 month period for exclusion of pre-existing conditions (and that can be waived if you had "creditable coverage" before you signed on). The rates don't seem terrible, depending on the deductible that you select.  I don't know how much the rates will go up as we age, though.     

It's all a puzzle to figure out.  One has to read the fine print carefully.

[tonydabbs]

It's easy to google up "William Russell" exoat health insurance, and read about their exclusion of pre-existing conditions. It doesn't sound so good if you've had heart attacks or cancer. I'm looking at the website for HTH insurance, and it might be better. You can google up "HTH global citizen expatriate insurance." As I read it, there's only a 6 month period for exclusion of pre-existing conditions (and that can be waived if you had "creditable coverage" before you signed on). The rates don't seem terrible, depending on the deductible that you select. I don't know how much the rates will go up as we age, though.

It's all a puzzle to figure out. One has to read the fine print carefully.

What people need to understand is that there are two major types of pre-existing conditions, those that are considered to be "curable" (or healable) and those that are considered to be "not curable", though, controllable.

Curable conditions can be covered after a period of healing. Cancer falls in the category of curable, if the doctor finally certifies that all of the cancer has been totally removed and you have gone for 5 to 7 years without any reoccurance, many insurance companies will cover you for cancer, including some in Thailand. Not skin cancer, though.

Diabetes, Hypertension and high cloistral are controllable but not considered to be curable. Since a heart attack has the potential of weakening the heart for life, that falls in this category also.

So, yes, read the fine print very carefully; but you should have some understanding of health insurance when you do.

Edited June 29, 2009 by tonydabbs

[Orangutan]

Tony Dabbs knows the insurance business in Thailand. I have a health Ins. for my wife and myself with one of the Thai companies that Tony represents .

Recently I was very sick and diagnosed with typhoid after being taken to the hospital by ambulance. When I was in the hospital billing office settling the bill I had some questions about what my ins. was suppose to pay. I called Tony and within minuets faxes were sent and his wife (business partner) was on the phone sorting it out.

He represents many Thai Insurance companies and I highly recommend him.

-O

[samran]

Saying your heart attack cannot be covered is sadly, a lie. Maybe whatever this Dude is selling won't cover it, but he doesn't represent every company. If you have not been treated, taking medication for, or seen a doctor about a pre-existing condition, said condition WILL be covered as long as the problem was 2 years ago or longer. I had the same problem (heart attack) 2 years ago in Feb. After Feb I will be covered.

Check out William Russell for excellent expat insurance. Believe me, I've shopped around.

I think that you are going to be sadly disappointed when you have a claim. If you told me that they have already covered you for treatment of a heart attack, I would sit up and listen. You are accusing someone of lying. I am now accusing you of not knowing what you are talking about. William Russell has a good reputation, that is true, and it provides good coverage. It is also much more costly than the Thai-based insurance that TV was talking about. No problem, though. If it would cover a pre-existing condition that a Thai-based insurer wouldn't cover, I would highly recommend it to people who need that coverage.

I wouldn't strictly say that William Russel was more expensive than a Thai policy.

My whole family used to be on Thai Health. A good brand as far as it went (one of the upper end 'healthy wealthy' policies). Two adults, one child (at the time, now two kids).

Then Thai health upped the premium for my 1 year old daughter, while my one stayed the same.

Started to shop around and compared a bunch of policies, including William Russel. Compared with Thai health (who I considered good value for money) the WR plan was more expensive for me, but cheaper for my daughter.

The total cost for WR vesus Thai health was cheaper, in total, for WR. And that gave us a much, much, higher level of coverage than what Thai health was giving us, and included benefits such as a free flight home in case of family health emergencies etc.

WR also have an excellent maternity package, which we had our second daugher on. No such thing as far as I could find existed in Thailand, except on your NZI type of insurance, which were much higher.

All in all, highly recommend WR. Just yesterday I had a 17,000 baht emergency in-patient visit to Samtivej, and they covered that totally. I didn't pay a cent.

As mentioned, we have had our second daugher on it, no problem (they also cover her for free for 28 days after birth, just in case anything goes wrong). They also provide a 20% discount on the second childs premium, from memory.

Also had to claim, unfortunately, for an emergency trip back to NZ when my wife's brother died. WR were absolutely fantasitc in organising for all of that side of things.

I'd highly recomend them if you are looking for affordable, but top quality international health care.

[FarangFlyer]

Tony Dabbs knows the insurance business in Thailand. I have a health Ins. for my wife and myself with one of the Thai companies that Tony represents .

Recently I was very sick and diagnosed with typhoid after being taken to the hospital by ambulance. When I was in the hospital billing office settling the bill I had some questions about what my ins. was suppose to pay. I called Tony and within minuets faxes were sent and his wife (business partner) was on the phone sorting it out.

He represents many Thai Insurance companies and I highly recommend him.

-O

Orangutan,

I second that. I have dealt with Tony for insurance purposes for almost 3 years now. He is very good, extremely knowledgeable, and professional. As a broker, he has access to a wealth of information from most insurance companies and can not only help you select the best policy, but save you a significant amount of time and the frustration of actually hunting around yourself. Price-wise, he was certainly not any more expensive than going to the selected insurer directly, and you can deal with him in English, or his wife in Thai for any queries. He certainly found me the best car insurance policy!

On a side note, I actually contacted BUPA Thailand for a quote through their website last week. I indicated that I would like them to contact me by telephone, NOT by email, and the idiots did not call me........you got it....they sent me an email! So I will be contacting Tony in the near future to look into health insurance for me!

[dille]

Where can I find this Tony Dabbs? Right now I am looking for insurance, health care and probably retirement plan as well.I will appreciate if someone will send me contact number of this guy.

[jazzbo]

Fact: All private health insurers (including Thai-based) have up to 2 years to find and exclude any pre-existing condition that existed prior to applying for the insurance. After that, they have to cover any pre-existing conditions not already excluded.

Where is this codified or part of any insurance certification. Almost all if not all health insurance application forms have some variance of the Thailand Civil and Commercial Code Section 865 notice e.g.:

"Before you enter into this policy, you must provide to the Insurance Company with the information, needed to enable the Insurance Company to decide whether and on what terms your proposal for insurance is acceptable and to calculate how much premium is required for your insurance. In the event that you [i]fraudulently misrepresent, or conceal information,[/i] the Insurance Company reserves the right to increase the premium, or reject the claim and void the policy in accordance with clause 865 of the Civil & Commercial Code."

The Statute of Limitations clause in the same Civil and Commercial Code is (courtesy of Samui4Sale):

*Section 448*. The claim for damages arising from wrongful act is barred by prescription after one year from the day when the wrongful act and the person bound to make compensation became known to the injured person,

or ten years from the day when the wrongful act was committed.

So I would like to see some instance in print or in some Thailand Supreme Court decision where someone invoked the 2 year rule i..e. that someone fraudulently concealed information on an insurance application and then after 2 years successfully pursued a substantial claim on that same policy after such concealment became known to the insurance carrier.

[jazzbo]

ALSO (courtesy Chaninat & Leeds)

What constitutes a fraud? When a person 1) conceals information which should be revealed and as a result obtains a property from another party dishonestly; or 2) deceives another party and causing this party to execute or destroy a document of right, he/she is said to have committed a fraudulent act, which is punishable under Thailand Penal law

Is fraud a civil offense or a criminal offense? In Thailand, fraud may be either a criminal action or a civil action, or both.

Which types of fraud are punishable under Thailand’s Penal Code? Identity fraud, public concealment fraud, employment fraud, insurance fraud, property fraud etc are all punishable offences under Thailand’s Penal Code. Common fraud cases that we encounter include land fraud, bank fraud and other types of financial fraud.

What are the criminal penalties concerning criminal fraud? For a person who has committed fraud in Thailand, he/she may be punished with imprisonment from a maximum of three years to seven years depending on the circumstances of the case.

[jazzbo]

SO, as it looks as if there may be no further response I will add the following ... BTW I never worked in personal medical insurance nor am I a licensed agent in Thailand or anywhere else. I DID work on (computer systems and product design) the type of financial insurance that hospitals buy to protect themselves against cases with costs overruns from major complications when they are only guaranteed a fixed payment by the insurer or group plan --- Bermuda / Lloyds of London-type stuff:

If you are planning on or thinking of withholding any pre-existing condition(s) on an insurance application here in Thailand, with the idea that if you don't submit any claims and otherwise stay under the radar for 2 or whatever number of years, then the insurance company is somehow obligated to pay on claims for that pre-existing condition even after the insurer realizes you falsified information and swore to and signed to that falsified information on said application --

DON'T DO IT

-- Of course, that is my opinion. My opinion and 50 baht will also get you a ride on the SKYTRAIN.

[jazzbo]

I hope Kuhn Baz doesn't mind my bumping this one up but it seems there are still persons out there it seems that the way to apply for medical insurance is to try to withhold information for which the company underwriters legitimately ask.

They can, under certain conditions, deny a claim based on information that was not specifically requested for in the application. It is in some ways better to supply a more complete, but factual, representation of your medical history even though that might cause you to be turned down. You can thus save your many years of premium payments against a large claim (or insurance elsewhere) than to have your first large claim turned down...

There are sometimes catch-all questions in the application such as " Are there medical conditions of which you are currently aware but have not yet sought treatment" or in the policy Certification (when policy is issued) says that the Company will not cover claims for which a 'prudent' persons should have already sought consultation or treatment prior to the policy being issued.

As noted in the 'BUPA Renewal' post I applied to 4 companies simultaneously and while the medical underwriting questions were nearly identical, they were not totally identical. One asked for family history of cancer or heart attack -- another did not. One asked for blood disorders such as hepatitis which I (stupidly) contracted in Mexico 30+ years ago, others did not. One asked for results of any medical tests such as prostate screening, colonoscopy, others did not. Etc. etc.

[jazzbo]

To whit (BUPA):

23. Pre-existing Conditions:

The company will not pay for any pre-existing condition... for which the Person was treated or knew about (or a PRUDENT PERSON should have been aware about) within 5 years before the commencement of policy... After 2 years from the first Policy commencement date, the Company cannot refuse to pay any claims for pre-existing conditions unless such pre-existing conditions have been endorsed.

The exception to which the FACT TB stated many posts above refers, and is mentioned in the same paragraph 23., deals only with a Pre-Existing condition of which you were unaware and could not possibly have been aware of such condition. It does not cover deliberate falsification and withholding of information on the application. It does not override Fraud and Statute of Limitation statutes in the Thai Civil and Commercial Code.

[jazzbo]

A good example of a Pre-Existing Condition that would NOT be aware to a Prudent Person and would fit the 2 year finding in BUPA 23. above would be Pancreatic Cancer. You could have it for years before applying for Insurance coverage and not know it nor could you be reasonably expected to know it:

(from the Mayo Clinic): "Pancreatic cancer often has a poor prognosis, even when diagnosed early. Pancreatic cancer typically spreads rapidly and is seldom detected in its early stages, which is a major reason why it's a leading cause of cancer death. Signs and symptoms may not appear until pancreatic cancer is quite advanced and surgical removal isn't possible. Signs and symptoms of pancreatic cancer often don't occur until the disease is advanced. When signs and symptoms do appear, they may include..."

[jazzbo]

from Tilleke & Gibbins International Ltd.:

(INSURANCE) CLAIMS

An insurance contract is defined as an agreement between the insurer and insured, whereby the insurer agrees to make compensation or pay a sum of money in case of contingent loss or any other future event specified in the contract, and the insured agrees to pay the premium.

An insurance contract is voidable if, at the time of its making, the insured, ... knowingly omits facts that would have induced the insurer to raise premiums or refuse to enter into the contract, or knowingly makes false statements in regard to such facts...

[oMega69]

I use William Russells insurance now for 1 yrs . , the coverage is real good for what you paying for ! ., I cant see any better insurance company ? If there is just tell me then i change

I pay 85 USD every month and have coverage up to 500.000 USD .,

[mark5335]

I use William Russells insurance now for 1 yrs . , the coverage is real good for what you paying for ! ., I cant see any better insurance company ? If there is just tell me then i change

I pay 85 USD every month and have coverage up to 500.000 USD .,

$85 per month sound ok, depending upon your personal details etc. I just got a quote for a similar coverage amount which amounted to $122 per month for someone in their mid 40s.

[jfchandler]

These kinds of discussions all hinge on the DETAILS...

I just got through with the annual renewal of my medical insurance. Before deciding, I reviewed the premiums and coverage details for pretty much all of the major expat medical insurance providers...and talked to a number of independent brokers.

I wanted inpatient and outpatient coverage, inpatient hospital coverage of at least 8,000 baht per day for room portion. The policy I ended up with fully covers me in Thailand and most other non-Europe and non-North America countries. For the latter, it's emergency coverage only. For me age 50, it worked out to about $110 U.S. per month.

I had LMG for the last two years. And, because of a singular, one episode problem I had with them this past year, I had zero intention of renewing with them. But after comparing all the other providers and the details of their policies, I couldn't find anything better than their Maxi-Care policy.

I found a lot of other policies that covered less for less or more money. I found a few policies that covered more, but their increased prices far exceeded the increased coverage they would have provided. So basically, I didn't find anything else that was even close to LMG in VALUE... what you get for what you pay.

And to top it off, when I talked with other independent brokers about not wanting to renew with LMG and looking for something better, after explaining what I wanted from my coverage... they basically told me... LMG is going to be the best value you're going to find...

So...its another year with LMG and MaxiCare.

[Firefan]

Jfchandler; what was your problem with LMG please? I am in the process of signing up with them. Cheers!

[vagabond48]

I wanted inpatient and outpatient coverage, inpatient hospital coverage of at least 8,000 baht per day for room portion. The policy I ended up with fully covers me in Thailand and most other non-Europe and non-North America countries. For the latter, it's emergency coverage only. For me age 50, it worked out to about $110 U.S. per month.

jfc, I also went with LMG Maxicare at the beginning of the year. I finally bit the bullet about keeping my almost useless (in Thailand) USA BCBS which for the cost of $180/month, I got an annual $10K US deductable and 50%/50% copay unless, the Thai hospital was in the network which a few are. As we know $10K US or 333,000 baht would probably cover 95% of all hospital surgery.

I chose LMG inpatient only, limited treatment area like you and a 40kbaht deductible. The cost was under $80/month. All this from a subsiduary of a major US insurance company (for what it's worth), Liberty Mutual.

Important

Regarding emergency coverage, according to my agent, unless you get supplement travelers insurance to non-treatment areas, you will not be covered by LMG except for emergency evacuation which would be worthless if you were in a serious auto accident or got a major heart attack. Although, I haven't been to Europe for a very long time. I suspect you could get free emergency care in a number of countries, one for sure is Spain (as I have been told).

[funlovinkid]

These kinds of discussions all hinge on the DETAILS...

I just got through with the annual renewal of my medical insurance. Before deciding, I reviewed the premiums and coverage details for pretty much all of the major expat medical insurance providers...and talked to a number of independent brokers.

I wanted inpatient and outpatient coverage, inpatient hospital coverage of at least 8,000 baht per day for room portion. The policy I ended up with fully covers me in Thailand and most other non-Europe and non-North America countries. For the latter, it's emergency coverage only. For me age 50, it worked out to about $110 U.S. per month.

I had LMG for the last two years. And, because of a singular, one episode problem I had with them this past year, I had zero intention of renewing with them. But after comparing all the other providers and the details of their policies, I couldn't find anything better than their Maxi-Care policy.

I found a lot of other policies that covered less for less or more money. I found a few policies that covered more, but their increased prices far exceeded the increased coverage they would have provided. So basically, I didn't find anything else that was even close to LMG in VALUE... what you get for what you pay.

And to top it off, when I talked with other independent brokers about not wanting to renew with LMG and looking for something better, after explaining what I wanted from my coverage... they basically told me... LMG is going to be the best value you're going to find...

So...its another year with LMG and MaxiCare.

Can you provide a little more information about LMG (like how to get in touch with them)? I've been using B*PA for the past three years, my policy is due for renewal, and I'm interested in exploring other options before I get too old to switch providers (I'm 53). Thanks.

[funlovinkid]

These kinds of discussions all hinge on the DETAILS...

I just got through with the annual renewal of my medical insurance. Before deciding, I reviewed the premiums and coverage details for pretty much all of the major expat medical insurance providers...and talked to a number of independent brokers.

I wanted inpatient and outpatient coverage, inpatient hospital coverage of at least 8,000 baht per day for room portion. The policy I ended up with fully covers me in Thailand and most other non-Europe and non-North America countries. For the latter, it's emergency coverage only. For me age 50, it worked out to about $110 U.S. per month.

I had LMG for the last two years. And, because of a singular, one episode problem I had with them this past year, I had zero intention of renewing with them. But after comparing all the other providers and the details of their policies, I couldn't find anything better than their Maxi-Care policy.

I found a lot of other policies that covered less for less or more money. I found a few policies that covered more, but their increased prices far exceeded the increased coverage they would have provided. So basically, I didn't find anything else that was even close to LMG in VALUE... what you get for what you pay.

And to top it off, when I talked with other independent brokers about not wanting to renew with LMG and looking for something better, after explaining what I wanted from my coverage... they basically told me... LMG is going to be the best value you're going to find...

So...its another year with LMG and MaxiCare.

As I'm currently evaluating options for providers other than my current BUPA, can you make any suggestions for which brokers you found helpful, and how I might contact them?

[vagabond48]

Can you provide a little more information about LMG (like how to get in touch with them)? I've been using B*PA for the past three years, my policy is due for renewal, and I'm interested in exploring other options before I get too old to switch providers (I'm 53). Thanks.

Here is their number. 66-263115824