Bupa

[sleepyjohn]

IMO this thread is about the American medical system writ small. It is almost automatic for an American to look for health insurance.....but there is another way.

Why is a huge layer of friction, expensive both financially and emotionally, necessary between Americans and their health provision.....or for all of us here in Thailand?

My personal conclusion for here if one can afford to pay for a reasonable series of bad events oneself then self-insure.

(What's needed, and this is an important issue, is real life cost information in this judgement. My girlfriend works in a major private hospital and I know a little. I think it would be well worthwhile for Thaivisarers to submit their knowledge of such possible costs. On a dedicated thread perhaps?) What do you think Sheryl?

cheers John

Edited October 29, 2009 by sleepyjohn

[Jingthing]

Why is a huge layer of friction, expensive both financially and emotionally, necessary between Americans and their health provision.....or for all of us here in Thailand?

I find this totally irrational. This has nothing to do with the health care system in the USA (which in my view is a nightmare). This has to do with accessing expensive private medical care in Thailand. Yes you can pay cash if you can afford it or you can also take another kind of risk, paying for insurance (if you can actually get it, good luck with any preexisting conditions) and hoping they actually pay out when you need it. Of course, the for profit insurance companies unless they are regulated well by the government (currently not the case both in the US and Thailand) will do all they can to favor people who will never need care, and also try in many cases to avoid payment when claims are made. That is the nature of insurance companies. It crosses nationalities. You can blame the USA for a lot of things, but I would blame Thailand completely for these problems. They have a government and a health care delivery system and they could regulate the companies about how they are required to behave in Thailand, but they don't.

Edited October 29, 2009 by Jingthing

[sleepyjohn]

Why is a huge layer of friction, expensive both financially and emotionally, necessary between Americans and their health provision.....or for all of us here in Thailand?

I find this totally irrational. This has nothing to do with the health care system in the USA (which in my view is a nightmare). This has to do with accessing expensive private medical care in Thailand. Yes you can pay cash if you can afford it or you can also take another kind of risk, paying for insurance (if you can actually get it, good luck with any preexisting conditions) and hoping they actually pay out when you need it. Of course, the for profit insurance companies unless they are regulated well by the government (currently not the case both in the US and Thailand) will do all they can to favor people who will never need care, and also try in many cases to avoid payment when claims are made. That is the nature of insurance companies. It crosses nationalities. You can blame the USA for a lot of things, but I would blame Thailand completely for these problems. They have a government and a health care delivery system and they could regulate the companies about how they are required to behave in Thailand, but they don't.

Irrational?

Why pay......a lot.....for a layer of treacle which never makes things go faster but certainly can make things go slower....or not go at all? Personally I cant afford that kind of "insurance".

If you can pay for a reasonably bad series of scenarios and save all the costs (not to mention worry) innately associated with insurance.....why not do so if and when? Why not direct instead of to a very demanding middleman?

Your post actually seems to argue for my case rather than against it. Do I have you topsy turvy?

[aussiebebe]

Could anyone give examples of the sorts of premuims they are paying for BUPA? All this talk about effectiveness - how much does it cost? I bought Emerald policies through a small-company package where I work for my family, paying around 6000baht each per year.

As we've never claimed, we've never tested whether it's enough cover or too little - how do other's work out what they need? Could anyone explain how much cover they purchased and why, please?

[maxtingtong]

I read the terms and conditions of AXA Optimum and Bupa Platinum. Them offer good level of coverage at reasonable prices, I'm close to opt for AXA just because it offers a 1,5M coverage while Bupa just 1M.

What makes me some confusion: in both policies in the starting definitions there's the DEPENDENTS of the covered person, that's wife and childs, and looks like they're covered with the policy owner. It is less clear if have to make a contract for every single component of the family (and pay the premium) or the close family is automatically covered by just one policy/premium.

Anyone did it with wife/family can help me?

Thanks

Max

[jazzbo]

My personal experience with BUPA(Thailand):

When I applied for the policy I told them that I had had prior orthroscopic surgery within the last 5 years on my left knee. They accepted the application with a 2-year rider exclusion on both knees. Within months after the 2 year rider expired, I could barely walk and the orthopedic Dr. at one of the BUPA-designated hospitals said that I needed full ACL knee reconstruction on my left knee.

BUPA(Thailand) paid for the surgery in full equal to 3 years' premium ... no hassle except that they did not pay for CocaCola's consumed while in the hospital -- 7 days in a private room.

YMMV.

[thaibutty]

Really good information in this thread, which has helped me to come to my final decision and choose Bupa over a bunch of other policies.

I am going to apply for the Bupa policy within the next days. They offer me a 15% discount if I name a reference person that already is a Bupa member. The person, who is referring me would get a gift certificate for Central. Unfortunately, I don't know anyone personally who is a Bupa member. So, if anyone is up for a gift certificate please PM me.

Edited July 19, 2010 by thaibutty

[grumpyoldman]

I just renewed my BUPA Platinum and was NOT hit with the increase notice you describe.

[thaiericsweden]

Why do health insurance premiums go up?

Insurance premiums are based on the collective results of all insured customers.

You are one of thousands of policyholders that are insured by Health Insurance Company.

Not all customers will have claims each year; this is what keeps annual-premium-increases manageable.

If all customers had claims every year, your insurance premiums will increase by a higher percentage.

The increase in premiums is determined by the collective customer claims that occurred during the previous policy year.

Even if you had no claims, your premiums will still go up by a small percentage.

The cost of insuring your family is averaged out among all customers insured by the company.

If you had a million dollar claim, you can expect a small incremental increase in premium the next year; the insurance company would not ask you to repay the million dollars.

The annual increase in premium would be the same for all other customers in the same age group that you belong to; you will not be penalized for your claim.

On the other hand; if you had no claims in one year, it would not make you eligible to pay the same premium as the previous year.

Four important factors that cause premiums to go up each year:

1. Hospitals increase their medical charges each year.

2. The price of drugs goes up each year.

3. As you get older, you pose a higher risk to the insurance company.

4. In addition to this; as you get older, the cost of treating you will rise exponentially if you have to go to the hospital for treatment.

This health insurance company; like most other health insurance companies charges premiums according to the customer age.

The premiums are usually split into 5-year age groups.

When you started your policy, you were in one age group.

As you get older, you move to a higher age group; you will notice a higher jump in the premium increase when you move to higher age groups.

Each year, health insurance companies have to revise their premiums based on the past year's claims expenses.

Health insurance companies are not a charitable organization; they do their best to make a nominal profit.

Health insurance profit margins are small, usually between 5% to 10%.

Insurance companies that make more than 10% profit are not competitive and cannot keep customers.

Unfortunately, there is nothing the insurance companies can do to control the hospital medical charges; all hospitals try their best to charge as much as possible for their services.

The definition of pre-existing conditions that I find satisfies most insurance companies:

Items a. to f. are all linked together as if they are in one sentence.....

a. Any medical condition or related condition for which you have received treatment.

b. Or medical condition that you had symptoms of.

c. Or to the best of your knowledge knew this condition existed.

d. Or sought advice for this condition.

e. Or taken (prescription or non-prescription) medication for treatment.

f. Prior to the start date of the insurance policy.

The only way to protect yourself from a claim dispute in the first few years of the health policy is to have a full medical check-up at the start of the policy.

Check-ups are a valuable tool in helping the customer when there is a dispute in a claim with the insurance company in the first year of the policy.

a. Hypothetical situation. The customer is treated by a doctor that makes a mistake in diagnosis of the customer's medical condition.

b. If the doctor mistakenly declares the medical condition is pre-dating the start-date of the policy, the insurance company has to deny payment of the claim based on the medical information provided.

c. If the customer has the results of a medical check-up (taken at the start of the policy) and these results dispute the mistaken diagnosis of the treating doctor, the customer has a good chance the insurance company will agree to a second doctor's diagnosis to review the claim and pay.

The positive benefits of a check-up far outweigh the negative aspects. Annual check-ups are a part of normal healthy life. Early detection of a medical condition is always to the benefit of that person.

Avoiding medical check-ups will not help the customer. Check-up or no check-up; if the customer has a pre-existing medical condition, even if there is no medical record at a hospital, the insurance company has to rely on the results of the treating doctor to state when this condition was present. You are relying on the treating doctor to asses you condition. The treating doctor has to make an educated guess to when this condition first manifested itself. The doctor can easily make a mistake. A medical check-up eliminates the chance of a mistake.