Question About Thai Gf Insurance - Don't Understand...

[schmutzie]

Hi,

My GF has recently been hospitalized following a motorbike accident. She received treatment for 5 weeks at Maharat Hospital in Korat.

After being discharged, she took out a health insurance with a regional insurer (I don't know their name, but she claims it's a well established company

in Isaan).

She told me she paid 3500 baht to be covered for 6 months. She would have to pay any cost upfront first and then apply to the insurance company to cover (similar to a travel insurance I guess). I was worried that the fee sounded low, especially considering her medical history, but she has told me that they have been informed about everything. Was also concerned they'd only cover her in Isaan, but this apparently is also not the case - she only has to cover the hospital fees herself upfront.

Recently she had a slight relapse, which required her to return to hospital for a few days, including ambulance transfer and CT scan. i don't know what the charge for this was, but when I enquired about the insurance, she told me that they did not cover, because she would have to pay for "3 years or pay something like maybe 20000 baht before they cover anything"

Can anyone explain what kind of deal this is - sounds totally useless to me. The ongoing financial cost of her health issues are creating family/emotional strain, but that aside I really would like to know if anyone has any idea what kind of policy it is she has signed up for and also what alternative policies to recommend.

Thanks in advance

[ballbreaker]

Does she have the government 30 baht card for coverage?

[schmutzie]

Does she have the government 30 baht card for coverage?

No idea, sorry.

[goldfinger]

Did you ever visit/see her in hospital?

or was everything told by phone??...???

[schmutzie]

Did you ever visit/see her in hospital?

or was everything told by phone??...???

Everything told by phone, but the issue is not whether she's lying/scamming and I'm not financially involved. I would just like to know if anyone is familiar with these 3500baht/6 month cover deals (which then absurdly appears to cover nothing...). Appears no-one is.

[ballbreaker]

Does she have the government 30 baht card for coverage?

No idea, sorry.

That 6 month price might be a bit low if out patient coverage is included but it all depends on her age. Hopefully its one of the major Thai companies like Thai Health or BUPA.

Its sounds like her payment coverage was denied because it was a pre-existing condition and most companies will not cover such conditions for the first 2-3 years of policy.

The government 30 baht card is Thailand's national health coverage. Its a gold card you obtain from the district you reside. It allows treatment in your district hospital and referrals to specialist in provincial hospitals. It use to have a 30 baht co-payment but I think that was dropped and it is now free. As with most government programs worldwide once you know the system it works but can be slow at times.

[madmitch]

Absolutely no idea regarding the type of policy but you get what you pay for with insurance and she hasn't paid very much. Maybe she has a policy with a premium of about 20,000 baht but has been told she can pay over three years at which time the policy would commence. I don't know.

A previous poster is quite right that a pre-existing condition would be excluded by just about any policy.

Unfortunately insurance agents in Thailand are not trained to any sort of standard. They just try to sell and often sell cheap personal accident policies and the buyer believes they have healthcare cover! My GF has often come and told me that she has a cheaper insurance deal than we have but of course it is a waste of money.

If you want decent healthcare coverage go for one of the multi-nationals: BUPA, LMG, Interglobal, Aviva etc. You will get a policy and application in English so you know what you are buying. Look online. Alternatively go to an insurance broker who may represtent a number of these companies rather than an agent who only sells for one.

Watch AIA: they are very popular but with their policies only in Thai you don't know what you are buying. Again, Thais often buy life cover from the basically-trained agents thinking they have bought healthcare.

Finally, I assume that your GF doesn't have the Thai national health insurance coverage through an employer.

[schmutzie]

Yeah, I guess it's pretty obvious that 3500baht for 6 months with a serious pre-existing condition (brain blood-clot from being run-down by motor bike)

should have alarmed me, but basically she did not consult me before making the purchase.

Most basic health care policies I saw advertised run at +20k easy if I remember correctly, which prompted me to ask her about the policy.

This actually sounds like one of these rolling policies I've read about in the US that targets vulnerable victims and actually give very little cover.

Basically at the time I did not pay too much attention because I was hopeful that any serious illness was now in the past, but then she relapsed.

i will have to look at some proper insurance (eg. BUPA) but I'm afraid I partly think this is also the responsibility of her family and not just me (not that I'm being asked to pay/investigate this).

I guess it's another one of those frustrating things that I will come to understand as I get my head around Thailand and hopefully one day the language.

Your responses are appreciated as well the one's I've received via PM.

[schmutzie]

Finally, I assume that your GF doesn't have the Thai national health insurance coverage through an employer.

correct

[ballbreaker]

Finally, I assume that your GF doesn't have the Thai national health insurance coverage through an employer.

correct

Why don't you tell her to go and apply for the card. Its not done through employer but is something she must do herself in district where she lives. My wife obtained one when we moved back to Thailand after living in US for 28 years.

[hhgz]

"she did not consult me before making the purchase....The ongoing financial cost of her health issues..."

Are you involved financially? Why?

[schmutzie]

"she did not consult me before making the purchase....The ongoing financial cost of her health issues..."

Are you involved financially? Why?

I'm not sure I understand what your question is: You want to know if I give money for my partners health problems and if I do, why I do it?

I'm not sure it's relevant.

[schmutzie]

Finally, I assume that your GF doesn't have the Thai national health insurance coverage through an employer.

correct

Why don't you tell her to go and apply for the card. Its not done through employer but is something she must do herself in district where she lives. My wife obtained one when we moved back to Thailand after living in US for 28 years.

As it turns out, she does have it. She claims that Maharat Hospital would not let her treatment go on the card as it doesn't cover/include "accidents" (actually, my partner was the victim of a hit'n'run, so yes, accident, but hardly self-inflicted...).

Anyway, I think that sounds like a load of BS - that Thai UC would not include accidents - could anyone clarify?

Does anyone have any good links that explains the gold card scheme in English? Most site I've found are more academic about the program as a whole.

I will try and contact Maharat in Korat and enquire about their policy (when I can get their website to work).

[Sheryl]

Of course the Thai system covers accidents.

The whole story fails to make sense to me.

[schmutzie]

Of course the Thai system covers accidents.

The whole story fails to make sense to me.

Hi Sheryl,

It's actually the same story you advised on previously. As per your advise she undertook a CT Scan at Maharat Hospital after my return to the UK in May.

The diagnosis was a blood clot, the severity of which I'm not sure (I have never seen a CT scan despite my request she keep copies).

She received treatment (the medication I alluded to above - again I never confirmed the exact nature of the this) for approx. 5 weeks with multiple visits to the ICU, staying in private accommodation at Maharat. She was then discharged and asked to continue medication for an additional two weeks at home and then received a final CT scan which the doctors told her confirmed that the treatment had been succesful. AFAICT the total cost of all this was approx. 50-55.000 baht, covered by her self and relatives.

Recently, a month ago, she had a relapse and needed to return to hospital for 3 days. At the return to Maharat, the doctors there wanted to do immediate surgery, prompting her mother to refuse this and have her transferred to Bangkok hospital (I'm not sure if this was Bangkok in Korat or actually Bangkok in Bangkok). She rested there and recovered. She was told that she'd become ill again because she had drunk alcohol (one night out with friends in Chiang Mai - my fault). In between the most recent incident and the Maharat treatment, she informed that she had taken out the 3500,- insurance - I believe the company is called (the name now escapes me...) Thai <something> Chinit (?). However, they would not cover the cost for the reasons i explain above.

Yesterday I asked about the yellow card, and she said her faimly had enquired at maharat and been told she would not be covered for "accident" (her wording). I'm guessing, but it could be that they were advised not to do it under yellow card as that would/could have delayed her treatment significantly.

That's where I'm at now.

There's a possible side story here that I've avoided, which is that my partner could be suspected of concocting this whole tale in order to somehow lure money out of my pocket. I have seen her get I'll (severe headache, vomiting) on two occasions. I would have to say she would be a very elaborate liar to have made this whole story up and she has never asked for any contributions. In which case it would have been fabricated to somehow create sympathy?

I only mention this, despite I so far have felt it irrelevant, because upon her most recent hospitalisation, I actually phoned Bangkok Hospital who denied having any such patient in their care. She later claimed they'd told her that they did not register her after her transfer from Maharat because they not want to take over the responsibility from Maharat in case she had passed away. Besides i think I may have called the wrong Bangkok Hospital (not realising they have a branch in Korat)

I'm sorry for the long addendum, now you literally know as much as I do. i just wanted to get to the bottom of the insurance issue inspite of the underlying narrative and it is hard to find relevant information in English.

Maybe I have gotten used to things not making sense....

[schmutzie]

In hindsight I would have liked to have edited that previous post but it doesn't appear to be an option here.

I hope you can all appreciate the difficulties of being in a long-distance relationship. I feel maybe I've said too much.

I will try and see of I can learn more about the yellow card coverage.

Thanks.

[Nana]

Does she have the government 30 baht card for coverage?

No idea, sorry.

That 6 month price might be a bit low if out patient coverage is included but it all depends on her age. Hopefully its one of the major Thai companies like Thai Health or BUPA.

http://www.bupa-intl.com/about/corporate-information

BUPA is not Thai company, although they have sales office in Thailand.

Cheers

Nana

[tonydabbs]

Of course the Thai system covers accidents.

The whole story fails to make sense to me.

Yes, I agree.

About coverage for accident, though, there situations where you have to pay the hospital yourself and then get reimbursed by your insurance company.

1. 2 vehicle accident - file a police report (in the hospital, if necessary). The insurance won't pay until the Compulsory insurance pays their part first.

2. Injured by 3rd psrty (s) - file a police report. Insurance won't pay if you knowingly created the situation that caused injuy to your body.

[ballbreaker]

The whole story fails to make sense to me.

She later claimed they'd told her that they did not register her after her transfer from Maharat because they not want to take over the responsibility from Maharat in case she had passed away.

This whole story is full of holes and you should take a big step back and start thinking with your big head.

Do you really believe a hospital would not have record on patient?

[ThaivisaInsurance]

Does she have the government 30 baht card for coverage?

No idea, sorry.

That 6 month price might be a bit low if out patient coverage is included but it all depends on her age. Hopefully its one of the major Thai companies like Thai Health or BUPA.

http://www.bupa-intl.com/about/corporate-information

BUPA is not Thai company, although they have sales office in Thailand.

Cheers

Nana

Sorry, but the BUPA insurance company you deal with in Thailand is a Thai company

[schmutzie]

The whole story fails to make sense to me.

She later claimed they'd told her that they did not register her after her transfer from Maharat because they not want to take over the responsibility from Maharat in case she had passed away.

This whole story is full of holes and you should take a big step back and start thinking with your big head.

Do you really believe a hospital would not have record on patient?

Yeah, the recent relapse was a bogus story. She has now confessed. Whether or not the whole accident and stay in Maharat was fabricated also I don't know yet and not sure if I really need to know. Sorry about all the trouble. I appreciate the well-meaning advice I've been given here.

[ballbreaker]

Yeah, the recent relapse was a bogus story. She has now confessed. Whether or not the whole accident and stay in Maharat was fabricated also I don't know yet and not sure if I really need to know. Sorry about all the trouble. I appreciate the well-meaning advice I've been given here.

Trust is one of the most important things you can have in a relationship.

I think its time to dump this lady and move on with your life.