The Grand Expat Health Insurance Poll

[Jingthing]

Health care in Thailand can be problematical. Some of us come from countries with state systems and are not used to the idea of paying for insurance or care.

As an American, I can unfortunately relate quite well to the Thai system:

-- the best care is expensive and the costs are rising faster than inflation

-- insurance is needed to cover any serious events unless you have big piles of cash

There is not really a safety net for expats. If you are not insured and you can't pay, well, you could just die.

Obtaining insurance can be a problem. Private insurance companies are not very interested in covering sick people as new customers. Unlike the US which has a nationalized health problem for the eldery, our expat elders can be denied the chance to buy private insurance at all here, as the companies generally have a cut off age for new customers.

So its a minefield out there, and the implications can ultimately be life or death for many of us.

Thus, I present this very imperfect poll, even more so than most polls, as the situation is so very complex. Please choose the choice closest to your personal situation. For example if you are a US veteran and covered in Thailand through that, the closest choice for you would be: My countries nationalized health plan covers me in Thailand

I hope this poll encourages discussion on this important issue. Cheers.

Edited November 17, 2009 by Jingthing

[PeaceBlondie]

Covered by federal employees insurance as retired civil servant.

[thaihome]

I and my family are covered by the US insurance provided by my company. We split the cost. I selected the second option (I get insurance from work in Thailand), but think it should have been split between a local Thai plan and an international one. It should have also specified who paid.

TH

[soundman]

Self insured - that way I'm not wasting 80% - 90% of my money on Insurance Sales commissions, Executives Salaries, Large Flashy Building, Expensive Advertising campaigns, internal beaurocracy etc, etc - all paid to a large company that usually won't pay up for the full amount of the medical bill anyway.

[sanook2me]

I didn't see fingers crossed and hope.. on your survey.

[simon43]

Insured by my employer, very comprehensive plan and extends to my son as well. But since employment is transient I need to investigate what will happen when this employment ends and whether or not I can automatically continue with this cover without having to be reconsidered by the insurer.

Simon

[ThaivisaInsurance]

Insured by my employer, very comprehensive plan and extends to my son as well. But since employment is transient I need to investigate what will happen when this employment ends and whether or not I can automatically continue with this cover without having to be reconsidered by the insurer.

Simon

This is a very important point you have raised and one that not many employed persons think of. As you say you need to ask your companies insurance company and some will allow you to continue BUT if you have had a problem during the time with the company scheme then that may well be excluded as a "pre-existing condition" when you swap to an individual plan.

The best solution is not to use your employers medical scheme but to ask for the money in lieu and get one's own individual plan set up.

[Jingthing]

In retrospect, based on the anemic response to this poll so far, it seems titling this "Grand" was a tad bit presumptuous. I am curious to know roughly what percentage of expats here carry ANY kind of health insurance good in Thailand. If I had to guess I would say under 50 percent.

Edited November 18, 2009 by Jingthing

[tonititan]

I am fully covered by my employer (and my dependents would be too, if I had any). The coverage is excellent. I go to one of the nicer private hospitals, and my insurance almost always covers everything. No complaints here.

[samran]

I've got just about all levels of cover. But, I am VERY lucky that I am young and healthy.

- Covered by SS at state hospitals. Never have used it, but it is 'there'. Get 700baht/month back from the government through it cause I have two kids.

- Get a crappy low level Bupa policy from work. Use this to see the GP if I've got the flu, not much good for much else, especially if you need to check into a major hostpial (Samtivej, etc).

- Got the William Russel one for my family and myself which provides and excellent level of coverage for all inpatient. Don't have outpatient as it isn't worth it in Thailand. Very importantly though, this provides a free ticket back 'home' in the case that I chose to have any treatment taken care of in my country of orgin...so if for some reason me or a member of my family are hitting the 'limit' on this policy William Russel will fly us back to Australia where .....

- ......I've got the Medicare care from Australia for me and my family to cover the rest.

[Jingthing]

I have a tummy ache.

Shameless bump with the hope that more people vote in this poll.

[JUDAS]

I'm covered through TV Insurance , 5m Baht policy which I think is sufficient.

[Nomad97]

I was with BUPA International for the last 17 years of my working career and I changed to BUPA Blue Cross (Thailand) when I retitred here 6 years ago. As I understand the policy, because I had the policy prior to my 60th birthday I can obtain insurance year after year until I die. If I had not joined the scheme before my 60th birthday I would have been limited to insurance up to my 70th year.

I do not cover outpatients costs as these are so cheap anyway and not worth the expense or trouble of sorting out claims. Fortunately for me, I have only ever claimed once on my policy during the past 23 years, and that was nearly 20 years ago. Maybe I will be lucky and will never need to claim again. Howver, I prefer to have insurance just in case.

My wife and children are covered under the Thai Government Gold Card Scheme, although I usually pay for private health care as and when the need arises.

[doggie888888]

I've got just about all levels of cover. But, I am VERY lucky that I am young and healthy.

- Covered by SS at state hospitals. Never have used it, but it is 'there'. Get 700baht/month back from the government through it cause I have two kids.

- Get a crappy low level Bupa policy from work. Use this to see the GP if I've got the flu, not much good for much else, especially if you need to check into a major hostpial (Samtivej, etc).

- Got the William Russel one for my family and myself which provides and excellent level of coverage for all inpatient. Don't have outpatient as it isn't worth it in Thailand. Very importantly though, this provides a free ticket back 'home' in the case that I chose to have any treatment taken care of in my country of orgin...so if for some reason me or a member of my family are hitting the 'limit' on this policy William Russel will fly us back to Australia where .....

- ......I've got the Medicare care from Australia for me and my family to cover the rest.

I have comprehensive health insurance with Interglobal which covers me for almost everything...it was something I had when I was working in Asia and since retiring I just continued with it. However, now that I am paying for it myslef, I noticed the premiums creeping up SIGNIFICANTLY as I get older. Thinking of scaling down the cover to bare necessities and go back to Australia and get covered by Medicare for anything else. I agree outpatient cover is not necessary in Thailand.

Samran, this is where I am interested in your last comment...my Medicare card expired last year and when I went back to Melbourne I approached them to get a new card...they told me I DO NOT QUALIFY AS I HAVE BEEN LIVING OVERSEAS for x years. Their records must be linked to Tax Office and/or Immigration. To re-qualify I need to live in Australia again for one year and proof it. SO you better check if you are still covered by Medicare!

[Jingthing]

Covered by federal employees insurance as retired civil servant.

I feel your situation is close enough to this choice:

My countries nationalized health plan covers me in Thailand

Not every possible wrinkle could be covered in the choices; the intention was for people to vote for the CLOSEST choice even if not exact.

[Jingthing]

I didn't see fingers crossed and hope.. on your survey.

You make a good point. I think that situation covers a huge number of people. It should have been a choice on the poll. The closest choices of

I can afford the cost but choose to self insure with savings

and

I want insurance but cannot afford the cost

are probably not close enough to reflect that.

Note:

This thread was moved from the general forum to the insurance forum. I can't argue with the logic that the topic is about insurance. However, I feel that placing it in this forum would tend to skew the voters towards more people who either already have insurance or are in the process of shopping for it. The original intention was to sample a more GENERAL population. In other words, the results will probably show a higher percentage of people who ARE insured than ACTUALLY are insured. Just my theory.

Edited November 19, 2009 by Jingthing

[PeaceBlondie]

Covered by federal employees insurance as retired civil servant.

I feel your situation is close enough to this choice:

My countries nationalized health plan covers me in Thailand

Not every possible wrinkle could be covered in the choices; the intention was for people to vote for the CLOSEST choice even if not exact.

Whatever - but the USA has no nationalized universal health plan. This an employer plan. I opted out of CHAMPUS and SS Medicare.

[Jingthing]

Covered by federal employees insurance as retired civil servant.

I feel your situation is close enough to this choice:

My countries nationalized health plan covers me in Thailand

Not every possible wrinkle could be covered in the choices; the intention was for people to vote for the CLOSEST choice even if not exact.

Whatever - but the USA has no nationalized universal health plan. This an employer plan. I opted out of CHAMPUS and SS Medicare.

For elders, the US does have such a plan. It is Medicare. But Medicare does not cover expats while abroad. I get your point though. Probably

I get insurance from work in Thailand

would have been closer even though you are retired. It seems I was mistaken before about the best fit for your wrinkle.

Edited November 19, 2009 by Jingthing

[samran]

I've got just about all levels of cover. But, I am VERY lucky that I am young and healthy.

- Covered by SS at state hospitals. Never have used it, but it is 'there'. Get 700baht/month back from the government through it cause I have two kids.

- Get a crappy low level Bupa policy from work. Use this to see the GP if I've got the flu, not much good for much else, especially if you need to check into a major hostpial (Samtivej, etc).

- Got the William Russel one for my family and myself which provides and excellent level of coverage for all inpatient. Don't have outpatient as it isn't worth it in Thailand. Very importantly though, this provides a free ticket back 'home' in the case that I chose to have any treatment taken care of in my country of orgin...so if for some reason me or a member of my family are hitting the 'limit' on this policy William Russel will fly us back to Australia where .....

- ......I've got the Medicare care from Australia for me and my family to cover the rest.

I have comprehensive health insurance with Interglobal which covers me for almost everything...it was something I had when I was working in Asia and since retiring I just continued with it. However, now that I am paying for it myslef, I noticed the premiums creeping up SIGNIFICANTLY as I get older. Thinking of scaling down the cover to bare necessities and go back to Australia and get covered by Medicare for anything else. I agree outpatient cover is not necessary in Thailand.

Samran, this is where I am interested in your last comment...my Medicare card expired last year and when I went back to Melbourne I approached them to get a new card...they told me I DO NOT QUALIFY AS I HAVE BEEN LIVING OVERSEAS for x years. Their records must be linked to Tax Office and/or Immigration. To re-qualify I need to live in Australia again for one year and proof it. SO you better check if you are still covered by Medicare!

I make sure I go back every now and then long enough so that it ticks over and that I am covered. Last time I checked, i was still. Pay a bit of tax..stay a while. Worth the piece of mind. They keep sending me a new card, so I still must be!

Edited November 19, 2009 by samran

[luvthailand]

I am mid-40s, retired, American, and live in Thailand half-time. I still maintain a USA-based, high deductible health insurance policy which costs me about $130 per month. I only spend a couple of months per year in the USA. Supposedly, the insurance would cover me in an emergency abroad, with a $10K deductible. But I don't know for sure if I invalidate the policy by "living" somewhere else than my policy is based rather than "visiting", the policy is not really clear. My deductible in the USA is $5K (and it is a separate deductible from the $10K abroad deductible). The policy pretty much covers everything above the deductible, including prescription drugs.

So mostly my plan is to pay cash in Thailand and abroad. And if something got *really* expensive, I would either fly back to the USA for care, or try to claim it under my insurance policy. I don't plan to get Thai insurance, I think it is mostly worthless in the long run for expats without cash flow problems (except as proof that you will pay).

When I am older, over 65, I plan to enroll in USA Medicare and visit a USA doctor on each visit back to the USA to maintain my foot in the system.

If my health insurance premiums went up significantly, I would consider dropping it and go cash only, basing my care in Thailand. For trips back to the USA, I would buy temporary health insurance.

LuvThailand

[jfchandler]

As I've posted elsewhere here, I just got thru doing a pretty rigorous shop-around for medical insurance, and I probably looked very closely at the details of a half dozen different expat packages, both based in Thailand and abroad... The best value (price/coverage) policy I could find in Thailand was the one I already had... LMG....

Age 50 male, 5 million baht maximum per event, 20 million lifetime, 8000 per night inpatient hospital room benefit, 100% outpatient coverage... etc etc... Annual premium about 44,000 or $1,330. Less of course if you opt for only inpatient coverage. Lifetime renewable if you join and maintain before a certain age... I believe 60.

If anyone knows of a better value package that's out there, I'd like to know about it...

[Jingthing]

As I've posted elsewhere here, I just got thru doing a pretty rigorous shop-around for medical insurance, and I probably looked very closely at the details of a half dozen different expat packages, both based in Thailand and abroad... The best value (price/coverage) policy I could find in Thailand was the one I already had... LMG....

Age 50 male, 5 million baht maximum per event, 20 million lifetime, 8000 per night inpatient hospital room benefit, 100% outpatient coverage... etc etc... Annual premium about 44,000 or $1,330. Less of course if you opt for only inpatient coverage. Lifetime renewable if you join and maintain before a certain age... I believe 60.

If anyone knows of a better value package that's out there, I'd like to know about it...

That includes international cover outside Thailand, even in the US? I had a quick look at a website about them and didn't notice any ONLY in Thailand offering.

[jazzbo]

Kuhn S. -- You are not self-insured; you just have NO insurance. Self-Insured in the Insurance world would mean that you yourself cover a large retention or if a company through a captive insurer e.g. in Bermuda; and then purchase 'catastrophic coverage' for the extreme or outlier event... You right now have a great plan as long as nothing unexpected happens to your or your family... and I can assure you that actuaries are way ahead of you on the numbers.

Kuhn JFC -- I have BUPA Platinum for roughly the same annual fee considering a few extra years for me (around 60K baht); I am covered 5 million baht per event with NO lifetime limit; 12,000 per day private hospital room -- 100% INPATIENT coverage - no outpatient coverage. Lifetime guarantee as they have expressed in writing.

International coverage everywhere EXCEPT the USA -- however I buy from BUPA / TH a 3 million baht per occurrence policy good for 60 day (each) trips to USA for $100 per year.

[zzaa09]

In retrospect, based on the anemic response to this poll so far, it seems titling this "Grand" was a tad bit presumptuous. I am curious to know roughly what percentage of expats here carry ANY kind of health insurance good in Thailand. If I had to guess I would say under 50 percent.

Under quite protest and chagrin, we're covered by a solid and secure {Thai} private health provider/insurer for the immediate family and the missus' Mom & Pop. The rates are not too bad...could be worse. Personally, I find the insurance scam {generally speaking} as a fabricated blackmail scheme created, and universally accepted by those systems that benefit, by the corporate/government {fascists} controlling bodies. The rather modern inventing of insurance has been forced upon us - the ideals of 'insurance' just reflects the reality that one doesn't own anything....vacant of independence, self-sufficiency, and self-reliancy. A plague on all their houses.

[aussiebebe]

I have basic health insurance through my work (Thai Insurance), the Thai social security card, and I bought a private policy for my family and I (BUPA Emerald).

Didn't like that I could only tick one option on survey - many expats do the same as I do, I'm sure.

Comparing what I'm covered for with other members like jazzbo and JFC has unnerved me quite a bit - if anything catastrophic ever happened I'd probably find that I'm woefully under-covered

I'm fascinated to learn what the premiums are for top-notch packages like BUPA Platinum and LMG.

I appreciate JFC's recommendations if all other avaliable options have been compared and contrasted. Very helpful.

[jfchandler]

Aussie...not sure what you're asking me, if anything...

I think, obviously, health insurance is a very personal, subjective thing.... The decisions certainly will be influenced by one's economics, personal health history, and a variety of other factors.

I had one bad experience with LMG (where a lower level person agreed to cut me some slack on a non-covered thing, I did it, and then they refused to reimburse afterward, contrary to their original promise), and so I was really wanting to change. I looked at many many plans this year, including several of the high end BUPAs, AXA, William Russell, HTH Global Citizen, Premier International, NZI, and some others....

I found some, like Premier and William Russell, that I could get somewhat better coverage for a lot more money. And I found most of the policies had lesser coverage than LMG for either more, the same or somewhat less money. But I didn't find anyone else with as good coverage as in the LMG policy (Maxi-Care, Mega Series) for a better price. Other than that one broken promise, they've been very good for the two+ years I've been with them, doing direct payments to the hospitals and no hassles.

A good resource for the armchair web surfer to compare different expat health policies is at the web site for E-InsureThailand. You can actually see all the details of each different company's policy there and even their rate sheets by age group, without having to get hassled by phone calls and emails from a dozen different agents/reps.

I have basic health insurance through my work (Thai Insurance), the Thai social security card, and I bought a private policy for my family and I (BUPA Emerald).

Didn't like that I could only tick one option on survey - many expats do the same as I do, I'm sure.

Comparing what I'm covered for with other members like jazzbo and JFC has unnerved me quite a bit - if anything catastrophic ever happened I'd probably find that I'm woefully under-covered

I'm fascinated to learn what the premiums are for top-notch packages like BUPA Platinum and LMG.

I appreciate JFC's recommendations if all other avaliable options have been compared and contrasted. Very helpful.

[jfchandler]

Jazzbo, yes, I looked at BUPA Platinum also.... But I wanted outpatient coverage for my package.... since I've never yet in my life spent a night in a hospital, but I do go to see doctors periodically for various smaller things. I figure if I'm paying for med insurance each year, at least I want to get something back for it.

For my LMG policy, if I were to exclude outpatient from it, I think that would knock 10 to 15K off the premium, bringing their inpatient only policy version of mine down to around 30K. The no lifetime limit is a good feature, I would have liked to have.... But outpatient was a bigger priority for me. And as best as I recall, BUPA doesn't cover for some major potential things.. I can't recall exactly at this point, but I'm thinking it was things like organ transplants and/or chemotherapy...

The 45K figure was a good compromise for me, especially since that rate is for their age range beginning at 50, meaning I won't have another age-based rate increase for another 3 or 4 years.

Kuhn JFC -- I have BUPA Platinum for roughly the same annual fee considering a few extra years for me (around 60K baht); I am covered 5 million baht per event with NO lifetime limit; 12,000 per day private hospital room -- 100% INPATIENT coverage - no outpatient coverage. Lifetime guarantee as they have expressed in writing.

[jfchandler]

Jing, my policy and premium with LMG (Maxi-Care, Mega Series) is based on emergency coverage in most of the world.

In looking at my policy documents, as I understand them, the policy covers routine medical treatment in Thailand only. But it covers emergency medical treatment in the rest of the world except for a list of countries that are excluded in total.

Those countries are the U.S., Japan, Hong Kong, Switzerland, and EU countries.... (How they devised that list, I've never been told). I believe by accepting that area limitation on emergency treatment, I'm getting a 20% premium discount over their same policy without that limitation.

Let me also correct something I said above, about their premiums and my age. My exact premium to renew at age 50 this fall was 43,700b. But that's the last year of their 46 to 50 age range. So next year, I'll move to their age 51 to 55 range, and my premium will go up probably to about 48,000b. Also, in checking my policy documents, I see that excluding outpatient coverage entirely would bring down the premium by almost exactly 10,000b per year.

I haven't seen that LMG offers a Thailand-only coverage package, but I've never asked either.

LMG also offers an option for their policies to include a 40,000 per year deductible, which of course reduces the regular premiums. But I wasn't interested in that. They also offer an even higher level policy (Ultra Care) with of course a higher price that includes a 16,000 per night hospital benefit and 20m/80m policy limits.

As I've posted elsewhere here, I just got thru doing a pretty rigorous shop-around for medical insurance, and I probably looked very closely at the details of a half dozen different expat packages, both based in Thailand and abroad... The best value (price/coverage) policy I could find in Thailand was the one I already had... LMG....

Age 50 male, 5 million baht maximum per event, 20 million lifetime, 8000 per night inpatient hospital room benefit, 100% outpatient coverage... etc etc... Annual premium about 44,000 or $1,330. Less of course if you opt for only inpatient coverage. Lifetime renewable if you join and maintain before a certain age... I believe 60.

If anyone knows of a better value package that's out there, I'd like to know about it...

That includes international cover outside Thailand, even in the US? I had a quick look at a website about them and didn't notice any ONLY in Thailand offering.

[Jingthing]

They exclude the US and other high cost countries because they are high cost countries. US care is the most expensive in the world.

Edited November 22, 2009 by Jingthing

[jfchandler]

Jing, that part about the U.S., for us U.S. folks, is pretty obvious, of course, since we know how ridiculously expensive our own health care system is. I was referring more to the other countries excluded, and others that weren't excluded. Like Hong Kong out, but Singapore and Taiwan in???

They exclude the US and other high cost countries because they are high cost countries. US care is the most expensive in the world.