Do You Pay For Medical Insurance In Los?

[Steve2UK]

Picking up on ProThaiExpat's post in the "AIA.... scam?" thread, I wonder how many agree and do as he suggests - i.e. don't pay premiums to a scheme and use the money to save for that rainy day when you might need medical services? To narrow this down a bit, I'm thinking particularly of single adults - i.e. without having a family to consider.

In Thailand, the cost of excellent medical care is so reasonable that you will have a sizeable fund available to you if you just bank the premium in a health account.

I was quoted 12k per month from Sun Alliance for world wide coverage and it seemed high to me.

That was three years ago and you can do the math on how much I have saved by self insuring as I am quite healthy and have always been so.

My guess is that if you saved the AIA premium for just two years, you would have enough to pay for even tripple bypass surgery in Thailand.

Insurance is sold by fear. Coming from the west where the medical costs are so expensive, having a medical problem is catostrophic and must be insured against, but that is not the case in Thailand. in my opinion.

[peterzxr]

Picking up on ProThaiExpat's post in the "AIA.... scam?" thread, I wonder how many agree and do as he suggests -  i.e. don't pay premiums to a scheme and use the money to save for that rainy day when you might need medical services? To narrow this down a bit, I'm thinking particularly of single adults - i.e. without having a family to consider.

In Thailand, the cost of excellent medical care is so reasonable that you will have a sizeable fund available to you if you just bank the premium in a health account.

I was quoted 12k per month from Sun Alliance for world wide coverage and it seemed high to me.

That was three years ago and you can do the math on how much I have saved by self insuring as I am quite healthy and have always been so.

My guess is that if you saved the AIA premium for just two years, you would have enough to pay for even tripple bypass surgery in Thailand.

Insurance is sold by fear. Coming from the west where the medical costs are so expensive, having a medical problem is catostrophic and must be insured against, but that is not the case in Thailand. in my opinion.

<{POST_SNAPBACK}>

From recent experience of paying 10k per person for ONE night in hospital in Koh Samui following a bike accident; I gotta say contact BUPA Thailand and pay the premium. Let's face it, who's actually gona save the money you mention anyway??

[Thetyim]

I totally agree with ProThai's reasoning.

[wimster]

Huh... ? you are with ProThai's reasoning ? I thought you were with AIA for ten years already ? BTW, PT's reasoning of having 2 years of AIS policy pay for a triple bypass is far from correct. Unless he knows where to get that bypass for 35K THB.

I totally agree with ProThai's reasoning.

<{POST_SNAPBACK}>

[Thetyim]

Yes with AIA/AIG for ten years but not medical insurance

[Lancelot]

Most people spend 70 to 80% of their total, lifetime medical costs in the last one or two years of their lives.

In Thailand I prefer to roll the dice...

Lance

[Ijustwannateach]

Having insurance recently made a big difference to me, but then again I get it through work.

Not having insurance OR savings is certainly a losing plan, even if you're very young.

"Steven"

[The_Other_Mac]

Picking up on ProThaiExpat's post in the "AIA.... scam?" thread, I wonder how many agree and do as he suggests -  i.e. don't pay premiums to a scheme and use the money to save for that rainy day when you might need medical services? To narrow this down a bit, I'm thinking particularly of single adults - i.e. without having a family to consider.

In Thailand, the cost of excellent medical care is so reasonable that you will have a sizeable fund available to you if you just bank the premium in a health account.

I was quoted 12k per month from Sun Alliance for world wide coverage and it seemed high to me.

That was three years ago and you can do the math on how much I have saved by self insuring as I am quite healthy and have always been so.

My guess is that if you saved the AIA premium for just two years, you would have enough to pay for even tripple bypass surgery in Thailand.

Insurance is sold by fear. Coming from the west where the medical costs are so expensive, having a medical problem is catostrophic and must be insured against, but that is not the case in Thailand. in my opinion.

<{POST_SNAPBACK}>

From recent experience of paying 10k per person for ONE night in hospital in Koh Samui following a bike accident; I gotta say contact BUPA Thailand and pay the premium. Let's face it, who's actually gona save the money you mention anyway??

<{POST_SNAPBACK}>

Well a typical BUPA package pays, AFAICR, around 500 baht per night. So, er...

By the way, the top Bangkok hospitals charge a tiny fraction of that. You paid special tourist price.

[austen]

As long as I'm working here, I'm all about the good ole Pragan Sang Kom...but you must understand that as an American, any form of social health care system is a novelty. No way I actually use the 750B per month that gets taken out of my check for it, but since it's money I never see, I just tell myself it's free...I should mention though that I haven't hit 30 yet, so health insurance isn't yet high on my list of priorities (I'll be hit by a bus tomorrow for sure)...good advice from Steven though...should probably listen up and start saving something for that rainy day (or bus)...

[charles]

As long as I'm working here, I'm all about the good ole Pragan Sang Kom...but you must understand that as an American, any form of social health care system  is a novelty. No way I actually use the 750B per month that gets taken out of my check for it, but since it's money I never see, I just tell myself it's free...

Prakan Sangkhom is not such a bad scheme, plenty of decent hospitals participate in it (e.g. Petcharevej which I and my family use). No payments at all, just show the card and you're done. Think there are some upper limits so it might not entirely cover multiple brain surgery but by and large it means free medical treatment (including run-of-the-mill outpatient treatment like you've got flu or tonsillitus etc.) and reasonable peace of mind.

It is also tax deductible, so if you're e.g. in 10% band it is in effect 675 baht per month. Me and wife have just had a child and it pays us 200 baht a month "child allowance" so now down to effectively 475 baht a month for my "medical insurance". Not bad at all. The scheme also paid me 6,000 baht cash toward the costs of the birth. Believe you will also qualify for a pension/lump sum later if you are still in Thailand after 50 years old! It won't be too much but seeing as you're not paying much in either (your employer has to pay in for you too) it is all round quite a nice scheme.

Edited May 20, 2005 by charles

[Orion76]

If you have some cash reserves then medical insurance is not necessary in Thailand.

If you are usually broke at the end of the month then you probably should have insurance, if you have a serious accident that requires multiple surgeries, a bed in ICU and and extended hospital stay you are going to have a pretty lousy time if all you can afford is a Thai government hospital.

[Steve2UK]

If you have some cash reserves then medical insurance is not necessary in Thailand.

If you are usually broke at the end of the month then you probably should have insurance, if you have a serious accident that requires multiple surgeries, a bed in ICU and and extended hospital stay you are going to have a pretty lousy time if all you can afford is a Thai government hospital.

<{POST_SNAPBACK}>

That ties in with PTE's thinking and is exactly what I'm wondering. In my case, I would expect to have reserves to meet an emergency (within reason). Like all insurance, it's a bet - and I'm just trying to gauge the odds. With that in mind, it would also be interesting to get an idea of what, say, a 2-week stay in an expat-oriented (private?) hospital would cost......... but I appreciate that that's such an open-ended question.

I'm really surprised at the small number of replies to this topic - surely every independent expat living in Thailand must consider the choice? I mean those who actually have to make the choice - not people who are automatically insured as part of their salary package.

As I mentioned before, I had single people in mind - I just assume that people with a family are much more likely to get themselves a family insurance deal. To narrow it down a bit further (will anyone reply then? ), I'm thinking particularly of those who are single, independent, 40+ into 50+/retired.

I'm 55 and seem to have led a charmed life where medicine's concerned - which probably means I'm due to get all the problems crammed into this end of it. That said, I'm from the UK and have always relied on the compulsory NHS (state) scheme........ so I never got the habit of choosing to pay.

EDIT

I just tried to search for Prakan Sangkhom as mentioned by Charles and Austen. Couldn't find anything to tell me about eligibility, costs and benefits. Any pointers?

Edited May 24, 2005 by Steve2UK

[austen]

I just tried to search for Prakan Sangkhom as mentioned by Charles and Austen. Couldn't find anything to tell me about eligibility, costs and benefits. Any pointers?

<{POST_SNAPBACK}>

Prakan Sangkhom is the Thai government's health scheme ("social insurance") for all (legal) workers in the Kingdom (even expats). For a small monthly salary deduction (plus some contribution by the employer), it gives you essentially full coverage at your choice of hospital from their approved list, which includes government and some private hospitals (like Paolo). Because of this, I've never had to make the choice for private coverage, but if I did, I'd probably go for one of the lower BUPA plans, which seemed like the best value for those who don't make too many trips to the hospital.

Edited May 24, 2005 by austen

[Digger]

I self insure myself in Thailand and have done so for the last couple of years after being with BUPA UK coverage for a number of years (kindly paid by my former employer). For me, it was based on the fact that the coverage with UK insurer was expensive but good, however i calculated that the cost of this, which was circa 200,000 baht per year if I continued it privately, was very high compared with the benefits. I have steered clear of local insurers because I felt the coverage versus costs of premiums was not very good and somewhat restrictive in where you went.

As your aware, medical costs are pretty low here but not cheap anymore with recent price increases certainly at some of the top private hospitals. As an example, I paid about 120,000 baht for a 4 night stay in Bumrungrad including 3 doctors fees but no surgery.

For me I am currently ahead in terms of what I have saved versus what I have spent on medical treatment, however the critical thing, is could you at the drop of a hat, pay a million baht fee to a hospital for something serious. Luckily I have credit cards and cash here that would cover pretty much this eventuality PLUS I have other people that can access money/gold on my behalf should I be incapacitated. The worry would be even if you have the money, not being in a physical or mental state to actually get it (e.g after serious road accident) which is why you need a safety net of people who can assist you. Hospitals (or at least private ones ) will not treat you without payment.

[Heng]

If you have some cash reserves then medical insurance is not necessary in Thailand.

Agree... however even if one could afford several back to back open heart surgeries without even checking the passbook balance, there's still the issue of a higher level of service given to those with insurance coverage (and most importantly that little plastic insurance card that they get from your wallet while you're unconscious at the hospital because Somchai the truck driver decided to have three Red Bulls today instead of two and smash into your car). I have one in my wallet and another laminated and hanging from my rear view mirror.

Your insurance card will work a lot better than a handwritten note that says "trust me, I have the cash."

[Orion76]

I have a friend who got bitten by a soi dog and then got infected with some "flesh eating bacteria" which gave him a terrible infection. He had to check into Bumrungrad hospital where he had to go into surgery 3 times to remove tissue and the doctors tried 7 anti biotics before they found something that worked.

He spent two weeks in there and the bill was approximately $35,000 USD. This was excluding the tissue transplant from his hip needed to replace the removed tissue on his shin which he had done in his home country.

He had insurance and they definitely verified this right away when he arrived, if he would not have the finacial means to cover this he would surely have been sent elsewhere.

I think a Platinum Visa will work just as well as an insurance card though

[Heng]

He had insurance and they definitely verified this right away when he arrived, if he would not have the finacial means to cover this he would surely have been sent elsewhere.

I think a Platinum Visa will work just as well as an insurance card though

Absolutely. So would Platinum Amex. However many places might not use it without your consent (as you wouldn't be legally obliged to pay the bill).

[ProThaiExpat]

Heng's comment that an insurance card gets you better service in a hospital is a new one for me. To the contrary, my experience is that an insurance card makes you a lesser citizen in a hospital. Hospitals well know that every hospital bill presented to an insurance company will be reviewed in detail and only a "scheduled" item will be paid. Granted, certain isurance companies are more generous with their schedule and thus their policy holders are more welcomed than policyholders of tight insurance companies.

Hospitals are largeley for profit institutions and are looking for every possible way to make money off your stay. Thailand is no different and they have learned the lessons well from the west.

The pharmacy scam is the traditonal place. Even on minor outpatient skin lesion removal visits, Rama 1 in Chiang Mai includes Tylenol as a prescription item at an outlandish price. It just goes on from there.

I checked the private room rate there a couple years ago and it was 900 Baht a day. However, I have no illusions about them surcharging that price with everything under the sun, including slippers, tootbrushes every day, water jugs, ad naseum.

It is a very good idea, as previously posted, to have backup people to help on the money end when you are incapacitated, however, Thais are afflicted with mai pen rai so one should probably have a pre-prepared instruction to th hospital regarding the level of service you are willing to pay for.

I have thought of requiring a system similar to the "chit" system used in most bars and restaurants. Sign for everything or you don't pay for it. If you are unconscious, then have a friend authorized to sign for your services daily.

I plan to have a max willing to pay after four or five days of hospitalization. If your out of it for that length of time or longer, your probably in a coma and where your warehoused will be of little concern to you.

I plan to have my medical guardian monitor the hospital stay on a daily basis and the hopital will be warned that the bill must be payed daily or not at all and only after a careful review.

They really need to get the message that your of limited means and can only pay for medical care and the bed and not all those luxury items that they buy for a song and sell to you for inflated prices.

My most recent experience with medical care was when my Thai suffered food poisoning while on a visit to Pattaya. Late at night, the symtoms were so severe and the usual medicine used here was not working, so the hotel sent us to a falang style clinic for tourists, not doubt a kick back to the hotel.

In the three hour visit, IV, for or five shots for almost everyithing possible and a bag of meds on the way out. Cost 3800 Baht, absolutely outrageous in evey way, but the level of care, comfort given to my Thai and ability to sleep the night with the drugs given, made the whole experience of limited impact on the trip. On balance, while the service was extemely expensive, it was worth it as it was a vacation experience. At home, it would have been a different story, as a more protracted recovery time would have been tolerated easily. The emergency nature of the service and the demand for immediate relief of symptoms made it expensive.

As a comparison, I impaled my arm on a fence spike, penetrating all the way through and protruding 8 centimeters out the other side. Emergencyroom treatment at Rama 1, incuding tetanous shot, followup doctor visit and all the charges the pharmacy could lay on totaled 1800 Baht.

The key in my view is getting five star medical service in a two star hospital/hotel, ie. room and food. Requiring the hospital to get your authorization prior to providing the "service" might be the way to go.

"On demand service" is the theory. Nothing unless you ask for it or they have your doctors order in writing.

Profit making institutions certainly understand your self professed "ability to pay" and would prefer to sell the bed and bare bones "services" rather than have an empty bed and under utilized physicians, since the beds and the doctors are fixed expenses in most cases.

[Heng]

Heng's comment that an insurance card gets you better service in a hospital is a new one for me.  To the contrary, my experience is that an insurance card makes you a lesser citizen in a hospital. Hospitals well know that every hospital bill presented to an insurance company will be reviewed in detail and only a "scheduled" item will be paid.  Granted, certain isurance companies are more generous with their schedule and thus their policy holders are more welcomed than policyholders of tight insurance companies.

Hospitals are largeley for profit institutions and are looking  for every possible way to make money off your stay.

If you're awake when you get to the hospital in an emergency situation, you may be afforded the same level of service as a cash customer. If you get there unconscious or delirious without them knowing that you have any means of payment, the individual who has a near guaranteed method of payment through insurance coverage will get better service. It's no different in the west. They won't put you in a private room and turn on ESPN for you after they sew your arm back on. They'll merely stabilize and then wait and hope someone shows up to sign for everything and give further instructions.

[camerata]

As I mentioned before, I had single people in mind - I just assume that people with a family are much more likely to get themselves a family insurance deal. To narrow it down a bit further (will anyone reply then?  ), I'm thinking particularly of those who are single, independent, 40+ into 50+/retired.

I'm 55 and seem to have led a charmed life where medicine's concerned - which probably means I'm due to get all the problems crammed into this end of it.  That said, I'm from the UK and have always relied on the compulsory NHS (state) scheme........ so I never got the habit of choosing to pay.

I'm 50+ and single too. I never seriously considered medical insurance in Thailand because of the stories about insurance companies only paying out on what they want to pay. Thai friends who have insurance usually have some kind of personal relationship with the agent who sold it to them, so they feel they'll get a fair deal.

At the company I work for, we get the prakarn sangkom as well as company-paid medical costs up to about 100,000 baht a year. So currently I see the doctors I want and it doesn't cost me anything.

But in the last few years all kinds of weird ailments have hit me - it seems to happen when you reach your 50s. Nothing expensive yet, but it started me thinking. One of my colleagues developed cancer last year. The 100,000 baht didn't go all that far and she had to transfer to a hospital in the prakarn sangkhom scheme.

Mostly, I'm concerned about what happens when I reach the mandatory retirement age. Premiums are expensive when you're older and I'm not sure it's worth signing up now since I have a provident fund and other savings to draw on.

I used to keep an American Express card (theoretically no credit limit) specifically for some major medical emergency, but now the law states your credit is limited to five times your monthly income (because with Thaksin's encouragement, household debt multiplied to alarming proportions) which isn't that much for me, and will be useless after I retire.

[Gary A]

I'm not much of a gambler so I'll just continue to pay my 18,000 baht a year premium. I also feel like if I am in a bad accident or have a serious problem they will find my insurance card in my wallet and I won't end up in a public hospital. A million two hundred fifty thousand baht per occurrence will pay for most any treatment anywhere in Thailand.

[alleypanda]

I bought a premium package from Bupa for my mother that way I don't have to worry about her while I am living far away from thailand.

[ProThaiExpat]

Heng's point is well taken and remins us all to have some form of emergency card on our persons at all times for use in the rare circumstances he speks of.

Personal identification, a credit card and who to contact in an emergency are critical documents in such instances.

Now that I think of it, if your registered with your embassy, providing them emergency information for your file might also be inorder.

Edited May 30, 2005 by ProThaiExpat

[ProThaiExpat]

Gary A: Risk vs. reward analysis of your situation makes health insurance a no brainer.

My quote from Sun Alliance three years ago was 18,000 a month!! BUPA doesn't insure those over 65 and many health insurance companies won't continue in force coverage for those over 65.

This thread and another may have crossed wires in my responses, clearly if your under 50, you have a good chance to get health insurance cheaply do to an employment situation and your age.

Ones general health is also a critical factor. If you were lucky in the gene pool and rarely get sick, you risk vs reward analysis would likewise be skewed toward no health insurance in Thailand.

[Boon Mee]

Most people spend 70 to 80% of their total, lifetime medical costs in the last one or two years of their lives.

In Thailand I prefer to roll the dice...

Lance

That's me and the old lady too. From what I've learned, trying to collect on the insurance whether it's BCBS or any of the so-called "Blue Chip" outfits is tough.

I'll simply pay as I go...

[Orion76]

Speaking of Bupa, a friend of mine was hit by a car quite recently, he fractured his arm and broke one of his front teeth.

While he was at Bumrungrad they fixed his arm and his cuts and said the tooth was not so urgent so he could go home after 48 hours and come back a few days later to repair the tooth.

When he claimed it with Bupa they refused to pay for the tooth because their accident insurance only covers immediate treatment. If he had it done during his initial 48 hour stay they would have covered it but since Bumrungrad told him to come back a few days later they wouldn't.

Replacing the broken tooth cost him 120,000 baht.

[camerata]

I checked with our company lawyer and apparently foreigners in Thailand with a prakarn sangkhom card have the same rights as Thais when they retire. As long as they register with 6 months of retiring and can prove they worked the previous 12 months they are allowed to stay in the scheme and pay their own contributions.

[barryofthailand]

I've been with Bupa for two years now in Pattaya. Not cheap, but i insure myself and my family. Never know when something is going to happen.

[ThaiPauly]

Nobody would insure me in Thailand so I have to "Pay as I fail" But my Wife well what a story with AIA.

When it was clear that I would not be a good risk, they focused on my Wife, who is a VERY HEALTHY, non drinker, non smoker 39 year old. The lengths that the Saleswoman went to were extrodinary. Firstly she invited my Wife out to dinner (she refused) drove her to her medical examination, came to our house blessing bearing gifts and helping with the washing up etc, came to our house warming party (invited herself to both bearing lavish gifts.) Then she kept pestering my Wife on a daily basis to sign the documents, to which my Wife had told her we were still considering it.

Get this, she rings a few days after the daily barrage to say our documents were ready to collect and just needed a signiture. She had paid the premium HERSELF, to save us the hassle and wanted us to go to the Bank to draw out the cash.

Needless to say I was LIVID, I told my Wife we would not give her F all. So what happens then. We get a refund cheque from AIA, then the blasted Woman is on the phone (no longer freindly by the way) asking for her money back. I say let her stew, then she is at the gate demanding her money. At this point we go to the bank on my way to hospital (knowing the cheque had cleared our account) She is very haughty, and guess what, we have not heard from our "FREIND" since.

These have to be the most underhanded sales tactics I have EVER experienced, and I was in sales for most of my working life.

I wonder if AIA are aware of these tactics? If they are they should be ashamed of themselves.

[jackr]

Nobody would insure me in Thailand so I have to "Pay as I fail" But my Wife well what a story with AIA.

When it was clear that I would not be a good risk, they focused on my Wife, who is a VERY HEALTHY, non drinker, non smoker 39 year old. The lengths that the Saleswoman went to were extrodinary. Firstly she invited my Wife out to dinner (she refused) drove her to her medical examination, came to our house blessing bearing gifts and helping with the washing up etc, came to our house warming party (invited herself to both bearing lavish gifts.) Then she kept pestering my Wife on a daily basis to sign the documents, to which my Wife had told her we were still considering it.

Get this, she rings a few days after the daily barrage to say our documents were ready to collect and just needed a signiture. She had paid the premium HERSELF, to save us the hassle and wanted us to go to the Bank to draw out the cash.

Needless to say I was LIVID, I told my Wife we would not give her F all. So what happens then. We get a refund cheque from AIA, then the blasted Woman is on the phone (no longer freindly by the way) asking for her money back. I say let her stew, then she is at the gate demanding her money. At this point we go to the bank on my way to hospital (knowing the cheque had cleared our account) She is very haughty, and guess what, we have not heard from our "FREIND" since.

These have to be the most underhanded sales tactics I have EVER experienced, and I was in sales for most of my working life.

I wonder if AIA are aware of these tactics? If they are they should be ashamed of themselves.

Nice one, Paul