Health Insurance.........Can You Answer These Questions?

[Jaochoo]

I need to take out health insurance and have been reviewing the various options available. I had assumed this would be a simple process of selecting a reputable insurance company with cover appropriate to my requirements. However, based on my research, many additional and important issues need to be considered before making any final decisions.

I would really appreciate some feedback and/or general "Pearls of Wisdom" regarding the points listed below. Hopefully, this will ensure my dealings with an insurance broker are made very much easier i.e. less chance of becoming confused and being sold a policy which is totally unsuitable!!

For your information I am a fifty two year old male, married, retired and living in Thailand. I have just undergone a comprehensive medical examination at 'Bangkok Pattaya Hospital' and I am delighted (and relieved!) to have been given a totally clean bill of health. I also have no pre-existing conditions.

1. If I take out health insurance with 'Company A' and then develop a medical condition (which may or, may not require treatment) I assume this would be covered indefinitely (subject to my policy/level of cover) for as long as I continue to renew my insurance (without any break in cover) with "Company A"?

2. Should I decide to move to a new insurance company for whatever reason, I assume any medical conditions which developed under the previous cover (treated or, not) would be considered pre-existing conditions and therefore, not covered by the new insurance company?

3. There are some very reasonably priced "Group" health insurance schemes available and at first glance they appear very attractive. In fact, I believe 'Thai Visa Forum' offer something similar to their members. However, I note that this type of scheme expires once you reach sixty five years of age. I understand health insurance is still available after you reach this age, but, you would need to take out a "personal" insurance policy.

Would I be correct in assuming that the "personal" health insurance which you need to take out at sixty five would be a new policy and therefore, any pre-existing conditions would be excluded from cover?..................I also presume this would be an annual policy with no guarantee of renewal?

4. I am starting to think that the more expensive policies with "guaranteed renewal for life" are worth serious consideration, especially if you start the cover with no pre-existing medical conditions. I appreciate that as we get older the premiums increase accordingly but, at least we will still be insured at a time in our lives when we are most likely to become ill.

5. I had hoped to be able to take advantage of one of the lower priced "Group" schemes but, assuming my comments in point 3 are correct, this could prove to be a very expensive mistake in the long term?

6. Becoming very tempted with a "BUPA" policy (with guaranteed renewal for life) but I cannot differentiate between "BUPA International" and "BUPA Thailand". Does anyone have any firsthand experience in dealing with either of these companies and/or reasons why one is clearly better than the other?

7. Not sure if this is relevant or, if such a thing even exists, but, I only require health insurance for cover/treatment in Thailand only - Should be very reasonably priced if available????

Apologies for such a long post and for those of you who have managed to stay the course, thank you for your patience and I look forward to receiving some helpful replies.

Many thanks.

[mallyrd]

A very interesting post and I also look forward to seeing responses from those either in the know or, those that have gone down a similar thought process as your own.

[tpthai2]

With "BUPA" your policy will increase at a rate of 10% a year after a "BUPA" specified age. If you have no policy clams within the year you will receive a marginal refund of that years renewal payment.

I believe "BUPA" only provides the Platinum Policy

at a specified age of enrollment or may only provide that policy now in any case.

If you expect to travel out of the Kingdom quite often you need to look at the international policy. If not, then you have the option of purchasing travel insurance options with "BUPA."

I have had some issues with "BUPHA."

PM me as I will not detail here.

[wandrinstar]

Avoid Ex Pats Club plans, and BUPA.. Ive compared the lot over 25 years and found often,its cheaper to pay privately than the Yearly Premium..Now i use a Private Hospitall Plan,take your time aand Shop Around.

[jazzbo]

(I've) found often it's cheaper to pay privately than the Yearly Premium. I agree completely as long as you don't have any major claim -- but then one never knows, does one? ... I have had BUPA Thailand (which is what you would purchase here in country) for 7 years -- during my third year of coverage they paid for surgery equivalent to 3 years' premium after a 2 year rider exclusion -- no problem at all at one of their approved hospitals who recommended the surgery.

I deal with BUPA Thailand Bangkok HQ directly... and I purchase Travel coverage for my annual or semi-annual trip to USA; otherwise I do no out-of-country travel.... I tried to purchase some of the Lloyd's of London policies (such as Aetna) and all 4 to whom I applied refused coverage due to underwriting criteria ...

[antony77]

I have been living in Thailand about 40 years. Originally I was insured with BUPA. But quite frankly thier rates are not worth it if you only want to be covered in Thailand, especially as you get older. . Government hospitals are very good and very cheap. But you do have to wait a long time. Many private Hospitals are good and cheap too. Major private hospitals have cut thier rates too.

My personal experience concurs with a post here. Many Hospitals have a "member scheme" you join for an annual fee and you get very big discounts and free facilities. One such scheme is at BGH for a about Bt30,000 for 3 years (10,000 BT per year.). Check out thier web site its called chinnawata or something like that . We use it. If you need to travel abroad you can take out a special travel insurance with a number of companies for as little as Bt 750 for a week.

[xylophone]

Quote: 1. If I take out health insurance with 'Company A' and then develop a medical condition (which may or, may not require treatment) I assume this would be covered indefinitely (subject to my policy/level of cover) for as long as I continue to renew my insurance (without any break in cover) with "Company A"?

Be careful on this one, as I have just taken out a new health insurance policy for the coming year and I was informed by the agent, who appeared to be very knowledgeable and was a friend of a friend, that in Thailand it is not illegal for a health insurance company to refuse renewal of your policy if you have had a costly illness. If they consider you are too much of a burden, then apparently they can just drop you, whereas this is illegal in many other countries.

You may want to check this out before proceeding.

[jazzbo]

Bangkok Hospital Chivawattana Perfect Diamond Card

Discount on in-patient room rates -- 50%

does not include meals, nursing service or other charges.

Discount on in-patient medical expenses -- 15%

does not include fee for doctors, special medication, special

equipment, special supply, special lab tests and other expenses.

Every time one these medical insurance questions comes up there is usually at least one guy who suggests a way that he can beat the house; one guy recently suggested that if he saves $100,000 in an account he and his family should be OK -- that is ONE major incident lifetime for a family of 3... and some guys like to say that if you have enough money socked away you should be able to self-insure which would presume that wealthy people -- who could donate a new wing to the hospital -- do not buy health insurance which is hardly the case...

As I like to put it only 1% of families may experience a catastrophic health incident but, of that 1%, 100% likely never considered it would happen to them...

[Jaochoo]

Just wanted to thank everyone for their prompt and very interesting replies.

tpthai2 Info noted. Are you referring to 'BUPA Thailand' or 'BUPA International' throughout your post? (This does not include the problem you mentioned, as this would need to be discussed privately as you suggest). My overseas travels would be very limited and I would take out travel insurance as required.

wandrinstar Advice noted and I will definitely investigate all options and not rush into anything.

jazzbo I know exactly what you mean about the risks of the unknown. It seems ironic that my recent medical report confirming my good health is actually what prompted me to investigate health insurance, namely, the advantages of commencing cover with no pre-existing conditions. Your good experiences with 'BUPA Thailand' are noted – Any reason you deal with them directly?

antony77 Based on the length of time you have lived in Thailand I would be foolish not to take note of your experience and subsequent advice! Will make enquires.

Philnz I was warned about this by a friend but couldn't obtain confirmation of all the facts. In view of your comments I am now concerned and was wondering if an expert such as the insurance company who sponsor 'Thai Visa Forum' could clarify?

Do you think this "Get Out" legal loophole applies to all health insurance in Thailand or, just insurance companies registered in Thailand? If the latter, does this apply to BUPA Thailand?

jazzbo Appreciate the research and point noted. Your final sentence sums it all up rather nicely!

Feel sure this is not the correct way to reply but trust you will all understand your relevant sections. Sorry if this causes confusion but this is all very new to me and I am still learning the ropes................or not, as it would appear!!!!!!!

[antony77]

Quote: 1. If I take out health insurance with 'Company A' and then develop a medical condition (which may or, may not require treatment) I assume this would be covered indefinitely (subject to my policy/level of cover) for as long as I continue to renew my insurance (without any break in cover) with "Company A"?

Be careful on this one, as I have just taken out a new health insurance policy for the coming year and I was informed by the agent, who appeared to be very knowledgeable and was a friend of a friend, that in Thailand it is not illegal for a health insurance company to refuse renewal of your policy if you have had a costly illness. If they consider you are too much of a burden, then apparently they can just drop you, whereas this is illegal in many other countries.

You may want to check this out before proceeding.

You are quite correct Health Insurance companies love Thailand they are allowed to discriminate against the elderly and refuse renewal

[Jaochoo]

Quote: 1. If I take out health insurance with 'Company A' and then develop a medical condition (which may or, may not require treatment) I assume this would be covered indefinitely (subject to my policy/level of cover) for as long as I continue to renew my insurance (without any break in cover) with "Company A"?

Be careful on this one, as I have just taken out a new health insurance policy for the coming year and I was informed by the agent, who appeared to be very knowledgeable and was a friend of a friend, that in Thailand it is not illegal for a health insurance company to refuse renewal of your policy if you have had a costly illness. If they consider you are too much of a burden, then apparently they can just drop you, whereas this is illegal in many other countries.

You may want to check this out before proceeding.

You are quite correct Health Insurance companies love Thailand they are allowed to discriminate against the elderly and refuse renewal

In view of my disastrous attempt earlier this evening at trying to respond to all posts together and no doubt causing total confusion, I thought I would try and make amends by replying to this post in the correct way. I am actually repeating part of my original reply to Philnz as this is still applicable. Details are as follows;

Do you think this "Get Out" legal loophole applies to all health insurance in Thailand or, just insurance companies registered in Thailand? If the latter, does this apply to BUPA Thailand?

Perhaps an expert from the insurance company who sponsor 'Thai Visa Forum' could clarify?

[jazzbo]

Dealing directly with BUPA Thailand is just my personal preference and I also did so with health insurance while in the USA -- there is really no downside to working with a broker and you certainly do not pay extra for his/her services ... I only have inpatient coverage with BUPA and the hospital insurance office -- who deals with BUPA on a daily basis -- can be my ally if so required... BTW from the BUPA website:

"We are the leading health insurance specialist in Thailand with over 80% share of the specialist health insurance market."

BTW -- It says on the published BUPA Platinum 'Schedule of Benefits': "...if you join before age 61 and are continuously insured, renewal is guaranteed for life." ... I do not care to chase down the references now but there are insurance fraud statutes in Thailand that would come into play if BUPA would renege on this published statement.

Edited October 6, 2010 by jazzbo

[jazzbo]

It says on the published BUPA Platinum 'Schedule of Benefits': "...if you join before age 61 and are continuously insured, renewal is guaranteed for life."

from Tilleke and Gibbins:

... pursuant to the amendments to the Casualty Insurance Act B.E. 2535 (A.D. 1992) and Life Insurance Act B.E. 2535 (A.D. 1992), all advertising images or solicitation documents shall be regarded as parts of the insurance policy; if the meaning of any advertised wording or image is contrary to that written in the policy, such meaning shall be interpreted in favor of the insured or the beneficiary.

[Jaochoo]

Dealing directly with BUPA Thailand is just my personal preference and I also did so with health insurance while in the USA -- there is really no downside to working with a broker and you certainly do not pay extra for his/her services ... I only have inpatient coverage with BUPA and the hospital insurance office -- who deals with BUPA on a daily basis -- can be my ally if so required... BTW from the BUPA website:

"We are the leading health insurance specialist in Thailand with over 80% share of the specialist health insurance market."

BTW -- It says on the published BUPA Platinum 'Schedule of Benefits': "...if you join before age 61 and are continuously insured, renewal is guaranteed for life." ... I do not care to chase down the references now but there are insurance fraud statutes in Thailand that would come into play if BUPA would renege on this published statement.

[Jaochoo]

Dealing directly with BUPA Thailand is just my personal preference and I also did so with health insurance while in the USA -- there is really no downside to working with a broker and you certainly do not pay extra for his/her services ... I only have inpatient coverage with BUPA and the hospital insurance office -- who deals with BUPA on a daily basis -- can be my ally if so required... BTW from the BUPA website:

"We are the leading health insurance specialist in Thailand with over 80% share of the specialist health insurance market."

BTW -- It says on the published BUPA Platinum 'Schedule of Benefits': "...if you join before age 61 and are continuously insured, renewal is guaranteed for life." ... I do not care to chase down the references now but there are insurance fraud statutes in Thailand that would come into play if BUPA would renege on this published statement.

Many thanks for your continued input.

I would only require inpatient cover the same as you.

Thanks for clarifying the broker issue – just wanted to ensure I hadn't overlooked something important/advantageous in dealing with the insurance company direct.

By strange coincidence I was discussing this very issue with a good friend last night. He uses the services of a local broker and rates them very highly. In his opinion, having a broker who speaks fluent English and Thai is a huge advantage when dealing with both the insurance company and hospital. To put this into perspective, he was admitted to hospital with a serious heart condition and whilst in bed awaiting an operation, he was informed that there was a discrepancy with his insurance cover and the operation would have to be delayed. Obviously, he couldn't have been in any immediate danger, but that's hardly the point! Anyway, to cut a long story short, he contacted his broker (from his hospital bed!) who, not only sorted everything out with the minimum of delay, but then proceeded to visit the hospital to double check all was well and that the operation had been rescheduled.

Based on the above, I would use the services of a (good) broker but this is just my personal view. In my opinion, having an impartial middleman with experience in health insurance is very important and this is something you are clearly aware of, hence your reference to having an ally in the hospital insurance office.

Thanks for the additional information regarding 'BUPA Thailand'.

[Jaochoo]

It says on the published BUPA Platinum 'Schedule of Benefits': "...if you join before age 61 and are continuously insured, renewal is guaranteed for life."

from Tilleke and Gibbins:

... pursuant to the amendments to the Casualty Insurance Act B.E. 2535 (A.D. 1992) and Life Insurance Act B.E. 2535 (A.D. 1992), all advertising images or solicitation documents shall be regarded as parts of the insurance policy; if the meaning of any advertised wording or image is contrary to that written in the policy, such meaning shall be interpreted in favor of the insured or the beneficiary.

Thanks for the the update which is very encouraging and would suggest the 'BUPA Thailand' renewal guarantee would be covered by the above.

Just been researching 'Tilleke and Gibbins' and they are certainly a well respected law firm to say the least.