Health Insurance Warning!

[danny4tsa]

if you are an expat living in thailand and you need health insurance, be aware who you are dealing with when you choosing the policy and company. i am insured locally by a company which the parent company is a major US insurance company. their policy and premiums looked good at the time but that is about it, it ONLY looks good. i am having a legitimate case and my case was rejected based on a bogus reason.

unfortunately, i can't publish the name of the company because of legal consequences, but i'll be happy to furnish the name of that company on a personal basis if you have any doubts it is the company you are choosing.

Edited February 23, 2011 by danny4tsa

[lannarebirth]

AIA?

[F1fanatic]

Too many people have fallen foul of health insurance companies.

My ex-husband gave up his BUPA insurance as it was too expensive, and took out a 'too' cheap policy (IMO) with, I seem to recall a Canadian company. He became v ill and ended up in hospital in Phuket - the company refused to pay after a short while claiming pre-existing conditions. It wasn't, but he died whilst he was arguing the case...

It also has to be said that the hospital diagnosis proved to be entirely wrong when he went back to England for NHS treatment, as his private insurers were refusing to pay.

BUT, it also needs to be remembered that pre-existing conditions are not covered by new health insurance policies - if you have had any problems in the past, be sure that the Insurer will find out once any claim looks as if it will be expensive.

At the end of the day, you get what you pay for.

[Moonrakers]

AIA, ain't they wonderful

We took out an AIA policy on our daughter, AFTER taking out the policy she was diagnosed as being epileptic (That's all under control now)

Anyway. We found out through another person that despite the fact that we had no idea our daughter was epileptic at the time the policy was taken out, the policy was effectively null and void. If something happened that was related to her epilepsy, we could claim nothing.

We questioned this with the person who sold us the policy, her response was to lie about the cause of death. I was speechless.

Even if a doctor could be convinced to falsify the death certificate, who on earth would want to do such a thing in the case of the death of their child.

Of course, we cancelled immediately.

[geriatrickid]

Don't you people read the policies? The references to pre-existing conditions are there. The conditions in respect to a serious illness being diagnosed within 2 years are clearly stated. The reasons these policies are subject to such conditions are due to people taking out policies once they realize they have illnesses, and yes it happens regularly. The contract wordings are such to eliminate any doubt and sometimes gray cases get dealt with harshly. If it wasn't that way, the health insurers would go bankrupt.

[F1fanatic]

Don't you people read the policies? The references to pre-existing conditions are there. The conditions in respect to a serious illness being diagnosed within 2 years are clearly stated. The reasons these policies are subject to such conditions are due to people taking out policies once they realize they have illnesses, and yes it happens regularly. The contract wordings are such to eliminate any doubt and sometimes gray cases get dealt with harshly. If it wasn't that way, the health insurers would go bankrupt.

Very few people are up to reading the small print, or even understand the medical jargon.

Having said that, I am sympathetic to the point you have made.

[Moonrakers]

Don't you people read the policies? The references to pre-existing conditions are there. The conditions in respect to a serious illness being diagnosed within 2 years are clearly stated. The reasons these policies are subject to such conditions are due to people taking out policies once they realize they have illnesses, and yes it happens regularly. The contract wordings are such to eliminate any doubt and sometimes gray cases get dealt with harshly. If it wasn't that way, the health insurers would go bankrupt.

I think most of us know how insurance policies work.

But do you think an agent should suggest the policy holders lie on a claim, solely so the policy is not cancelled and the omissions continue?

And I am sure that all insurance companies have their rogue employees, but it seems a bit odd that the same name pops up every time when something is amiss.

Edited February 23, 2011 by Moonrakers

[Huey]

Don't you people read the policies? The references to pre-existing conditions are there. The conditions in respect to a serious illness being diagnosed within 2 years are clearly stated. The reasons these policies are subject to such conditions are due to people taking out policies once they realize they have illnesses, and yes it happens regularly. The contract wordings are such to eliminate any doubt and sometimes gray cases get dealt with harshly. If it wasn't that way, the health insurers would go bankrupt.

Sadly you are correct. Thats the problem when you put health care in the hands of private enterprise. They are all about profit and they can only make money when they can deny treatment to people that need it. They only win when sick people who need help loose.

Something fundamentally wrong with that, I hope folks wake up to that in the States before I'm an old man.

[robblok]

Don't you people read the policies? The references to pre-existing conditions are there. The conditions in respect to a serious illness being diagnosed within 2 years are clearly stated. The reasons these policies are subject to such conditions are due to people taking out policies once they realize they have illnesses, and yes it happens regularly. The contract wordings are such to eliminate any doubt and sometimes gray cases get dealt with harshly. If it wasn't that way, the health insurers would go bankrupt.

Sadly you are correct. Thats the problem when you put health care in the hands of private enterprise. They are all about profit and they can only make money when they can deny treatment to people that need it. They only win when sick people who need help loose.

Something fundamentally wrong with that, I hope folks wake up to that in the States before I'm an old man.

While i agree with you about this problem i don't see why someone working in health care cant have a nice salary and someone working for a bank can. Then you don't get any professionals working in that field.

And yes insurance companies are out to make a buck but im not sure they cost more then an ineffective government machine. We changed from government health care to private health care in Holland and yes it got more expensive. However im not sure that because of the change or the constantly evolving possibilities that get more expensive all the time.

Ideally a government insurance would be best as they are not out to make a profit. However governments agencies are not the most cost effective or efficient.

[lannarebirth]

Don't you people read the policies? The references to pre-existing conditions are there. The conditions in respect to a serious illness being diagnosed within 2 years are clearly stated. The reasons these policies are subject to such conditions are due to people taking out policies once they realize they have illnesses, and yes it happens regularly. The contract wordings are such to eliminate any doubt and sometimes gray cases get dealt with harshly. If it wasn't that way, the health insurers would go bankrupt.

Sadly you are correct. Thats the problem when you put health care in the hands of private enterprise. They are all about profit and they can only make money when they can deny treatment to people that need it. They only win when sick people who need help loose.

Something fundamentally wrong with that, I hope folks wake up to that in the States before I'm an old man.

Great post Huey. You are right on.

[lannarebirth]

Don't you people read the policies? The references to pre-existing conditions are there. The conditions in respect to a serious illness being diagnosed within 2 years are clearly stated. The reasons these policies are subject to such conditions are due to people taking out policies once they realize they have illnesses, and yes it happens regularly. The contract wordings are such to eliminate any doubt and sometimes gray cases get dealt with harshly. If it wasn't that way, the health insurers would go bankrupt.

Sadly you are correct. Thats the problem when you put health care in the hands of private enterprise. They are all about profit and they can only make money when they can deny treatment to people that need it. They only win when sick people who need help loose.

Something fundamentally wrong with that, I hope folks wake up to that in the States before I'm an old man.

While i agree with you about this problem i don't see why someone working in health care cant have a nice salary and someone working for a bank can. Then you don't get any professionals working in that field.

And yes insurance companies are out to make a buck but im not sure they cost more then an ineffective government machine. We changed from government health care to private health care in Holland and yes it got more expensive. However im not sure that because of the change or the constantly evolving possibilities that get more expensive all the time.

Ideally a government insurance would be best as they are not out to make a profit. However governments agencies are not the most cost effective or efficient.

I agree with you as well robblok, but what if government provided healthcare were to have a citizen oversight group? A citizen oversight group I should note not from the healthcare sector. We don't want any revolving doors between service providers and overseers such as is commonly found in the finacial sector. That would be a catastrophe. America's institutions used to work this way once but sadly not anymore.

[jazzbo]

Because of medical history, I was excluded at all but unreasonable cost from the US Individual policy health care insurance market. My late Father was a firm believer in health insurance as an employer and -- although he was not thrilled that I was moving to Thailand -- the fact that excellent affordable insurance was available to me was enough for him to think it a wise move. I am a happy-to-be-in-Thailand health care refugee.

[samran]

Ideally a government insurance would be best as they are not out to make a profit. However governments agencies are not the most cost effective or efficient.

My masters studies in health economics cares to differ.

Governments insurance is generally best a pooling all community risk, lowering 'premiums' for all as you have both good risk (ie the young) and the not so good risk (the old) all under the same insurance umbrella.

The government as the 'purchaser' of both health products (ie Doctors and their services) as well as pharmaceuticals means the government can use its extraordinary size and negotiation power to bring down prices of both of these.

Add in reduced admin costs and you generally have a leaner and more cost effective system where health costs are a lower % of GDP for those countries which have government insurance. (this also ignores the forgone costs of having people uninsured, getting sick and thus being a drag on economic productivity).

Unfortunately for you Americans, some idiot will throw in the word 'socialism' which for some reason scares the bejezus out of you, despite the fact that in most of the western world 'socialist' doctors still drive BMW's and Mercedes to work, live in the best suburbs in the biggest houses, send their kids to the best private school and have a weekender down the coast when they aren't on their foreign holidays.

ney, they tend to forget there is no such thing as a 'free market' when it comes to health care. On the demand side you don't choose to consume health care (ie no one chooses to get sick) and on the supply side it isn't as if you have an unlimited supply of doctors to choose from who will bid down the cost of their services to get customers.

[robblok]

Ideally a government insurance would be best as they are not out to make a profit. However governments agencies are not the most cost effective or efficient.

My masters studies in health economics cares to differ.

Im not saying you are wrong but in Holland they believed that it would reduce cost. Im sure some really capable people looked at it. To be honest im not sure either way.

[jazzbo]

from post #13 -- On the demand side you don't choose to consume health care (ie no one chooses to get sick) What the medical community will say is that, due to the litigious nature of the USA and malpractice suits that are settled regardless of the merits of the case, and the resulting high-cost of medical malpractice insurance, many tests and procedures that may be marginally necessary are performed so that no one -- particularly lawyers -- can claim that there was any malfeasance... i.e. 'well, if you had done this or that, maybe my client would not be in such bad shape.'

This is what the mdical community points to as a large component of the high cost of health care in the USA.

[asiasurfer]

Just a personal opinion here:

Generally, I would advise everyone to be very careful about health insurances in Thailand! (No coverage after the age of 65?!) Instead you may wish to check out if certain insurers in your home country can insure you abroad. At least there are some of these companies in Germany… It may be of course more costly.

[jazzbo]

With BUPA Thailand if you join before age 61 you are guaranteed renewal for life if premiums are maintained (as documented in Benefits Package) ... a few years ago I applied to four different US based health care insurers with international policies and I was declined coverage by all four.

[Kwasaki]

Just a personal opinion here:

Generally, I would advise everyone to be very careful about health insurances in Thailand! (No coverage after the age of 65?!) Instead you may wish to check out if certain insurers in your home country can insure you abroad. At least there are some of these companies in Germany… It may be of course more costly.

What happens to all the money you have paid.

[jazzbo]

Post #18: What happens to all the money you have paid.Well the insurer says:

'We Keep It ... but if you want to have some incident that sucks up that premium you paid (and then some) do your best next year to get sick ... cancer or a brain aneurysm would work pretty well.'

[samran]

from post #13 -- On the demand side you don't choose to consume health care (ie no one chooses to get sick) What the medical community will say is that, due to the litigious nature of the USA and malpractice suits that are settled regardless of the merits of the case, and the resulting high-cost of medical malpractice insurance, many tests and procedures that may be marginally necessary are performed so that no one -- particularly lawyers -- can claim that there was any malfeasance... i.e. 'well, if you had done this or that, maybe my client would not be in such bad shape.'

This is what the mdical community points to as a large component of the high cost of health care in the USA.

...which may (or may not) be true but kinda distracts from getting doctors themselves to control costs, which when you think about it, is the main issue.

When you think about it, doctors are Monopolists. Monopolists charge prices that would otherwise be found in a 'free market'.

They meet all the criteria for monopoly

- high barriers to entry into that industry (5 years of basic medical training, that again in specialisation)

- legislated responsibilities which allow them to do certain things that others aren't.

All well and good, you want these things out of doctors (well trained and qualified personnel) but...and there is a big BUT

when you are a monopolist, you get to charge damn well what you want, which is pretty much what happens in the US, which is why costs in the US are sometimes double or triple than what they are elsewhere in the developed world.

You as a patient have very little opportunity to control what the doctor gives you and how much he/she charges. Most of the time we accept our diagnosis and treatment cause frankly, we are unqualified to contradict them.

Add this up across the board, and you have a very expensive health system which not only is more expensive than it needs to be, but it undersupplies medical care...ie uninsured people miss out. Not good if you want to have a tickty boo economy.

Contrast this to government orientated systems, the governments there essentially says 'best practice means that the base cost for providing this procedure is X. We will pay you X plus some sort of uplift to provide this service."

When you think about it, at its very basic level it is exactly how world over, governments regulate the provision of essential utilties - which are also monopolies.

Unfortunately, electricity transmission lines, water and oil pipelines can't lobby governments not to regulate them. Doctors can via one of the most powerful unions in the US, the AMA.

Edited February 24, 2011 by samran

[jazzbo]

Post # 20: Contrast this to government orientated systems ... All well and good Kuhn Samram -- but even though I worked peripherally in the industry (involving insurance that hospitals purchase for themselves) my recourse was to move to Thailand... and as I have no dependents in the USA I will leave those worries of the state of the US Health Care system to others or at least until I have to make decisions upon qualifying for Medicare at age 65

[samran]

Post # 20: Contrast this to government orientated systems ... All well and good Kuhn Samram -- but even though I worked peripherally in the industry (involving insurance that hospitals purchase for themselves) my recourse was to move to Thailand... and as I have no dependents in the USA I will leave those worries of the state of the US Health Care system to others or at least until I have to make decisions upon qualifying for Medicare at age 65

I wasn't taking a shot at what you are saying, rather just addressing a red-herring of the medical mal-practice argument that is run in the 'debate' on US medical insurance reform (of course after 'socialism' is screamed out).

But I am way off topic now and I'm sure one of my former mod colleges will be lining up to slap my wrist shortly!

[jazzbo]

Well -- once again -- I am very satisfied with my insurance here in Thailand. I had surgery which was equal to my first 3 years premium and -- after the doctor at the network hospital deemed the surgery necessary -- it was paid in full with no problem. So those who raise bugaboos about coverage here reference a few horror stories which may or may not have credence if the other side was heard.

[Spee]

from post #13 -- On the demand side you don't choose to consume health care (ie no one chooses to get sick) What the medical community will say is that, due to the litigious nature of the USA and malpractice suits that are settled regardless of the merits of the case, and the resulting high-cost of medical malpractice insurance, many tests and procedures that may be marginally necessary are performed so that no one -- particularly lawyers -- can claim that there was any malfeasance...

This is what the mdical community points to as a large component of the high cost of health care in the USA.

...which may (or may not) be true but kinda distracts from getting doctors themselves to control costs, which when you think about it, is the main issue.

When you think about it, doctors are Monopolists. Monopolists charge prices that would otherwise be found in a 'free market'.

Sorry, but your reply is loaded with misinformation, disinformation and propaganda.

Independent doctors are no more a monopoly than any other profession. Medical school is no more a barrier to entry than a state PE license to be a Professional Engineer, or a state contracting license to be an electrician, plumber, general contractor or any other skilled trade. Calling doctors monopololists is sheer nonsense.

There are more than 100 doctors of every possible profession within a 10 mile radius of where I live. They are no more a monopoly than any other professional or skilled trade person in the same radius.

On the other hand, government-run healthcare is a monopology. If the government mandates that patients must see a government doctor or that no doctor may practice medicine unless they do so as part the government program, well that is a monopoly. It is no different than what the government and unions like the NEA have done to the public education system in places like the US.

The malpractice points that the other poster makes are quite valid. I have a close relative who is a retired pediatrician, who treated tens of thousands of patients over a 40-year career with nary a threat of malpractice. Yet in his final years, his annual malpractice premium was hundreds of thousands of dollars. That is just wrong, and that is a big part of the problem.

The biggest parts of the problem are primarily two-fold. The first is self-preventative care. Many people have crappy diets, do not exercise, and do very little to maintain the physical and mental health of their bodies.

The second is the misconception that health insurance should be some all-encompassing coverage for every last little scratch, hiccup and wet fart. Any reputable insurance business has historically always been based on major or catastrophic coverage. People don't get insurance for tuneups and oil changes for their car. So why should they get insurance for an annual checkup or diagnosis and treatment of a minor illness?

Government mandated "health insurance" that is required to cover every last little malady, isn't insurance at all. At best, it is "crony capitalism" between corrupt government agencies and corrupt businesses. At worst, it is just plain welfare, government theft of one individual's property to hand out to another individual for the sole purpose of seeking political favor.

Cutting through all the other stuff, you make a closing statement that the AMA is essentially a doctor's union. This is pure steer manure. First of all, most reputable doctors have been running far and fast away from AMA membership for decades. Wikipedia claims that fewer than 20% of US doctors are AMA members. And why are reputable doctors running far and fast from the AMA? Because the AMA has been thoroughly corrupted by those who desire a government monopoly over healthcare.

[samran]

Gee Spee - and you didn't even have to shout the word 'socialism' once. Must have been tough to hold your tongue. You couldn't help yourself knocking welfare though.

I stand by what I wrote. I'm an economic rationalist - economic efficient outcomes rule for me. Market achieves that most of the time, and where it doesn't - especially where there are huge market distortions of the once I mentioned, then you seek alternative methods of providing those outcomes.

Are doctors as a group monopolists? Of course they are. You have to use them, and most of us don't even get the choice of when we want to use them. You get sick (not your choice) off to the doctors you go.

Being a natural monopolist doesn't make them evil, far from. They simply meet the criteria and economic evidence shows that they are (in the form of higher prices and medical inflation in the US and less than optimal coverage of the population).

And where in my writing did I say that a government run sector has to provide coverage for every little malady? Nor did I say that preventative care isn't a worthy goal.

Plenty of systems run successful dual public and private systems. Australia is a case in point.

What should be a prime concern to policy makers however is that if one get sick (something in the main people have very little control of), they are able to access medical system in such a manner that the economic position of that person needing care isn't the main determinant of whether they get treatment.

This need not happen where there is a reduction in standards, services, nor god forbid, Doctors salaries.

Edited February 25, 2011 by samran

[F1fanatic]

With BUPA Thailand if you join before age 61 you are guaranteed renewal for life if premiums are maintained (as documented in Benefits Package) ... a few years ago I applied to four different US based health care insurers with international policies and I was declined coverage by all four.

I looked into BUPA Thailand as my current Insurer (Bupa International - the policy excludes N America) is v expensive. My previous BUPA UK was cheaper.

Disappointingly I found that the basic cover is far too basic if one is unfortunate enough to come down with a serious medical problem, and once I looked at their top packages they were no cheaper than BUPA International!

It makes no sense at all. Medical costs in Thailand are far cheaper than in Western countries, but GOOD medical policies are more expensive!

[oldsailor35]

I am 75 and apart from arthiritus in one knee, could pass any medical test. But am unable to qualify for medical insurance. So if i get hit by a taxi, i am not covered. So <deleted> does age have to do with that ?

[F1fanatic]

I am 75 and apart from arthiritus in one knee, could pass any medical test. But am unable to qualify for medical insurance. So if i get hit by a taxi, i am not covered. So <deleted> does age have to do with that ?

Basically, as the general population get older they suffer more health problems, so health insurance premiums go up.

Have you looked into accident insurance? They are being advertised all the time in the UK, pretending they are medical insurance.

[terrier123]

Several issues have been brought up on a subject important to all of us -- especially if that guy in Phuket gets his way.

When I enquired more than 12 years ago, I remember there was some legislation preventing cover for Brits out of the country for more than 6 months ie ex-pats. But, as always, rules get changed and I stand to be corrected.

When I reached 60 and after 6 years without claims, my Thai policy premium actually went down by 5,000 baht . I enquired why and was told that more than 50% of the cover had been removed because of my age -- policy cancelled. Unfortunately most of the policy was in Thai although I could get emails answered in English.

I don't understand why some of the scribes reduce this subject to a political platform; but does anyone have experience of the medical insurance advertised on Thaivisa?

Now that info would be helpful.

[citizen33]

This struck me as an interesting thread in which it didn't take posters long to make the connection between the personal troubles of the OP and the public issue of private health insurance. Samran clearly benefited from a sound Masters programme.

The Netherlands is an unusual case where since 2006 people of working age have been mandated to purchase a standard health insurance package from private insurers, regulated by the state and arms-length bodies. The earlier poster doesn't mention the risk equalisation and risk pooling put in place as a result of governmental intervention.

http://content.healthaffairs.org/content/27/3/771.abstract

The above ensures that people are not excluded because of pre-existing conditions. Thus the health care market of the Netherlands bears very little resemblance to the US system that Obama is trying to reform, and indeed would be just as unpalatable to the Neo-Cons as the present US reform package.