Health Insurance In Thailand And Us Medicare

[californiabeachboy]

I am a 60 year old retired American citizen seriously considering moving over to Thailand. I am eligible for the retirement visa, and I have been to Thailand before, so those areas are covered. The one issue I have not resolved involves health insurance. In about 4 1/2 years I will be eligible for US Medicare. I know it does not cover me overseas, but it still would have some use as a "backup" in case of serious problems. I am considering the pluses and minuses of waiting for Medicare to kick in before I come over there, and then buy a local policy, or move over in a year or so and buy Thai insurance that will cover me as I travel back here to the US (and I also will be traveling to Australia).

As I see my two options:

1. Wait until I turn 65, enroll in Medicare, then move over to Thailand and get the appropriate policy there, covering me in Thailand and trips to Australia, and make sure it covers me for transport back to the US for serious issues, and rely on Medicare (plus maybe a supplement) in the US. The advantage of this is that is is simpler and easier. The disadvantage is that I understand from reading some of the posts here it is difficult to get health insurance in Thailand when you are 65 or over.

2. Move over around 62 or 63, get full coverage in Thailand that also covers me in Australia and the US, then when I turn 65 decide if anything needs to change when I enroll in Medicare.

Luckily I am in very good health with no prior health conditions other than I take a diuretic for mild high blood pressure. But I am not one of those brave souls who will ever not be fully covered. I am not worried about the little things like doctor's appointments etc., but the big ticket items, like getting hit by a motorbike while I am walking down the sidewalk in Thailand (about a 50-50 chance based on my prior experience in Thailand).

For reference I now pay about 330 USD per month for a high-deductible policy in which I pay the first $2500 and then it pays 100% after that up to 5 million. I would like to have something close to that in Thailand, not necessarily 100%, and maybe up to 1 million (if it costs more than that just shoot me and put the money to better use).

I am sure I am not the first old-dog US citizen to go through this, so I would appreciate any thoughts or personal experiences regarding the advantages or risks.

Thanks.

Cheers.

[cheeryble]

I really feel for Americans with their healthcare nightmares.

Happily there's an easy option.

Simply don't get insured. I'm not, nor are many friends.

Most care is very reasonable here. In a worst case scenario that something expensive happens in the next few years do you have savings to cover the hit? (Remember that US costs are many multiples of Thai costs. They're a sick joke which Americans work themselves into the grave to pay.......possibly a factor in why their life expectancy is less than Europeans).

Edited September 29, 2011 by cheeryble

[tonydabbs]

Beachboy You are asking the wrong questions. First, you have to understand your Thai based "renewable for life" options here.

1. If you apply for coverage at age 60, you will have two local insurance options, Bupa Thailand or LMG Pacific Thailand.

LMG Pacific is a good buy, but they will require you to take a physical. Bupa won't require a physical.

2. If you apply at age 61, Bupa is no longer a real option. They will only insure you to age 70.

3. Bupa only covers for accidents in the US. No problem with Australia, though. LMGP may require you to share costs in the US (80/20 or 70/30?)

4. Both have emergancy medical evacuation back to Thailand, but not to another country. You may be able to make additional arrangements through SOS for about another 20,000 baht.

5. Your hypertension will be excluded from coverage; but, if you keep it well under control, your heart and other areas of potential risk will be covered.

6. There are a few off-shore health insurers that service Thailand, also. LMG Pacific is a bit cheaper, though.

Good luck! I'm from the L.A. area myself.

Edited October 2, 2011 by tonydabbs

[Baht Man]

I agree with Tonydabbs.

Getting your coverage here before your over 60 is critical if you want local Thai insurance (even BUPA Thailand) but they will not cover ANY pre existing conditions. Enrollment age is limited and renewal terms are also short (65 70).

I'm 62 with "pre hypertension" and need to look internationally for the coverage due to my age now, lifetime reneawals, and coverage for the hypertension.

Most, but not all, have coverage for "out of geographical area" for accidents and unscheduled treatments for limited terms, but they'll not allow you scheduled treatment back in the US unless you have it included in your policy which will make the price go vertical due to the costs there.

I started with a broker who reps 30+ companies, Pacific Prime.

First they told me BUPA International would never cover pre-existings so I submitted an application online just for grins. They came back with a policy offer including a load of $1100 for the hypertension, just the opposite of what the broker said.

They offered a plan for $7000.00 annually or a reduced premium of $5700.00 with a $850.00 deductable.

P. Prime then sublitted an application for me to another company, saying this co. the most liberal when it comes to pre existings.

They not only replied back that they would never cover hypertension, but wanted to charge me an $1300.00 load to cover the acute broncitis I had in March and to cover any complications relating to a minor shoulder injury I had 5-6 years ago. I was floored. This is being liberal??

Based on the mis-information I recieved from the broker prior, I used a different email address and submitted an online application to them directly and got a totally new quote, as if I was a different person.

Not only did they cover the hypertension and all future cardiac related problems, but they offered to pay all OP charges related to monotoring it as well. They would not however, pay for any meds needed. The load was $900.00. A lower load than BUPA, coverage in the US for unscheduled treatment and emergency evacuation (not offered by BUPA). The 0 deductable, 0 co pay premium was $6255 incldung the load.

My point is ... well I'm not sure, but I feel more comfortable talking direct with the company vs a broker as I've always gotten better quotes and conditions from the horses mouth.

Start now at age 60 if you want local coverage at good pricing. But remember, no pre existings and no out of country on base policies. Also check renewability terms.

If you need the hypertension covered with some "out of Thailand" services if needed you need to look internationally, with or without US coverage.

I've been at this for over a month and by no means anywhere near an expert, but know a lot more than I did prior as I've been in touch with BUPA, Healthcare International, Interglobal, Allianz, Nordic< Aetna, William Russell, IMG and others.

PM me if you have any questions or want access to some of the data I gathered.

Good luck.

Edited October 4, 2011 by Baht Man

[ProThaiExpat]

I really feel for Americans with their healthcare nightmares.

Happily there's an easy option.

Simply don't get insured. I'm not, nor are many friends.

Most care is very reasonable here. In a worst case scenario that something expensive happens in the next few years do you have savings to cover the hit? (Remember that US costs are many multiples of Thai costs. They're a sick joke which Americans work themselves into the grave to pay.......possibly a factor in why their life expectancy is less than Europeans).

Thank you for your post. In another thread on this subject I posted my experience in Thailand for the past ten years and quoted a savings in excess 1 million baht by not paying for health insurance. Included in my costs was 30 days hospitalization and four surgeries.

The one direct response to my post was that I should not live in Thailand if I couldn't pay for insurance and quoting my savings over the years, I only used the quote from my first year without increases, I was considered smug.

Self insurance is a concept practiced by many business and individuals that have assets to take care of the unexpected. Of course, if you are lucky to have good genes as measured by the diseases of your family, you are taking far less risk by being self insured than those that have debilitating diseases in their families.

Edited October 4, 2011 by ProThaiExpat

[californiabeachboy]

Thanks for the information - very helpful.

Priority Number One, as all of us Yanks know, is to not find yourself with your feet on US soil with a serious medical condition that is not covered by insurance - it can take away 30 years of savings before you can scream health care reform. Having read the above posts, Bupa will not work (coverage only for accidents leaves a gaping hole in coverage) and it may not be long term coverage anyway. And I would always want coverage for hypertension, simply because excluding that coverage seems to leave the door open for claims by the insurer that my condition is related to hypertension. The bottom line is that I don't see any Thai insurance that works for me before I am eligible for medicare, and maybe not even after.

As for the self-insurance, I understand some are willing to do that, but it is not for me. Insurance buys me peace of mind. Plus, while it may work if you are spending the entire year in Thailand, I am not sure self-insurance works so well when you are planning on spending a few months a year in high medical cost countries, as I am planning to do. Also, I have found that I am more willing to go get preventive medical tests when it is covered by insurance (as some such tests here in the US are not subject to the deductible). So in that way I have found that insurance actually may improve my health and catch something early.

The way I feel at the moment is that I am going to keep my home base here until I turn 65, then see what is available to add to my US Medicare coverage if I am so inclined. I like living here in California, my only thought was that I may want to move my "base" over to Thailand at some point in time in the future so I am looking at options, and insurance is one of the big items. But since I can come over there to Thailand for at least 6 months at a time, and possibly longer, and maintain my health coverage here in the US (which based on the above sounds pretty good compared to Thailand), that sounds best to me.

Thanks again.

Cheers.