How Do You (If At All) Manage Health Insurance Here At 55, 65, 75, 85?

[bangkokburning]

How do you (if at all) manage health insurance here at 55, 65, 75, 85?

I undertand that insurance companies won't pick you up (+60) or even carry you in elder years?

What about a Thai national (wife)?

thanks

[exeter]

If you have a property, in the Thai wife's name she will have a blue book which gives her free medical care in the state hospitals, you, as the husband can geta yellow book which then entitles you to the same free medical care. Some contributors have suggested that the interpretation seems to vary around the country, but that is certainly the case in central Thailand province that I live in.

If this is not an option you can look at local insurance policies, you will be required to take a medical, it will be relatively expensive, will not cover everything, the ones I have seen dont likely cover the cost of an operation so at best its a bit towards it and at 80 you will likely not be renewing after that birthday, too much of a risk.

Another option would be to put money into an account for a rainy day and if you dont use it you can leave the proceeds in the account to someone else via a will. You might just not get up one morning have a long lie-in.

This is a problem I suspect for most people over 65 here have and dont assume travel Insurance you took out before your visit is valid either, in the UK you have to have been resident in the UK for the 3 months immediately prior to the departure. The UK insurance industry do not view you as a resident in the same way as HMRC. House, bank accounts, passport do not count, neither does a UK address.

SO, if you have not got a plan best think about it, a heart by pass operation was, a couple of years ago my way about 1.5mbts to give you a figure, there are bound to be add ons, room etc and 2 years ago, inflation?

MMMM not good news day is it!

Edited January 14, 2012 by exeter

[nong38]

If you have a property, in the Thai wife's name she will have a blue book which gives her free medical care in the state hospitals, you, as the husband can geta yellow book which then entitles you to the same free medical care. Some contributors have suggested that the interpretation seems to vary around the country, but that is certainly the case in central Thailand province that I live in.

If this is not an option you can look at local insurance policies, you will be required to take a medical, it will be relatively expensive, will not cover everything, the ones I have seen dont likely cover the cost of an operation so at best its a bit towards it and at 80 you will likely not be renewing after that birthday, too much of a risk.

Another option would be to put money into an account for a rainy day and if you dont use it you can leave the proceeds in the account to someone else via a will. You might just not get up one morning have a long lie-in.

This is a problem I suspect for most people over 65 here have and dont assume travel Insurance you took out before your visit is valid either, in the UK you have to have been resident in the UK for the 3 months immediately prior to the departure. The UK insurance industry do not view you as a resident in the same way as HMRC. House, bank accounts, passport do not count, neither does a UK address.

SO, if you have not got a plan best think about it, a heart by pass operation was, a couple of years ago my way about 1.5mbts to give you a figure, there are bound to be add ons, room etc and 2 years ago, inflation?

MMMM not good news day is it!

In a nutshell, spot on.

[somtampet]

I have had my medical with axa,and covers me for 1 million baht inpatient only.Been with them for 4 years and had no claims so i am pretty certain i can still get this policy until 67.My next yearly renewal will be approx 18,000 baht,and i will be 59.

[citizen33]

I've mentioned in past threads that a yellow housing registration book does not entitle a non-citizen to a UCS gold card, and think I am in a position to know that is the case through my work (no details provided I'm afraid). Suffice it to say that I put the question directly to some very senior officials in the NHSO and MoPH, who agreed on this point. It is possible that some local staff may have given out cards when they shouldn't have, but in fact I have never met a westerner who had obtained UCS membership in that way. Do either of the two posters above who say this is possible have their own gold card?

There is no easy answer to the OP's question. My own view is that the preferred solution would be to work for a period in Thailand before age 60, so to obtain membership of the Social Security Scheme (SSS), and then continue to maintain entitlements by making the modest monthly payments. While of working age one should also arrange private insurance and maintain coverage as long as the insurer offers a reasonable proposition. When that ceases to be available - probably at around age 70 - one falls back on the SSS and any earmarked savings that one has. If one is married to a Thai woman who is a member of the Civil Servant Medical Benefits Scheme this will also serve that same function, and probably at a slightly better level of cover. The main alternatives in terms of a safety net for people who have no state scheme as backup are either a cash nest egg (it better be large) or the more risky alternative of returning to the home country when illness strikes and asserting an intention to resume permanent residency (works in the UK at least). There may be some private insurance policies that hold open a guarantee of indefinite renewal (e.g. BUPA if one starts early enough) but they do not usually offer a guarantee about pegging premiums, so I think people are lucky if this works for them past 75.

Edited January 14, 2012 by citizen33

[bangkokburning]

Thanks this is all good and appears to be no easy solution. As an American with its health care system falling apart it appears it will be easier to rely on private insurance here rather than even using medicare + supplement there.

Sort of ironic but don't we all know it - insurance is good until you need it. Then they don't want to touch you even if you have had a policy for years. What a racket.

The solution for elderly people (foreigners) appears to be - out of pocket.

Thanks

[nong38]

I've mentioned in past threads that a yellow housing registration book does not entitle a non-citizen to a UCS gold card, and think I am in a position to know that is the case through my work (no details provided I'm afraid). Suffice it to say that I put the question directly to some very senior officials in the NHSO and MoPH, who agreed on this point. It is possible that some local staff may have given out cards when they shouldn't have, but in fact I have never met a westerner who had obtained UCS membership in that way. Do either of the two posters above who say this is possible have their own gold card?

There is no easy answer to the OP's question. My own view is that the preferred solution would be to work for a period in Thailand before age 60, so to obtain membership of the Social Security Scheme (SSS), and then continue to maintain entitlements by making the modest monthly payments. While of working age one should also arrange private insurance and maintain coverage as long as the insurer offers a reasonable proposition. When that ceases to be available - probably at around age 70 - one falls back on the SSS and any earmarked savings that one has. If one is married to a Thai woman who is a member of the Civil Servant Medical Benefits Scheme this will also serve that same function, and probably at a slightly better level of cover. The main alternatives in terms of a safety net for people who have no state scheme as backup are either a cash nest egg (it better be large) or the more risky alternative of returning to the home country when illness strikes and asserting an intention to resume permanent residency (works in the UK at least). There may be some private insurance policies that hold open a guarantee of indefinite renewal (e.g. BUPA if one starts early enough) but they do not usually offer a guarantee about pegging premiums, so I think people are lucky if this works for them past 75.

I do not have the Thai medical care card as I am not married to the g/f. Following on from several correspondents on this issue who have claimed that they have the card as previously mentioned, sometimes in the hand and sometimes arriving through the post I went to the local office in town as indicated by the health centre where the g.f got her medical card on the spot.

Now I can only tell you what I have been told and that is "If you marry the lady we give you free Thai health card." I dont think I can make it any clearer than that.

Now it I dont know who you spoke to, different people tell you different things and you need to be lucky. It also seems possible that different offices interpret things in a different way.

I have been told I can have get a card when I marry the g/f so that is fine by me so on that day I will feel lucky.

[nong38]

Thanks this is all good and appears to be no easy solution. As an American with its health care system falling apart it appears it will be easier to rely on private insurance here rather than even using medicare + supplement there.

Sort of ironic but don't we all know it - insurance is good until you need it. Then they don't want to touch you even if you have had a policy for years. What a racket.

The solution for elderly people (foreigners) appears to be - out of pocket.

Thanks

Yes I agree with you, insurance companies want all the good odds and take back their ball when times dont look so good. In the end you will need cash at bank.

Be lucky and not get ill, if you do hope you get a doctor who knows what they are doing because even if you have the best policy available if you get a duff doctor you are toast.

[bangkokburning]

Thanks and thanks citizen33 - that solution is too complicated. Its also very possible I will only spend half year here after 60+. Zero interest in teaching English.

[mausbiber]

If you are interested to cover only the expenses in a hospital this plan may find your interest: http://healthcareint...edicalIndex.php

You have to select "Emercency+" and the appropriated age bracket.

Selecting different ages you can compare the premiums when you get older.

AFAIK there is no age limit once you have a contract.

But be warned: for each case you have to pay the first US$ 2000 by yourself. So it covers only the risk of serious treatment - for a lower premium.

[ludditeman]

My wife and children all use the free government hospital.

I do too, I have to pay but it's cheap as chips, no need for expensive insurance.

[exeter]

Ludditeman, I presume you are happy with what is provided? From what I have seen patients seem happy and the rooms are the same as in private hospitals.

[exeter]

If you are interested to cover only the expenses in a hospital this plan may find your interest: http://healthcareint...edicalIndex.php

You have to select "Emercency+" and the appropriated age bracket.

Selecting different ages you can compare the premiums when you get older.

AFAIK there is no age limit once you have a contract.

But be warned: for each case you have to pay the first US$ 2000 by yourself. So it covers only the risk of serious treatment - for a lower premium.

I just had a look at what you suggest and for me it comes out at £1022 pa for emergency only and age does not go above 75, there is no mention of a rolling contract. Not for me but thanks for the option.

[ludditeman]

Ludditeman, I presume you are happy with what is provided? From what I have seen patients seem happy and the rooms are the same as in private hospitals.

Same doctors as the private hospitals.

The nurses don't speak English, but the doctors do.

The private rooms were fine (1k a night at my local).

But

I wouldn't want any Thai doctor cutting into me, actually I wouldn't be happy with anyone of any nationality cutting into me.

[exeter]

Ludditeman, I presume you are happy with what is provided? From what I have seen patients seem happy and the rooms are the same as in private hospitals.

Same doctors as the private hospitals.

The nurses don't speak English, but the doctors do.

The private rooms were fine (1k a night at my local).

But

I wouldn't want any Thai doctor cutting into me, actually I wouldn't be happy with anyone of any nationality cutting into me.

Yes I know what you mean but as means of last resort?

I had an eye problem a couple of years ago and was under Moorfields in City Road London. I told them I was coming out to Thailand, they gave some paperwork and the doctor there said " Dont worry the Thai doctors are good if you need to go back with this problem." Which I found re assuring, if Moorfields say they are good.

[ludditeman]

Yes I know what you mean but as means of last resort?

I had an eye problem a couple of years ago and was under Moorfields in City Road London. I told them I was coming out to Thailand, they gave some paperwork and the doctor there said " Dont worry the Thai doctors are good if you need to go back with this problem." Which I found re assuring, if Moorfields say they are good.

Or alternatively, a pal of mine had a detatched retina, went to a well known and reccomended hospital in BK, had three operations over 6 months costing 100k out of his own pocket, and left him blind in that eye. They originally said they could fix it without any problems.

[pschef]

If you have a property, in the Thai wife's name she will have a blue book which gives her free medical care in the state hospitals, you, as the husband can geta yellow book which then entitles you to the same free medical care. Some contributors have suggested that the interpretation seems to vary around the country, but that is certainly the case in central Thailand province that I live in.

If this is not an option you can look at local insurance policies, you will be required to take a medical, it will be relatively expensive, will not cover everything, the ones I have seen dont likely cover the cost of an operation so at best its a bit towards it and at 80 you will likely not be renewing after that birthday, too much of a risk.

Another option would be to put money into an account for a rainy day and if you dont use it you can leave the proceeds in the account to someone else via a will. You might just not get up one morning have a long lie-in.

This is a problem I suspect for most people over 65 here have and dont assume travel Insurance you took out before your visit is valid either, in the UK you have to have been resident in the UK for the 3 months immediately prior to the departure. The UK insurance industry do not view you as a resident in the same way as HMRC. House, bank accounts, passport do not count, neither does a UK address.

SO, if you have not got a plan best think about it, a heart by pass operation was, a couple of years ago my way about 1.5mbts to give you a figure, there are bound to be add ons, room etc and 2 years ago, inflation?

MMMM not good news day is it!

I would love to think it is true, I am going to ask my Thai Doctor, who just happens to be the director of our local hospital. But I really dont think its correct. Expats que here for free medicare wow wait for the rush

[bangkokburning]

Seems it should not be impossible to find accident insurance. Thinking more about medical care as one ages.

[steve187]

Yes I know what you mean but as means of last resort?

I had an eye problem a couple of years ago and was under Moorfields in City Road London. I told them I was coming out to Thailand, they gave some paperwork and the doctor there said " Dont worry the Thai doctors are good if you need to go back with this problem." Which I found re assuring, if Moorfields say they are good.

I have had reason to have a detached retina operation whilst on this trip, I took out travel insurance for 8 months and they paid direct no problem. The hospital in Bangkok, was excellent as was the Thai lady doctor, who instilled a lot of confidence in a somewhat shaky patient. I would recommend them, to someone in the same circumstances, Good food, good bedroom, no English by the staff, good English by the doctor, diagnosed 8pm one day operation the next.

[exeter]

If you have a property, in the Thai wife's name she will have a blue book which gives her free medical care in the state hospitals, you, as the husband can geta yellow book which then entitles you to the same free medical care. Some contributors have suggested that the interpretation seems to vary around the country, but that is certainly the case in central Thailand province that I live in.

If this is not an option you can look at local insurance policies, you will be required to take a medical, it will be relatively expensive, will not cover everything, the ones I have seen dont likely cover the cost of an operation so at best its a bit towards it and at 80 you will likely not be renewing after that birthday, too much of a risk.

Another option would be to put money into an account for a rainy day and if you dont use it you can leave the proceeds in the account to someone else via a will. You might just not get up one morning have a long lie-in.

This is a problem I suspect for most people over 65 here have and dont assume travel Insurance you took out before your visit is valid either, in the UK you have to have been resident in the UK for the 3 months immediately prior to the departure. The UK insurance industry do not view you as a resident in the same way as HMRC. House, bank accounts, passport do not count, neither does a UK address.

SO, if you have not got a plan best think about it, a heart by pass operation was, a couple of years ago my way about 1.5mbts to give you a figure, there are bound to be add ons, room etc and 2 years ago, inflation?

MMMM not good news day is it!

I would love to think it is true, I am going to ask my Thai Doctor, who just happens to be the director of our local hospital. But I really dont think its correct. Expats que here for free medicare wow wait for the rush

As has been mentioned early, you may very well get a different response from hospitals in "TOURIST" spots and we can all understand why, as said loads of foreigners with no medical cover turning up for free medicalcare at Thailand's expence. I can fully see this and I am sure you can as well.

Whatever your Thai director of the hospital tells you applies to you, where you are living, I wish you good luck.Whatever your result, I will get the card and others have found the same as me so, whatever you find where you are applies to you and other foreigners in your area, it seems you do not live where I am, not many foreigners where I am so not much pressure on the local system and maybe that is the real answer whether you like it or not.

If the doctor says no you will need to look at other options, it costs nothing to ask.

[holidaze]

My wife and children all use the free government hospital.

I do too, I have to pay but it's cheap as chips, no need for expensive insurance.

But you haven't said who you're insured with, whether the wife is farang or thai, how much 'cheap as chips' is, or what it covers and to what age.

[ludditeman]

My wife and children all use the free government hospital.

I do too, I have to pay but it's cheap as chips, no need for expensive insurance.

But you haven't said who you're insured with, whether the wife is farang or thai, how much 'cheap as chips' is, or what it covers and to what age.

Wife and family Thai, so government hospital free, expenses over the last 4 years

3 nights in private room for her to have a baby, 3000bht, optional vitamin suppliments during pregnancy approx 300bht over 6 months. PAYG for me, so far precancerous spot removal on forehead 250bht, blood tests for me due to her pregnancy 250bht. Root canal for me 5000bht over 3 months. Minor items, I can just get the appropiate drugs from a pharmacy and self medicate.

Edited January 16, 2012 by ludditeman

[citizen33]

It is true that you can pay out-of-pocket in public hospitals and get good value. One point to note, however, is that the facilities in a community (or district) hospital are quite limited, so that you really need to go to a provincial or tertiary care hospital if you think your condition is serious. Probably the university hospitals (and also some military hospitals) are about the best in the public system and give excellent treatment for the money.

Those who think a yellow house registration document will get you a gold card should of course try locally. But for goodness sake don't get married just to test out whether this is true! I'm in a blue book myself and don't have a UCS card. I sounded out a couple of senior NHSO and MoPH colleagues about this (partly tongue in cheek), and I don't mean at community hospital director level, which is not high.

Edited January 16, 2012 by citizen33

[Pib]

I've mentioned in past threads that a yellow housing registration book does not entitle a non-citizen to a UCS gold card, and think I am in a position to know that is the case through my work (no details provided I'm afraid). Suffice it to say that I put the question directly to some very senior officials in the NHSO and MoPH, who agreed on this point. It is possible that some local staff may have given out cards when they shouldn't have, but in fact I have never met a westerner who had obtained UCS membership in that way. Do either of the two posters above who say this is possible have their own gold card?

There is no easy answer to the OP's question. My own view is that the preferred solution would be to work for a period in Thailand before age 60, so to obtain membership of the Social Security Scheme (SSS), and then continue to maintain entitlements by making the modest monthly payments. While of working age one should also arrange private insurance and maintain coverage as long as the insurer offers a reasonable proposition. When that ceases to be available - probably at around age 70 - one falls back on the SSS and any earmarked savings that one has. If one is married to a Thai woman who is a member of the Civil Servant Medical Benefits Scheme this will also serve that same function, and probably at a slightly better level of cover. The main alternatives in terms of a safety net for people who have no state scheme as backup are either a cash nest egg (it better be large) or the more risky alternative of returning to the home country when illness strikes and asserting an intention to resume permanent residency (works in the UK at least). There may be some private insurance policies that hold open a guarantee of indefinite renewal (e.g. BUPA if one starts early enough) but they do not usually offer a guarantee about pegging premiums, so I think people are lucky if this works for them past 75.

I also have never meet a farang who had a Gold/30baht card as that program is limited to Thai citizens...I think people who have obtained Permanent Residence also qualify. A yellow book (which I have also) only means you have a residence in Thailand; it does not qualify you for free medical care. If only getting a yellow book was all that's needed to get universal health care in Thailand I think it would have been made known years ago, thousands of farangs would already be using the program and telling their friends, and there would be thousands upon thousands of farangs moving to Thailand in a hurry to get free medical care...heck, there would probably be Thai companies setup just to guide a person through getting there yellow book closing followed by their Gold/30 Baht card to get free medical care. Nice dream.

Here's the National Health Security Office "English" web link where more information (in English) can be found on the Thai Universal Health Care Program which the Gold/30 Baht program falls under. Link.

[nong38]

Thanks for that but I notice 2 things whilst glancing through it, some of the site is still under construction and its dating from 2002 this is 10 years out of date. I will go with what my local authority have told me, if it changes when I go to get the card then I will have to think again and at my age it will probably be pay as you go, at a government hospital so started puting cash away last year as a precaution.

[Pib]

Thanks for that but I notice 2 things whilst glancing through it, some of the site is still under construction and its dating from 2002 this is 10 years out of date. I will go with what my local authority have told me, if it changes when I go to get the card then I will have to think again and at my age it will probably be pay as you go, at a government hospital so started puting cash away last year as a precaution.

Don't know about the out of date thing...the web site has been redesigned over the last few months and parts are still under construction. If you are referring to the 2002 Copy Right Protection notice on some pages, that don't mean information is that old....that just means that when the govt office obtained copy right protection for certain information/the site.

Good luck in how it works out for you...even if you get a card issued, which will probably be issued by mistake, your surprise will probably come when trying to use the card unless you are a Thai citizen....but good luck.

[nong38]

Well I gues you are right, if I am unlucky enough to have to go the hospital, they either accept the card or they dont, I will just need fixing and if it free thats great, if I have to pay then I have to pay. We are talking about the future and what is right today may not be on another day, which is why I am banking a fall back fund to be on the safe side, still hoping I wont need it and I can leave it someone who does.

[Khonwan]

A 70 year old English friend of mine living in Nakhon Sawan got the Gold Card from the main provincial hospital here in Nakhon Sawan (where I also live) around 1 year ago. I know this for sure since I still have a photo of his card (which I obviously will not share here). This chap has now already received free consultations and x-rays and is awaiting a free operation.

Another mutual friend in the province states he also has received one via his community hospital at that same time.

I applied a month or two later at my local community hospital within the province – last time I enquired about the progress of my application, I was told they were still processing it but that I was now registered with my local hospital and my local health clinic as a non-paying member and need only produce my yellow house registration for ID. I have in fact used the health clinic twice since then at no cost to me.

I normally use private hospitals for minor things, to avoid the long waits at the government hospitals (my local health clinic is convenient for very minor things), but I’m very pleased to have free access to the government Gold Card scheme as a form of insurance...as an option.

Another friend in Khampaengphet failed in his efforts to obtain membership so I agree that it does, in effect, depend on your location.

I recall reading (somewhere – a lawyer’s website I think) over a year ago that the issuance of membership came about through a change in the law aimed at allowing legal immigrants from bordering countries to register their residence via the issue of the yellow house registration and subsequent membership of the universal health care but that the law was not crafted in a way to exclude others from non-neighbouring countries.

By the way, Citizen33 mentioned that we non-Thais can obtain free treatment via our spouse’s scheme should they be in the civil service scheme – this also applies if you have a child in the civil service, such as a government teacher. This does not currently apply to me though may in the future since my 15yo daughter wishes to be a government school teacher (for her reasons, not mine!).

My two friends and I all are legally married to Thais.

[citizen33]

It is interesting to hear reports of what is possible, though I think it is important to be absolutely sure of the position before posting. At the moment the official position is that somebody seeking treatment under the UCS must produce either (a) the UCS gold card together with old-style citizen identity card, or ( b ) the new-style chipped citizen ID card alone, which will store information on health scheme entitlements. The plan is to phase out the UCS gold card when everybody has the new-style citizen identity cards. At face value that would seem to make it hard for Westerners who may have obtained gold cards to be sure of treatment.

http://www.nhso.go.t...04,%202009).pdf

Edited February 29, 2012 by citizen33

[jayjay2001]

obtain membership of the Social Security Scheme (SSS), and then continue to maintain entitlements by making the modest monthly payments.

citizen33, thanks for this info. It was timely for me... and a lot of help. I am leaving my current employment soon, and did not continuing the SSS was an option. As far as I now understand, all I need to do is to go to the SSS office at city hall near where I work and fill out an application.

Thanks for the info.