Health Insurance Vs. Self Insurance: Your Thoughts?

[SkyRider]

And, if you purchase health insurance from company, which company do you think gives the best value for the buck?

And, which companies will not drop you at a certian age?

[manarak]

Unless you are a multi-millionaire in dollars, self insurance is risky, plus you put your family in a difficult situation if xxxx hits the fan.

Edited April 6, 2013 by metisdead

[Sheryl]

BUPA guarantees to keep you enrolled for life if you enroll by a certain age (I forget what, maybe 55?) and keep up the premiums.

A major drawback to self insurance IMO is that people are seldom able to put aside more than enough for 1 major hospitalization. (for which one needs >1 million baht, more if you want the option of going private). So once that is used up -- you're stuck, especially if relocating to farangland is not in your plans.

Of course some people are lucky and live to a ripe old age & die without ever needing a prolonged stay in an ICU or very major surgery (these being what will eat up savings fast). But some aren't...

[cooked]

BUPA guarantees to keep you enrolled for life if you enroll by a certain age (I forget what, maybe 55?) and keep up the premiums.

A major drawback to self insurance IMO is that people are seldom able to put aside more than enough for 1 major hospitalization. (for which one needs >1 million baht, more if you want the option of going private). So once that is used up -- you're stuck, especially if relocating to farangland is not in your plans.

Of course some people are lucky and live to a ripe old age & die without ever needing a prolonged stay in an ICU or very major surgery (these being what will eat up savings fast). But some aren't...

BUPA sure does, but they don't tell you what premium you will be paying at the age of 65, 75 etc. You won't be able to afford it. I have dead cheap Thai Health Insurance for emergencies plus self insurance plus possibility of going home if everything goes banana shaped.

[utalkin2me]

I have always felt a good credit card provides all the insurance I need here. The great part is, the payments/interest will be negotiable, you are in the hospital after all.

[kurnell]

I was going to say LMG until they refused to pay one of my bills this year, hence I, my family, my staff and their families will not be using them again next year.

[utalkin2me]

The other thing you can do is keep about 5k dollars in an account if possible. If you have bills, pay with that. If it is under, you are fine. If it goes over, just say something like "I got 5k here for payment in full, if you don't take it send me a monthly bill", or something like that (ie negotiate).

Edited January 29, 2013 by utalkin2me

[SkyRider]

Do you have the contact info for a broker that I can contact at BUPA, and a Thai health insurance company?

[NancyL]

We're with Health Care International, a company from London, and they're similar to BUPA in that they won't drop you after age 75 if you keep paying the premiums. The % change in the premium payment for each age band is disclosed in their promotional materials, but of course they can't tell you what the actual payment will be when you reach age 75, just the % increase over what it was in the previous band. No one can tell you at age 55 what the company will be charging 20 years in the future.

The key is to obtain health insurance when you're still young and relatively healthy -- like when you first arrive here -- rather than waiting until you're in your 60s and have probably developed some health conditions which they may exclude from coverage. Start young, keep up the payments and then nothing will be considered a pre-existing condition if you developed it after buying the policy.

I agree with Sheryl about the problem with "self-insurance". I've seen medical bills over 1,000,000 baht -- at the public hospital in Chiang Mai! You may think health care is cheap here if you're only experience is in treating something minor like road rash from a motorcycle fall or something routine like having a baby. The costs can soar if someone needs weeks in ICU, IV drips of the latest powerful antibotics and procedures like kidney dialysis.

Edited January 30, 2013 by NancyL

[JohnC]

The other problem is when you have a pre existing condition and they refuse to insure you, then when you approach another company the first question is " have you ever been refused insurance "

I have type II diabetes and was turned down for health insurance despite no other problems and controlled by tablets. So my only options are self insure and go home!

Edited January 30, 2013 by JohnC

[lovetotravel]

BUPA guarantees to keep you enrolled for life if you enroll by a certain age (I forget what, maybe 55?) and keep up the premiums.

A major drawback to self insurance IMO is that people are seldom able to put aside more than enough for 1 major hospitalization. (for which one needs >1 million baht, more if you want the option of going private). So once that is used up -- you're stuck, especially if relocating to farangland is not in your plans.

Of course some people are lucky and live to a ripe old age & die without ever needing a prolonged stay in an ICU or very major surgery (these being what will eat up savings fast). But some aren't...

BUPA sure does, but they don't tell you what premium you will be paying at the age of 65, 75 etc. You won't be able to afford it. I have dead cheap Thai Health Insurance for emergencies plus self insurance plus possibility of going home if everything goes banana shaped.

Is that Thai health insurance available to everybody????

[Sheryl]

BUPA sure does, but they don't tell you what premium you will be paying at the age of 65, 75 etc.

Actually, they do. Their premium rates, by age, appear in their info brochures and can probably be found on their website. And yes, the rates do go up as you age. That is true of pretty much all ndividual policy health insurance.

[cooked]

BUPA guarantees to keep you enrolled for life if you enroll by a certain age (I forget what, maybe 55?) and keep up the premiums.

A major drawback to self insurance IMO is that people are seldom able to put aside more than enough for 1 major hospitalization. (for which one needs >1 million baht, more if you want the option of going private). So once that is used up -- you're stuck, especially if relocating to farangland is not in your plans.

Of course some people are lucky and live to a ripe old age & die without ever needing a prolonged stay in an ICU or very major surgery (these being what will eat up savings fast). But some aren't...

BUPA sure does, but they don't tell you what premium you will be paying at the age of 65, 75 etc. You won't be able to afford it. I have dead cheap Thai Health Insurance for emergencies plus self insurance plus possibility of going home if everything goes banana shaped.

Is that Thai health insurance available to everybody????

yes it is although I suppose you do need a Thai address. I went to the local clinic for a jab and asked about which insurance they recommended. Of course the guy was round like a shot and I signed up for a 'Simply healthy' policy, ฿10 000.- a year. I had looked into this before on internet and knew about it beforehand. I did this just before I turned 65, next year I'll be paying ฿15 000.-. http://www.thaihealth.co.th/company_eng.php

As I said before, I am also going for self insurance and have the option of going home for 'free' treatment.

http://www.swissinfo.ch/eng/swiss_news/Switzerland:_We_look_after_our_own.html?cid=32898472

not everybody can do this. You will find in the small print of the insurance policies something like ' we have the right to terminate the insurance at any time, we can set premiums as we see fit'. Why should they insure 70 year olds unless they hope that they will drop dead quick or be demanding ฿200 000 a year?

[Sheryl]

Moving this to the Insurance forum leaving linek in Health.

Ah, so the company's name is Thai Health Insurance. That's a new one to me. Has anyone had experience filing claims with them?

From the website their rates look rather comparable to BUPA to me especially when the level of cover is factored in. I note that they too dramatically increase their rates as you age....topping out at 174,000 baht a year for people over 75....

[cooked]

Moving this to the Insurance forum leaving linek in Health.

Ah, so the company's name is Thai Health Insurance. That's a new one to me. Has anyone had experience filing claims with them?

From the website their rates look rather comparable to BUPA to me especially when the level of cover is factored in. I note that they too dramatically increase their rates as you age....topping out at 174,000 baht a year for people over 75....

This was recommended to me by the hospital I was attending and they won't be interested in recommending an insurance that doesn't pay. Good to have a local rep. who will look after my interests when I have a problem. I don't expect too much from these guys but it's good to have an insurance card in your wallet. I myself am also wondering why most people talk about International insurance when there are cheaper local alternatives. Travel insurance when you go abroad is always available.

[AAInsuranceBrokers]

Thai health is an old and very well respected insurance company – part of the Thai Life group which also includes Paiboon Ins.

The premiums are obviously similar to BUPA’s and the other medical companies but Thai Health does have a very good claims department.

For any individual quotes or information please go to the quotes page on our web site HERE

[Naam]

BUPA sure does, but they don't tell you what premium you will be paying at the age of 65, 75 etc.

Actually, they do. Their premium rates, by age, appear in their info brochures and can probably be found on their website. And yes, the rates do go up as you age. That is true of pretty much all ndividual policy health insurance.

not necessarily Sheryl. my wife and me are insured with a private German insurance company (operating under tight government control) and our premiums have gone down after age 60, and they are stable since then.

the secret is that we joined a long time ago (me since 41 years, my wife since 34 years) which, over the years, caused a "financial provision built-up" meant to cover increased medical care of elderly people.

the coverage is "first class", valid worldwide and provides free selection of hospitals and medics. a decade ago we selected "stationery cover only" which resulted in a much lower premium. we are now paying €UR 4,100 per annum (approximately THB 164,000). full cover, including ambulant treatment and drugs would be a whopping triple, i.e. approximately half a million Baht per annum.

Mrs Naam never filed a claim but my claims (4 of them) during the last 20 years exceeded the premiums i paid since "inception".

[mania]

I was going to say LMG until they refused to pay one of my bills this year, hence I, my family, my staff and their families will not be using them again next year.

Sorry to hear that as I was just looking at one of their plans.

Their Basic Hospital/Surgical Plan

Guess I will go back to looking at BUPA & the Simply Healthy Plan from Thai life

[mania]

yes it is although I suppose you do need a Thai address. I went to the local clinic for a jab and asked about which insurance they recommended. Of course the guy was round like a shot and I signed up for a 'Simply healthy' policy, ฿10 000.- a year. I had looked into this before on internet and knew about it beforehand. I did this just before I turned 65, next year I'll be paying ฿15 000.-. http://www.thaihealt...company_eng.php

Thanks I was just looking at that plan & a few others.

Have you ever needed to use it?

If so were things paid direct or did you have to pay fees & get reimbursed later?

Thanks

[cooked]

Sorry, I just got into it before my 65th birthday, two weeks ago, and have never been seriously ill in my life. So I don't know.

[mania]

Sorry, I just got into it before my 65th birthday, two weeks ago, and have never been seriously ill in my life. So I don't know.

Thanks anyway & glad to hear your healthy

That is a better answer than a list of times you used it actually

I am the same way but just wondering about having something more as a follow up

to accident insurance which I do have on my 1st class truck & bike insurance.

[kurnell]

I was going to say LMG until they refused to pay one of my bills this year, hence I, my family, my staff and their families will not be using them again next year.

Sorry to hear that as I was just looking at one of their plans.

Their Basic Hospital/Surgical Plan

Guess I will go back to looking at BUPA & the Simply Healthy Plan from Thai life

They are unprofessional also. They are currently trying to bill my colleague for a hospital visit he made with his kids 10 months ago, which they 'forgot' to bill. Our broker says that they have had numerous complaints and many people are abandoning LMG.

[Chivas]

BUPA guarantees to keep you enrolled for life if you enroll by a certain age (I forget what, maybe 55?) and keep up the premiums.

A major drawback to self insurance IMO is that people are seldom able to put aside more than enough for 1 major hospitalization. (for which one needs >1 million baht, more if you want the option of going private). So once that is used up -- you're stuck, especially if relocating to farangland is not in your plans.

Of course some people are lucky and live to a ripe old age & die without ever needing a prolonged stay in an ICU or very major surgery (these being what will eat up savings fast). But some aren't...

BUPA sure does, but they don't tell you what premium you will be paying at the age of 65, 75 etc. You won't be able to afford it. I have dead cheap Thai Health Insurance for emergencies plus self insurance plus possibility of going home if everything goes banana shaped.

I always believe that Insurance normally over covers you.......

Firstly if you are entitled to Medical Care within your own country then in my opinion you absolutely need no more than the Majors ie Stroke, Heart Attack, Neuroligical and Traumas (accident)

You dont need all the rest of the Coverage you get if you are capable of hopping on the Plane home. I have had Cancer in the Bladder and know that any Episode of Blood again in the Urine means a trip to Hospital but its never an emergency (trust me it isn't !!)

If my backs plays up savagely as it does on occasion I go home ??

Interesting this because have just done Staysure Annual Coverage which I appreciate is not the same as Bupa but costs just £51 a year for maximum 183 days per calender year by removing all that excess coverage. (age 53 next)

My friend because he wanted to include coverage for pre existing conditions and whilst 6 years younger paid £120 odd for 2-3 weeks of cover.....

[gguy]

Best choice would be cheap policy with very high deductible.

Most insurances cut the prices changed by providers by 50% or more. Insurance company would just review and adjust the claim. Most claims would be under deductible.

You still pay the bill but the price should be reduced dramatically.

[JLCrab]

I will say that as one gets older, 'hopping on a plane' in even the best of circumstances is considerable wear-and-tear on one's physical well being. Regardless of the non-emergency conditions described above, your doctor here in Thailand might also tell you that you are not fit to travel to Bangkok let alone to your home country.

Also, there are many procedures wherein the doctors at home will tell you not to travel post-procedure for up to several months.

If you are covered by insurance here in Thailand for emergency conditions such as heart attack, stroke, aneurysm, trauma, etc. you probably will be covered for anything else that you might go home for anyway.

[THAIPHUKET]

BUPA sure does, but they don't tell you what premium you will be paying at the age of 65, 75 etc.

Actually, they do. Their premium rates, by age, appear in their info brochures and can probably be found on their website. And yes, the rates do go up as you age. That is true of pretty much all ndividual policy health insurance.

not necessarily Sheryl. my wife and me are insured with a private German insurance company (operating under tight government control) and our premiums have gone down after age 60, and they are stable since then.

the secret is that we joined a long time ago (me since 41 years, my wife since 34 years) which, over the years, caused a "financial provision built-up" meant to cover increased medical care of elderly people.

the coverage is "first class", valid worldwide and provides free selection of hospitals and medics. a decade ago we selected "stationery cover only" which resulted in a much lower premium. we are now paying €UR 4,100 per annum (approximately THB 164,000). full cover, including ambulant treatment and drugs would be a whopping triple, i.e. approximately half a million Baht per annum.

Mrs Naam never filed a claim but my claims (4 of them) during the last 20 years exceeded the premiums i paid since "inception".

This interesting Naam, I´m with Continentale Vers, Dortmund , since some 40 years, unfortunately they told me that long term living abroad is not part of their business, they will stop coverage outside the EU as of the end of this year. Not a pleasant thought. Would never be without insurance, had serve accident with years of rehab, that was 20 years ago, but that was exactly the situation where being well insured makes or brakes your life. My premiums were and are the best investment ever.

Mind telling which insurer you are with? Although switching at 67 will be expensive, if at all possible.

[BEENTHEREDONETHAT]

I'm self insured as I have gone past my use-by date and cannot get insurance. However I do have Medicare in the US, but I have to be there to use it. Last year I had a ruptured appendix and no way to get back to the US for coverage. That cost me 300,000 Baht. Next week I go into Bangkok for spinal surgery. I have 3 bulging disk. That will set me back between 550,000 - 600,000 Baht.

There is a problem with medicare (assuming I could make the 33 hour trip, portal to portal). It is very difficult to become a new Medicare patient as many Dr. will not accept new Medicare patients. Being senor+ does not help. The Medicare Dr. we had retired last year. Medicare is famous for there lousy pay to the physicians.

But even if I was confident in Medicare I question being able to make the trip as I have difficulty going 15 meters. an certainly couldn't stand in line.

Before moving to Thailand I had insurance in Australia for 15 years but it didn't cover outside of the country. So being in my 70's when we moved to Thailand pretty much dictated being self insured. I'm quite impressed with the Thai hospitals, and fortunately we can afford it.

[mikecwm]

I've been in touch with several Health insurance companies and pointedly asked what sort of premiums someone in their 80s is currently paying.

Here's a quote from one agent (GIBG) - "the restrictions on such (policies offering 'for Life' cover) are very high and the costs at levels above 75 are frankly beyond comprehension in expense"

That was enough to convince me to Self Insure.

Of course it will pay to start off healthy and try and keep that way.

I very much doubt that anyone in their 80s or 90s would be able to afford health insurance premiums - even if they signed onto a company that would keep their cover going that long.

[khunPer]

There was a post by user “zyphodb” in the thread No Travel Insurance Proves Costly For British Tourist ():

»I'm 50 & as far as I can see I can't get insurance for the big things at all, ie. over 200000 bhts of problems without having to get a policy that includes all the small things & then they hit you for 5500 bhts a month at least, which is outrageous, dunno what the solution to this is, but as a reasonably healthy 50 year old without a lot of financial backing I can't afford to get insured... If anyone knows of a sensible policy that would cover me only for the big risks I'd be delighted to see it....«

I have the same considerations – a wish for a health insurance that covers incidents over 200,000-300,000 baht only, and I have been wondering if others have a similar “problem”.

I moved to Thailand some eight years ago when I was 56. In my budget I had space for the best Bupa insurance around 60,000 baht a year, but I could see, that when I reached 60, the annual rate would exceed what I was prepared to pay and when I will reach 70 or 75, I most probably will be kicked out or the rates would be outrageous.

I decided for the second best and saved the remaining balance in the bank, in case of some incidents not covered and at some point, I may later need to be self-insured and therefore need some savings. When I passed 60 I changed to the cheapest 14k/y Bupa – really not much cover – just to continue having insurance, as one may not be able to sign up when over 60 or 65, and in case of I needed a health insurance for my retirement extensions. There were some articles about a Phuket politician complaining about foreigners without health insurance had unpaid hospital bills and that a health insurance should be compulsory. Instead I saved a bit more up.

I have never been hospitalized or sick, but something may happen and it is the serious incident that worries me – some 300,000 baht are Okay, but when it gets a lot more, it may knock your savings and future plans totally apart.

User “cooked” was kind to dump a link to Thai Health Insurance earlier in this thread, and it seems like the have an option “Maxi Healthy” for some kind of deductible self-risk and coverage up 80 years for a reasonable fee (http://www.thaihealth.co.th/product_maxi_eng.php), which may be a good option.

It think, if one plan to remain as retired in Thailand at old age, you shall always plan some cash in your budget or save up for health self insurance. When 75+ years old, one may either not be able to be insured or it may be so costly that it is not worth it; furthermore there may still be cases not covered by the insurance. If you have many claims, the insurance company may also terminate the agreement. I tried to compare for example the cheapest Thai Health Insurance plan from “Simply Healthy”, the one with 150,000 baht annual cover, with the most expensive 1,200,000 baht plan. Over the 20 year period from 61 year to 80 year the premium difference is 1,757,785 baht.

A reasonable solution by now seems like a Thai Health Insurance “Maxi Healthy” 150,000 or 300,000 baht cover, so you have some kind of insurance. The premiums are that fair – for 51+ from 4,100 b/y – that everybody can afford it, even with the 10% self risk. And then save up any difference between the actual premium and the fee you can afford in budget – over some years the savings + interest may be quite a nice cash sum in back-up.

Would be interesting to hear other suggestions.

[mania]

User “cooked” was kind to dump a link to Thai Health Insurance earlier in this thread, and it seems like the have an option “Maxi Healthy” for some kind of deductible self-risk and coverage up 80 years for a reasonable fee (http://www.thaihealt...ct_maxi_eng.php), which may be a good option.

I agree & am also looking at that plan & their Simply Healthy Plan

The thing I am confused over is the Major Medical Section

When they say they pay 90% of eligible charges in excess of deductible

do they mean just up to the max payable per year?

Example with 300k coverage & 30k Deductible they will pay no more than 270k?

Again this is just the Major Medical Rider not the In Patient Sections of their simply healthy plans etc.

Confused because all my life I bought insurance in the US where they just paid everything & my co-payment

was just a fixed per visit amount on top of the monthly premiums.