Health Insurance Vs. Self Insurance: Your Thoughts?

[stevenl]

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.

Sounds to me like they'd pay 240k. 300k coverage -/- 30k deductable -/- 10% (max. 90% of eligIble charges) .

[Naam]

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.

answered by PM.

[Morden]

Self-insurance for minor issues is fine but, if you need major surgery and aftercare, you may be looking at a total bill of THB1.5 or 2m. A disadvantage of self-insurance is that you are at the mercy of profit making hospitals and you are unlikely to be able to differentiate between what's necessary and what's being suggested merely because it makes more money for the hospital. Bangkok Hospital is a good example of this.

I use LMG Pacific and am very happy with them. They pay bills directly to private hospitals - you just sign a few hospital claim documents and leave. They also, if you take the trouble to consult them, will give advice on your treatment and help find the most suitable and convenient hospital. The GM is a native English speaker and very approachable.

I always buy insurance through a broker. They will have a range of products to offer and will help with any problems. I use BSI in Bangkok, run by Andy, a Brit. He too is very approachable and helpful.

[Bandersnatch]

Like others on this topic, I am looking for a combination of insurance and self-insurance, with the insurance cover for just the higher cost items, but when I looked on the Bupa site http://www.bupa.co.th/en/individuals/health-insurance/compare-insurance-plan.aspx?cgid=6 the Thailand only insurance just covers ฿600,000 a year.

[Morden]

I've already made a suggestion. Self-insurance amounts to taking a deductible. LMG pacific has a product that allows deductibles of THB40,000, 100,000 and upwards for substantial premium deductions.

[lovetotravel]

I spent a few hours with a broker yesterday. Some interesting things I'd like to run past you guys:

1. He said LMG and another popular one (can't remember the name) are Thai based and have the option of dropping you whenever they want. Pre-existing conditions are also an issue. I think he said these are issues with BUPA also. A big concern if you get dropped at, say 67.

2. He talked about ACS/Allianz. Saying they can't drop you, but rates are plain crazy after 70. And something like only 10 people in all of Thailand over the age of 75 are insured. This company offers full coverage here in SE Asia, and you can pick and choose where you want your procedures done. You're not limited to just Thailand (Taiwan is on the list, don't think Singapore is). Plus, you're covered for up to 7 weeks no matter where you are in the world....US and Europe included. They've got 1MM USD coverage per incident. Not just per year.

[JLCrab]

From the BUPA.co.th website:

Guarantee lifetime renewal

You can renew your policy with us for lifelong if you apply your health insurance before 60 years old. It guarantees you that you will always be protected by Bupa even if you are at your old ages.

BTW, for those who like to talk about 'obscene' insurance company profits at the expense of policy holders:

No shareholders Bupa doesn't have shareholders, all surpluses and profits are continuously reinvested into the services we offer so that we can continue to improve your health and care

Edited February 14, 2013 by JLCrab

[Morden]

I spent a few hours with a broker yesterday. Some interesting things I'd like to run past you guys:

1. He said LMG and another popular one (can't remember the name) are Thai based and have the option of dropping you whenever they want. Pre-existing conditions are also an issue. I think he said these are issues with BUPA also. A big concern if you get dropped at, say 67.

2. He talked about ACS/Allianz. Saying they can't drop you, but rates are plain crazy after 70. And something like only 10 people in all of Thailand over the age of 75 are insured. This company offers full coverage here in SE Asia, and you can pick and choose where you want your procedures done. You're not limited to just Thailand (Taiwan is on the list, don't think Singapore is). Plus, you're covered for up to 7 weeks no matter where you are in the world....US and Europe included. They've got 1MM USD coverage per incident. Not just per year.

I don't know where the idea that LMG can 'drop you' comes from. My policy with them is renewable at my option for life with no re-underwriting at renewal. Like all health insurers, they may apply terms at inception for pre-existing health conditions. Of course they do! Wouldn't you?

[YLPO]

Like others on this topic, I am looking for a combination of insurance and self-insurance, with the insurance cover for just the higher cost items, but when I looked on the Bupa site http://www.bupa.co.th/en/individuals/health-insurance/compare-insurance-plan.aspx?cgid=6 the Thailand only insurance just covers ฿600,000 a year.

I am also searching for a good health insurance and im currently looking into msh international. They have plans that cover up to 1 mil USD annually.

F.Y.I. the company has a plan called vital which covers you for your hospitalization costs. Check it out and let me know your opinion

[nong38]

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.

Exactly right, this is turning up many times with the same thread but using different words. The simple fact is that when you get into your 60's your sell by date is almost done as far as Insurance companies are concerned. If you can get a pokicy it will almost certainly have restrictions and will have a closing date, even it says its for life as stated before the premiums start rise dramatically every year so you will not be able to afford them and thats the way you are removed from the policy and their risk.

Self insure is the best way for 60+ just be realistic about what figure you put aside.

When I worked in the UK I worked for a big company but set up their own insuarance company in the Channel Islands and paid their premiums into it and they still do, they have saved a fortune, so can you now go self insure.

[nong38]

Like others on this topic, I am looking for a combination of insurance and self-insurance, with the insurance cover for just the higher cost items, but when I looked on the Bupa site http://www.bupa.co.th/en/individuals/health-insurance/compare-insurance-plan.aspx?cgid=6 the Thailand only insurance just covers ฿600,000 a year.

I am also searching for a good health insurance and im currently looking into msh international. They have plans that cover up to 1 mil USD annually.

F.Y.I. the company has a plan called vital which covers you for your hospitalization costs. Check it out and let me know your opinion

Agaoin I would suggest the Allianz plan from AA Ins brokers from what I compared - and they are the sponsors who have a good reputation

Whatever suits your situation and everyone is different, if you are happy go with it.

[nong38]

Self-insurance for minor issues is fine but, if you need major surgery and aftercare, you may be looking at a total bill of THB1.5 or 2m. A disadvantage of self-insurance is that you are at the mercy of profit making hospitals and you are unlikely to be able to differentiate between what's necessary and what's being suggested merely because it makes more money for the hospital. Bangkok Hospital is a good example of this.

I use LMG Pacific and am very happy with them. They pay bills directly to private hospitals - you just sign a few hospital claim documents and leave. They also, if you take the trouble to consult them, will give advice on your treatment and help find the most suitable and convenient hospital. The GM is a native English speaker and very approachable.

I always buy insurance through a broker. They will have a range of products to offer and will help with any problems. I use BSI in Bangkok, run by Andy, a Brit. He too is very approachable and helpful.

The Thai govt hospitals are not profit making as far as I am aware so I dont think you would be at their mercy as you say. The LMG policy that I have seen is restrictive, it only pays out a limited sum which may not cover your bill and its a one claim per same hospitalization, dont break the same leg twice! You did not say how old you are by the way that would make a difference to you decision. The other thing about LMG policy I saw ended at 74. I did not look again after I saw how steep the premiums rose up.

Its your choice, but sooner or later you will join the ranks of the self insured, company rules can change at the drop of a hat, nothing you can do about it.

[JLCrab]

My thoughts? Some of you self-insured guys should look at what's going on with the 'dilema' on the Isaan Forum.

[citizen33]

That is fair comment where insurance is possible, but simply repeating the mantra that everybody needs to get insured rather papers over the problem. The sobering message coming from this and other threads is that private insurance becomes very difficult past 70 and, when combined with the problem of exclusion of pre-existing conditions, means that the discussion about the best mix of insurance and self-insurance is highly relevant to many expats. Actually very few health care systems around the world leave medical care of older people to private insurance. Even in countries like the US and, in Europe, the Netherlands (often cited for its move towards private funds), there are special schemes for older people that depend on risk pooling. Indemnity insurance, with individual actuarial calculations of risk, is not a good option for older people, but unfortunately there are few alternatives for expats in Thailand. Those with a civil servant in the family or who kept their social security entitlements going are the lucky ones.

Edited March 20, 2013 by citizen33

[JLCrab]

The schemes or plans as mentioned above for elderly persons cover such persons while they domicile in their home country. Once you choose to live in a country where you are not a citizen or maybe married to one, the rules change. In Thailand, there are coverages that are only in effect if you subscribe before the age of 60. If you wait until post 60, your options are greatly limited.

NB: Self-insurance and no-insurance are not the same thing. 'Insurance' by definition has some component of probability. Putting a stash of cash away in reserve is not insurance self or otherwise if you have no other coverages ie catastrophic illness coverage.

Those who take the approach that they can 'hop on a plane' back to their home country for treatment should the need arise presume they will be well enough even to make it to Swampy let alone for the long haul flight and wait for treatment back home.

Edited March 20, 2013 by JLCrab

[cooked]

This discussion depends very much on where you are in life. Not everybody lives in Bangkok with its access to first class hospitals (5-6 hour drive for me for instance) and not everyone is 55/65/75 years old. I looked and worried about this stuff for a long time, and imagine that my solution - cheapo insurance for emergencies, a few hundred thousand Baht in a foreign bank, easily accessible with card was the best solution for me. As I mentioned before, I get 'free' (I paid insurance for 40 years and never used it) treatment if I can get back to Switzerland.

Most important is that my wife and family here will look after me.

These are my options, other people maybe have millions in the bank, can't count on treatment back home, etc, etc.

I'm trying to say that it's up to you, everyone has a different perspective.

It's easy enough to say that you won't start paying for expensive treatments when the time comes, however that is my plan.... easy to say.

[nong38]

This discussion depends very much on where you are in life. Not everybody lives in Bangkok with its access to first class hospitals (5-6 hour drive for me for instance) and not everyone is 55/65/75 years old. I looked and worried about this stuff for a long time, and imagine that my solution - cheapo insurance for emergencies, a few hundred thousand Baht in a foreign bank, easily accessible with card was the best solution for me. As I mentioned before, I get 'free' (I paid insurance for 40 years and never used it) treatment if I can get back to Switzerland.

Most important is that my wife and family here will look after me.

These are my options, other people maybe have millions in the bank, can't count on treatment back home, etc, etc.

I'm trying to say that it's up to you, everyone has a different perspective.

It's easy enough to say that you won't start paying for expensive treatments when the time comes, however that is my plan.... easy to say.

At least you have a plan and thats good. As you say travelling to BKK is not easy fro a start and then you might be let on the plane because actually you dont look like you make it. You are looking at desperate situation with probably 24 hours of travelling, its not going to happen is it, take your chances here and hope for the best.

[pinfold]

Health insurance especially in Thailand after 60 is pointless,overpriced with limited options,getting more limited as time progresses.(think BUPA have recently altered their policies)Better to have other options,money in the bank? yes fair bit,registered at govt hospital for short stabilising stay,then out of Thailand.If catastrophic and over 60,well your at the end game anyway

Personally I think all medical care/treatment in Thailand stinks,all about money,tons of it. One hour 'plane ride away from BKK all the first class treatment you care to choose from for a fraction of Thailand costs,3 hours away(where my preferred choice is even cheaper and better).There are other ex pat blog site in the specific areas to help choice. Some airlines take stretcher cases for seat price,one per flight. Just do a bit of homework to work out options

As age takes its toll,and if it does not your already dead,its all about choice,the body is a machine somewhere along the way it will go wrong,staying in Thailand with progressive illness is madness,just keep as fit as can be had ,whack the heart rate up to 150 few times a week,swimming's a pointless exercise,plenty of sex,enjoy the sun,that's it

[DavidChristensen]

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.

Presumably you tried to claim on something outside the terms of the cover. I have not known any insurer to not pay if the claim meets the criteria and that should be in black and white in the policy Document. yGood luck with the expectation your new insurer will be any different.

[DavidChristensen]

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![/quote

You should have no problem obtaining cover that excludes the pre-existing condition. Talk to a competent broker specializing in personal lines cover for expats in Thailand like www.e-insurethailand.com or www.bsibroker.co.th

[Morden]

Self-insurance for minor issues is fine but, if you need major surgery and aftercare, you may be looking at a total bill of THB1.5 or 2m. A disadvantage of self-insurance is that you are at the mercy of profit making hospitals and you are unlikely to be able to differentiate between what's necessary and what's being suggested merely because it makes more money for the hospital. Bangkok Hospital is a good example of this.

I use LMG Pacific and am very happy with them. They pay bills directly to private hospitals - you just sign a few hospital claim documents and leave. They also, if you take the trouble to consult them, will give advice on your treatment and help find the most suitable and convenient hospital. The GM is a native English speaker and very approachable.

I always buy insurance through a broker. They will have a range of products to offer and will help with any problems. I use BSI in Bangkok, run by Andy, a Brit. He too is very approachable and helpful.

The Thai govt hospitals are not profit making as far as I am aware so I dont think you would be at their mercy as you say. The LMG policy that I have seen is restrictive, it only pays out a limited sum which may not cover your bill and its a one claim per same hospitalization, dont break the same leg twice! You did not say how old you are by the way that would make a difference to you decision. The other thing about LMG policy I saw ended at 74. I did not look again after I saw how steep the premiums rose up.

Its your choice, but sooner or later you will join the ranks of the self insured, company rules can change at the drop of a hat, nothing you can do about it.

I think that you have seen a budget LMG policy and not the best they offer. Mine is renewable at my option for life with no re-underwriting and has limits easily adequate for major surgery and after-care.

[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.

Presumably you tried to claim on something outside the terms of the cover. I have not known any insurer to not pay if the claim meets the criteria and that should be in black and white in the policy Document. yGood luck with the expectation your new insurer will be any different.

In fact they agreed to pay, after I argued. Do you know how insurance companies operate??

[pinfold]

Self-insurance for minor issues is fine but, if you need major surgery and aftercare, you may be looking at a total bill of THB1.5 or 2m. A disadvantage of self-insurance is that you are at the mercy of profit making hospitals and you are unlikely to be able to differentiate between what's necessary and what's being suggested merely because it makes more money for the hospital. Bangkok Hospital is a good example of this.

I use LMG Pacific and am very happy with them. They pay bills directly to private hospitals - you just sign a few hospital claim documents and leave. They also, if you take the trouble to consult them, will give advice on your treatment and help find the most suitable and convenient hospital. The GM is a native English speaker and very approachable.

I always buy insurance through a broker. They will have a range of products to offer and will help with any problems. I use BSI in Bangkok, run by Andy, a Brit. He too is very approachable and helpful.

The Thai govt hospitals are not profit making as far as I am aware so I dont think you would be at their mercy as you say. The LMG policy that I have seen is restrictive, it only pays out a limited sum which may not cover your bill and its a one claim per same hospitalization, dont break the same leg twice! You did not say how old you are by the way that would make a difference to you decision. The other thing about LMG policy I saw ended at 74. I did not look again after I saw how steep the premiums rose up.

Its your choice, but sooner or later you will join the ranks of the self insured, company rules can change at the drop of a hat, nothing you can do about it.

I think that you have seen a budget LMG policy and not the best they offer. Mine is renewable at my option for life with no re-underwriting and has limits easily adequate for major surgery and after-care.

"My option"get it clear,"their options" will override any of "your options". Do not know your age ,but looked at a few policies for life after 65,and yes possible to renew,but the amounts to renew and what was on offer was derisory,4 or 5 years at the eye watering renewable amounts being quoted would have reached the maximum payout benefit they would provide. Does your policy include emergency medivac on the over 60/65 bit? no thought not.

It akin to the much derided "over 50s" plans seen on day time TV in the UK,"only starting blah blah blah",this is the same,instead of continually paying into something with ever reducing benefits seems pointless

[Morden]

Self-insurance for minor issues is fine but, if you need major surgery and aftercare, you may be looking at a total bill of THB1.5 or 2m. A disadvantage of self-insurance is that you are at the mercy of profit making hospitals and you are unlikely to be able to differentiate between what's necessary and what's being suggested merely because it makes more money for the hospital. Bangkok Hospital is a good example of this.

I use LMG Pacific and am very happy with them. They pay bills directly to private hospitals - you just sign a few hospital claim documents and leave. They also, if you take the trouble to consult them, will give advice on your treatment and help find the most suitable and convenient hospital. The GM is a native English speaker and very approachable.

I always buy insurance through a broker. They will have a range of products to offer and will help with any problems. I use BSI in Bangkok, run by Andy, a Brit. He too is very approachable and helpful.

The Thai govt hospitals are not profit making as far as I am aware so I dont think you would be at their mercy as you say. The LMG policy that I have seen is restrictive, it only pays out a limited sum which may not cover your bill and its a one claim per same hospitalization, dont break the same leg twice! You did not say how old you are by the way that would make a difference to you decision. The other thing about LMG policy I saw ended at 74. I did not look again after I saw how steep the premiums rose up.

Its your choice, but sooner or later you will join the ranks of the self insured, company rules can change at the drop of a hat, nothing you can do about it.

I think that you have seen a budget LMG policy and not the best they offer. Mine is renewable at my option for life with no re-underwriting and has limits easily adequate for major surgery and after-care.

"My option"get it clear,"their options" will override any of "your options". Do not know your age ,but looked at a few policies for life after 65,and yes possible to renew,but the amounts to renew and what was on offer was derisory,4 or 5 years at the eye watering renewable amounts being quoted would have reached the maximum payout benefit they would provide. Does your policy include emergency medivac on the over 60/65 bit? no thought not.

It akin to the much derided "over 50s" plans seen on day time TV in the UK,"only starting blah blah blah",this is the same,instead of continually paying into something with ever reducing benefits seems pointless

Premiums are higher for older people because they are more likely to claim. However, no premium is likely to be as costly as a single major operation.

Yes, I do have emergency evacuation cover, if that's what you mean by 'medivac'. My policy also extends to treatment in a number of other countries.

It's up to the individual to decide between self-funding and insurance. I would rather pay the annual premium than risk my personal resources being eroded by the need for major treatment.

[pinfold]

Obviously your under the 65 age barrier because I have seen no provisions for medical evacuation for 65s and over.

"No premium is likely to be as costly as a single operation" , no, but two or three years premiums would certainly put you in that bracket in the ever increasing eye watering amounts required

. Have you seen the maxed out amounts that insurance companies are willing to pay out for over 65s?never would they meet the cost of a major operation.This is Thailand

Personally I have no medical insurance pointless in Thailand,overpriced medical crap on offer along with supposed medical assurance,but personally I am bombproof,through past employment my care/flights/recuperation are met to the full, privately too,better than any printed out medical insurance crap that can be pulled at a moments notice in LOS

One more thing,any incident of over an 65 year old requiring surgery would induce a cancelled policy ASAP as soon as the maxed out amount was reached, and that would obviously be reached as soon as the OAP entered the hospital

Edited March 31, 2013 by pinfold

[mania]

Personally I have no medical insurance pointless in Thailand,overpriced medical crap on offer along with supposed medical assurance,but personally I am bombproof,through past employment my care/flights/recuperation are met to the full, privately too,better than any printed out medical insurance crap that can be pulled at a moments notice in LOS

I also am self insured currently but,

I do have US credit cards that have millions of Baht limits

usable here & could use them in case of an emergency.

When you say your bombproof do you mean because you can be flown out to services?

I also realize that in a true crisis I may not be stable enough to fly out

so do not count on foreign services back in my home country being readily accessible either.

So in lieu of having a locally recognized/accepted insurance card I would want some form of

payment available to get cared for till flight capable.

Edited March 31, 2013 by mania

[chiang mai]

The schemes or plans as mentioned above for elderly persons cover such persons while they domicile in their home country. Once you choose to live in a country where you are not a citizen or maybe married to one, the rules change. In Thailand, there are coverages that are only in effect if you subscribe before the age of 60. If you wait until post 60, your options are greatly limited.

NB: Self-insurance and no-insurance are not the same thing. 'Insurance' by definition has some component of probability. Putting a stash of cash away in reserve is not insurance self or otherwise if you have no other coverages ie catastrophic illness coverage.

Those who take the approach that they can 'hop on a plane' back to their home country for treatment should the need arise presume they will be well enough even to make it to Swampy let alone for the long haul flight and wait for treatment back home.

Have you yet noticed how nobody bothers to repsond any more to your single point on this issue that gets reguritated every time this subject reappears.

[pinfold]

Personally I have no medical insurance pointless in Thailand,overpriced medical crap on offer along with supposed medical assurance,but personally I am bombproof,through past employment my care/flights/recuperation are met to the full, privately too,better than any printed out medical insurance crap that can be pulled at a moments notice in LOS

I also am self insured currently but,

I do have US credit cards that have millions of Baht limits

usable here & could use them in case of an emergency.

When you say your bombproof do you mean because you can be flown out to services?

I also realize that in a true crisis I may not be stable enough to fly out

so do not count on foreign services back in my home country being readily accessible either.

So in lieu of having a locally recognized/accepted insurance card I would want some form of

payment available to get cared for till flight capable.

Yes,yes and yes

To put medical services/charges in this crap hole of Thailand under scrutiny Thailand's own Ministry of Health was issuing warnings recently to their overpricing tactics of medical providers. Anywhere in surrounding countries (Singapore no) better treatment and costings can be achieved for a fraction of Thailand's

[chiang mai]

Personally I have no medical insurance pointless in Thailand,overpriced medical crap on offer along with supposed medical assurance,but personally I am bombproof,through past employment my care/flights/recuperation are met to the full, privately too,better than any printed out medical insurance crap that can be pulled at a moments notice in LOS

I also am self insured currently but,

I do have US credit cards that have millions of Baht limits

usable here & could use them in case of an emergency.

When you say your bombproof do you mean because you can be flown out to services?

I also realize that in a true crisis I may not be stable enough to fly out

so do not count on foreign services back in my home country being readily accessible either.

So in lieu of having a locally recognized/accepted insurance card I would want some form of

payment available to get cared for till flight capable.

Yes,yes and yes

To put medical services/charges in this crap hole of Thailand under scrutiny Thailand's own Ministry of Health was issuing warnings recently to their overpricing tactics of medical providers. Anywhere in surrounding countries (Singapore no) better treatment and costings can be achieved for a fraction of Thailand's

So Laos, Cambodia and Myanmar have cheaper health care costs you say (Malaysia is more expensive), I wonder, how's the difference in quality and the range of choice, a rehtorical qiuestion!

[Morden]

Obviously your under the 65 age barrier because I have seen no provisions for medical evacuation for 65s and over.

"No premium is likely to be as costly as a single operation" , no, but two or three years premiums would certainly put you in that bracket in the ever increasing eye watering amounts required

. Have you seen the maxed out amounts that insurance companies are willing to pay out for over 65s?never would they meet the cost of a major operation.This is Thailand

Personally I have no medical insurance pointless in Thailand,overpriced medical crap on offer along with supposed medical assurance,but personally I am bombproof,through past employment my care/flights/recuperation are met to the full, privately too,better than any printed out medical insurance crap that can be pulled at a moments notice in LOS

One more thing,any incident of over an 65 year old requiring surgery would induce a cancelled policy ASAP as soon as the maxed out amount was reached, and that would obviously be reached as soon as the OAP entered the hospital

You are wrong on so many points unless you are talking about cheap low cover policies. Perhaps you are just anti-insurance as a matter of principle.

LMGs top product gives very high limits and the cover, once in force, isn't limited or cancelled. I don't know about other companies' products except for BUPA which I recall was inferior.

You can run up a bill for THB1m in no time. It would take a few years for premiums to accumulate that sort of total. Perhaps, instead of buying insurance you could save the same amount as the premiums and hope that you don't need major treatment until you have enough!