Health Insurance Discount Practices

[gguy]

Do any reputable insurance companies offer high deductible health insurance, 1,000,000 Baht?

The main reason for the policy is to have the insurance company handle the claim and reduce the amounts to the contracted amounts negotiated between the hospital and the insurer.

I would pay the medical bills but hopefully the bills would be reasonable. In the US, most insurers discount bills by 50% or more.

What is the typical discount seen on bills for the currently insured for Thai claims?

[lopburi3]

What do you mean by "discount"? Are you talking the percentage they pay (or not pay) for covered service? My US insurance pays about 85% for most things and 100% for hospitalization less a deductible of a few hundred dollars. Are you really asking for an insurance that pays nothing unless over 1 million baht?

[Sheryl]

It sounds like yes, that is what he means. And I have not seen any Thai policies like that. In fact most do not have a deductible for inpatient at all, just a limit on how much they reimburse.

Moving this to insurance forum where there may be more info available

[citizen33]

I believe that the OP is referring to the cost benefits that were gained when US third party payers (including insurers) moved from reimbursement based on listed provider prices to reimbursement based on negotiated contracts. In the old days the patient simply paid the provider (probably both the physician and the hospital) according to a fees schedule and the insurer refunded whatever this cost (subject to any specified payment maxima). Later third party payers found they could control costs more effectively if they negotiated contracts direct with providers, taking advantage of their purchasing power to pay less for a given treatment than an individual patient would pay, and usually paying direct. So I think the idea of the discount over what an individual patient would normally pay refers to the lower price an insurer can often get by buying in volume. Lay persons often assume that there is a fixed price for a particular treatment, but in practice it is common for different purchasers to pay different prices.

I don't know whether Thai insurers offer policies where the insured member would pay a large proportion of the cost as a deductible, but benefit from a lower total price than an individual patient could get paying the hospital out of pocket. What I do hear is that the 'loss ratio' is lower in Thailand than in most Western countries - in other words, the insurers pay out a lower proportion of money received from members for treatments and enjoy nice profits.

Edited February 1, 2013 by citizen33

[NancyL]

Perhaps someone can confirm if private hospitals actually charge insurance companies less than they do cash customers. Suan Dok Hospital, the regional government hospital in Chiang Mai, will discount bills for hospital stay by 20% if the patient makes a hefty cash deposit prior to a procedure and pays cash for the balance upon discharge. But, you have to ask for it.

I've also heard stories that CM Ram hospital (a private hospital) actually has a surcharge if they are asked to bill the insurance company directly (at least a foreign insurance company). Something about how the foreign insurance companies often reject their bills as not being in the "correct" format and it creates additional work for them to figure out the correct format to use to obtain payment.

[Youpi88]

Perhaps someone can confirm if private hospitals actually charge insurance companies less than they do cash customers. Suan Dok Hospital, the regional government hospital in Chiang Mai, will discount bills for hospital stay by 20% if the patient makes a hefty cash deposit prior to a procedure and pays cash for the balance upon discharge. But, you have to ask for it.

I've also heard stories that CM Ram hospital (a private hospital) actually has a surcharge if they are asked to bill the insurance company directly (at least a foreign insurance company). Something about how the foreign insurance companies often reject their bills as not being in the "correct" format and it creates additional work for them to figure out the correct format to use to obtain payment.

I can confirm you that hospitals charge less the insurance providers with which they have agreements.

The reasons are simple: this way the insurance company can recommend a hospital (which is good for the hospital as it brings clients), and the insurer has the peace of mind to know that when people go to a certain hospital the costs are controlled by the insurance provider.

For the insured person it is also better has he can pay less upfront.

Basically everybody wins.

[candypants]

in thailand you may experience quite the contrary. hospital often charge insurance companies more because the AR cycle is generally much longer and it can take them up to 6 months to get their money.

[tonydabbs]

What you are talking about is called a deductible (by Americans) and an excess by Europeans.

Buying high coverage health insurance with a high deductible is a good practical way to go.

I lean towards 40,000 Thai Baht deductible. The highest deductibe available in Thailand is 340,00 Thai Baht. Sorry. No one million baht deductibles

Only three of the highest coverage insurers in Thailand offer deductibles. Bupa doesn't.

Edited March 31, 2013 by tonydabbs

[Youpi88]

What you are talking about is called a deductible (by Americans) and an excess by Europeans.

Buying high coverage health insurance with a high deductible is a good practical way to go.

I lean towards 40,000 Thai Baht deductible. The highest deductibe available in Thailand is 340,00 Thai Baht. Sorry. No one million baht deductibles

Only three of the highest coverage insurers in Thailand offer deductibles. Bupa doesn't.

By "highest coverqge insurers in Thailand" you mean local companies right ? Not the international ones ?

[tonydabbs]

What you are talking about is called a deductible (by Americans) and an excess by Europeans.

Buying high coverage health insurance with a high deductible is a good practical way to go.

I lean towards 40,000 Thai Baht deductible. The highest deductibe available in Thailand is 340,00 Thai Baht. Sorry. No one million baht deductibles

Only three of the highest coverage insurers in Thailand offer deductibles. Bupa doesn't.

By "highest coverqge insurers in Thailand" you mean local companies right ? Not the international ones ?

Of course. These companies are under regulation by the Thai government and sell in Thai Baht.

Many international insurers are setting up offices in Thailand, but they can only sell to expats and their (Thai)families. None use Thai Baht.

[Mike45]

What you are talking about is called a deductible (by Americans) and an excess by Europeans.Buying high coverage health insurance with a high deductible is a good practical way to go.I lean towards 40,000 Thai Baht deductible. The highest deductibe available in Thailand is 340,00 Thai Baht. Sorry. No one million baht deductiblesOnly three of the highest coverage insurers in Thailand offer deductibles. Bupa doesn't.

Tony which companies are they and how can I see their plans and policy prices?

Thanks