Health Care In Thailand

[smokie36]

When I first came here, I was 62 I think and had travel Insurance from the UK. As time has gone on I have found that 2 things have happened, the first was that after 65 costs went up if you get insurance and the second was the UK Insurance companies require you to have been a resident of the UK, in the UK for the previous 6 months before applying.

Not helpful for someone who spends 9-10 months here.

You can take out Insurance and hope they dont spot you were not in the UK when you took out the policy, but they will look at that first, so you have just given them money for nothing!

I have put money in the bank and hope I dont have to use it, time will tell, but it would be iresponsible to do anything else, although I accept a lot do, they come and try and turn night into day and gussle like no tomorrow, its their choice not mine, each must make their own decision.

You have made two very good posts there and kudos for doing so when so many others have backed off from commenting.

Nuff said I think.

[FunFon]

I understand Thailand starting to consider requiring us to hold sufficient insurance. I think that would eliminate a very large percentage of the older expats here.

Personally I'd be perfectly happy to sign a waiver stating that my health care is my own responsibility and if I don't have the funds to cover a treatment I realize I won't receive any and am willing to be left to die.

[CWMcMurray]

Your talking about accident insurance not health insurance. Why didn't you say that's what you're talking about?

No its health insurance....the kind which pays the first x amount of treatment. Its not rocket science JT....most people can afford it yet many simply show a cavalier attitude.

Sad.

No actually accident insurance is a completely different thing than health insurance....

For example ... Giving some preconditions that I have (previous car accident, no treatment in over 10 years), insurance carriers were quoting me aprox USD 3000 per year (in patient only) for premium with many exclusions...

For ACCIDENT insurance, cost is only THB 9,000 per year.. This covers you only if involved in an accident

http://www.axa.co.th/18/en/retail-insurance/personal-accident/smartcare-prime

So is your position everyone should have health insurance or that everyone should have accident insurance? As they are two completely different animals

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[candypants]

You don't get it. If your policy excludes the things you are mostly to need it for, it is almost worthless.

What do you suggest then JT?

Are you saying all expats should have a cash back up before moving to Thailand?

Or perhaps they can run back to their socialist haven with their tail between their legs?

What happens in the case of a bike accident or other serious injury?

I know you can't be suggesting no insurance or back up at all......as my Scottish dining companion, who also happens to blether a bit on here just mentioned to me....

"Anyone living in Thailand without medical insurance is a complete nutter."

so you two are eating dinner while sharing an insurance moment on thai visa?

oh how some live.

[jocko]

When I first came here, I was 62 I think and had travel Insurance from the UK. As time has gone on I have found that 2 things have happened, the first was that after 65 costs went up if you get insurance and the second was the UK Insurance companies require you to have been a resident of the UK, in the UK for the previous 6 months before applying.

Not helpful for someone who spends 9-10 months here.

You can take out Insurance and hope they dont spot you were not in the UK when you took out the policy, but they will look at that first, so you have just given them money for nothing!

I have put money in the bank and hope I dont have to use it, time will tell, but it would be iresponsible to do anything else, although I accept a lot do, they come and try and turn night into day and gussle like no tomorrow, its their choice not mine, each must make their own decision.

You have made two very good posts there and kudos for doing so when so many others have backed off from commenting.

Nuff said I think.

I agree two good posts with realistic outlook I am in the same position at 70 I have always had travel ins covering 90 days trips I have been coming for 13yrs my plan is to stay as of next trip for good of course as soon as I sneeze I will be on the plane home .

Just to be sure I will get treated in the UK I will claim political asylum as soon as I get of the plane.

[chiangmaikelly]

You don't get it. If your policy excludes the things you are mostly to need it for, it is almost worthless.

What do you suggest then JT?

Are you saying all expats should have a cash back up before moving to Thailand?

Or perhaps they can run back to their socialist haven with their tail between their legs?

What happens in the case of a bike accident or other serious injury?

I know you can't be suggesting no insurance or back up at all......as my Scottish dining companion, who also happens to blether a bit on here just mentioned to me....

"Anyone living in Thailand without medical insurance is a complete nutter."

so you two are eating dinner while sharing an insurance moment on thai visa?

oh how some live.

So where doe the 70 year old guy buy insurance in Thailand? Did some one answer that?

[Robby nz]

When I first came here, I was 62 I think and had travel Insurance from the UK. As time has gone on I have found that 2 things have happened, the first was that after 65 costs went up if you get insurance and the second was the UK Insurance companies require you to have been a resident of the UK, in the UK for the previous 6 months before applying.

Not helpful for someone who spends 9-10 months here.

You can take out Insurance and hope they dont spot you were not in the UK when you took out the policy, but they will look at that first, so you have just given them money for nothing!

I have put money in the bank and hope I dont have to use it, time will tell, but it would be iresponsible to do anything else, although I accept a lot do, they come and try and turn night into day and gussle like no tomorrow, its their choice not mine, each must make their own decision.

I was also 62 when I came to Thailand and had never needed or had health insurance, free medical care.

No pre existing and the only time I had been inside a hospital was visiting others.

About 6 months after I arrived I applied for and got comprehensive health insurance from BUPA in Hua Hin.

3 years later I had serious problems that required surgery and other ongoing treatment.

BUPA paid out to the full extent of the cover no problem.

You have to realize though that you have to pay yourself then send the receipt to the insurance company so you do have to have the ready cash.

In my case I had 800k set aside for my visa and was able to tap into this.

BUPA is still covering me at 69 and now I have chosen to have only inpatient cover as I have regular tests and think it is easier to pay for them as they come rather than having to make claims also much cheaper and I think that if I was making claims all the time they would be more likely to refuse me cover.

Incidentally I think it is much better to have 800k sitting in a Thai bank on TD rather than having to prove income each year for a visa.

[chiangmaikelly]

When I first came here, I was 62 I think and had travel Insurance from the UK. As time has gone on I have found that 2 things have happened, the first was that after 65 costs went up if you get insurance and the second was the UK Insurance companies require you to have been a resident of the UK, in the UK for the previous 6 months before applying.

Not helpful for someone who spends 9-10 months here.

You can take out Insurance and hope they dont spot you were not in the UK when you took out the policy, but they will look at that first, so you have just given them money for nothing!

I have put money in the bank and hope I dont have to use it, time will tell, but it would be iresponsible to do anything else, although I accept a lot do, they come and try and turn night into day and gussle like no tomorrow, its their choice not mine, each must make their own decision.

I was also 62 when I came to Thailand and had never needed or had health insurance, free medical care.

No pre existing and the only time I had been inside a hospital was visiting others.

About 6 months after I arrived I applied for and got comprehensive health insurance from BUPA in Hua Hin.

3 years later I had serious problems that required surgery and other ongoing treatment.

BUPA paid out to the full extent of the cover no problem.

You have to realize though that you have to pay yourself then send the receipt to the insurance company so you do have to have the ready cash.

In my case I had 800k set aside for my visa and was able to tap into this.

BUPA is still covering me at 69 and now I have chosen to have only inpatient cover as I have regular tests and think it is easier to pay for them as they come rather than having to make claims also much cheaper and I think that if I was making claims all the time they would be more likely to refuse me cover.

Incidentally I think it is much better to have 800k sitting in a Thai bank on TD rather than having to prove income each year for a visa.

If you don't mind; what do you pay per year and did you take a physical and are prior conditions covered?

[candypants]

So where doe the 70 year old guy buy insurance in Thailand? Did some one answer that?

once again you attempt to twist a threead towards your agenda. the topic is about healthcare not about finding health care for septuagenarians.

but i will bite. where does a 70 year old guy buy healthcare anywhere?

The upshot is it can be purchased at a cost -- the chances you will recoup are very high as are the risks to the insurer -- hence the cost. this should be obvious.

pre-existing conditions are very likely out if you are changing insurers. the only hope is that you picked the right insurer and have been with them as the conditions develop and they don't drop you -- which is why you have to pick the right insurer in the first place.

you start planning young, you might make it through. if you start looking for an insurer at 70, you have already missed the boat.

The simple fact is any 70 year old in living permanently in Thailand has already willingly forsaken any social programs they may have been entitled to back home and must live with the consequences of that decision.

Edited March 14, 2013 by candypants

[candypants]

When I first came here, I was 62 I think and had travel Insurance from the UK. As time has gone on I have found that 2 things have happened, the first was that after 65 costs went up if you get insurance and the second was the UK Insurance companies require you to have been a resident of the UK, in the UK for the previous 6 months before applying.

Not helpful for someone who spends 9-10 months here.

You can take out Insurance and hope they dont spot you were not in the UK when you took out the policy, but they will look at that first, so you have just given them money for nothing!

I have put money in the bank and hope I dont have to use it, time will tell, but it would be iresponsible to do anything else, although I accept a lot do, they come and try and turn night into day and gussle like no tomorrow, its their choice not mine, each must make their own decision.

I was also 62 when I came to Thailand and had never needed or had health insurance, free medical care.

No pre existing and the only time I had been inside a hospital was visiting others.

About 6 months after I arrived I applied for and got comprehensive health insurance from BUPA in Hua Hin.

3 years later I had serious problems that required surgery and other ongoing treatment.

BUPA paid out to the full extent of the cover no problem.

You have to realize though that you have to pay yourself then send the receipt to the insurance company so you do have to have the ready cash.

In my case I had 800k set aside for my visa and was able to tap into this.

BUPA is still covering me at 69 and now I have chosen to have only inpatient cover as I have regular tests and think it is easier to pay for them as they come rather than having to make claims also much cheaper and I think that if I was making claims all the time they would be more likely to refuse me cover.

Incidentally I think it is much better to have 800k sitting in a Thai bank on TD rather than having to prove income each year for a visa.

A truly intelligent and realistic approach. you must sow thee seed for future cover with a good insurer. looking for insurance after your 3rd heart attack is the equivalent of having missed the boat.

[CWMcMurray]

Of course if starting early, you also have to hope the insurance company doesn't drop you once you get to an age where you will start to need to actually use the insurance

Otherwise said young gentleman would have been better off paying to premiums to himself for 30 years and then he will have a nice chick of change to cover any medical expenses when he is older

After going through and investigating with many insurance companies, my wife and I have decided to set up a medical fund and put 100k a year into it

We are both relatively young ( under 40), so should have a good chunk of change for an medical needs once we start getting a bit older

Although we also both have Thai SS just in case something very serious happens as well

Sent from my iPhone using ThaiVisa app

[nong38]

You don't get it. If your policy excludes the things you are mostly to need it for, it is almost worthless.

What do you suggest then JT?

Are you saying all expats should have a cash back up before moving to Thailand?

Or perhaps they can run back to their socialist haven with their tail between their legs?

What happens in the case of a bike accident or other serious injury?

I know you can't be suggesting no insurance or back up at all......as my Scottish dining companion, who also happens to blether a bit on here just mentioned to me....

"Anyone living in Thailand without medical insurance is a complete nutter."

so you two are eating dinner while sharing an insurance moment on thai visa?

oh how some live.

So where doe the 70 year old guy buy insurance in Thailand? Did some one answer that?

There are companies that do it. I saw one that give it to you up to 74 but looking at how it rose from 60-74 it was ridiculous and they only covered you for a set amount of money so you were only partially covered. I have seen some that claim to go to 80+ but the premiums would scare you off.

The answer for you is to put cash in the bank, hope you dont need to use it then you can leave it someone, wo hopefully wont squander it lifes luxuries today, if you get my drift.

[chiangmaikelly]

So where doe the 70 year old guy buy insurance in Thailand? Did some one answer that?

once again you attempt to twist a threead towards your agenda. the topic is about healthcare not about finding health care for septuagenarians.

but i will bite. where does a 70 year old guy buy healthcare anywhere?

The upshot is it can be purchased at a cost -- the chances you will recoup are very high as are the risks to the insurer -- hence the cost. this should be obvious.

pre-existing conditions are very likely out if you are changing insurers. the only hope is that you picked the right insurer and have been with them as the conditions develop and they don't drop you -- which is why you have to pick the right insurer in the first place.

you start planning young, you might make it through. if you start looking for an insurer at 70, you have already missed the boat.

The simple fact is any 70 year old in living permanently in Thailand has already willingly forsaken any social programs they may have been entitled to back home and must live with the consequences of that decision.

So are you saying my question, "If you don't mind; what do you pay per year and did you take a physical and are prior conditions covered?" is off topic?

[Pakboong]

Dead is dead whatever the country. I think you come from a nanny state country. I should be so lucky.

Health care is a bit of a lottery worldwide nowadays JT....unless you pay for it.

I am talking about straightforward emergency care....which you will not receive in a lot of places without insurance or hard cash if you are a foreigner.

Surely that is a concern to many expats?

Of course it is. Thailand is a dangerous place. I'm just talking about reality, lots of expats don't have health insurance. It would be great if they all did, but they don't, and the reasons are very varied and not all nuts.

BTW, I would be totally cool IF Thailand required all long term expats to have health insurance but ONLY if they offered a BUY IN to a government run health insurance program.

The reason in all cases is that they either cannot afford it, in which case they should not be living there, or simple ambivalence, which is even worse if they can afford it.

I would expect the second more in "nanny state" expats to be honest. Those from North America I would expect to have factored in some costing before making the move.

If you are talking about not being able to afford insurance, it is a lot cheaper to not afford insurance here than it would be in the USA. If I were to gamble on such, I would clearly do it here.

[CWMcMurray]

Completely agree with Pakboon above...

If uninsured in Thailand and worst case happens, you are likely looking at an amount that can be put on a credit card (worst case) if you do not have the funds readily available

While if in the same situation in the US it would likely put you into Bankruptcy and/or you may end up needing to sell your house to pay the medical bills

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[metisdead]

Posts with messed up quotes and quote headers have been removed. Inflammatory posts and a round and round bickering session has been removed as well.

[Sheryl]

I see that this has been moved in Health forum.

Your Moderator has a confession to make: I had spotted a day or 2 ago but not moved it, despite it obviously belonging here, because I did not feel up to moderating all the bickering that it was attracting.

SO....

Please be on notice that absolutely NO bickering will be tolerated now that you are here in the Health Forum.

Personally it reads to me like the issues has already been hashed to death. As it has been many times before in similiar threads.

If anyone feels they have a new point to make, fine, but be sure to keep it civil and avoid personal jibes.

[isawasnake]

Anybody who judges others for not having health care, whether they have the money for it or not, is out of line.

[Hedghog]

Due to pre,existing,conditions I can't get travel insurance,never mind health insurance.

What should I do?

Stay at home.

[TerryLH]

"I am talking about straightforward emergency care....which you will not receive in a lot of places without insurance or hard cash if you are a foreigner.

Surely that is a concern to many expats?"

Surely it is.

Instead of all the negativity, do you have any specific tips where people who haven't been able to purchase health insurance here can go for it?

Names of companies that will do what you say can be done will be really helpful to many here.

Terry

[Sheryl]

I think it is recognized that there is a big gap in that respect, one that is particularly problematic given that many of the expats resident in Thailand are retirees and thus likely to either have pre-existing conditions and/or be too old to obtain private insurance.

Those who are able to work legally in Thailand will get coverage under the Thai Social Security scheme and can maintain that for life if they keep up the payments (not everyone knows that, however, and some lose that opportunity when they stop working because they were not informed of that option).

An arrangement whereby expats on one year visa extensions for reasons of retirement or spouse etc could also contribute to and be covered by the Thai SS systems would be ideal and one can only hope the government comes around to the idea or something similiar. They have started to be seriously concerned about losses sustained in public hospitals for the care of foreigners with catastrophic illness/injuries who can't pay their bills. If that leads to a mandatory insurance requirement for visa extensions then it will run straight into this problem. I have heard that some other countries require proof of insurance for long-term visa extensions but then issue waivers to people who can demonstrate they are unable to obtain it, which of course rather defeats the whole purpose. One would hope that instead something would be done to address that problem. Since by definition it involves people who from an insurance perspective are higher than average risk, the solution is unlikely to come from the private insurance sector. It needs to come from a scheme which is already risk-pooled across a large population segment.

US citizens who qualify for Medicare may be able to obtain "Medicare plus" policies that include overseas coverage. Pre-existing conditions would still probably be an issue but age would not.

Beyond that all I can offer by way of advice to those in this situation is:

1. Self insure if you can.

2. Do whatever you can/need to to maintain eligibility for whatever type of health cover is available to you in your home country.

and/or

3. If you can, get under the Thai SS system by working for a year legally and then whatever you do, never stop making the premiums.

And for those not in the situation of being unable to get insurance yet also not insured, think carefully now because you may have cause to regret not taking out insurance when you still could.

[FunFon]

The other option, which some may consider irresponsible, is to simply resign yourself to the possibility that you'll die earlier being poor than if you had money, which of course has always been and will always be true.

Just don't B & M about it if you choose to live here, but grew up in a culture that fooled you into thinking decent health care was some kind of God-given right, it's in reality a very context-dependent privilege, and one that more and more of us are realizing we should be very grateful for if it's available to us more than others.

[Jingthing]

Perhaps slightly off topic, but retirees considering retiring in Thailand who have even seemingly minor preexisting conditions, meaning they may NOT be able to purchase meaningful insurance here, should strongly consider NOT retiring to Thailand mainly for that very reason. Better options may be staying in the home country or seeking a retirement country destination which offers a buy in to health care access (yes they exist). I love Sheryl's idea that the Thai government address this and start to offer a BUY IN option for foreign retired expats, but my feeling is that the chances of this actually being offered by Thailand to be very remote. I hope I'm wrong, it's a great idea, but it's best to be realistic.

Edited March 15, 2013 by Jingthing

[JSixpack]

Those who are able to work legally in Thailand will get coverage under the Thai Social Security scheme and can maintain that for life if they keep up the payments (not everyone knows that, however, and some lose that opportunity when they stop working because they were not informed of that option).

But I think you have to be in the system by the time you reach 60 and must have worked at least one year. Correct me if I'm wrong.

[Sheryl]

Those who are able to work legally in Thailand will get coverage under the Thai Social Security scheme and can maintain that for life if they keep up the payments (not everyone knows that, however, and some lose that opportunity when they stop working because they were not informed of that option).

But I think you have to be in the system by the time you reach 60 and must have worked at least one year. Correct me if I'm wrong.

You definitely have to have worked a year (13 months actually). Not sure about having to get in by age 60 but could be. If anyione out there knows for sure please advise.

[Sheryl]

The other option, which some may consider irresponsible, is to simply resign yourself to the possibility that you'll die earlier being poor than if you had money, which of course has always been and will always be true.

The problem with this idea is that people more often do not simply drop dead. They experience prolonged illness and disability first. Sometimes for many years. They end up admitted to hospital either because they couldn't stand the suffering or were so ill/disabled they were unable to speak for themselves. At which relatives get tracked down -- even remote ones a continent away -- over the mounting bills and the whole thing becomes a problem for more than the individual.

Seen it many, many times. Usually involving someone who assumed he'd just drop dead one day and forego medical cvare. Things seldom follow our expectations that way.

[Sheryl]

Perhaps slightly off topic, but retirees considering retiring in Thailand who have even seemingly minor preexisting conditions, meaning they may NOT be able to purchase meaningful insurance here, should strongly consider NOT retiring to Thailand mainly for that very reason. Better options may be staying in the home country or seeking a retirement country destination which offers a buy in to health care access (yes they exist). I love Sheryl's idea that the Thai government address this and start to offer a BUY IN option for foreign retired expats, but my feeling is that the chances of this actually being offered by Thailand to be very remote. I hope I'm wrong, it's a great idea, but it's best to be realistic.

Actually pre-existing conditions do not always preclude getting insurance. Depending on what they are it is sometimes possible to get a policy which excludes just the pre-exising condition but covers everything else. Which is better than nothing.

Insurance companies can be absurd in what they consider "pre existing", sometimes these are things that have already been fully treated and are unlikely to recur or that even if they recurred wouldn't entail expensive treatment.

[Jingthing]

Yes obviously it would depend on what preexisting conditions but an example I like to use is medically treated high blood pressure. It is my understanding that people with that can purchase insurance but the policies will exclude all conditions related to the heart, including strokes. In my view, that is not good coverage. Correct me if I'm wrong about that.

[Sheryl]

No, you are probably right. Despite that it is still worth having. Would still cover cancer, car accidents and a host of other things.

I have noticed over my many years as a health professional that most people seem to have, consciously or unconsciously, a "script" in their heads of when and how they are going to die, how they'll age, what health problems they'll perhaps face. But more often that not, life has different plans and what ends up happening is something they never remotely envisioned.

[Jingthing]

No, you are probably right. Despite that it is still worth having. Would still cover cancer, car accidents and a host of other things.

I have noticed over my many years as a health professional that most people seem to have, consciously or unconsciously, a "script" in their heads of when and how they are going to die, how they'll age, what health problems they'll perhaps face. But more often that not, life has different plans and what ends up happening is something they never remotely envisioned.

That's an excellent point especially about vehicular related accidents.

However, for older or not so old people with a number of common preexisting conditions, it can get kind of absurd how many things are excluded, that is, if they can purchase any plan at all.

Here is an example of how crazy this kind of stuff can be. Many years ago, I went to a Thai hospital dermatologist with symptoms of dry skin (I already know I have patches of eczema). This young doctor starting blabbing about cancer (there was no evidence, no lesions) and of course scared me and sold me on her screening tests (blood basically). It was negative but not I would be surprised if this wasn't an issue with getting insurance here to cover skin cancer or perhaps any cancer.

Insurance is great but the companies are clearly designed to deny anything they can get away with and they can get away with alot.

Edited March 15, 2013 by Jingthing