Proof Of Medical Insurance Proposed For 1 Year Visa

[Keesters]

800,000 is money to spend in Thailand to live on, etc.

it all depends on the care you would require, a few nights in ICU will cost you a fortune. Especially at a private hospital. A 1 week stay at ICU will not leave you much money if you only have 800,000 baht and need hart surgery.

A one week stay at my local private hospital is Bht,3.500 per day plus medication.

Hardly breaking the bank.

Where's that?

Agree with Mario2008. ICU cost me 45,000/day, room only, in a Sri Racha private hospital. I needed a heart unit and this was the best deal to be found within the very limited time frame I had. All the extras, stent procedure, ambulances etc. and 3 days came to 400,000. Edited May 7, 2013 by Keesters

[bdenner]

Haven't read all of this BUT:

Step back and assess all the legitimate expat retirees you know and ask yourself how many of them have freeloaded on the Thai Medical system. Been here over 12 years now, of the 30 or so I know the answer is not a one! Some have insurance but most just pay their way as required including me.

I do/did know a number on tourist type visas who have bummed off the system.

[Keesters]

Haven't read all of this BUT:

Step back and assess all the legitimate expat retirees you know and ask yourself how many of them have freeloaded on the Thai Medical system. Been here over 12 years now, of the 30 or so I know the answer is not a one! Some have insurance but most just pay their way as required including me.

I do/did know a number on tourist type visas who have bummed off the system.

You make a very good point. Made me have a think and in almost 30 years knowing many resident farang and meeting many tourists here I've never met one in any category that bummed off the Thai system. Didn't even know it was possible. I do know of a case however where a farang died because nobody would treat him because he appeared to have no money. It was an incorrect assumption by the hospital.

[Morden]

A simple solution would be:

1. For tourists. A small increase in the airport tax that is added to the ticket cost. 100 baht for example which reimburses hospitals for any unpaid bills. This is not buying insurance for tourists, in fact they don't know it exists.

2. For uninsured retirees. Double the 65000/800000k requirement with the increase going to a special medical account which can only be accessed by claims filed against the account by hospitals. Nobody is grandfathered. Letting a medical lien placed against a chanote to satisfy this requirement should be considered.

1. How do you know that the amount you suggest would be sufficient? why should those with insurance fund those who can't pay?

2. Why should everyone pay the same amount, regardless of pre-existing health an age? How can it be certain that the 'fund' would be sufficient?

1. I don't but the numbers of tourists going through Suvarnaphumi is something like 13 million so the revenue generated far exceeds the reported shortfalls from both the tourists and retiree community combined. Philosophically some may have a problem indirectly funding medical insurance for tourists.

2. Historically, Immigration has doubled this amount in the past but the amount could be a lot less or more. The increase is in the neighborhood of what people here have been throwing around for a major medical event. This really isn't a fund that the retiree uses to pay medical bills. It is more like a guarantee, it can only be accessed for unpaid hospital claims. The bond or fund could be in a higher interest account. If a claim is made against the account then the retiree must replenish the amount to renew the retirement visa. Only those with medical insurance are grandfathered since the older foreigners are at the greater risk. A retiree could put up his house or condo as collateral for the bond/fund. Just putting some ideas out there.

Sure, I see what you're getting at.

Medical insurance underwriting and administration is a complex and skilled undertaking. I have to wonder whether a simple fee system would work. Getting the amount correct would be difficult, bills would have to be checked by competent people and there would almost certainly be a list of approved hospitals based on cost rather than the convenience of the patient.

[Postmaster]

WaywardWind +1

[Jingthing]

WaywardWind +1

What post are you referring to?

[NancyL]

Haven't read all of this BUT:

Step back and assess all the legitimate expat retirees you know and ask yourself how many of them have freeloaded on the Thai Medical system. Been here over 12 years now, of the 30 or so I know the answer is not a one! Some have insurance but most just pay their way as required including me.

I do/did know a number on tourist type visas who have bummed off the system.

You make a very good point. Made me have a think and in almost 30 years knowing many resident farang and meeting many tourists here I've never met one in any category that bummed off the Thai system. Didn't even know it was possible. I do know of a case however where a farang died because nobody would treat him because he appeared to have no money. It was an incorrect assumption by the hospital.

Oh, I know of dozens of resident foreigners who have "bummed off" the Thai hospital system. An amazing number of them are on long-term overstay, and before that they'd been doing back-to-back border runs for visa exempt entry until they got to be too frail to keep up the trips. Costs the gov't hospitals here in CM several million baht a year. Yes -- not much in the "big picture" of what the resident foreingers bring into the economy, but still enough that the doctors in the govn't hospitals have been put on notice not to order any treatment beyond basic life-saving needs.

[Keesters]

Haven't read all of this BUT:

Step back and assess all the legitimate expat retirees you know and ask yourself how many of them have freeloaded on the Thai Medical system. Been here over 12 years now, of the 30 or so I know the answer is not a one! Some have insurance but most just pay their way as required including me.

I do/did know a number on tourist type visas who have bummed off the system.

You make a very good point. Made me have a think and in almost 30 years knowing many resident farang and meeting many tourists here I've never met one in any category that bummed off the Thai system. Didn't even know it was possible. I do know of a case however where a farang died because nobody would treat him because he appeared to have no money. It was an incorrect assumption by the hospital.

Oh, I know of dozens of resident foreigners who have "bummed off" the Thai hospital system. An amazing number of them are on long-term overstay, and before that they'd been doing back-to-back border runs for visa exempt entry until they got to be too frail to keep up the trips. Costs the gov't hospitals here in CM several million baht a year. Yes -- not much in the "big picture" of what the resident foreingers bring into the economy, but still enough that the doctors in the govn't hospitals have been put on notice not to order any treatment beyond basic life-saving needs.

We move in different circles.

[TallGuyJohninBKK]

Oh, I know of dozens of resident foreigners who have "bummed off" the Thai hospital system. An amazing number of them are on long-term overstay, and before that they'd been doing back-to-back border runs for visa exempt entry until they got to be too frail to keep up the trips. Costs the gov't hospitals here in CM several million baht a year. Yes -- not much in the "big picture" of what the resident foreingers bring into the economy, but still enough that the doctors in the govn't hospitals have been put on notice not to order any treatment beyond basic life-saving needs.

I guess that's a charitable way of saying, they're here illegally, apparently without the required financial resources to obtain a retirement visa/extension of stay, or perhaps some who just can't be bothered to jump thru the Immigration hoops.

As I noted above, if the Thai govt wanted to, they certainly could ascertain just what exactly is the common/majority profile of the farang medical patients that are incurring these expenses at government hospitals -- tourists or expats, what kind of permission to stay if any they have...

That would be the sensible way aimed at crafting some sensible solution to what the Thai system perceives as a problem. Unlikely, though, that the authorities will take that approach.

[Soutpeel]

Haven't read all of this BUT:

Step back and assess all the legitimate expat retirees you know and ask yourself how many of them have freeloaded on the Thai Medical system. Been here over 12 years now, of the 30 or so I know the answer is not a one! Some have insurance but most just pay their way as required including me.

I do/did know a number on tourist type visas who have bummed off the system.

You make a very good point. Made me have a think and in almost 30 years knowing many resident farang and meeting many tourists here I've never met one in any category that bummed off the Thai system. Didn't even know it was possible. I do know of a case however where a farang died because nobody would treat him because he appeared to have no money. It was an incorrect assumption by the hospital.

Oh, I know of dozens of resident foreigners who have "bummed off" the Thai hospital system. An amazing number of them are on long-term overstay, and before that they'd been doing back-to-back border runs for visa exempt entry until they got to be too frail to keep up the trips. Costs the gov't hospitals here in CM several million baht a year. Yes -- not much in the "big picture" of what the resident foreingers bring into the economy, but still enough that the doctors in the govn't hospitals have been put on notice not to order any treatment beyond basic life-saving needs.

We move in different circles.

Oh dear..."I am a higher class farang than you are " comment...rather sad...but if make you feel better about yourself knock yourself out..

[Soutpeel]

Oh, I know of dozens of resident foreigners who have "bummed off" the Thai hospital system. An amazing number of them are on long-term overstay, and before that they'd been doing back-to-back border runs for visa exempt entry until they got to be too frail to keep up the trips. Costs the gov't hospitals here in CM several million baht a year. Yes -- not much in the "big picture" of what the resident foreingers bring into the economy, but still enough that the doctors in the govn't hospitals have been put on notice not to order any treatment beyond basic life-saving needs.

I guess that's a charitable way of saying, they're here illegally, apparently without the required financial resources to obtain a retirement visa/extension of stay, or perhaps some who just can't be bothered to jump thru the Immigration hoops.

As I noted above, if the Thai govt wanted to, they certainly could ascertain just what exactly is the common/majority profile of the farang medical patients that are incurring these expenses at government hospitals -- tourists or expats, what kind of permission to stay if any they have...

That would be the sensible way aimed at crafting some sensible solution to what the Thai system perceives as a problem. Unlikely, though, that the authorities will take that approach.

The sensible way is to require all non nationals living here or visiting to have medical insurance and have proof of said insurance before granting visa's or extension of stays in the absence of having insurance they can require someone to lodge a bond with the goverment

[TallGuyJohninBKK]

Yes, that could be done, and might even be a good idea. Though as was cited above, then the authoroties would have to get into specifying just how much med insurance they will require as a minimum. And then what about someone with that insurance who then exceeds its coverage limits, etc, etc.

But more to the point, the people Nancy's mentioning above aren't getting visas or extensions or presumably even 90 day reports. They're living outside the "system." So legal mandates are pretty irrelevant to them - until and unlless they are caught and detained/deported.

[Soutpeel]

Yes, that could be done, and might even be a good idea. Though as was cited above, then the authoroties would have to get into specifying just how much med insurance they will require as a minimum. And then what about someone with that insurance who then exceeds its coverage limits, etc, etc.

But more to the point, the people Nancy's mentioning above aren't getting visas or extensions or presumably even 90 day reports. They're living outside the "system." So legal mandates are pretty irrelevant to them - until and unlless they are caught and detained/deported.

of course you will get people playing this game, but if there were requirements such as the medical insurance, these people may not have been granted visa's in the first place, as they must have had a visa/extension at some point in time, further on from that if these sorts of people turned up at a goverment hospital with out insurance could be s simple case of the hospital calling the BiB and they would be caught for visa violations as well..

[TallGuyJohninBKK]

Presumably, a government hospital right now - without neediing any new law or reg - today could probably notify Immigration, if they were stuck with a farang who had no insurance and unable to pay their bill since, odds are, someone in that circumstance probably also isn't staying here legally.

[Soutpeel]

Presumably, a government hospital right now - without neediing any new law or reg - today could probably notify Immigration, if they were stuck with a farang who had no insurance and unable to pay their bill since, odds are, someone in that circumstance probably also isn't staying here legally.

you may be right...I have no idea..

[NancyL]

Presumably, a government hospital right now - without neediing any new law or reg - today could probably notify Immigration, if they were stuck with a farang who had no insurance and unable to pay their bill since, odds are, someone in that circumstance probably also isn't staying here legally.

This is exactly what they do -- unpaid medical bills put someone on Immigration's "radar screen" and they get special attention the next time they come for a visa extension. Also, Immigration is notified if someone doesn't have a current permission to stay and pleads poverty. Interestingly, they don't if the person who is clearly here illegally is able to pay their bill at the gov't hospital.

Private hospitals don't work the same way -- they simply keep someone's passport until they pay. Gov't hospitals can't hold passports because it's a U.N. human rights violation to hold someone's passport against their will.

[TallGuyJohninBKK]

Also, Immigration is notified if someone doesn't have a current permission to stay and pleads poverty.

Trying to reconcile what you say here about impoverished farang who visit government hospitals, and what you said earlier about being familiar with quite a few elderly farang on long-term overstay (read no legal permission to stay) who are having their medical expenses eaten by Thai government hospitals.

If Immigration is notified in such cases, presumably those on long term overstay would be found. But it seems that's not the case???

I've never been a patient in a Thai government hospital, and only been an outpatient in private ones here. But within that experience, the hospital never asks or cares or has access to my immigration status.

They ask for my passport, and I give them my laminated wallet-sized color photocopy of my passport face page. None of the privates I've dealt with have ever asked for anything more.

But then again, I've never been unable to pay my own hospital bill either.

[NancyL]

Someone isn't prevented from leaving the country if they have an unpaid medical bill at a government hospital, nor is payment of those bills a condition of deportation. Also, hospitals are left with unpaid bills if a destitute foreigner dies in a gov't hospital. They won't release a body until the bill is paid, but unfortunately some bodies are never claimed for this reason.

If someone has a valid visa extension in their passport (even if it appears to be obtained by misrepresentation of income), the hospital will notify immigration and the person will encounter more questioning at the time of the next extension.

In practice, many foreigners have some income, just not enough to pay the entire bill, and the hospital will agree to accept a deposit (usually about 1/2 the total amount of the bill) and then accept payment on contract over time. They don't hold the passport as collateral. Often, the foreigner makes a few payment and then just disappears, leaving an unpaid balance.

A private hospital often won't ask an outpatient about a passport if a they have treated that person before and/or the person looks like they have some funds. They will ask about a passport when someone is admitted as an in-patient.

[Soutpeel]

They don't hold the passport as collateral. Often, the foreigner makes a few payment and then just disappears, leaving an unpaid balance.

A private hospital often won't ask an outpatient about a passport if a they have treated that person before and/or the person looks like they have some funds. They will ask about a passport when someone is admitted as an in-patient.

Technically speaking requesting or offering up a passport to a hosptial as collaterial is illegal, as the passport concerned is not the passport holders property, its their goverments property...legally speaking only persons such as immigration/police/courts etc can legally withhold someones passport

[lopburi3]

Actually the simple answer would be to increase tax to pay for this and reimburse hospitals as is done for Thai nationals. A simple increase in one year extension fee for those on extensions for other than employment (where medical coverage is paid) and a portion of entry/airport tax should be able to pay for such without strain or excess bureaucracy or hardship on anyone.

Yes those of us with insurance might complain about having to pay but the price would be so small do not believe it would be a real issue if spread over everyone - our insurance would still provide us the choice of hospital facility so nothing really lost and worth keeping for that choice.

[TallGuyJohninBKK]

Lop, in your suggestion above, I don't quite see the logic in exempting from the tax/added fee those who are employed (and thus covered by insurance through that) vs. your notion of not excluding those who pay privately for their own private medical insurance.

If the government wanted to offer me a scheme to pay to buy into their government health insurance scheme, I might consider that in addition to my private medical insurance. But I'd kind of object to being charged extra for my annual retirement extension of stay to pay for health coverage, when I'm already paying quite a high premium for my own insurance coverage.

It ought to be those who DON'T have their own health insurance (either through employment OR private insurance) who ought to pay any extra fee. Not those who are already insured.

Your approach would penalize those who have taken responsibility for their own affairs. That's not the equitable way to go.

Edited May 10, 2013 by TallGuyJohninBKK

[lopburi3]

It would be a very small amount of increase in extension of stay fees and could either be across the board or only for those without government social security coverage - no need to check or prove outside insurance in that case and those with such will have the benefit of using it for private care. It is normal for people around the world to pay for minimal social programs and do not believe most would feel such payment for government type coverage to be an issue - when you start to require proof of coverage you make costs of enforcement, for everyone, more than just covering in the first place. But only my thought on the subject - keep it simple.

[Morden]

Several posts have suggested that a levy on foreigners would be small. How do they know that?

However large or small it might be, I would resent having to fund people who had no money, who avoided paying when they could or who don't have insurance.

[NancyL]

They don't hold the passport as collateral. Often, the foreigner makes a few payment and then just disappears, leaving an unpaid balance.

A private hospital often won't ask an outpatient about a passport if a they have treated that person before and/or the person looks like they have some funds. They will ask about a passport when someone is admitted as an in-patient.

Technically speaking requesting or offering up a passport to a hosptial as collaterial is illegal, as the passport concerned is not the passport holders property, its their goverments property...legally speaking only persons such as immigration/police/courts etc can legally withhold someones passport

Yes, but it's common practice for the private hospitals to ask for the passport as collaterial. The government hospitals don't do it because, yes, it is a U.N. human rights violation to hold someone's passport against their will. I've known of private hospitals refusing to admit someone when they refused to turn over their passport. They were told to go to the government hospital.

[ThaiBob]

Several posts have suggested that a levy on foreigners would be small. How do they know that?

However large or small it might be, I would resent having to fund people who had no money, who avoided paying when they could or who don't have insurance.

The amount should be very small based on the published numbers. For example, a 27 million short fall for tourists and retirees equates to just a few baht increase in let's say the airport tax. If the government had simply quietly increased the tax this subject wouldn't even be discussed. But, as a matter of principle it is sweeping the dirt under the carpet and not addressing the issue of foreigners abusing the system.

[attrayant]

However large or small it might be, I would resent having to fund people who had no money, who avoided paying when they could or who don't have insurance.

How do you feel about childless citizens paying taxes for schools? Or how about people who've never had an auto accident but who have paid car insurance their entire lives? These are analogous situations where we understand that our contributions are for the societal good, even though we may never personally benefit from them. I wouldn't mind paying a small health tax if I knew it meant we'd all be covered.

As for the dirt poor foreigners who wouldn't even be able to afford the 200 baht (or whatever) monthly payment, well I expect that number is vanishingly small and could be covered by charitable contributions or other sources. Yes a few people might be left out, but at least we will have reduced the problem by several orders of magnitude.

[Morden]

However large or small it might be, I would resent having to fund people who had no money, who avoided paying when they could or who don't have insurance.

How do you feel about childless citizens paying taxes for schools? Or how about people who've never had an auto accident but who have paid car insurance their entire lives? These are analogous situations where we understand that our contributions are for the societal good, even though we may never personally benefit from them. I wouldn't mind paying a small health tax if I knew it meant we'd all be covered.

As for the dirt poor foreigners who wouldn't even be able to afford the 200 baht (or whatever) monthly payment, well I expect that number is vanishingly small and could be covered by charitable contributions or other sources. Yes a few people might be left out, but at least we will have reduced the problem by several orders of magnitude.

Your examples don't equate with the issue.

No-one who qualifies for insurance needs to be here unprotected. Those who can't get insurance are more likely to be of an age or health standard that they would avail themselves of medical care at the expense of others. Those who can't afford insurance shouldn't come.

Insured or well funded people paying a levy for uninsured or impecunious visitors is not the way to deal with this. paying for these voluntary travellers is not for the 'societal good'.

[jrtmedic]

At my age, despite being fit, healthy and with no previous medical history or pre existing conditions, the Insurance companies quote outrageously high rates for minimal cover.

I will not be "blackmailed" into paying exorbitant premiums and am fortunate to be in a situation whereby I am able to self insure at a significantly reduced rate. I am particularly outraged when I find many of these "health insurance packages" include cover for events (Maternity care) which I will never claim for !

I would support and pay into any Government scheme which could offer reasonable cover at a reasonable cost.

Edited May 11, 2013 by jrtmedic

[Soutpeel]

I would support and pay into any Government scheme which could offer reasonable cover at a reasonable cost.

I understand what your saying, but why should the Thai goverment provide reasonable cover at a reasonable cost for people who are not even nationals or PR of Thailand ?

[jrtmedic]

By offering Government based insurance the country could make it a reasonable condition to long term stays. I at least, if I were willing to pay exorbitant premiums, can obtain private insurance. Many people because of their medical history are either priced out of the market or are unable to obtain insurance at any price.

A Government scheme would ensure at least a substantial reduction in the debts owing to the Public Hospitals which are generated by people who are unable to obtain/afford private insurance.