Thailand's health care described as "cheap" in expat retirement overview

[sam sen]

healthcare is free where i come from. can't get cheaper than that

[Tolley]

I wouldn't want to get very sick in Thailand.

Very very expensive. And quality of healthcare is another issue.

No place to retire if you don't have good insurance.

Millions of baht could easily disappear treating a chronic condition.

[Jingthing]

I wouldn't want to get very sick in Thailand.

Very very expensive. And quality of healthcare is another issue.

No place to retire if you don't have good insurance.

Millions of baht could easily disappear treating a chronic condition.

I know, I know, but a whole lot of people are taking those kinds of risks.

[Sheryl]

And a whole lot of really bad situations unfold as a result. Trust me, I know......

[eppic]

I wouldn't want to get very sick in Thailand.

Very very expensive. And quality of healthcare is another issue.

No place to retire if you don't have good insurance.

Millions of baht could easily disappear treating a chronic condition.

I know, I know, but a whole lot of people are taking those kinds of risks.

I am from the U.S., new to Thailand after 14 years as a spoiled expat in Singapore.

First, I don't find healthcare here cheap, if you want quality care. I recently had a cyst removed (minor procedure) and cost was around US$700 including removal and follow-up visits. Cost in the U.S. would have been similar (this was Bumrungrad, btw, but I don't want a cheapo hospital). My wife is considering a a fibroid removal surgery, an we were quoted THB140,000+ (about US$4300 for a non-invasive surgery, no hospital stay. A little research indicated the cost would be a bit more in States (not dramatically so) and similar in a private hospital in the UK (wife is UK citizen)..

Overall, I find costs at Bumrangrad pretty similar to Mt E. in Singapore, which I lived next to and visited regularly. Again, this is by no means cheap, other than for very routine visits (no specialists, just for a sniffle or whatever).

As for insurance, I have been corresponding with BUPA, and their top "Platinum package" has a maximum cover of THB 5 million. I'm sorry, but this is absolutely peanuts, about US$150k, which would not cover any major illness such as cancer. It also has many exclusions and limitations that would make it mostly worthless. Pregnancy cover costs 22K bt/yr while only giving maximum of 40k benefit.

So, I decided it's not worth it. If I get very ill (high risk of cancer), I would simply return to the U.S. and sign up for the ACA (aka Obamacare) in a state with a good specialist hospital. Honestly, is it worth paying $US 5K/yr for $150K, very limited coverage? I certainly think not, so I don't know why anyone would bother with healthcare insurance here, so few illnesses would be adequately covered anyway.

And once again, specialist or complicated care at a good hospital in BKK is by no means cheap, though routine care would be quite affordable for those with even modest means

[Sheryl]

And what if you are too ill to travel?

What if you are in a traffic accident and require immediate on the spot care?

Or have a stroke, or heart attack?

There are dozens of scenarios in which your plan of just going back to the US would not work and believe me, I have seen people run into all of them here.

I have the BUPA Platinum Plan, and while I too wish the cover were higher, it is hardly worthless (and does not cost $5K a year, either, if you get only in-patient cover). It is rare for a single illness or accident to run over 5 mill baht, the only things likely to do that are the sort of semi-chronic issues like cancer, renal failure etc wherein a return home would usually be possible.

I strongly urge you to rethink insurance -- or else self-insure by setting aside at least 5 mill baht in readily accessible cash for medical emergencies.

One real value to insurance, especially if a well known local plan like BUPA Thailand, is that the card guarantees you smooth entry into a private hospital in an emergency. The fact that you have self-insured might not, as there could likely be some delays in process of contacting someone who could in turn get the funds and make an advance payment to the hospital. (ANd private hospitals here will turn you away, or hold off on treatment, if they are in any doubt as to your ability to pay...)

[eppic]

@Sheryl, Thanks for the feedback, you obviously have a lot more experience in Thailand than I do. Sorry if this has gotten slightly off topic, but permit me one brief reply:

As for the BUPA costs, you are correct, at my age the top in-patient only plan would cost me maybe THB90k+ (~US$3k), but I would consider that far from comprehensive insurance. It wasn't clear that it would even cover expensive procedures such as MRI/CT/PET scans if not admitted to the hospital, so investigations for many diseases may be precluded. But, perhaps I am mistaken about this.

Given my very low likelihood of cardio issues (just over 50, very fit), any emergency here would most likely come from an accident. Although, given that I live in Bangkok, Ratchaprasong, a stray bullet wouldn't be a surprise these days (or a drunk motorist), so perhaps cover for accidents is still worthwhile.

However, for me personally, I wouldn't be that worried about the first bt 5 million, but the next 25-50 million might be a bit of a concern [no decent U.S. plan would coverage less than US$1.0 million, or bt 30+ million], and that would not be covered by BUPA or any Thai plan that I have seen. I realize that everyone has a different situation, so coverage would certainly be very prudent for those with limited liquid assets.

Your last point, though, is something I had not really considered. Assuming I had been blown up at BIg C Ratchaprasong, a couple hundred meters from my home, what would happen at the hospital if I couldn't prove creditworthiness on the way to the hospital? So maybe it's worth having coverage, even if a lesser, basic plan, for that possibility alone.

[wym]

.....No need to try to make sure you're covered if you're willing to wear the risk.

When it's time for each of us to die, we should IMO just let go of life. Far too many use advanced medical technology to live long past the point where they're living useful lives, better to free up the resources for the young.

The problem is that people do not have an accurate, realistic understanding of what the risk is.

There is a vast field of experience and issues in between perfect health and "time to die". Most people do not simply go from completely fit and well to terminal/end of life. They spend decades with basic faculties intact but gradually increasing problems. Or they may even get serious problems will still young and with potentially decades of life left to live.

There is the pain of joints that have given out/need replacement in people who are 100% alert, with it, and likely to live another 30+ active years.

The effects of major accidents, at any age...multiple fractures, need for surgery...

etc etc etc.

Can't begin to count the number of horror situations I have seen emerge here because people blithely assumed they'd be OK until they were "ready to die", never anticipating all the in-between scenarios.

Most foreigners who retire here either come from countries with some type of universal health care coverage, or from the US where there is universal cover for those over 65. So the majority are in fact moving from a situation of good access to health care to one where they will potentially face financial barriers. That the "cost" of health care in Thailand is less than in many of these countries is misleading given that people rarely pay out of pocket for it there, whereas they may well have to in Thailand.

Yes of course, and I'm not in any way advocating that people that can afford good health insurance go without.

Nor that people shouldn't think long and hard about the consequences of being "irresponsible", both to themselves, their friends and family and society at large.

Just pointing out that there are many of us that aren't in a position to afford good (or any) coverage, and it isn't in fact irresponsible if we are TAKING responsibility, accepting the consequences of needing to top ourselves if and when the time comes.

For myself, even if I had all the health insurance in the world, I wouldn't want to live any longer if my quality of life because significantly impaired, requiring oxygen, drips, colostomy bags anything like that.

And that's my choice - I'm all for fully socialized medicine for those societies that want to go that way and can actually make the hard decisions required to afford it. But don't say people can't choose to live where they like unless they can afford the huge cost of medical care according to (in my opinion crazy inflated) back-home standards.

If I get in an accident that requires my leg to be amputated, and back home they would have saved the leg, so be it, I've made my bed and I'm willing to lie in it.

Up to me.

[CaptHaddock]

I wouldn't want to get very sick in Thailand.

Very very expensive. And quality of healthcare is another issue.

No place to retire if you don't have good insurance.

Millions of baht could easily disappear treating a chronic condition.

I know, I know, but a whole lot of people are taking those kinds of risks.

I am from the U.S., new to Thailand after 14 years as a spoiled expat in Singapore.

First, I don't find healthcare here cheap, if you want quality care. I recently had a cyst removed (minor procedure) and cost was around US$700 including removal and follow-up visits. Cost in the U.S. would have been similar (this was Bumrungrad, btw, but I don't want a cheapo hospital). My wife is considering a a fibroid removal surgery, an we were quoted THB140,000+ (about US$4300 for a non-invasive surgery, no hospital stay. A little research indicated the cost would be a bit more in States (not dramatically so) and similar in a private hospital in the UK (wife is UK citizen)..

Well, if the minimum acceptable care to you is the most expensive hospital in the country, then you are likely to find healthcare here expensive indeed.

Care in Thailand seems cheap to me though. You can search the story here of one fellow who got an aortic valve replacement at the govt hospital that has the most experience in such surgeries (not Bamrungrad.) In the US such an operation starts at $100,000, but can easily become $200,000 with any complication. This fellow got it done for about $6,000.

[Balance]

I'd still say it's cheap when you consider the cost of health care in places like America, maybe you have been here too long Jing and take the cheap for granted..

Of course but the article is correct, if you get something medically devastating, most people are going to be ruined financially in Thailand as well if they don't have good cover. Also, good cover isn't actually for sale to all here, based on age and preexisting conditions.

Which is why when considering moving abroad is making sure you get the right insurance for you to cover all eventualities, and if you can't afford the insurance then moving abroad is IMO a bad move...

As for those who have been here for years and are now finding that they can't afford or won't pay for it, or as you say can't get cover for certain things, then maybe it's time to pack up and go, or take the risk if things go wrong....

If you are over 70, or if you have preexisting conditions, you are SOL in Thailand or most 3rd world countries. U.S. Medicare will not cover anyone living overseas. I got a high end AIA policy with no preexisting conditions for 6,500 THB per month. This is about twice what I was paying for Medicare Part B, but there are no co-pays or co-insurance. Downside is that right now, AIA will cancel the minute I turn 80, and the premium increases each year.

Bottom line, this insurance is much less expensive that Medicare A & B when you consider that it covers you 100% until you reach a very high cap per admission. Past 80? Who knows; my father dropped dead from a stroke at 93 and perhaps I will be that lucky. Recommend everyone read The Bardo Thadol (the Tibetan Book of the Dead) that editied by Evan-Wentz.

[ThaiBob]

I just came from Bangkok Pattaya Hospital yesterday and had their "Essence Health Package". I prepaid at the end of last year, 3,000 baht. I had a full blood panel, chest xray, EKG, vitals, vision, and met with doctor to discuss results. This easily would have been 1,000 USD in America.

Year and a half ago, I was taken to the same hospital by emergency ambulance. The cost for everything was 19,000 baht, overnight stay, tests, emergency room, ambulance, etc. This is 50% of just the one mile ambulance ride I had in California recently.

My insurance copayment is just as expensive as a doctor's visit here so I don't bother filing a claim.

Yes, Thailand is still cheap but like everything else is getting more expensive. Being aged and is self insured is doable IF you have the self discipline to do your planning while you still can.

[Sheryl]

....As for the BUPA costs, you are correct, at my age the top in-patient only plan would cost me maybe THB90k+ (~US$3k),

Are you sure? I think at that age it would be morel like 2K...?

It will indeed not cover MRIs etc if done as an outpatient, but it will cover same day surgeries. I have had 2 such over the years, covered with no problem.

[eppic]

....As for the BUPA costs, you are correct, at my age the top in-patient only plan would cost me maybe THB90k+ (~US$3k),

Are you sure? I think at that age it would be morel like 2K...?

It will indeed not cover MRIs etc if done as an outpatient, but it will cover same day surgeries. I have had 2 such over the years, covered with no problem.

I stand corrected, I rechecked the BUPA numbers and you are right, $2k is closer, so actually not that bad. I think I would really need to view it as an emergency-only policy, though, since scans are a high cost item that are often needed to evaluate many medical conditions, and expensive, leading-edge drugs (such as current chemo / immunotherapy) would certainly not be covered/available. Overall, though, you've made a good case for me to reconsider coverage along with a back-up plan for covering expensive, more chronic conditions.

Regarding an earlier comment about Bumrungrad being very expensive. Yes, but if you truly want health care that is leading edge and of comparable quality to 1st world countries, I don't personally think looking for the cheapest option is the best choice. I would also look for the best regional hospital in my home country, so it seems valid to compare the most reputable here and in Singapore. Others might go to India because it can be far cheaper even than Thailand, but that wouldn't be on my agenda nor that of many others.

[Slinky1958]

My friend is 65 and he has only an AIA accident and life care card for 100000 baht what will he do if he falls ill and need s medical attention and hospital treatment it is a Plan top value card he also as no yellow book or residency letter but as a retirement visa

[TerryLH]

"At least one hospital in BKK accepted me without question."

"I am considering moving to Ubon very soon and there is a gov't hospital there, but not sure if they would accept me in case of need."

Is there some confusion about this?

The way hospitals work is that anyone can register at a hospital. They give you a card with a hospital number on it. That number allows the hospital to find your file each time you go there for service.

Sometimes people post here thinking they have a special deal because a hospital let them register, and gave them a card for the hospital.

Government hospitals will try to help anyone who shows up.

Do you like to travel? Have time on your hands? Want an odd hobby? Try to register at as many hospitals as possible. In theory, a person should be able to register at almost every hospital in Thailand. Not sure if all military hospitals would allow that, but I know some will.

Sheryl: "Only being offered in some locations, and some places that initially offered it have no rescinded it (i.e. Chiang Mai)"

Should that be, 'have now rescinded it',?

Terry

[Sheryl]

Yes, have now.

[Sheryl]

My friend is 65 and he has only an AIA accident and life care card for 100000 baht what will he do if he falls ill and need s medical attention and hospital treatment it is a Plan top value card he also as no yellow book or residency letter but as a retirement visa

If your friend's policy has a 100,000 baht limit then he will be out of pocket for all costs in excess of 100,000 baht -- an amount that will be exceeded in no time flat.

Are you sure this policy is only 100,00 baht? As that is virtually useless. A serious illness or accident can easily run to the millions of baht, even at a government hospital.

Type of visa and whether or not you have a yellow book is irrelevant. regardless of visa type, whether you have a yellow book etc etc, hospitals expect to be paid for the care they provide.

Private hospitals may refuse to admit you if they are in doubt as to ability to pay. Government hospitals wil not turn a seriously ill/injured person away, but they to expect to be paid.