Obamacare in Thailand

[Jingthing]

I tried to sign up but was told I can't because I live in Thailand.

I think that is the expected answer to applicants who are not presenting themselves as a U.S. state resident (whether they are or not).

[thailand49]

I tried to sign up but was told I can't because I live in Thailand.

Personally that is your problem! You told them you live in Thailand SO WHAT DO YOU THINK YOU GET POINTS FOR TELLING THEM THAT!

Get yourself a plan, minor treatment like you are doing now pay it out of your pocket, if you are diagnosed with a major problem and need a second opinion get your ass on a airplane and go home and get fixed.

Be stupid and play the part no one needs to know you are living here in Thailand. Just say you got sick traveling.. Now if you don't have a resident address go home and find a friend or family member who doesn't hate you and use their address!

Obama care are those who are not of Medicare age! and when you apply for Medicare do the same thing " Keep your month shut that you live here file and do the same as above! and when you get sick go back to " your ass on Airplane "

Sorry nothing personal but everyone is getting their share of money from the States, in particular every illegal immigrant so why not you! Countries like China, Soviet Union and every damn Mid-Eastern country got their hands out and you got to tell them you are living in Thailand! You have earned it and maybe fought for it basically when it comes to coverage I feel and think you deserve some payback for once!

Uncle Sam talks about a Global economy but can't insure someone like you or me when it was just reported our country gives each year something like 600 million to Hamas while they are tossing bombs right now!

Edited July 12, 2014 by thailand49

[curtklay]

You are walking a tightrope.

When the time comes to make a claim, they can easily confirm how much time you have spent in the US no matter what you tell them or don't tell them. It's all in your passport.

[ProThaiExpat]

I become a believer when I hear someone has actually received paid for care from an insurance carrier or state plan in Thailand!!!!

[Loptr]

To the OP, you DO NOT HAVE TO HAVE AN ACA POLICY.... Sorry to shout, but needed to get your attention...

Insurers are still offering policies in the US that are not a part of the ACA... They will not pay direct payments to overseas health providers, but will reimburse you for out-of-network health care... You pay for health care out-of-pocket, then file a claim with the insurance company for reimbursement... I just signed up for one of these policies through UHC last week and this was a specific question I asked, so this info is current...

[ClutchClark]

To the OP, you DO NOT HAVE TO HAVE AN ACA POLICY.... Sorry to shout, but needed to get your attention...

Insurers are still offering policies in the US that are not a part of the ACA... They will not pay direct payments to overseas health providers, but will reimburse you for out-of-network health care... You pay for health care out-of-pocket, then file a claim with the insurance company for reimbursement... I just signed up for one of these policies through UHC last week and this was a specific question I asked, so this info is current...

So if an American that is subject to US Income Tax were to purchase the coverage you did, would that coverage be sufficient to avoid the penalty for not having Obamacare?

[curtklay]

To the OP, you DO NOT HAVE TO HAVE AN ACA POLICY.... Sorry to shout, but needed to get your attention...

Insurers are still offering policies in the US that are not a part of the ACA... They will not pay direct payments to overseas health providers, but will reimburse you for out-of-network health care... You pay for health care out-of-pocket, then file a claim with the insurance company for reimbursement... I just signed up for one of these policies through UHC last week and this was a specific question I asked, so this info is current...

This is true, but the OP's pre-existing condition will probably exempt him from most of these plans. That's the big plus for ACA.

[thailand49]

You are walking a tightrope.

When the time comes to make a claim, they can easily confirm how much time you have spent in the US no matter what you tell them or don't tell them. It's all in your passport.

I can safely say from experience and seeing my own brother who also is living and use Bangkok/Pattaya for over ten years off and on pay for the treatment up front gotten his bills and taken it back and submitted it to his carrier and never once have taken the time to confirm how much time he has been away. Never has anyone ever ask for his passport. Personally that assumption that they would is laughable to me sorry!

Sure with national security being what it is today they can just simple put your name in a computer and know where you been. But for a government who can't seem to run anything REALLY going to find out or even ask! These people are basically clerks they are not National security you barely show up as a pimple unless you sound out that your are!

They can? but the chances are slim and none as far as I'm concern... when I signed up for Obama care in California exchange call Covered California the lady who ask all the questions was on the job for only a week and I told her I travel a lot so get it right because I will not be around if you need something again from me she said got everything! Two weeks later I'm back in Thailand and my cousin emails me that they sent me a letter saying they have no record of me being in America. I've been filing <deleted> taxes for fifty plus years and now they tell me I do not exist? They wanted proof so I FAX from Thailand a copy of my Passport, now I'm covered!

End of story! You guys that want to brag to the world or too scare to lie about things knock yourself out sorry but you get what you deserve. What they going to do put you in jail? in jail you can get free medical care and if you need a heart transplant or liver you have a better chance of getting one than the general people!

Do want politician and your own President do currently and all of them in the past! Lie Lie Lie to get what you need!

Edited July 12, 2014 by thailand49

[ClutchClark]

You are walking a tightrope.

When the time comes to make a claim, they can easily confirm how much time you have spent in the US no matter what you tell them or don't tell them. It's all in your passport.

I can safely say from experience and seeing my own brother who also is living and use Bangkok/Pattaya for over ten years off and on pay for the treatment up front gotten his bills and taken it back and submitted it to his carrier and never once have taken the time to confirm how much time he has been away. Never has anyone ever ask for his passport. Personally that assumption that they would is laughable to me sorry!

Sure with national security being what it is today they can just simple put your name in a computer and know where you been. But for a government who can't seem to run anything REALLY going to find out or even ask! These people are basically clerks they are not National security you barely show up as a pimple unless you sound out that your are!

They can? but the chances are slim and none as far as I'm concern... when I signed up for Obama care in California exchange call Covered California the lady who ask all the questions was on the job for only a week and I told her I travel a lot so get it right because I will not be around if you need something again from me she said got everything! Two weeks later I'm back in Thailand and my cousin emails me that they sent me a letter saying they have no record of me being in America. I've been filing <deleted> taxes for fifty plus years and now they tell me I do not exist? They wanted proof so I FAX from Thailand a copy of my Passport, now I'm covered!

End of story! You guys that want to brag to the world or too scare to lie about things knock yourself out sorry but you get what you deserve. What they going to do put you in jail? in jail you can get free medical care and if you need a heart transplant or liver you have a better chance of getting one than the general people!

Do want politician and your own President do currently and all of them in the past! Lie Lie Lie to get what you need!

I don't understand your post at all.

If an American HC Insurer is faced with a claim of any size, they can and will attempt to figure out reasons to avoid paying it. They do this as a matter of routine...even when the insured is 100% within policy guidelines.

Your brother is not within policy guidelines and so walks a tightrope as a previous poster has suggested.

Cheers

[poweratradio]

1) Did you qualify through Hawaii Health Connector (the ACA subsidized Plan)?

yes

2) What is your first day of enrollment/coverage?

I can't enroll until Nov 15 and coverage doesn't begin until 1/1/15. I don't know if I qualify for a subsidy or not.

3) You are enrolled in an "Indivudual" Plan?

yes

4) They said "Out of Network" coverage "includes" Thailand?

yes - using Blue Cross there will be direct payment. Otherwise I must pay and they will reimburse me.

5) What instructions did they provide to process a claim? You pay and they reimburse you?

see #4

The cheapest plan is $350/mo with a $6,350 deductible - then 100% payment. The plans get more liberal and max out at $830/mo. I'm more interested in the cheap plan - in case something catastrophic occurs.

Just let me die for those rates. Canada has nothing for offshore with pre existing and over 65 at deaths door insurance companies think....and in fact stay gone more than 6 months and lose pensions tell them and have an automatic tax withheld 0f 25%

[ClutchClark]

1) Did you qualify through Hawaii Health Connector (the ACA subsidized Plan)?

yes

2) What is your first day of enrollment/coverage?

I can't enroll until Nov 15 and coverage doesn't begin until 1/1/15. I don't know if I qualify for a subsidy or not.

3) You are enrolled in an "Indivudual" Plan?

yes

4) They said "Out of Network" coverage "includes" Thailand?

yes - using Blue Cross there will be direct payment. Otherwise I must pay and they will reimburse me.

5) What instructions did they provide to process a claim? You pay and they reimburse you?

see #4

The cheapest plan is $350/mo with a $6,350 deductible - then 100% payment. The plans get more liberal and max out at $830/mo. I'm more interested in the cheap plan - in case something catastrophic occurs.

Just let me die for those rates. Canada has nothing for offshore with pre existing and over 65 at deaths door insurance companies think....and in fact stay gone more than 6 months and lose pensions tell them and have an automatic tax withheld 0f 25%

How much is your monthly premium in Canada?

How much is the deductible and out-of-pocket you must meet annually?

How much is your co-pay for pharmacy?

Do you have vision & dental included?

The plan the OP has received is not an "off-shore" plan. It is supposed to be for people residing in the US, specifically, residing in Hawaii; however, it apparently includes Global "out-of-network" care for emergency/life threatening hospitalizations (although there are some who think this might need further clarity).

Hope this helps you feel better about your own Countries most excellent "non-profit" social healthcare system.

Edited July 12, 2014 by ClutchClark

[Jingthing]

Yeah if you buy something on false pretenses, when you REALLY need it, it may well backfire on you. I can certainly see that people who live part time in the U.S. and part time in Thailand should get U.S. coverage (it's mandated actually now) and then they can have it all set up when they're in the U.S. or even need to do an unexpected trip for that. Don't forget there are limited ENROLLMENT periods ... so people thinking they can always repatriate and instantly get on a plan ... well maybe if you're lucky with the timing.

[tac]

I hope the OP is correct, but I am skeptical.

Everything I have read about ACA clearly states that coverage is not available to full-time expats, and that treatment is only available within the US. If I am missing something, I would certainly appreciate being directed to further information.

Also, when I have researched pricing for various plans, I have not seen any that are as high as what the OP quotes ($350 per month with a $6K deductible).

As said, for the OP's sake I hope he is correct, but I suspect there is a misunderstanding somewhere. Please correct me if I am wrong.

Even though I live in Thailand - I have a non-O retirement extension visa, I have a house in Hawaii and pay taxes there. I was up front with the lady from HMSI and told her I spend most of my time in Thailand. She put me on hold while she had a long talk with her supervisor then told me there would be no problem. It's certainly possible they both may be incorrect, but I was clear about my situation, and they seemed confident about their reply.

I guess I should try to get something in writing.

Edited July 12, 2014 by tac

[Jingthing]

They are treating you as a legal resident of Hawaii which it sounds like you actually are even though you spend "most" of your time in Thailand. So in that sense I am not so surprised you could purchase coverage. What would surprise me is if you have a chronic condition with regular expenses, month after month, ALL coming from Thailand, if this company doesn't review your case and decide you weren't ever really eligible for this. Obviously different states are doing different things as well.

[tac]

They are treating you as a legal resident of Hawaii which it sounds like you actually are even though you spend "most" of your time in Thailand. So in that sense I am not so surprised you could purchase coverage. What would surprise me is if you have a chronic condition with regular expenses, month after month, ALL coming from Thailand, if this company doesn't review your case and decide you weren't ever really eligible for this. Obviously different states are doing different things as well.

In reality, if someone were to develop such a chronic condition, the insurance company should thank their lucky stars that person chose to get treatment in a country where the costs were 50%-80% cheaper then the U.S.!

[ClutchClark]

They are treating you as a legal resident of Hawaii which it sounds like you actually are even though you spend "most" of your time in Thailand. So in that sense I am not so surprised you could purchase coverage. What would surprise me is if you have a chronic condition with regular expenses, month after month, ALL coming from Thailand, if this company doesn't review your case and decide you weren't ever really eligible for this. Obviously different states are doing different things as well.

In reality, if someone were to develop such a chronic condition, the insurance company should thank their lucky stars that person chose to get treatment in a country where the costs were 50%-80% cheaper then the U.S.!

Tac,

Ain't that the truth ;-)

As was just mentioned, the additional information you just provided about residency status (homeownership & State Income tax) would undoubtedly be a good argument in the event the Insurer did ever deny your claims in the future.

I suppose the key here is how they choose to define "residency" -- i.e. Does it require a physical presence in the State for "X" number of days per annum.

For me, and I think many Americans, the trick is trying to actually nail down the specifics of the ACA. In fact, as recently as 6 months ago, I heard several instances where agents themselves were still scrambling to understand their own policies ;-) and it appeared the entire focus was just increasing "enrollment".

I have read that trying to increase "enrollment" will continue to be the goal for another couple of years and to gain market share from their competition. Perhaps that was part of their motivation in your case. Somewhere down the road, they might start investigating claims and claimants' eligibility status more closely if their claims start creating a net loss for the insurer. The ACA that America is stuck with was designed by and created for the Healthcare Industry after all.

Adding to the confusion in the US and here on TV is that each State is allowed to define their own unique plans from every other state as long as certain core principles are adhered to. The cost of monthly premiums varies widely from State-to-State as well and even within the same State (rural markets costing more than urban).

The main thing is you were able to obtain coverage and can shortly put it to the test IF you intend to submit invoices from Thai doctors and facilities.

Edited July 12, 2014 by ClutchClark

[Mrjlh]

Look at the issue from this viewpoint. You might be able to sign up and pay a monthly fee to get ACA. But how are you going to get re-reimbursed for medical treatment? Submit bills from a foreign country hospital or doctor and expect a check? Seems to me that becomes the problem due to the insurance plan not recognizing a foreign hospital bill. Then if they do pay, where are you going to cash that check? It's not always easy to cash checks here. Unless it specifically states in "writing" you will be paying for service but won't get the outcome you are looking for.

[Jingthing]

They are treating you as a legal resident of Hawaii which it sounds like you actually are even though you spend "most" of your time in Thailand. So in that sense I am not so surprised you could purchase coverage. What would surprise me is if you have a chronic condition with regular expenses, month after month, ALL coming from Thailand, if this company doesn't review your case and decide you weren't ever really eligible for this. Obviously different states are doing different things as well.

In reality, if someone were to develop such a chronic condition, the insurance company should thank their lucky stars that person chose to get treatment in a country where the costs were 50%-80% cheaper then the U.S.!

Zero percent even cheaper.

Good luck.

[thailand49]

My last word on this subject... as harsh as I have been I believe it is a individual choice as to what you want to do! Reading the last few post I will try my best to address them the best I can in my own frustrating style.

The people who are working on these exchanges are all in the learning process they have been pushed into signing up people not even their supervisors know the real answer. Remember there are thousands of pages thousands? Like many insurance coverage at your work you are covered when you travel only at hospital that are International Accredited! Like Bangkok/Pattaya Hospital or Bumrungrad in Bangkok.

Usually these places will ask you if you need a invoice for your insurance company and it will be provided in my case English not sure about others? The invoices clearly states what the services were for and your Insurance company in general have a out of network clause or a International rate chart for services overseas? You can't go to the clinic and expect to be repaid!

Using your head the old fashion way solves lots of problem. Some said how you cash the check etc.... Majority of these International Accredited hospital DO NOT DO DIRECT BILLING TO YOUR INSURANCE COMPANY BACK HOME! Here is what my brother does... he takes all the bills and FedEx it back home to my cousin who monitor our mail.. once she gets the delivery she pulls it into a general envelope and mail it. When the claim is process and a check is cut and sent to his house. She takes the check sign them and mail them to his Credit Union for deposit now he has access to his money via ATM! He has been doing this now for nearly 10 years! there are thousand of claims being process personally they do not have time.

Here is what happen recently,, the insurance policy I selected ask me to pick a Doctor from their list which I did and left it with my cousin when the Insurance invoice comes pay it and attach the selection with the invoice she did exact as ask! Later I'm left a message on my U.S. phone saying I did not make a selection that I needed to call or they will assign one for me. I ended up picking up the message late and calling and when I did the insurance had already assign me one. I ask to change to one closer and sorry I was not able to call earlier since I was OUT OF THE COUNTRY! he responded " why didn't you tell us " I politely replied " what are you my mother do I need to tell you where I go each day and ended " what I do each day and where I go is none of your business! ".

And if this is a tightrope to some then DON'T DO IT! sure signing checks and such might be all illegal to some of you! not to me! There are many plans in these exchanges many offered by current Insurance company in business. The more you want to pay the more options you have to hospital and Doctor. The plan I pick is the cheapest I must stay within the network and my listed physician assigned I must see first and he or she refers me to hospital and clinics for further test if needed.

Good luck to all of you who choose or do not choose to tell the government where you are?

[DannyTheWriter]

The way I understand it, every state system is different. If your residence is in New York (as mine is), it is impossible to buy any policy that includes out-of-network coverage. Every available policy specifically excludes overseas coverage.

Sent from my iPad using Tapatalk

[ClutchClark]

My last word on this subject... as harsh as I have been I believe it is a individual choice as to what you want to do! Reading the last few post I will try my best to address them the best I can in my own frustrating style.

The people who are working on these exchanges are all in the learning process they have been pushed into signing up people not even their supervisors know the real answer. Remember there are thousands of pages thousands? Like many insurance coverage at your work you are covered when you travel only at hospital that are International Accredited! Like Bangkok/Pattaya Hospital or Bumrungrad in Bangkok.

Usually these places will ask you if you need a invoice for your insurance company and it will be provided in my case English not sure about others? The invoices clearly states what the services were for and your Insurance company in general have a out of network clause or a International rate chart for services overseas? You can't go to the clinic and expect to be repaid!

Using your head the old fashion way solves lots of problem. Some said how you cash the check etc.... Majority of these International Accredited hospital DO NOT DO DIRECT BILLING TO YOUR INSURANCE COMPANY BACK HOME! Here is what my brother does... he takes all the bills and FedEx it back home to my cousin who monitor our mail.. once she gets the delivery she pulls it into a general envelope and mail it. When the claim is process and a check is cut and sent to his house. She takes the check sign them and mail them to his Credit Union for deposit now he has access to his money via ATM! He has been doing this now for nearly 10 years! there are thousand of claims being process personally they do not have time.

Here is what happen recently,, the insurance policy I selected ask me to pick a Doctor from their list which I did and left it with my cousin when the Insurance invoice comes pay it and attach the selection with the invoice she did exact as ask! Later I'm left a message on my U.S. phone saying I did not make a selection that I needed to call or they will assign one for me. I ended up picking up the message late and calling and when I did the insurance had already assign me one. I ask to change to one closer and sorry I was not able to call earlier since I was OUT OF THE COUNTRY! he responded " why didn't you tell us " I politely replied " what are you my mother do I need to tell you where I go each day and ended " what I do each day and where I go is none of your business! ".

And if this is a tightrope to some then DON'T DO IT! sure signing checks and such might be all illegal to some of you! not to me! There are many plans in these exchanges many offered by current Insurance company in business. The more you want to pay the more options you have to hospital and Doctor. The plan I pick is the cheapest I must stay within the network and my listed physician assigned I must see first and he or she refers me to hospital and clinics for further test if needed.

Good luck to all of you who choose or do not choose to tell the government where you are?

Thanks for the reminder about Nationally Accredited.

You do understand that its not the government that is asking your whereabouts--it is a private corporation that you have a contractual agreement with.

Granted, the government has made it a law that you have to enter into that private agreement; however, the govt could care a less where you are each day...as long as you pay your taxes like every other responsible American.

Thanks for the post but I still don't understand if you have been receiving "non-life threatening" medical care in Thailand and getting reimbursed? And I don't understand if your primary care physician is giving you referrals to providers in Thailand.

Cheers

Edited July 13, 2014 by ClutchClark

[OMGImInPattaya]

My understanding of the ACA is it only applies for medical treatment received in the US or a US territory.

There are some threads that discussed ObamaCare here on thaivisa so a search might help:

http://www.thaivisa.com/forum/topic/705761-enroll-in-obamacare/

Yet, that same law requires you to maintain an American insurance policy, while living in Thailand, that you cannot use here. Or you will be subject to an annual fine that goes up to 96,000 baht per year. Yes, Obama gave into the mandatory provision, as he gives into everything the lobbyists ask for. There is a real stink in the senate over this, but from what I hear it is still in effect. Want to hear the real kicker? An American who lives overseas for over 330 days per year is exempt. Want to know how the insurance companies worked around the exemption? You have to be paying income tax in your country of residence, in order to qualify for that exemption. Can you believe that? How many Americans do you think pay income tax in Thailand? This leader of ours is bought and paid for. He is owned by the lobbyists. He works for them, and not for the citizens of his country.

Spidermike

Sent from my iPad using Thaivisa Connect

I am not required to buy this coverage. Since I am a non-resident of the US. I am required to pay taxes in Thailand, but I do not because I have no income. But, even though it's not required, I am exceedingly grateful I'm allowed to buy this insurance despite my pre-existing conditions. For me, this is a very good law.

I doubt very much that you are covered by any ACA plan...either from a state or federal exchange. Most (all?) of the plans have lists of approved doctors/hospitals and I highly doubt, in fact I'm 99.99999% sure there are no Thai doctors or hospitals on any of those lists. As was said originally, the ACA is for Americans living and/or working IN the good o'le USofA. Like Medicare, us stupid federal taxpayers who live outside the fatherland are not covered for any treatment for illness or injury outside the United States. Now, if you were a member of the US military-industrial complex, and spent any time since WWII killing yellow, brown, and black-skinned people on Uncle Sam's orders, they you would of course be covered. You figure that one out.

But getting back to the ACA, I'm sure what whoever you spoke with in HI thought you were a HI legal resident and was under the impression you were traveling to Thailand short-term for vacation, work, family visit, etc. and not living full-time there. Therefore, you would be covered (like a private travel health policy) for illness and accidents. It's the same for all the other exchange policies...they provide overseas coverage provided one is there for the aforementioned reasons. The policies do not provide health insurance for Americans who are basically full-time expatriates (either working or retired).

[ClutchClark]

My understanding of the ACA is it only applies for medical treatment received in the US or a US territory.

There are some threads that discussed ObamaCare here on thaivisa so a search might help:

http://www.thaivisa.com/forum/topic/705761-enroll-in-obamacare/

Yet, that same law requires you to maintain an American insurance policy, while living in Thailand, that you cannot use here. Or you will be subject to an annual fine that goes up to 96,000 baht per year. Yes, Obama gave into the mandatory provision, as he gives into everything the lobbyists ask for. There is a real stink in the senate over this, but from what I hear it is still in effect. Want to hear the real kicker? An American who lives overseas for over 330 days per year is exempt. Want to know how the insurance companies worked around the exemption? You have to be paying income tax in your country of residence, in order to qualify for that exemption. Can you believe that? How many Americans do you think pay income tax in Thailand? This leader of ours is bought and paid for. He is owned by the lobbyists. He works for them, and not for the citizens of his country.

Spidermike

Sent from my iPad using Thaivisa Connect

I am not required to buy this coverage. Since I am a non-resident of the US. I am required to pay taxes in Thailand, but I do not because I have no income. But, even though it's not required, I am exceedingly grateful I'm allowed to buy this insurance despite my pre-existing conditions. For me, this is a very good law.

I doubt very much that you are covered by any ACA plan...either from a state or federal exchange. Most (all?) of the plans have lists of approved doctors/hospitals and I highly doubt, in fact I'm 99.99999% sure there are no Thai doctors or hospitals on any of those lists. As was said originally, the ACA is for Americans living and/or working IN the good o'le USofA. Like Medicare, us stupid federal taxpayers who live outside the fatherland are not covered for any treatment for illness or injury outside the United States. Now, if you were a member of the US military-industrial complex, and spent any time since WWII killing yellow, brown, and black-skinned people on Uncle Sam's orders, they you would of course be covered. You figure that one out.

But getting back to the ACA, I'm sure what whoever you spoke with in HI thought you were a HI legal resident and was under the impression you were traveling to Thailand short-term for vacation, work, family visit, etc. and not living full-time there. Therefore, you would be covered (like a private travel health policy) for illness and accidents. It's the same for all the other exchange policies...they provide overseas coverage provided one is there for the aforementioned reasons. The policies do not provide health insurance for Americans who are basically full-time expatriates (either working or retired).

Wouldn't the fact he has to wait for the next "open enrollment" period indicate that it is an ACA Plan since that is only an ACA requirement, enrollment being Jan-Mar of each calendar year?

[OMGImInPattaya]

I tried to sign up but was told I can't because I live in Thailand.

Personally that is your problem! You told them you live in Thailand SO WHAT DO YOU THINK YOU GET POINTS FOR TELLING THEM THAT!

Get yourself a plan, minor treatment like you are doing now pay it out of your pocket, if you are diagnosed with a major problem and need a second opinion get your ass on a airplane and go home and get fixed.

Be stupid and play the part no one needs to know you are living here in Thailand. Just say you got sick traveling.. Now if you don't have a resident address go home and find a friend or family member who doesn't hate you and use their address!

Obama care are those who are not of Medicare age! and when you apply for Medicare do the same thing " Keep your month shut that you live here file and do the same as above! and when you get sick go back to " your ass on Airplane "

Sorry nothing personal but everyone is getting their share of money from the States, in particular every illegal immigrant so why not you! Countries like China, Soviet Union and every damn Mid-Eastern country got their hands out and you got to tell them you are living in Thailand! You have earned it and maybe fought for it basically when it comes to coverage I feel and think you deserve some payback for once!

Uncle Sam talks about a Global economy but can't insure someone like you or me when it was just reported our country gives each year something like 600 million to Hamas while they are tossing bombs right now!

No so easy to get one's ass to a hospital, let alone on a plane for a 20 hour flight to the USA, when having a massive heart-attack or stroke or have just been in a smash-up in a car or on a moto! What you are advising may work for major elective surgeries, where one can plan a trip back to the States. Of course, when you present with a major (though elective) medical condition at your MD there may be some questions about where you've been all this time (and of course getting in for an appointment with no history with the plan or MD won't be that easy either), how you found out about your condition, and why no prior visits or consultations. The insurer may also have some questions along these lines when it comes time to pay the doctor and hospital costs and may do a little investigation of their own.

So you can try it your way if you want and maybe it will work out for you. But like I said, just try to avoid those non-elective strokes and heart attacks and accidents while enjoying living in Thailand.

Edited July 13, 2014 by OMGImInPattaya

[OMGImInPattaya]

I doubt very much that you are covered by any ACA plan...either from a state or federal exchange. Most (all?) of the plans have lists of approved doctors/hospitals and I highly doubt, in fact I'm 99.99999% sure there are no Thai doctors or hospitals on any of those lists. As was said originally, the ACA is for Americans living and/or working IN the good o'le USofA. Like Medicare, us stupid federal taxpayers who live outside the fatherland are not covered for any treatment for illness or injury outside the United States. Now, if you were a member of the US military-industrial complex, and spent any time since WWII killing yellow, brown, and black-skinned people on Uncle Sam's orders, they you would of course be covered. You figure that one out.

But getting back to the ACA, I'm sure what whoever you spoke with in HI thought you were a HI legal resident and was under the impression you were traveling to Thailand short-term for vacation, work, family visit, etc. and not living full-time there. Therefore, you would be covered (like a private travel health policy) for illness and accidents. It's the same for all the other exchange policies...they provide overseas coverage provided one is there for the aforementioned reasons. The policies do not provide health insurance for Americans who are basically full-time expatriates (either working or retired).

Wouldn't the fact he has to wait for the next "open enrollment" period indicate that it is an ACA Plan since that is only an ACA requirement, enrollment being Jan-Mar of each calendar year?

I did allot of research on the ACA and expatriates last year when the first enrollment period was coming up because for many of us living overseas the option to buy an affordable plan that would cover us in Thailand (or wherever) would be something useful. All my research basically lead to the conclusion that ACA plans do not provide coverage for Americans living (that's the key) abroad. I think some people are confusing or trying to twist the travel coverage provided in these plans to cover their living abroad. Don't forget, these are private insurance policies, subsidized by the Federal government. The coverage and prices are based on the insurers' knowledge of the costs and patient actuarial data from various state and local health insurance markets. The companies wouldn't even know how to price a policy for someone living overseas, let alone Thailand.

I don't know what you are asking about the open enrollment period...all health insurance plans, ACA, private, employer, etc. have open enrollment periods when people can change policies or insurers. The ACA does too, and it's also possible to sign-up for coverage any time of the year if one has a "qualifying event." Like lets say I moved back to CA next month, August, then I could contact CA Covered (the state exchange) and select a plan and get covered immediately. If one missed the deadline earlier this year, and don't have a qualifying event as a reason, then yes, they have to wait till the next open enrollment period.

This fella you are quoting may in fact have bought an ACA policy or intends to buy one next enrollment, but it won't provide any coverage in Thailand, unless he's a genuine HI resident (not that he used to be or still is but doesn't live there per the number of days required per year) and visiting Thailand.

[Balance]

Jingthing,

You sound certain that I can't buy any Obamacare policy that will cover me here. May I ask how you came to be so sure? Do you work in the insurance industry? Have you done some research into this? I'm not trying to be disrespectful, it's just that I really want to buy a policy, if that's at all possible.

None of the U.S. Government health insurance plans (Medicare and Medicaid) pay for coverage outside the U.S. except in the cases of Emergency for people on Medicare, and if you are retired military covered under TriCare. I am guessing that Medicare coverage will be extended to expats in the next 5 years or so if a democrat is elected President in 2016, but the House may continue to be a problem unless we can get rid of the wackos running it.

As far as the ACA is concerned. You need to go through the process of applying assuming that you can prove U.S. residence and then see if you can find a plan that will pay for traveling. But it is not likely and if you have a big bill here, you will still have to pay the bill here out of pocket and submit the paperwork for reimbursement.

Good luck to you.

[curtklay]

thailand49 is clearly operating illegally, and if his brother has been doing this scam for 10 years, he is not in an ACA plan. He seems to think the risk is small, but his foresight is clouded by his political bitterness.

"Lie, lie, lie to get what you need" is not a great philosophy. I would not want to be in either of their shoes when they submit a large claim and an insurance investigator decides to have a look.

tac: Considering your home ownership in Hawaii, you may well be OK, but definitely get it in writing!

Edited July 13, 2014 by curtklay

[spidermike007]

My understanding of the ACA is it only applies for medical treatment received in the US or a US territory.

There are some threads that discussed ObamaCare here on thaivisa so a search might help:

http://www.thaivisa.com/forum/topic/705761-enroll-in-obamacare/

Yet, that same law requires you to maintain an American insurance policy, while living in Thailand, that you cannot use here. Or you will be subject to an annual fine that goes up to 96,000 baht per year. Yes, Obama gave into the mandatory provision, as he gives into everything the lobbyists ask for. There is a real stink in the senate over this, but from what I hear it is still in effect. Want to hear the real kicker? An American who lives overseas for over 330 days per year is exempt. Want to know how the insurance companies worked around the exemption? You have to be paying income tax in your country of residence, in order to qualify for that exemption. Can you believe that? How many Americans do you think pay income tax in Thailand? This leader of ours is bought and paid for. He is owned by the lobbyists. He works for them, and not for the citizens of his country.

Spidermike

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I am not required to buy this coverage. Since I am a non-resident of the US. I am required to pay taxes in Thailand, but I do not because I have no income. But, even though it's not required, I am exceedingly grateful I'm allowed to buy this insurance despite my pre-existing conditions. For me, this is a very good law.

I doubt very much that you are covered by any ACA plan...either from a state or federal exchange. Most (all?) of the plans have lists of approved doctors/hospitals and I highly doubt, in fact I'm 99.99999% sure there are no Thai doctors or hospitals on any of those lists. As was said originally, the ACA is for Americans living and/or working IN the good o'le USofA. Like Medicare, us stupid federal taxpayers who live outside the fatherland are not covered for any treatment for illness or injury outside the United States. Now, if you were a member of the US military-industrial complex, and spent any time since WWII killing yellow, brown, and black-skinned people on Uncle Sam's orders, they you would of course be covered. You figure that one out.

But getting back to the ACA, I'm sure what whoever you spoke with in HI thought you were a HI legal resident and was under the impression you were traveling to Thailand short-term for vacation, work, family visit, etc. and not living full-time there. Therefore, you would be covered (like a private travel health policy) for illness and accidents. It's the same for all the other exchange policies...they provide overseas coverage provided one is there for the aforementioned reasons. The policies do not provide health insurance for Americans who are basically full-time expatriates (either working or retired).

I believe you are correct. There are massive provisions that compel expat Americans to pay into the system, without receiving any benefits. The compulsory clause is still in effect, I am fairly certain. And the fact that he does not pay income tax in Thailand, despite the fact that he does not earn enough to have to pay, I would guess would be enough to disqualify. Do not forget. These laws were written to enrich the insurance companies, and were written by the companies themselves. Did Obama vet these laws? Yes. Did he say no to any of the most egregious aspects of these laws? No.

And in regard to your comment about a veteran of war getting coverage, while that is true on paper, what about the millions of vets who have been waiting months to get in to see a doctor? The VA secretary was fired for a reason. His department was doing horrendously bad work. And though these thoughtless presidents lobby hard to put our men in harms way, they do not put the same amount of vigor into seeing that they are taken care of, when they return homes with limbs blown off. Shame on them for that. Shame on Obama for that. He cares little for these men in uniform. He has shown that repeatedly.

[Jingthing]

Bona fide expats are completely EXEMPT from any obligation to have/purchase U.S. insurance coverage. Now on the other hand, if you don't meet the definition of bona fide expat, you indeed ARE required to have U.S. insurance coverage or be subject to penalties.

For example, a state resident of Texas who lives 10 months in Texas and 2 months in Thailand is NOT an expat. Such a person is required to have U.S. coverage. He is not required to have coverage in Thailand.

ACA/Obamacare is NOT nationalized/government health care!

An "ACA" policy is just a policy from a FOR PROFIT private insurance company that meets the requirements of the ACA law.

Private policies under ACA are subsidized based on income ... wealthier people pay full freight.

Government health care programs that already existed still exist such as Medicare (for elders over 65) and Medicaid (a poverty program).

In the U.S. states controlled by right wing republicans for the most part they have refused to cooperate with "EXPANDED" medicaid. Basically Medicaid is for people in severe poverty and expanded medicaid includes millions of Americans who are somewhat less poor. In effect, most of these people remain uncovered even with ACA going into effect. That's politics for you.

I think too many people think ACA is nationalized health care like in Canada or the U.K. NOT EVEN CLOSE!

Edited July 13, 2014 by Jingthing

[richard10365]

I tried to sign up but was told I can't because I live in Thailand.

Personally that is your problem! You told them you live in Thailand SO WHAT DO YOU THINK YOU GET POINTS FOR TELLING THEM THAT!

Get yourself a plan, minor treatment like you are doing now pay it out of your pocket, if you are diagnosed with a major problem and need a second opinion get your ass on a airplane and go home and get fixed.

Be stupid and play the part no one needs to know you are living here in Thailand. Just say you got sick traveling.. Now if you don't have a resident address go home and find a friend or family member who doesn't hate you and use their address!

Obama care are those who are not of Medicare age! and when you apply for Medicare do the same thing " Keep your month shut that you live here file and do the same as above! and when you get sick go back to " your ass on Airplane "

Sorry nothing personal but everyone is getting their share of money from the States, in particular every illegal immigrant so why not you! Countries like China, Soviet Union and every damn Mid-Eastern country got their hands out and you got to tell them you are living in Thailand! You have earned it and maybe fought for it basically when it comes to coverage I feel and think you deserve some payback for once!

Uncle Sam talks about a Global economy but can't insure someone like you or me when it was just reported our country gives each year something like 600 million to Hamas while they are tossing bombs right now!

They also said I don't have to sign up.

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