Taking the ultimate gamble with medical insurance

[jvs]

At Chiangmai, you will find Bupa UK and Bupa Thailand are not really the same,just go get a quote.

I tmakes a big difference if worldwide coverage or not.

[DavoTheGun]

OK so what happens if A Farang gets very ill and is taken to Hospital where he has to have Surgery to survive, and he has no money, what do they do?

[kurnell]

I drink (more than most), eat poorly, never exercise, smoke (when I drink) and I never visit doctors unless something is hanging off. I self diagnose and after 20 years think I am almost a qualified doctor, so much so that my mates come to me for a diagnosis and treatment. I've never spent a night in hospital in my life, but I am insured, mainly because my company pays for it. However, even if my company didn't pay, I would get health insurance (for serious/expensive complaints) as I don't want to lose my fortune in medical bills and leave my family destitute.

You don't need insurance. You need a change of lifestyle. And quick.

Cannot do my friend. I just had 70 craft beers, a case of Hoegaarden, a case of Leffe, 12 bottles of Absolut, 2 Bacardi, 2 Gin, 1 Grey Goose, 2 Ardbeg, 4 bottles of champagne, 40 assorted bottles of wine + other things I haven't even looked at delivered to my house, so the current lifestyle will have to linger for a week or 2.

[Card]

I drink (more than most), eat poorly, never exercise, smoke (when I drink) and I never visit doctors unless something is hanging off. I self diagnose and after 20 years think I am almost a qualified doctor, so much so that my mates come to me for a diagnosis and treatment. I've never spent a night in hospital in my life, but I am insured, mainly because my company pays for it. However, even if my company didn't pay, I would get health insurance (for serious/expensive complaints) as I don't want to lose my fortune in medical bills and leave my family destitute.

You don't need insurance. You need a change of lifestyle. And quick.

Cannot do my friend. I just had 70 craft beers, a case of Hoegaarden, a case of Leffe, 12 bottles of Absolut, 2 Bacardi, 2 Gin, 1 Grey Goose, 2 Ardbeg, 4 bottles of champagne, 40 assorted bottles of wine + other things I haven't even looked at delivered to my house, so the current lifestyle will have to linger for a week or 2.

I hope you live long enough to enjoy them all :-)

I used to drink every day for about 10 years. I had a major check up at Bumrungrad and found I had a fatty liver - no idea I had one, but it was a severe warning and I cut right down, ate better, and started exercises daily and lost about 24 pounds in weight and no more fatty liver. Never felt better in my life, even as a teenager. Best thing I ever did, apart from stopping smoking 25 years ago. I still drink about once or twice a week but feel so much better the days I don't.

Edited September 16, 2014 by Card

[kurnell]

I drink (more than most), eat poorly, never exercise, smoke (when I drink) and I never visit doctors unless something is hanging off. I self diagnose and after 20 years think I am almost a qualified doctor, so much so that my mates come to me for a diagnosis and treatment. I've never spent a night in hospital in my life, but I am insured, mainly because my company pays for it. However, even if my company didn't pay, I would get health insurance (for serious/expensive complaints) as I don't want to lose my fortune in medical bills and leave my family destitute.

You don't need insurance. You need a change of lifestyle. And quick.

Cannot do my friend. I just had 70 craft beers, a case of Hoegaarden, a case of Leffe, 12 bottles of Absolut, 2 Bacardi, 2 Gin, 1 Grey Goose, 2 Ardbeg, 4 bottles of champagne, 40 assorted bottles of wine + other things I haven't even looked at delivered to my house, so the current lifestyle will have to linger for a week or 2.

I hope you live long enough to enjoy them all :-)

I used to drink every day for about 10 years. I had a major check up at Bumrungrad and found I had a fatty liver - no idea I had one, but it was a severe warning and I cut right down, ate better, and started exercises daily and lost about 24 pounds in weight and no more fatty liver. Never felt better in my life, even as a teenager. Best thing I ever did, apart from stopping smoking 25 years ago. I still drink about once or twice a week but feel so much better the days I don't.

All well and good for some, I agree. I did meet an 85 year old in Washington Square one afternoon who told me he drank and smoked every day for the last 70 years, so it's not all bad news.

[pomchop]

I stopped buying medical insurance over ten years ago, I'm 64 and I self insure. I reckon I have paid medical bills here in Thailand to the tune of around 250k Baht but I've saved over seven or eight times that amount in insurance premiums. It's not for everyone and of course the risk increases as you get older. But if you have the money and can set aside say three million at age 40, invest it sensibly and let it build up, it's always there in the event of a medical emergency.

I reckon I have paid medical bills here in Thailand to the tune of around 250k Baht but I've saved over seven or eight times that amount in insurance premiums.[/size]

8 times Baht 250,000 would be Baht 2,000,000. If you spent that much on medical insurance over ten years, you would have had premiums of Baht 200,000 a year, when you were in your 50's. Makes no sense. [/size]

Some of the other comments in this thread make no sense for Thailand either.[/size]

Maybe just take major medical which only pays if you are admitted to the hospital but would not pay for any everyday type doctor visits. At your age it would be pretty cheap and it will protect you from the BIG bills....keep in mind that there may be limited coverage for motorbike accidents though.

Insurance on offer in Thailand, like BUPA, is hospital insurance. Unless you add on highly uneconomic out-patient care coverage, the only time your insurance will pay is when you are admitted to hospital and, possibly, for emergency/accident treatment.

And some of you use the term "major medical," clearly without any idea what it means.

Major medical insurance is a form of health care coverage that provides benefits for most types of medical expenses that may be incurred. Offering more complete coverage with fewer gaps, major medical insurance covers a much broader range of medical expenses - including those incurred both in and out of the hospital - with generally higher individual benefits and policy maximum limits. These more extensive medical insurance policies are divided into two general groups: comprehensive major medical insurance, in which the traditional basic coverages and essentially any other type of medical expense are combined into a single comprehensive policy; and supplemental major medical insurance, in which coverage begins with a traditional basic policy that pays first, with the major medical coverage added to pick up expenses left uncovered by the initial basic policy. Let's look at each of these groups and examine how the generally operate.

give me a break..i think I know what major medical in Thailand is as I carried a BUPA policy for many years....and as I said just the kind that pays if you are admitted to a hospital which is exactly what I had and BUPA called it major medical(inpatient)....but feel free to complicate what was a simple answer to a simple OP question.

Edited September 16, 2014 by pomchop

[Card]

OK so what happens if A Farang gets very ill and is taken to Hospital where he has to have Surgery to survive, and he has no money, what do they do?

They would most likely do the op and ask you for the cash afterwards or you get booted out of the hospital and maybe the country. But do you really want to be in debt to a hospital in Thailand that saved your life?

[canopus1969]

OK so what happens if A Farang gets very ill and is taken to Hospital where he has to have Surgery to survive, and he has no money, what do they do?

You are assuming they would admit him without proof of insurance or money ...

[Card]

You don't need insurance. You need a change of lifestyle. And quick.

Cannot do my friend. I just had 70 craft beers, a case of Hoegaarden, a case of Leffe, 12 bottles of Absolut, 2 Bacardi, 2 Gin, 1 Grey Goose, 2 Ardbeg, 4 bottles of champagne, 40 assorted bottles of wine + other things I haven't even looked at delivered to my house, so the current lifestyle will have to linger for a week or 2.

I hope you live long enough to enjoy them all :-)

I used to drink every day for about 10 years. I had a major check up at Bumrungrad and found I had a fatty liver - no idea I had one, but it was a severe warning and I cut right down, ate better, and started exercises daily and lost about 24 pounds in weight and no more fatty liver. Never felt better in my life, even as a teenager. Best thing I ever did, apart from stopping smoking 25 years ago. I still drink about once or twice a week but feel so much better the days I don't.

All well and good for some, I agree. I did meet an 85 year old in Washington Square one afternoon who told me he drank and smoked every day for the last 70 years, so it's not all bad news.

Well that's what he said. In any case for every one of those there are probably hundreds who are now 6 feet under, possibly at a much younger age.

the other aspect of health and longevity is your friends and family. You good health is not only good for you but by putting it at risk, you are risking the welbeing of your family, espcecially your kids who may grow up without a father, and your friends. If you have any, think of them whenever you are abusing your body.

Edited September 16, 2014 by Card

[charliebadenhop]

Cassde,

Would you mind saying, how much did your procedure cost in total, and how much of that did you have to pay out of your own pocket?

TIA

Charlie

[Si Thea01]

Back when I was your age and living in Australia I was in a similar situation and did not have any medical cover. In my case, it was because I was unable to afford the premiums but in the end, when my wife gave birth I soon found out that I had trouble paying the medical costs and this almost bankrupted me. I soon learnt that no matter what, I had to have insurance. No so much for me but for my wife and child and any future children, of which we later had two.

Even though you are healthy you will never know when illness or an accident will strike and if you are the only bread winner who will pay the medical bills if you need hospitalisation. If you have sufficient funds to self insure then you must make a decision, that is beneficial to you and your family, but do so rationally. Why would you want to gamble on insurance, do you have a vehicle and is it insured? If so any gamble, there? It may well be beneficial for you to take out cover and the reason I say this as owing to your age and apparent good health, and if your wife and child are healthy then the cost will not be as high now as it could be as you and the family grow older.

Sure you can use the funds to educate your little girl but remember if anything occurs, and it can, although we never wish this, then what you have outlaid there can never meet the medical costs that can arise. I am many years older then yourself and always kept myself fit but as I reached 55 I started going down hill and over the past ten years required some 7 operations, one where I almost died. Thank god I had medical insurance. I have now retired in Thailand and just prior to my 65 birthday I took out a life policy with a company that I will swear by. The policy lasts until I am 80, if I live that long, cost 104.0,000 baht yearly and gives my wife a million baht if I die. it also included medical and accident policies, which covers me for almost all possible scenarios. In the first 11 months no problems, then on the 12th month a medical check revealed large polyps in my nose.

I had these removed but unfortunately the doctor caused trauma to my eyes and I was hospitalised again only 1 day after my discharge and was admitted through the ER section of my local government hospital. Within two days I was transferred to a large university hospital where I spent three weeks recovering, however, I may need further surgery on the nose and eyes so that whatever the initial doctor occasioned can, hopefully, be rectified and I can see clearly again. Sure, I have a legal case against the doctor but I still need medical treatment, which has to be paid for and through the company that I had taken out the policy with my costs were and are still being met.

I have included this aspect just to show you how things can occur over which you have no control. Just imagine the costs I would have to pay, especially now that I am being treated by two professors and maybe two more operations. As the hospitals where I was hospitalised on the 2nd and 3rd occasions, are government, I have to pay at the end of my treatment but those costs are reimbursed to me within a month. One thing I will give you advise on, never gamble with health, as in actual fact if you do, you are gambling with your and your family's life and how much do you value that at? I am not aware if I can disclose the names of the insurer or hospital so I won't but if you want to know any more just email and I will oblige.

[Minnehaha]

Thailand's social security is mandatory, provided via employer (when the salary is above a certain small number), and all farang who have a WP would have this as well. Part is paid by the employer and part by the employee.

One is obliged to select a hospital from the list - many (most?) are lower quality hospitals, but not all. One can find decent hospitals on the list, at least in Bangkok.

Major medical, all out patient, etc. How good are the doctors? Well, one needs to ask this question of any hospital, especially places like Bumrungrad, which is ridiculously expensive and a far cry from what it was 10 or 12 years ago - a top quality institution that was not priced insanely.

Thai health insurance (social security) is a good back up (or first up) coverage to have. I mean, in addition to a top quality MM international brand, you could just use the Thai coverage for small things and even some in patient care. Also, you can continue to keep the Thai coverage after you leave the job, by contacting the SS office within 6 months of leaving, and pay the monthly premium. It is about 440 Baht a month.

Health insurance is important to have and I know several people who have paid heavily for not having it.

A person is far more likely to suffer disability in their lifetime. If you are a father and concerned about the family, you should look into how to handle disability. In western countries this is good insurance to buy. Not sure if it is available here.

[KittenKong]

I'm single and nearly 60. I self-insure because I'm fairly healthy, have a yearly check-up, have the money in the bank and dont go running to the hospital for every little thing. I also suspect that hospitals here regularly bill more for work covered by insurance, and often want to do things that aren't really necessary. So anyone paying their own bill can make some savings there without compromising their health.

If I had a Thai family I would probably take out family cover because I think a mother is more likely to go the doctor with her offspring, and the rates seem to be lower per person for families than for single people.

As I get closer to the cut-off points of 65 and 70 I will consider getting major illness cover that excludes out-patient care etc.

[cassde]

Cassde,

Would you mind saying, how much did your procedure cost in total, and how much of that did you have to pay out of your own pocket?

TIA

Charlie

Hi Charlie, the procedure cost 204,000 in total and of that I paid 100,000 as a condition of my insurance policy was that I paid £2000 up front. What I found out afterwards was that my policy did not cover outpatient treatment, which will cost me at least 16,000 baht each month for at least 12 months for drugs.

[12DrinkMore]

OK so what happens if A Farang gets very ill and is taken to Hospital where he has to have Surgery to survive, and he has no money, what do they do?

They would most likely do the op and ask you for the cash afterwards or you get booted out of the hospital and maybe the country. But do you really want to be in debt to a hospital in Thailand that saved your life?

A friend had a serious motorcycle accident on Phuket. Both legs broken, arm broken and pelvis broken, plus assorted skin damage, bruising and concussion.

The private hospital where he was taken to stabilised him and stitched up the bigger rips.

But they refused to perform the major operations to screw the bones together until he got some funding from the Bank of Mum and Dad in Germany.

I have wondered what would have happened if the money had not been paid. I would guess step one taken to a government hospital and into the government system.

With illnesses that require expensive operations and no funding is available palliative care is given.

[chiang mai]

At Chiangmai, you will find Bupa UK and Bupa Thailand are not really the same,just go get a quote.

I tmakes a big difference if worldwide coverage or not.

Yes I do understand that's the case, but I'm nearly 65 and I've been paying my way on this for ten years or more so it's a bit late to change.

[chiang mai]

Some very sensible advice here, thanks very much.

Just for info, I don't smoke, don't ride a motorbike, and drink very moderately (I can go several months or more without drinking), I eat healthily, and exercise 4 times per week.

That said, I think, as some posters have already mentioned, it is always better to be safe than sorry, right?

Guess I better start looking for an insurance policy (yawn!)

Thanks again guys!

To give you an idea of premiums for a full payment policy form Allianz, a 30 year old with a max benefit level of 16m Baht would be 20,000 Baht for this year for IPD (hospitalisation)

Perhaps you can give us an idea of what a similar policy (or BUPA perhaps) might cost a 64 year old?

[khunPer]

»Is anyone else taking this kind of gamble with insurance?«

Yes, but when you reach a certain age, typically past 60 and have a good health, you begin thinking if Health Insurance is worth the money, as they just become more-and-more expensive and may anyway not cover all.

Today I’m self-insured, but in the beginning in Thailand I did have a health insurance, but instead of the most expensive Bupa I chose the middle class and saved up the difference in a “rainy day” account; I also put little extra in whenever I could afford it. When I passed 60 I changed to the cheapest insurance and saved up little more; however the cheapest insurance covers next-to-nothing, so I decided to skip it after a few years, as my emergency savings then were higher than the annual maximum pay out, so instead I deposited 10-years insurance fee in my “rainy day” account and now continue some regular savings, so in total that balance the annual fee I originally paid for my first years insurance here.

Like you, OP, I consider myself in good health, never been hospitalized and only see a doctor for the necessary statement needed for driving license. I also have a child here and therefore some level of responsibility, that being both as a living father in good heath and being able to contribute with something for school and education. I keep a Thai PA (Personal Accident) insurance running that is relative cheap; don’t cover much in medical, but some cover in case of disability or death. And yes, you need a cash back up in case of something happens, other insurances and an additional PA may not even cover enough in case of accident. So taking the risk of being self insured, I believe that you shall have some easy access savings here in Thailand – how much is a question of what one can afford, but a relative nice lump sum – and continue with some regular savings, also in cover of inflation.

[wilailuk]

»Is anyone else taking this kind of gamble with insurance?«

Yes, I´m considering to scrap my 15,848 THB pr. year Insurance (I´m 59), and just go with a PA from either K-Bank or Bangkok Bank.

Why?

Because if bad luck hits and I need a "biggie" - heart, stroke, aneurism etc. - the mediocre insurance I have won´t be enough!

Examples: "Surgical fee, actual but not exceeding 60,000 THB" - "General expenses 40,000 THB." - "Room and board 4,000 THB".

I live close to Ramkhamhaeng and Samitivej Srinakarin Hospitals and will use them in an eventual emergency, I won´t get much covered there with this insurance IMO.

Edited September 16, 2014 by wilailuk

[ManaoBkk]

I've just been looking at medical insurance after my daughter had an accident and been comparing some quotes...

To cover me (44) and my two kids (7&8) for the year - the best two for standard coverage, no outpatient or dental were:

Bupa: 12,614 for me and 9,842 each for the kids

MSH: 35,040 for me and 14,307 each for the kids

[chiang mai]

What is generally referred to on this Forum as 'self-insurance' is not self-insurance -- you have a reserve.

And precisely how does this differ from Insurance Companies, a concept I might add that is built on fear and gambling?

[JLCrab]

Because with a reserve you put in say $20,000 and (excluding interest and dividends) that's what you have.. If at the end of say 10 years, if you have no major medical problems, you will still have all or most of your money.

If you buy insurance at $2000 for 10 years, at the end of 10 years your $20,000 premium is gone and you may have had no major claims. But if you DID have a major claim, you might have received $100,000 or (much) more in medical coverages.

That is why insurance is different than a reserve.

[Strangebrew]

Let me tell you a true story my mom and dad had no insurance but they had a stupid son namely me I ended up costing my dad his dream of a house for him to raise his family I had an accident which gave me 3rd degree burns may Dad god rest his soul worked overtime 15 years straight to pay off the medical bills even money he saved for down payment on house was gone. Then two years his company got medical plan. to little to late. So after I did my military duty saved every dime I made held two jobs went to college which I had to pay myself. Well I got real lucky one weekend in Vegas and walked away with enough money plus with what I saved and got my parents there house 3 years later they died but at least it was in there own home. The costs of not having insurance far out weighted the costs not having. You willing to risk your children's future on a few baht a month?

[chiang mai]

Because with a reserve you put in say $20,000 and (excluding interest and dividends) that's what you have.. If at the end of say 10 years, if you have no major medical problems, you will still have all or most of your money.

If you buy insurance at $2000 for 10 years, at the end of 10 years your $20,000 premium is gone and you may have had no major claims. But if you DID have a major claim, you might have received $100,000 or (much) more in medical coverages.

That is why insurance is different than a reserve.

Wheel of chance or roulette, take your pick, they're both similar odds, except in the case of personal/health insurance we need to weight towards the fear factor of the purchaser. Maybe you win, maybe you loose, the house always wins.

And why should we exclude interest and dividends from the "self insured" calculation, do insurance companies not invest and receive dividends and/or interest payments fro the payments they receive, do bears sh*t in the woods!

You are/were an insurance salesman, we both know this from our past incursions, I love you regardless of that fact, well, a little bit anyway.

[JLCrab]

I never was an insurance salesman. I once did work of a mathematical nature for some Lloyd's syndicates in Bermuda.

Going without any insurance is just as much a gamble as no insurance -- go to any hospital any day to an ICU or high-care unit and almost all the people there never figured it would happen to them.

[chiang mai]

I never was an insurance salesman. I once did work of a mathematical nature for some Lloyd's syndicates in Bermuda.

Going without any insurance is just as much a gamble as no insurance -- go to any hospital any day to an ICU or high-care unit and almost all the people there never figured it would happen to them.

If indeed you were an actuary or similar, you will understand the percentage risk factors, perhaps useful for you to explain why "the house" always wins and punters (people who pay premium), always loose, on average?

[traviss]

At Chiangmai, you will find Bupa UK and Bupa Thailand are not really the same,just go get a quote.

I tmakes a big difference if worldwide coverage or not.

I have an international family plan from Integra Global, UK. The plan covers myself, son and stepson. Annual cost is $6,300.00 US with a $1,000.00 deductible with a 100% insurance pay-out after the deductible is met. The international coverage for the boy's was less expensive than domestic coverage from BUPA Thailand and grants coverage worldwide. The only drawback is that we are only allowed to reside within the US for no more than 180 days within a policy year.

The coverage is great, customer service unmatched and a good network. Seems that the Thais/hospital staff either don't like international coverage or don't understand it. Perhaps it is more labor intensive to process as apposed to domestic policies. They like to tell you that insurance doesn't cover so need to pay in cash and seek reimbursement from the insurance company. I simply involve the international staff and the problem goes away very quickly.

The domestic policies from Integra Global will be less expensive so that may be better if you don't travel outside Thailand.

My wife is covered with a BUPA policy as for some reason it was less expensive than adding her to the family plan. Honestly, we are still confused on what is covered and what is not covered under the policy. Point is, with a global insurer I know exactly what I am buying and the benefits that go along with the policy.

[Sheryl]

Plenty of people take the same risk you are. And plenty end up in very dire straits as a result, harming not only themselves but their immediate and extended families. I could write a book about the situations I have seen/gotten involved in trying to untangle.

The fact that you are currently healthy and have not had any serious health issues in no way means you are immune to accidents nor that you will never get a serious illness. You aren't, and odds are that sooner or later you will. At which point you will no longer be able to get insurance.

Your good health to date does however mean that it will be easy for you to get insured now. When you are young and healthy is the time to get insured. Rates will be much lower and if you choose your plan carefully you can get one that will guarantee lifetime enrollment as long as you keep up the payments.

Do not underinsure, either. Many young healthy people make the mistake of getting a very low level of cover. the problem is that once you have a pre-existing condition you lose the option to upgrade your level of cover. So plan your level of cover not according to your current state of health but according to your financial circumstances, current and projected, understanding that the possible per illness/incident cost of treatment for a catastrophic accident or illness in Thailand currently is about 2 million baht for care in government hospitals and 5 mill for private.

One limitation to plans offered in Thailand is that they don't seem to include deductibles, a common feature of plans in the West, i.e. plans in which you pay out of pocket up to a certain amount and then the insurance kicks in thereafter. These have much lower premiums and for people who have savings and reasonable income (and expect to be able to maintain both long-term i.e. will have reasonable pensions coming after retirement) they make good sense.So as you compare plans look both internationally and in Thailand.

Insurance works through risk pooling. In years where you pay premiums and don't use the insurance, you are not throwing the money away -- you are subsidizing the health care costs of others less lucky just as they will in turn subsidize yours when the time comes.

[NoshowJones]

If your in good health, have good family genes, don't smoke, drink in moderation, eat healthy, wear a good helmet when motorcycling and generally not engage in high risk activities it is more than likely you are fine going without. I'm 61 and lost medical coverage over 4 years ago when I gave notice to my American company and quit. I was based in Shanghai at the time and wanted out of the big city. They still wanted me to work so I am now a contractor working from a (virtual office) I looked into insurance plans here and to me it seemed like all the big scary things that will financially break you are somehow not covered or have strict limits, especially pre-existing and chronic conditions. I am comfortable with my decision and pay as I go for the odd injury here and there, but it is a personal decision and based on many factors mentioned above and also the fact that I have a good financial cushion. You did not mention work. If you can get medical coverage from your employer then that would be the way to go. Good luck,,,,

Good post, nothing is ever guaranteed, and you have to take some chances in life. If you go by the book for everything, unless you are very rich, you are going to be very miserable, having to pay out for this and that insurance, and when it's payout time they will try everything they can to not pay out, this and that tax etc. etc.etc. Although I have not experienced it myself, I can't see anything worse than having to live from week to week.

[JLCrab]

I never was an insurance salesman. I once did work of a mathematical nature for some Lloyd's syndicates in Bermuda.

Going without any insurance is just as much a gamble as no insurance -- go to any hospital any day to an ICU or high-care unit and almost all the people there never figured it would happen to them.

If indeed you were an actuary or similar, you will understand the percentage risk factors, perhaps useful for you to explain why "the house" always wins and punters (people who pay premium), always loose, on average?

With health insurance most people will pay more than they will ever claim. However, they would be covered should the unexpected occur. I don't see how that makes them a loser.

I came to Thailand from USA in part because the company that for years had included me in their health plan was sold and I had to buy insurance as an individual. Maybe it is the American experience at work here but I considered myself damn lucky to be able to purchase health insurance here in Thailand as an individual at a reasonable cost.