Taking the ultimate gamble with medical insurance

[canopus1969]

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?

Why do policyholders lose ? I for one would love to pay premiums, live to 100 and never claim

[Moonlover]

I am like, many here, in the 60 plus bracket and without medical cover. Yes, I know it's a gamble, but I do shorten the odds by living sensibly. I eat healthily, (mainly Thai) and exercise daily. I do not smoke and am a moderate drinker.

I did like the paragraph in the OP's second message.

"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" You're on the right track laddie.

As I said before, it's a gamble, but I do believe that if you live life sensibly, there is no need feed the already blotted insurance industry.

I am 68, enjoy a full and healthy lifestyle. Go diving regularly and have never been hospitalized in my life.

Good luck Pinkpanther. Or maybe we make our own luck. What do you think?

[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?

Why do policyholders lose ? I for one would love to pay premiums, live to 100 and never claim

A partial quote again which excluded the words, "on average".

[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?

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.

Thank you.

[off road pat]

TIT, ...this is Thailand,......people drive very carefully, .......safety measures are applied the full everywhere,....and if you believe this you should not have a insurance.....as natural selection will take it's course....you will learn the meaning of the Thai word "Som Nam Na" !!!

I needed urgent medical care a few months ago, and I was very happy to have Insurance covering the costs of some 330.000 Bth and repatriation for my wife and I to my country, for further medical follow up. the fact that I had Insurance saved my life....The Insurance looked for the best hospital around and this was some 200 km further up North....we were on a remote location..in the south. they send-ed a ambulance with a professional team, in the Ambulance they started with a IV and so on. Unless you can see into the future you should get a Insurance. I know so many people with long lasting pain and injuries (complicated injuries , multiple fractures, broken limbs,..Etc) from bad or inadequate treatment in bad hospitals......

Finally, It's up to you.

PS: I have to say We have a European Insurance......for years and I needed it a few times...in the past years....

I know if nothing happens it feels like a waste of good money, but if the unexpected arrives you'll be happy that some one ells is paying the bills.

Having a insurance is no guarantee, just like putting on a safety belt will never be a guarantee of no accidents....it just gives you more chance to get out alive, One more empty chamber in the Russian roulette that's life.....

Off Road Pat.

Edited September 16, 2014 by off road pat

[JLCrab]

Whether one is a loser on health insurance or one is a 'winner' who has the big claim many times greater than his paid in premium, I think of the following attributed to the pioneer American retailer John Wanamaker (1838-1922):

"Half the money I spend on advertising is wasted; the trouble is I don't know which half."

[mrfaroukh]

Well let put it this way. You are very healthy and you enjoy riding a bike. One bad day you have an accident it which you may break your legs or even worse some bad head injury. You then need treatment. Who will pay for it? You? Your bike insurance? I have no clue but you must think of all alternatives. I just know that you may pay something around 25000 Baht a year, and you may never get sick, but if you just have a bad luck it may cost you much much more. I know a friend who got sick and spend 6 hours in International Hospital in Pattaya. His bill was almost 19000 Baht.

[Bredbury Blue]

Should you get health / life insurance in your 30’s? Should you get health / life insurance ever?

Two true stories for you to consider.

1. I had insurance. My wife had insurance. She didn’t think it was necessary to get insurance for our first son 11 years ago. Five months old he keeps throwing up. Days in the hospital of tests and debate between the doctors what it could be. Turned out that his stomach was in the wrong position. Result was a successful operation but my pocket severely depleted. Wife was wrong.

2. Wife learns her lesson. Becomes an insurance seller years later. One of her wealthy Thai friends is interested in taking out a policy; wife’s friend’s husband doesn’t believe in health insurance, wife’s friend doesn’t take out policy. Three months later she takes seriously ill with colon cancer. Husband takes out a very good health policy for him and daughters. Doctors give her 3-6 months to live, they spend a fortune, she died last year after a 15 month fight. Wife’s Thai friends who knew the deceased still don’t take out a policy as according to them “it won’t happen to me/us”.

Insurance is paying for peace of mind; hopefully you’ll never use it, but if you need to it may be a life saver for you.

[carter1882]

All insurance is statistically against you. I have saved a huge amount of money by not having it or only having the bare minimum when the law requires it. Save money against it, and you will beat the odds.

[alfieconn]

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?

You cannot compare so called "self insurance" with a Health policy, for a start with self insurance generally the amount is always going to be a lot lower, if you make a claim for say 3m, would that hurt you financially ? perhaps no, so you have to make another claim for 4m, would that hurt you financially ? sooner or later it's going to hurt you financially, where as with a decent health policy it's never going to hurt you financially !

[JLCrab]

All insurance is statistically against you. I have saved a huge amount of money by not having it or only having the bare minimum when the law requires it. Save money against it, and you will beat the odds.

So if the odds are 10:1 that you will never have a claim way exceeding your paid-in premiums you are just assuming you will never be in that 1 category?

[belg]

do you work ? if yes, than you are intitled to ...

if you don't work, 30 years old, how do you make a living ?

[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?

You cannot compare so called "self insurance" with a Health policy, for a start with self insurance generally the amount is always going to be a lot lower, if you make a claim for say 3m, would that hurt you financially ? perhaps no, so you have to make another claim for 4m, would that hurt you financially ? sooner or later it's going to hurt you financially, where as with a decent health policy it's never going to hurt you financially !

I swear the quality of these chats is reducing by the day, how difficult can it possibly be to work out compound interest rates versus risk percentages/factors, goodness, next we'll be hearing that THB/GBP is in no way related to GBP/USD.

[alfieconn]

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?

You cannot compare so called "self insurance" with a Health policy, for a start with self insurance generally the amount is always going to be a lot lower, if you make a claim for say 3m, would that hurt you financially ? perhaps no, so you have to make another claim for 4m, would that hurt you financially ? sooner or later it's going to hurt you financially, where as with a decent health policy it's never going to hurt you financially !

I swear the quality of these chats is reducing by the day, how difficult can it possibly be to work out compound interest rates versus risk percentages/factors, goodness, next we'll be hearing that THB/GBP is in no way related to GBP/USD.

Compound interest rates, what, at these rates

As usual not answering questions and if your going to quote someone them quote them correctly.

[djhotsox]

Take it from someone who has been mulling over that exact same question for two years now, thinking, no, hoping or betting that I wouldn't need it but unfortunately I just recently lost that bet! Get some kind of insurance! ! Even if only basic to cover a possible event where you may require hospital care either short or long term. For you and for your family. In the event something unfortunate happens you can then demand the best possible care and treatment and not be worried about the bill at the end of it all as you may do if you were paying out of pocket.

Accidents happen, that's why they are called accidents! I recently broke my right wrist in an accident and the hospital bills in Thailand have totalled almost 26,000 baht. That, at one of he more expensive hospitals - i was unaware and assumed they had standard fees for most things ? I likely could have found a cheaper hospital and opted to find cheaper medicine as well as I was gouged for that too. But hindsight is 20/20 and I guess that is my point. You'd hate to look back one day and say "I should have"!

We all think we are healthy when we are young as well, as I did about 5 or 6 years ago or so (40?). I was working and living in Hong Kong at the time and luckily the company I worked for had very good insurance policy for their employees. One night at home all of a sudden I dropped to the floor as a searing pain like someone had put a knife into my knee virtually incapacitated me for a few moments. After coming and going all night I eventually made it to an emergency room by morning. Long story short. Torn meniscus. Cause, damaged over time likely from sports I played all my life, it finally tore. Required an MRI and surgery asap, the sooner the better as far as I was concerned. MRI done that day, surgery a few days later at the best hospital in Hong Kong. It was taken care of by the insurance company. I didn't pay a dime. The bill was huge. Thank you insurance company.

I think you should look at the insurance (premium) from a different angle. Don't consider it so much insurance if you get hurt or hospitalized. Think of it as insurance for your kid's future college tuition, home owners insurance because you'd hate to have to sell it to pay hospital bills, or simply insurance for peace of mind!

I will be starting a new job in another month and they will likely have insurance coverage for me there but if they didn't I would definitely be looking into a policy of some sort, got to make sure the kid has money for college!

[Robert2006]

I have lived in thai for 3 years. Never been hospitalised in all my life. I was riding a motorcycle.

A man from netherlands is confined to a wheelchair, he was under the influence of alchohol ane crossed a busy intersection right in front of me. I hit the wheelchair, and dont remember a thing. I was in intensive care for 9 days with a brain heamorrage and broken jaw. 400,000 baht later, i have titanium and screws in both sides.

Yes you can all say motirbikes are dangerous, but it was a freak accident, who expects someone to just cross at a green light in a wheelchair.

Now im purchasing insurance. Good lyck playing russian roulette.

I’ve never had Medical Insurance in my life except when I was a child under my parental plans. I’ve studied holistic treatments over the past 25 years and have treated myself through some very serious health issues successfully. Of course in the event of a motorbike accident I would not be capable of dealing with those types of injuries myself, I would have to pay for that treatment personally.

I estimate I have saved approximately $165,000 over the years by not paying for medical insurance. If it came down to it and I had to use that money for a medical emergency, then I would have no choice but to pay for those services, however I am content that at least I didn’t give my money away before I had a need to use it.

I understand many would not be comfortable with my chosen method of dealing with medical expenses, it is clearly unconventional. You may define my chosen path as a form of Russian roulette, nonetheless in life there are no guarantees; medical insurance included, in the USA medical errors the third-leading cause of death, behind heart disease, which is the first, and cancer, which is second. I would assume that number might be even higher in Thailand. Regrettably for some subjects there are no definitive easy answers.

[richard_smith237]

I've had sports accidents which require MRI's and CT scans - I can cover the cost of these myself, however, I was insured and thus when under the stress of an injury I was not worried about incremental or additional and potentially high expense - I went to the best hospitals without concern for the costs.

A handful of years ago as a result of another sports 'impact' I had a DVT which migrated into my lungs and thus subsequently a Pulmonary Embolism (I was 35), I required emergency medical treatment and a medivac to Singapore. The insurance took care of it all, I didn't have to worry about organising anything, no proof of funds required etc...

The total cost was covered completely by my insurance (medivac and hospitalisation in Singapore totalled about US$50,000).

A friend also in her 30's was struck down out of nowhere with a rare and completely debilitating illness, she was in life-support for a month - her bill was huge.

IMO: Medical insurance is there to cover the costs of the catastrophic events we cannot foresee or comfortably cover financially.

My Wife, Son and I are all covered under BUPA.... premiums are relatively high, service is first class.

Cost for my Wife and Son: £1580 per year for both (with a £500 deductible each). Work pay my insurance (which I believe to be about US$2700 without excess).

[Jonmarleesco]

I suppose that all depends on how much you think constitutes a rainy day fund, and how long it might sit around, unused.

[lcp0761]

As a future Thailand retiree (in 2-years) I am also looking at all my options on avenues where I can save costs.

What health insurance options are available in Thailand? Might there be something cheaper in Thailand then what I am currently paying (family option costs me $400 per month)

Note --- I currently have a great health care provider (US based Blue Cross & Blue Shield) who will cover me when I retire to Thailand, at no additional costs.

[JLCrab]

$165,000 saved over e.g. 40 years = over $4000 per year average for medical insurance. Over 25 years would be $6600 per year. Huh?

[jacko45k]

Thirty year olds end up in hospital too!

Perhaps not with heart concerns etc, but broken bones tend to happen to them more often.

You have to look at insurance (or not) as a bit of a gamble.

On one side of the scales, at your age,what is probably going to be a cheap policy of 30-60,000 baht pa.

Relative to a small risk of an accident putting you in hospital for a few weeks and a million baht bill.

If the million baht bill would sink you, the insurance looks more attractive. You could make it even more attractive by searching for a joint policy for you and your wife.

[cassde]

Re ICP0761 - you don't state your age, but I surmise it is in the 60 mark - I was 69 when I first applied for a Cigna Global policy, excluding the US, and now pay £289 - about $400 - per month. It is very difficult to get Health insurance here in Thailand for over 60's - so stick with your current insurer is my advice.

[arnestockholm]

Sorry to say but if you can't pay for an insurance you will never can save enough for an "self insurance". I am in the same age as you are. When I came to Thailand I start the insurance and pay around 180 USD per month. Not really much but have huge coverage. Know paying since about 2 years the premium und luckily never need the insurance but things can change so get an insurance!!!! If you can't pay for it you are doing something wrong...

[waitingforalife]

Personally, I am in agreement with the majority of the posters on this topic that with a young family, it is extremely foolhardy to go without medical insurance. The potential savings are not very great and the potential costs, particularly of an unforeseen accident, are extremely high!

There are a number of sensibly priced policies available (and an even bigger amount of silly priced ones). It is easy enough to see the cost and do the risk/reward analysis for yourself. Take a look at www.worldwidehealthcover.com and see for yourself and if you need assistance, just contact these guys via their website. At your age you can get an excellent policy, with international coverage, for around $1,000 - less if you accept a small deductible.

Best of luck

[thailand49]

My final words on this subject... I started out when I came here to live in Pattaya very positive about buying insurance since I came here without. I was very ignorant but learn it the hard way that like many things here buying insurance is all smoke and mirrors it is not what you think it is? I had AIA, Thai Insurance, Bupa, looked into LMG, etc..when you get the find print if you are lucky before you pay your money as you read the fine print you are lucky if you do not throw up? When you are done the conclusion is you have nothing but ????? as to what you just purchased and whether they will cover you?

One thing for sure it is all a la cart,,, majority of people will tell you buy the hospitalization and outpatient pay out of pocket? Good idea because the out patient is just if not more than the inpatient and who in hell goes needs 30 plus visit outpatient? And if you do I can safely say your policy will be cancelled in one or two years them knowing you have all these problems. Basically like all insurance they want the premiums and do not want to pay out. In the beginning, I my son then onlu 6,7, every time he got a high fever his Thai mother would take him to the BPH, surely they would keep him overnight saying he most likely have Dengue Fever? although aside from the high fever he had no other Dengue signs. Two days later cost to insurance is 25,000 baht, will his premium per year is much less, a loss to the insurance he was cancelled after two years?

When you sign these insurance policy of course majority of them are in Thai will in Thailand you are signing your rights away that they can contact anyone/any hospital to obtain information about you if necessary. So if you are one of those who like to go for checkups like BPH, they will find something and it is on record and if you happen to think it is small and do not say anything to the Insurance when the time comes to cover you they just might not because they might label it pre-existing and you never inform them? Long time ago I applied for a policy and honestly told them I had one time high cholesterol they came back and told me they would cover me but not for anything heart related etc. which was half my body? So what was the point paying full coverage for half a body? They can term anything as pre-existing and not pay and what are you going to do get a lawyer in Thailand and fight it? I say get real I went through that route in another case?

When people talk about self insurance... there are very few people who have the discipline and rich enough to say for example put 2 million baht in a bank account strictly for that use. most of us will say I put the money away but how many really do it? for those of us who are 60 plus and can't be covered we do not have a choice the discipline is force on us as if we had a loan for a house we put it away each month I have admiration for anyone who takes care of himself at any age.. I do because I have no choice and it is tiring... today over 60 I am faster and better shape that when I was twenty and can take a licking and give out the same licking to Thai men in their 20's which I have but it is hard work and if I take one day off it is like taking a month off. Regardless of how lucky I have been in not getting sick or hurt father time will catch up to me and you that is as true as the fact we get older each day!

For those of you that can and have insurance from your own country, which is usually one card or policy covers all, that means out and inpatient and pharmacy get down on your knees and pray to god " thank you " for those of us like myself here in Thailand it is a crapshoot! If you go to hospitals like BPH as soon as they see that insurance card it is max charge no matter if you are a local or foreigner. And if you have insurance oversea and need to pay first and get your money back later from your carrier they will gladly do the paper work for you and at the same time charge you double or triple than a local because they know your insurance back home would gladly pay the bill since it is still much less than what your home country hospital will charge. Here is a example.. my brother been using BPH for over ten years has insurance back home from his work prior to retirement. His Thai wife had a C-section 3 day stay cost 80,000 baht.. our cousin no insurance Thai wife use the same Doctor stay same room and hospital but my cousin was not there the Thai wife and sister handle everything price was 20,000 baht.

Had a friend in Pattaya got hit by a motorbike next day had a seizure taken to BHP, they did save his life, operation on his skull to relieve the pressure etc.. nearly a month in hospital, no insurance in Thailand but had insurance back home from his retired work, they took every penny from his Thai bank account and credit card got him the necessary paperwork to get reimburse back home. Another friend drunk on a motorbike accident over one month stay in BPH, majority of it in ICU, cost nearly 2 million baht. These are all examples if something happens to you major what to expect and hopefully give you guys something to think about as to what you need in the bank or how much coverage you might need Insurance?

Another example..... I needed a outpatient procedure went to BPH, in December for consultation quoted 15,000 baht.. had arrange date in early Feb.. just before procedure went in for final meeting.. doctor forgot to book surgery so referred me to another Doctor on staff, agree on date when I went to the office to arrange payment now it was 25,000 baht... the represent told me to my face the price you got earlier is for Thais only. I ask to see the manager/supervisor in the back room I told her that it was against the law to charge like that and if it is done I know the owners of the two major expat papers and Pattaya One and I will have them print and put my story for everyone to see. I got the Thai price..

In the end, Insurance is a nightmare at least for me.. I have other horror stories regarding private hospitals and the Insurance carriers here in Thailand. Current, I have ACS a french company but the level I purchased does not carry accident so I got another policy with AXA for accident for 50,000 coverage for 2,000 baht. Not sure if enough but based it on two visits to emergency at BPH both times just for cuts.few stitches and x-ray 10,000 baht.. It seems if you have accident automatic 10,000 baht, no insurance you a foreigner 10,000 baht..

When I use other hospital or need blood test I go to a private lab and use a different name I also have another passport fake using a different name this is to avoid my main carrier ever telling me " sorry pre-existing condition you not covered " So my final opinion is regardless, you got to find a way to cover yourself especially since you are so young and you have a family. If not.. you better be rich or you are gambling!

Take care be well everyone!

[chiang mai]

On the other hand:

five years ago I needed angioplasty and a cardiac stent, the UK private hospitals (Spire Group) quoted me £15k++ whilst Bumrungrad quoted £3k, (THB 160:) I chose the latter of course, that plus a series of MRI's and tests over a span of ten years represents the sum total of my medical expenses.

The key question is, would I do the same over again and/or would I recommend a 30 year old do similar - yes and no, in that order.

[Robert2006]

$165,000 saved over e.g. 40 years = over $4000 per year average for medical insurance. Over 25 years would be $6600 per year. Huh?

Firstly I understand your confusion and secondly there is a significant element of approximation in the $165,000 estimate of my lifetime savings achieved so far by not paying health insurance premiums. For the record I am aware it is a gamble and all those saving could be gone in the blink of an eye.

I assume you are calculating using after tax money to pay premiums, most people mistakenly think in those terms and it’s a big error in evaluating what a good or service actually costs. There are of course other adjustments that could be used however to keep it simple I will just use after tax and say for the record, $165,000 is an educated guess.

I merely averaged a typical plan costing $350 a month or $4,200 USD per year. In order to net $4,200 to pay those premiums I would have needed to earn in gross income $5,600. On earnings of $5,600 I pay $1,400 in income tax at a rate of approximately 25%. So the reality is that it costs me $466.67 a month to earn the $350 premium ($5,200 / 12 = $466.67).

Just for fun let me break it down this way. A large beer Chang cost 50 Baht or $1.56 USD, in order to net $1.56 to buy that beer I need to earn $2.10 or 67 Baht. So the reality is that a large beer Chang costs me 67 Baht not 50 Baht. Your cost may be different depending on the income tax rate you pay on your earned income. I guess I’m a nerd because I’ve always found analyzing all this sh!t incredibly interesting.

[JLCrab]

I am a nerd when being a nerd makes sense. I promised people in USA I would properly take care of myself in Thailand. Doing so involved purchasing health insurance as it was available to me on much better terms than it was in the USA. It was not solely a matter of cost -- it was an obligation to others which does not involve taking a gamble.

BTW after taking out health insurance in Thailand I had knee surgery which equaled the first 3 years premium paid -- covered 100% except for 2 Coca-Colas from the hospital room minibar.

Edited September 17, 2014 by JLCrab

[wilailuk]

deleted

Edited September 17, 2014 by wilailuk

[USNret]

I am 71 years old and until 15th June this year was totally fit. On the 15th June I suffered a major heart attack and was admitted to the Thainakarin hospital in Bangna where I had a stent inserted inside one of the arteries of my heart. I fortunately had medical insurance, taken out the year before, but because of my age had to pay £2000 up front. Also, the hospital did not have an arrangement with my insurer. The hospital, like most private hospitals in Thailand, demanded 200,000 baht as a deposit up front, which I was fortunate to have and paid. Now fully fit again and only another 4000 baht to pay, my insurance company paid 100,000 baht.

Now you have a young family, if you haven't a 200,000 baht up front payment, take out a major illness policy to avoid what I had to pay.

Not used to thinking in £ so I had to do a little conversion... bear with me in USD -- You paid $3260 USD up front. Paid the deposit out of pocket. Then your insurance paid back $3120 USD. I sounds to me like you would have been better without the insurance, and just paid everything out of pocket. What did I calculate wrong?