Taking the ultimate gamble with medical insurance

[Robert2006]

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.

OK now I understand, your decision makes sense but mine does not, you’re a nerd when being a nerd makes sense and my chosen path on the subject is a gamble, yours is not, let’s analyze that.

This is a fascinating example of deep thinking and risk analysis. I’m sure you’re aware that healthcare coverage is not a guarantee of continued health, in fact accessing the healthcare system is one of the most dangerous activities in which you can engage. In the USA medical errors are currently the third-leading cause of death. Do you trust Thailand’s hospitals are more capable that those in the USA? What do you think the medical error rate is in Thailand? You said you policy was cheap, do you think maybe you get what you pay for? Have you ever even considered these issues? Have you done any research at all or are you one of the cattle preprogramed to do as everyone else does? Your being “a nerd when it makes sense” healthcare promise could very well be your demise.

I take it from your post you’re not very good with numbers so let me help you out, 1,200 people a day die in the USA from medical errors and in my opinion that number is underreported. I’m by no means saying I would not use the system if I need it, but I will simply purchase the care at that time, in effect I insure myself with my own money, I’m self-insured. Who do you think gets better care someone like me or someone with a budget medical plan in a developing nation like you?

If you want the only fact based, well researched no gamble guarantee regarding health I have it for you, none of us are getting out of here alive.

[pinkpanther99]

Thanks again for all info and feedback.

It wasn't so much that I was undecided about getting insurance before but I was more just weighing up my options and trying to get advice from others who may be in a similar position.

Like people have pointed out, I think for the sake of my family if nothing else, the responsible thing to do is get insured. I've already started to get quotes.

One thing that I have noticed from this thread is that there are a hell of a lot of people without insurance. I thought going without insurance was in the minority but that doesn't seem to be the case?

[cassde]

re USNret - your calculations are about right, but I already had the insurance and would have been foolish to not take advantage of it. Fortunately, when the policy was renewed at the end of July, they did not include my heart attack, so I start again with a clean sheet.

[Robert2006]

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!

Wow that is a very in-depth composition, very interesting. I’m about 10 years younger than you but I’m now starting to feel the age. I’ve never had insurance; always treated myself, my cousin is a naturopathic doctor and as I have a lot of interest in the subject he trained me to deal with many health issues years ago.

I’ve always handled my medical issues more or less myself but sooner or later I know we all have a major health event and I am no different, fortunately I have the ability to pay for treatment when that happens. Getting older I have had to face many of my loved ones deaths and have resigned myself to be at peace with the fact the someday my time will come as well.

Who knows maybe if I’m lucky, one day I’ll meet you on the other side!!

[JLCrab]

From the post above: I’ve always handled my medical issues more or less myself ...

From the screenplay for The Fugitive -- Harrison Ford as Dr. Richard Kimble:

Dr. Anne Eastman: Hey, Do you have a particular interest in our paitient's X-Rays?

Dr. Richard Kimble: What do you mean?

Dr. Eastman: I saw you looking at that boy's chest film.

Dr. Kimble: It's a hobby of mine.

Dr. Eastman: It's a hobby, really? What are your other hobbies - brain surgery?

[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!

Wow that is a very in-depth composition, very interesting. I’m about 10 years younger than you but I’m now starting to feel the age. I’ve never had insurance; always treated myself, my cousin is a naturopathic doctor and as I have a lot of interest in the subject he trained me to deal with many health issues years ago.

I’ve always handled my medical issues more or less myself but sooner or later I know we all have a major health event and I am no different, fortunately I have the ability to pay for treatment when that happens. Getting older I have had to face many of my loved ones deaths and have resigned myself to be at peace with the fact the someday my time will come as well.

Who knows maybe if I’m lucky, one day I’ll meet you on the other side!!

I'm like you, taken care of myself and lucky me I have many family members who are in the medical field so when I have problems I contact them for advice and what to do. Whenever I could visit back home I get free examine and advice and what type of medication would be good for me which is obtainable here without much trouble.

I have sacrifice much so that my wife and son can have medical coverage as for my wife she has cancer and I cover her with my savings. My goal is to keep her alive as long as possible so she can see our son grow up and have his own family one day, so far so good? As for myself I too have seen love one die and pretty much have resided to the fact that I want to see my son grow up and have his own family and once that day comes I couldn't care less what happens to me. I'm not religious but have spoken to the man upstairs and told him " I know you have your ways and it all might be a test for me " I have sin and will continue to sin because I'm just human! I have done real bad things in the past but I also have done good things and would get my last baht to someone in need basically generally I'm a good person/not perfect so when my day comes and I come before your kingdom and I have no idea what the standards are but if refused I will not beg or complaint if Hell is my faith so be it? At this point I couldn't give a flying FFFF

So meeting me on the other side?????

Good luck everyone... cover or go uncover like the discussion on Condom is a individual choice 555?

Edited September 17, 2014 by thailand49

[Robert2006]

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!

Wow that is a very in-depth composition, very interesting. I’m about 10 years younger than you but I’m now starting to feel the age. I’ve never had insurance; always treated myself, my cousin is a naturopathic doctor and as I have a lot of interest in the subject he trained me to deal with many health issues years ago.

I’ve always handled my medical issues more or less myself but sooner or later I know we all have a major health event and I am no different, fortunately I have the ability to pay for treatment when that happens. Getting older I have had to face many of my loved ones deaths and have resigned myself to be at peace with the fact the someday my time will come as well.

Who knows maybe if I’m lucky, one day I’ll meet you on the other side!!

I'm like you, taken care of myself and lucky me I have many family members who are in the medical field so when I have problems I contact them for advice and what to do. Whenever I could visit back home I get free examine and advice and what type of medication would be good for me which is obtainable here without much trouble.

I have sacrifice much so that my wife and son can have medical coverage as for my wife she has cancer and I cover her with my savings. My goal is to keep her alive as long as possible so she can see our son grow up and have his own family one day, so far so good? As for myself I too have seen love one die and pretty much have resided to the fact that I want to see my son grow up and have his own family and once that day comes I couldn't care less what happens to me. I'm not religious but have spoken to the man upstairs and told him " I know you have your ways and it all might be a test for me " I have sin and will continue to sin because I'm just human! I have done real bad things in the past but I also have done good things and would get my last baht to someone in need basically generally I'm a good person/not perfect so when my day comes and I come before your kingdom and I have no idea what the standards are but if refused I will not beg or complaint if Hell is my faith so be it? At this point I couldn't give a flying FFFF

So meeting me on the other side?????

Good luck everyone... cover or go uncover like the discussion on Condom is a individual choice 555?

Sorry to hear about your wife that is a challenging situation, have you ever heard of or thought of trying the Gerson Therapy? It’s basically a strict diet all based around juicing and detoxing, it’s a lot of work but it seemed to really help the people I know that used it. I had a friend who kept her mother alive for 7 years with it after she was discharged and sent home to die with terminal cancer. I just had a friend diagnosed with stage 4 tongue cancer he did Gerson for 2 months to strengthen up before his chemo and went back on the program after it was completed, so far so good he’s cancer free and he looks great, really healthy!

http://gerson.org/gerpress/the-gerson-therapy/

Similar to you I’m lucky to have some free quality medical advice; my Uncle is the director of one of the most prestigious cancer hospitals in the USA, I’m very proud of him, my cousin is a naturopathic doctor and my sister a nurse practitioner. Of course my Uncle and Sister believe I should have insurance but my Cousin believes given the right treatments the body is capable healing itself naturally, he is fanatical that everything be natural. Myself I believe there is merit in both conventional and natural medicine.

In the last two years I lost my Father, an Uncle and my older Brother, it really hit me hard but I’ve come to terms with their passing and now. I’m beginning to recognize my turn will come, something I had never considered before. It really brings into focus what is important in life, family and friends and to try to enjoy each day like it could be the last, which sometimes is easier said than done. Good luck to you and your family!

[KittenKong]

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.

How much did you pay at age 69, and how long ago was that? How much will you pay at age 80 (or 85 or 90) and will they even cover you then? How much will you pay if you develop some illness that will require treatment forever? Will they even cover you then? I looked at their website and this is not clear.

The problem with insurance is not what they charge when you are (fairly) young and healthy or when you first sign up, it's how much they will charge when you get to an age or condition when you are actually likely to make claims.

[Robert2006]

From the post above: I’ve always handled my medical issues more or less myself ...

From the screenplay for The Fugitive -- Harrison Ford as Dr. Richard Kimble:

Dr. Anne Eastman: Hey, Do you have a particular interest in our paitient's X-Rays?

Dr. Richard Kimble: What do you mean?

Dr. Eastman: I saw you looking at that boy's chest film.

Dr. Kimble: It's a hobby of mine.

Dr. Eastman: It's a hobby, really? What are your other hobbies - brain surgery?

You offer nothing cognitive to the discussion, simply insults and negativity, you should be ashamed of yourself.

[JLCrab]

From the above : For the record I am aware it is a gamble ...

I have said it ad nauseam: If you are medically qualified and can afford it, taking a gamble that you will not be in the albeit small class of persons with one or more major medical incidents is a gamble not worth taking. All the rest is side-show.

[GinBoy2]

We're all healthy, until we're not. Good lifestyle etc reduces your chances of contracting an illness, but it's just that 'chance'. Same with accidents, you're safe from accidents until one slams into your car for example.

Good medical treatment gets expensive (even here in Thailand) real fast if you unfortunately have something serious. Age increases risk that you are going to have some unforeseen ailment, which if any of us could predict, insurance companies would be out of business.

I'm an insurance kinda guy, I couldn't live with the uncertainly of what 'might' happen.

I'm not sure if this applies to all insurance companies, but over 60 it gets increasingly difficult to get any coverage. Bupa at least, if you have been insured with them for a certain number of years they won't refuse you.

[PacificCrossInsurance]

The purpose of health insurance is to ensure that cash is available to pay for medical costs that otherwise you would either not be able to meet, or would prefer not to (e.g. you may have sufficient equity in your family home so you could use this, but would prefer not to if the funds could be found elsewhere). Some people have sufficient cash reserves to meet any eventuality, and others may not have the money but choose to take the gamble that they will never be placed in that situation.

A very wealthy couple once asked me if I thought they should have health insurance - they were in their early 50's and had never had health insurance cover but were genuinely asking if that was the wisest choice. So I posed a hypothetical question, along the lines that they don't have health insurance and one of them had visited the doctor that morning because of chest pains and had been told they were on the point of heart failure and needed an emergency operation immediately ... without this they would be dead within 2-3 days. And the cost of the operation and everything related would be $150,000 - most of which was required to be put on the table that day and the operation scheduled for the following morning. I asked them what they would do in such a situation.

The answer was as I knew it would be, that a cheque would be written for this amount without flinching and without the slightest problem or impact in their overall situation, and the ambulance was already on its way to take them to the hospital to prepare for the operation.

'You don't need health insurance' was my answer, and explained that it really didn't make sense for them to pay an insurance company to make sure money was available for medical treatment ... when they didn't need this. But then I went on to explain what would happen to me under the same circumstances of no health insurance and the same diagnosis. I would have gone home with just two things on my mind to be done immediately - firstly to call my lawyer and make sure my will was in order and secondly gather my family to say goodbye - because there was no possible chance I could meet the medical costs under any circumstances. That meant I was the one who needed health insurance - not them.

Responding to some specific points that have been raised:

- a person in their 30's that has kept remarkably good health until this point and leads a healthy lifestyle will without doubt be statistically less likely to develop major health problems in the future. However thinking that a major medical incident free 30 years somehow guarantees the next 30 years will be the same is using very tenuous logic. Certainly the statistical likelihood of the onset of some conditions like heart disease and diabetes may be lowered (but not eliminated) but makes the person no less at risk of being injured in a car accident, contracting dengue fever, developing Parkinson's or MS, or having a detached retina. And the problem with a reduced statistical risk of developing certain conditions is that you are a person, not a statistic. You may have gone from the overall population statistical risk of 5% (50 in every 1,000 people) of developing bowel cancer during their lifetime to a 3% risk - but that still means 30 in 1,000 will still develop this condition ... you may be less likely to get this condition but it is a bold assumption that you are somehow bulletproof

- a number of people are of the opinion that health insurance companies do not want older clients and actively raise prices to drive customers away as they get older. We can't speak for every insurance company but as a general rule this is not the case and increases in premiums as people get older is matched to the corresponding claims cost experienced by the age band concerned with the aim of the entire company's portfolio having a similar level of profitability - premiums minus claims and administration costs. On an individual basis some people who have had significant claims may see their insurer asking for an increased premium and they conclude this increase is a function of age (which it is not), and they may also assume everyone in the same age band is experiencing the same as their premium increase (which also may not be the case).

- when faced with increasing claims costs (which have a number of contributing drivers) health insurance providers in general terms need to increase the overall premium income by the same level as claims costs have risen by (or are expected to rise by). But there are different approaches as to how this is applied. Some insurers take the approach that increases should be averaged across all customers - so if claims cost increases require, say a 5% increase in overall premiums then they add 5% to all renewals. Other insurers take the view that it is more equitable to apply a higher increase to the small percentage of customers who have had significant claims in the past year or so, which means the customers who have not made significant claims have a smaller increase, or perhaps no increase at all. There are arguments for and against both of these approaches

- there have been several comments that correctly point out the unwillingness of many health insurers to accept new customers over certain ages, and if you are not a client by that time the entrance door is closed. Sometimes there can be the impression that this signifies a desire to get rid of clients above a certain age, and even for existing clients annual renewals are offered reluctantly in the hope the client will eventually get the message they are not wanted! This is the wrong conclusion, at least in the majority of cases. In the case of Pacific Cross Health Insurance we do not have an arbitrary age limit for new applications and take each case on its merits but this is not common with most health insurers setting age 60 or even lower as the age by which you must already be a client

This comes about not because of the age of the applicants per se, but because of another issue that is called 'anti selection' and is an issue the health insurance industry has to be mindful of. Health insurers who want to stay in business need to make sure that the risks they are insuring in their client base are in line with the general population, and the assumptions that go into projecting their likely future claims cost - which in turn has a large bearing on required capital and solvency - which are tightly regulated (yes, in Thailand as well as most other countries).

The experience of the health insurance industry globally over many years is that - generally speaking - as people get into their late 50's and beyond, individuals have much better understanding of their health, where and how often aches and pains and twinges appear and disappear, etc. Those without health insurance begin to fall into two groups. The first group are those people who feel good about their health, and they may not even consider starting health insurance considering they have successfully dodged all bullets to that point - or they consider the possibility, look at the cost, and decide on balance that they are confident to stay uninsured. The second group are those that have less confidence about their future health prospects; perhaps they have a family history which niggles at the back of their mind, and sometimes people may have a feeling something may not be right years before there is any medical evidence of a problem.

What worries health insurance companies is that they don't want to have a business that is based on the future assumptions of the occurrence of certain conditions, severity, duration, and treatment options and costs - all of which assumes the normal mix or spread of healthy and not so healthy people ... but in fact their client base has half the number of 'healthy' people than the general population (because these people didn't take out health insurance in the same proportions) and double the amount of likely claimants (because everyone who was worried about their health took out a policy). Just like election times in many countries sometimes only a very small change to the overall balance can have a dramatic effect on whether the government changes or not this 'anti selection' issue can have a major impact on an insurance company ... and this is the reason why companies don't accept new clients after a certain age.

The way this is handled - and the comments on this posting - are not addressing individuals or specific cases - but are about the very large statistical databases that are used by the insurance industry, so if you believe this is total poppycock as far as your situation is concerned ... you are probably quite correct!

Pacific Cross Health Insurance does not restrict the age for new applications for health insurance and considers each case on its own merits. In addition we offer a range of Personal Accident plans which offer cover up to age 75. This type of cover does not require any medical evidence as part of the application process and as an option to comprehensive health cover can provide a cash payout if injured as the result of an accident - which can be used for medical treatment. You can obtain more information on these options from your local broker (only brokers registered in Thailand are permitted by law to sell the products of Thai registered insurance companies) or directly on our website - Pacific Cross Health Insurance or by email [email protected].