Health - premium increase after operation?

[inbangkok]

I was always talking in the abstract, my wife served only as a sample. Same with cancer, only to illustrate the problem.

You are insured , have a cyst removed, insurer increases the premium, Not a word about what new risks may cause the increase. Not a word about cancer OUR HOLY assessment says YOU ARE A HIGHER RISK.

Fact is there are no legal definitions, no binding yard sticks , to go by.

Sheryl , can you not get a real expert into this discussion, start a completely new and pinned subject title? It really important for TV members.

PS No ;

German Tax payers don´t pay, it´s the mass of millions of insurance payers balancing out the risk. Health is mostly fate. We fared all very well under this system introduced by Bismark 1883

The last part about all the German insurance payers balancing out the risk......that is kinda' the attempt with Obamacare. If healthy people are forced to buy insurance, it will balance out when people get sick and need to claim.

Unfortunately, that's just not the reality of the situation here in Thailand for us foreigners.

I just cannot imagine how foreigners don't but insurance and sooner or later I would not be surprised if the government forces it on expats. I read all the time about someone in Phuket who crashes his motorbike, or something here in BKK that leaves an individual seriously injured and they cannot pay for their medical bills or medical transport to their home country.

I think the Thai government has some very questionable policies directed at foreigners who reside here for a long time. However, I would have no problem if they required expats to maintain private insurance.

I agree the government should have foreigners incurred, but the only way they can make it work is by having all foreigners incurred under a single pay system so the healthy subsidise the unhealthy, otherwise a large amount of retirees would not be able to get insurance, a lot of these people spend a lot of money in Thailand and look after extended families. There would definitely be a drop in GDP, if they had to leave.

Yeah, I have no clue how something like that would be implemented. But considering this is Thailand, they would probably just screw things up even if they tried. Even if this happened though, I would still maintain my own private insurance, because I would assume any mandatory pay system for foreigners would only cover you at a public hospital. Anyway, it is not an easy situation but far too many foreigners seem to do stupid things (like ride a motorcycle with no helmet) and end up incurring huge hospital bills and they cant pay.

In addition, I really don't think it is Thailands responsibility to insure people who retire here. It does not really matter if they spend money and care for extended families. The public hospital system covers Thai people who work and pay into Social Security. I think it would be good if foreigners were given a flat fee option to join the public hospital network though. But like I said, I don't think it is the responsibility of the Thai government. No differently, I don't want my tax dollars paying for a foreigners medical care in my country. If they want to come to America, they need to pay for their own insurance just like we do.

Edited October 22, 2014 by inbangkok

[Sheryl]

ThaiPhuket, I am not aware of any TV experts on insurance law to bring into this.If you know of someone, please let me know who. I don;t see why we would need a new thread, the title of this one is fine. As for pinning, will consider once the thread has run its course. I would like to have more definitive information on Thai law too if possible.

It is not surprising that the legal framework for health insurance in Thailand is less favorable than in countries where private health insurance plays a larger role. Bear in mind that Thailand has a comprehensive system of universal health care access for its own citizens which does not involve private insurance. Hence very few Thais have private insurance policies and they are something of an optional luxury for them. The smallness of the private insurance market here also reduces risk pooling which (along with plain old greed and the fact that the law apparently allows them to) may affect local insurance companies behavior.

It is at least in theory possible to lodge a complaint about the actions of a health insurance company. The place to do so is http://www.oic.or.th/en/home/index.php

Of course, need to read the small print in your policy first. If it only allows rate increases for a change in risk profile, then one could lodge a complain if an insurance company appeared to have wrongly assessed this or is claiming an increased risk on flimsy grounds. Ditto one could appeal exclusions for pre-existing conditions. Whether you'd get satisfaction, who knows, and would almost surely need a Thai speaker to help you navigate the process.

Thai insurers do require the permission of the OIC to operate and their licenses can be revoked, so OIC does have some real clout. That said, I haven;t heard any first hand expereinces of appealing to them.

Spurred by this discussion - which is timely as my BUPA Thailand annual premium is due next month - I have been scouting out international policies i.e. policies issued by first world countries. I sent some inqueries to Cigna UK, which has a very attractive looking plan, asking specifically about rate hikes post claims and possibility of being dropped and received this reply:

"Your premiums are not affected by claims made on the policy. Your premium will change each year as you are a year older and also with any rate increases or decreases across the business.

As long as you have an eligible claim under the policy Cigna will cover you up to any benefit limits on your policy. Cigna would only remove cover if there has been fraudulent activity or through non-payment of premiums. Your cover will remain in place for as long as you want it as there are no upper age limits."

(I assume by the last they mean no upper age limit to remain enrolled, I expect they do have limits on age at which one can newly enroll).

I will of course check out the actual policy wording before making a decision, and compare with other international policies. But assuming it is true that Thai insurers can both up premiums if your risk profile change and even refuse to re-insure you, I will change to an policy issued in a country where this is not allowed.

[THAIPHUKET]

Sheryl, that is most constructive and encouraging. This type of certainly is worth some money. Will check applicability to my own case.

[Sheryl]

Another great advantage to international insurance policies is that they offer moire flexibility in products, for example varying premium rates depending in whether and how much deductible and co-pay you opt for.

The Thai insurance products are usually 0 deductible, 0 co-pay and just one premium option.

I only have insurance in case of a catastrophic event or major long-term illness that might render me unable to work and involve costly treatments. So for me, a deductible and co-pay in exchange of lower premiums makes good sense.

[THAIPHUKET]

You nailed it ! My insurance has the highest self-deductible, which cuts the premium by 50%. A risk easy to assume here in Thailand, though times are changing.

[inbangkok]

You nailed it ! My insurance has the highest self-deductible, which cuts the premium by 50%. A risk easy to assume here in Thailand, though times are changing.

I think you are right, as long as you have a realistic hospital in mind. I got into a bad motorcycle accident in 2010 and a 1 week stay at Bumrungrad was something like 750,000 Baht. I am sure it would be more now. Still a steal compared to what it would cost in America should you need to be hospitalized as a normal (not luxury) hospital for an entire week.

I think some of the private hospitals (not international ones) in BKK seem acceptable and would cost far less.

[THAIPHUKET]

Just to illustrate the point , my insurance is unlimited, no matter how many events, no matter for how much or long the individual case needs to be treated.

Sheryl, pls share any additional info about Cigna as it becomes available to you, eg what is the age limit for acceptance?

[inbangkok]

Just to illustrate the point , my insurance is unlimited, no matter how many events, no matter for how much or long the individual case needs to be treated.

Sheryl, pls share any additional info about Cigna as it becomes available to you, eg what is the age limit for acceptance?

I unfortunately do not have unlimited coverage. However, I am covered up to 5 million baht PER illness which is fine for me. I always figured if I need more that 5 million baht worth of treatment for one illness (considering how low overall medical costs are here in Thailand, even at international hospitals) I would probably need to go back to my country. I can keep this policy as long as I renew it every year and don't let it lapse (plus the possible 5-30% increase). However, I have no clue what happens in your 60s or 70s with BUPA and if they would cut me off. Too far away to consider.

Edited October 23, 2014 by inbangkok