An emergency fund rather than insurance?

[Craig krup]

My uncle drove on third party insurance for 20 years or more. He always said that insurance companies have to make money, so the risk of something happening multiplied by the cost has to mean that the average person pays back a lot more than they pay in. Insurance is a certain cost rather than the possibility of a loss that you can't survive. If the chance of your house burning down is 100:1 and it costs £100,000 to rebuild it then you know the policy is going to be £1300 a year, or more. If you were really rich you wouldn't buy the insurance. You only buy it because you can't survive the event. My uncle, incidentally, hit a deer and wrote off a £20,000 car, in 1985 money, and never complained: he just bought another car. Plus, of course, the cost of the premiums is set on the basis of the group that you belong to. If you're fifty you'll pay health insurance based on what insurance companies think about the average male 50 year old in Thailand. If you are healthier than that you (again) are going to overpay.

So - finally! - here's the thing. Insurance for me is about £630 a year if I pay in advance and accept a £2,000 excess. But I've never smoked, don't drink, exercise hard, have 100/50 blood pressure, cholesterol of 3.94, a resting pulse of forty odd and I've never been seriously ill. I haven't been to the doctor for more than a decade. [My nose is also moist and I've a shiny coat ] I can't help but think that this all looks a bit expensive.

If I accepted that a five grand "thing" could happen - and set aside money for that - how likely is it (given Thai costs) that something could happen that was more than that? The way I see it if something scary like cancer happened I'd come back to the UK. I feel fine about that because I'm being royally rogered on dividend taxes and receive damn all for it. Other things that could happen which are acute and traumatic are 1) heart attack, 2) stroke and 3) assault/road accident. I know that any of these could be more than five grand, but (bluntly) what does the average heart attack cost in Thailand? A ride in an ambulance, a load of clot-busting drugs and a week of s*******g myself - bitterly regretting all of those wasted hours in the gym - what could it possibly cost?

What do you reckon - set aside some money on the basis that insurance is expensive and also no panacea, or pay the premiums?

[MaeJoMTB]

All the people I know with cancer died, not sure it's worth wasting money on treating, maybe just enough to buy a big dose of morphine.

Heart attack, you should know if you're at risk.

Stroke is pretty random.

I dunno, I've got the 30k BKB accident insurance policy for 2,500bht/year, not really bothered beyond that.

60 now, figure I've had my turn in life, not gonna fight all that much, just go quietly.

[Issangeorge]

A friend had a heart episode, went to the local hospital, they sent him by ambulance to the University Hospital in Khon Kaen, a government hospital, but probably the best in Isaan. They put in a stent and kept him for two days. The cost was ฿200,000 so figure it out from there. Go to the best government hospitals and stay away from the over priced private ones and £5,000 is probably okay, to be on the safe side go for £10,000. I major accident could cost you more, so you are taking a chance. However I think you can get just accident insurance relatively cheaply.

[falang07]

And remember that the cancer treatments cause cancer themselves (both the toxic chemotherapy and radiation) so go figure. If I ever get cancer, I will spare myself from those dreadful "treatments" and better spend the money on something useful than for the bigpharma profits.

[dotpoom]

You would need a big emergency fund here if you were unfortunate enough to injure, kill or maim a person while driving, taking into account that we are foreigners and seen as good "pickings", and considered to be in the wrong no matter what, in many cases.

Edited April 16, 2015 by dotpoom

[nongsangcity]

My friend in Pattaya had a heart attack about 6 weeks ago.....got fitted with a stent...felt better in seconds....got charged 4500000 baht....couldn't pay...they have his passport....hes been back to see a doctor, blood test, tablets...25000 bht...he went back last week more tablets....15000 bht......costing more and more......

[MaeJoMTB]

A friend had a heart episode, went to the local hospital, they sent him by ambulance to the University Hospital in Khon Kaen, a government hospital, but probably the best in Isaan. They put in a stent and kept him for two days. The cost was ฿200,000 so figure it out from there. Go to the best government hospitals and stay away from the over priced private ones and £5,000 is probably okay, to be on the safe side go for £10,000. I major accident could cost you more, so you are taking a chance. However I think you can get just accident insurance relatively cheaply.

You've seen the latest American & Swedish research saying stents are basically useless if not harmful?

Handling the problem with drugs is allegedly far more worthwhile, but doesn't make the hospital as much money.

Stents cause too much disruption to the vascular system and actually encourage future heart attacks.

"For decades, people have been told that large constrictions in the coronary artery signal future heart attacks which must be prevented by an immediate artery-opening procedure called angioplasty. This hypothesis was disproved 3 years ago by two landmark trials. Many, if not most, of the one million or so Americans who undergo angioplasty each year (with or without stents) can be treated just as successfully with the same multiple-drug regimen advised for just about everyone after angioplasty.

The exception: People in the midst of a heart attack are appropriate candidates for angioplasty. Unfortunately, about one-third of all heart attack patients do not receive artery-opening treatment within the recommended 12 hours after the first symptoms of a heart attack."

http://medicalconsumers.org/tag/cardiac-stent-harm/

Edited April 16, 2015 by MaeJoMTB

[umbanda]

For some reason, that it is a mystery for me, bad things happens exactly when we decided to not have insurance.

First time, when I was 20 years old and was using my father's car. He had 3 company cars paying insurance and he decided to stopped and make a fund, because for many years nothing happened with its cars. Just 2 weeks after his decision, I crashed his car very badly.

Second time, 8 years ago in the US, I was 62, paying a heavy self employed health insurance for most than 10 years without any problem, and having a very good health. I decided to canceled. Less than a year later I was diagnosed with malign colon cancer. I had to retire to get into Medicare, but not without many problems and setbacks.

I have health insurance here in Thailand, but I just found out that its not cover much, and after paying more than a trip to the US will cost me. I am thinking in cancel, and I may do it, but it is not an easy decision after my past experiences.

[kingstonkid]

Personally I have health coverage but have also set up an emergency fund as the health coverage is after I pay the bills.

[KamalaRider]

Personally I believe in preventing having a stroke or heart attack in the first place.

Just ask your doctor what warning signs there are before hitting with full force, like a stroke.

Sudden dizziness could be the warning a stroke is coming on.

I have started to take a quarter of a 300mg, around 70 mg Aspirin (I estimate about 5 mg becomes powder when cutting a pill) every day to thin out my blood as a preventive purpose against both heart attack and stroke.

Some of the guys out there shouldn't drink and use viagra at the same time is another example.

Just preventive measures can go a long way, don't need to be extreme methods to avoid getting a medical problem.

That said, I don't encourage anyone to go without a med insurance, but they are bloody expensive, even in LOS.

Edited April 16, 2015 by KamalaRider

[Jonmarleesco]

'If you were really rich you wouldn't buy the insurance.' You mean just like HM/HMG and the Windsor Castle fiasco? But they were happy, and able, to let the taxpayer pick up the tab. And it probably remains uninsured.

And I hate to rain on your health parade, but at 100/50 vs 120/80, it sounds as though you've got a low blood pressure issue.

[khunPer]

As Sheryl wrote in another thread about health insurance, that if a ”big thing” happens, all the money set-aside can be gone in one incident, and you’re back to square one. Sheryl also said, that if you are going to be self-insured, you should set something like 3 million baht aside.

The insurance question mainly rise when you pass 60 years and the annual premium goes up, and the only guarantee you have is that premiums will continue up, the older you become. Take an example, like I calculated on, where you buy a Bupa health insurance with cover up to 1 million baht – but still with some limitations in room and board per day, and some other subjects – which costs you about 50,000 baht a year; 75,000 with OPD coverage. If you are in good health and normally never need help from a doctor, you will with interest and interest’s interest have paid the full cover in little more than a decade. So if you are not ill enough to use the insurance in about 10-years time, you could have saved up the 1 million baht yourself; and at that time your annual insurance premium may be up around 100,000 baht.

PA (Personal Accident) you can buy fairly cheap in Thailand, but the cover is often limited; so is the cover on PA included in a health insurance. However for some 1500 to 2500 baht you can get cover that is better than included in many an expensive health insurance.

I’m a in favor of OP’s suggestion for self-insurance – of course depending on your health records and family health record – so when I moved to Thailand I decided for not the best 5 million baht Bupa offer, but a lower grade and set the difference in premium aside – also based on that there will be cases where the insurance may not cover, or not cover fully. After some years, where I never had used the insurance, I decided to be self-insured. I now had some money in a “rainy day account” and could add up with the premium I should pay in a few coming years, so there was a reasonable amount in the emergency account – keeping the savings going with an affordable amount every month. On top I buy one of the very affordable PA insurances from one of the Thai banks.

You have to be aware of the risks that Sheryl pointed out. If something “big” happens, all your savings may be gone – and if you don’t have set enough aside, you may be limited in choice of hospital and treatment. If enough is Sheryl’s suggested 3 million baht or less, I cannot say, but there should be some kind of lump sum. Going back home is an option for many foreigners, but if you are in state where a normal air-ticket cannot bring you back, repatriation may be extremely expensive.

Another thing is one’s own condition when something happens. When having a health insurance the payments are normally organized without (too much) hazel between hospital and insurance company – but when you are self-insured, will someone else have access to your emergency savings to settle your hospital bill...?

In my case I have someone I trust, but I don’t know what else you can do; perhaps some other forum members can advise...?

[Lone Ranger]

336,000.00 baht is the price a bed ridden friend of mine has been quoted to be repatriated back to UK !

This is with a Thai rescue agency used by UK Embassy & covers nurse flying with patient in business class [nurse returns on economy] as he cannot sit & delivered through to Red cross ambulance at Heathrow.....so be warned having a paralizying stroke is very expensive....

[Sheryl]

Self insuring is certainly an option but not at 5k!!! That won't even cover a perforated appendix, let alone a major car or moto accident, stroke, heart attack etc. Etc.

As a rule of thumb, for a single event you should allow for at least 2 million baht if all treatment is in govt hospitals and 5 million if you want the option of private.

As for the idea that you'lljust go back tothe UK, (1) suggest you readthe various threads about loss of NHS eligibility for those who live abroad and (2) keep in mind that you might not be stable enough to fly. As above, medical evacuation is extremely expensive.

Naturally the average insured person will, over the course of time, receive less in reimbursed costs than they paid in. If this were not the case the insurance companies couldn't stay in business. But a minority will receive far more in reimbursed costs than they paid in and there is no telling in advance which group you will fall into.

The other issue with self-insuring is that most people can't afford to put aside enough for more thwn one major event.

[Balance]

My friend in Pattaya had a heart attack about 6 weeks ago.....got fitted with a stent...felt better in seconds....got charged 4500000 baht....couldn't pay...they have his passport....hes been back to see a doctor, blood test, tablets...25000 bht...he went back last week more tablets....15000 bht......costing more and more......

If you did meant to write 4.5 million Bhat, then your friend was at the wrong end of a colossal rip off, to the tune of 2.2 million Bhat. He needs to go see a lawyer and raise hell on social media.

[Craig krup]

My friend in Pattaya had a heart attack about 6 weeks ago.....got fitted with a stent...felt better in seconds....got charged 4500000 baht....couldn't pay...they have his passport....hes been back to see a doctor, blood test, tablets...25000 bht...he went back last week more tablets....15000 bht......costing more and more......

Jesus - 4,500,000! I could wear 450,000. I'm hoping there's one zero too many here. I thought Thai medicine was famously inexpensive?

[Craig krup]

'If you were really rich you wouldn't buy the insurance.' You mean just like HM/HMG and the Windsor Castle fiasco? But they were happy, and able, to let the taxpayer pick up the tab. And it probably remains uninsured.

And I hate to rain on your health parade, but at 100/50 vs 120/80, it sounds as though you've got a low blood pressure issue.

My mother is the same, as are other family members. There's quite a good correlation between depression and low blood pressure. Then again, when they've tested isolated populations who don't eat junk food they typically have 100/50 blood pressure. A lot of people think that there's nothing "normal" about normal 120/80 blood pressure. No added salt and a load of CV exercise should see something much lower.

[Craig krup]

336,000.00 baht is the price a bed ridden friend of mine has been quoted to be repatriated back to UK !

This is with a Thai rescue agency used by UK Embassy & covers nurse flying with patient in business class [nurse returns on economy] as he cannot sit & delivered through to Red cross ambulance at Heathrow.....so be warned having a paralizying stroke is very expensive....

Seven grand (£7,000). Expensive, but (nearly) worst case scenario, and a lot of the insurance policies head towards a grand.

Something occurred to me overnight - you get a discount for paying it all in one go, but the chance of something happening is spread through the year. You (presumably) aren't going to keep paying after you've nearly died and been shunted back to the UK, so month-by-month might make more sense. However, I also guess that if you had a "near miss" - a little heart attack that presaged something bigger - they'd use that to refuse your next monthly premium and cancel the policy.

[bkkreed]

As Umbanda says, accidents and emergencies often happen when we are under-prepared. I didn't realize how commonly young, healthy people suffer strokes/traumatic brain damage. The costs for survivors of severe brain damage are astronomical, and continue for the rest of their lives.

My youngest had a tbi at 22, an athlete in top condition who had recently moved and was therefore temporarily without insurance; . Medical and rehabilitation costs forced us to move to Thailand from the U.S. And we are among the lucky -- our family has been able to afford rehabilitation and medical care here.

[csabo]

If your resting pulse is 40 you suffer from bradycardia. See a doctor immediately and buy insurance on the way to the hospital.

[Sheryl]

My friend in Pattaya had a heart attack about 6 weeks ago.....got fitted with a stent...felt better in seconds....got charged 4500000 baht....couldn't pay...they have his passport....hes been back to see a doctor, blood test, tablets...25000 bht...he went back last week more tablets....15000 bht......costing more and more......

Jesus - 4,500,000! I could wear 450,000. I'm hoping there's one zero too many here. I thought Thai medicine was famously inexpensive?

this was more than a stent as he had a heart attack first. So there will have been stays in ICU etc. For all that at a top end private hospital this is typical cost. Hence recommendation of not less than 5 mill per incident cover.

Costs of health csre havr risen steadily and steeply in Thsiland over the past fecade and are continuing to rise.

[csabo]

My friend in Pattaya had a heart attack about 6 weeks ago.....got fitted with a stent...felt better in seconds....got charged 4500000 baht....couldn't pay...they have his passport....hes been back to see a doctor, blood test, tablets...25000 bht...he went back last week more tablets....15000 bht......costing more and more......

Jesus - 4,500,000! I could wear 450,000. I'm hoping there's one zero too many here. I thought Thai medicine was famously inexpensive?

Yeah, my friend had the same emergency and procedure for 500000 in Phuket.

[Issangeorge]

Ever since the man in Dubai decided to promote Thailand as a medical hub, the cost of the major private hospitals have become very expensive. Then again you get what you pay for, a 5 star facility for a 5 star price. When I am sick I just want to get well, a ward is fine for me, I'm too sick to enjoy 5 star facilities anyway.

Edited April 16, 2015 by Issangeorge

[konying]

I am of a strong opinion that self insuring simply does not work.

Sure, for a small thing here and there its fine, but should anything major happen, such as heart attack, stroke, kidney failure etc, self fund will get you through the front door and thats about it.

Sure insurance companies make money, keeping in mind some people do not claim for years.

I currently pay about 35K per year and may not have a claim for 10 years, so one would say i am wasting 350K, but should something happen, this 350K would be gone in 1-2 days in fees.

I had a surgery about 7 years ago, shoulder, 1 night in the hospital, 345 000 baht.

6 months physio, another 150 000 baht.

Early acceptance is also a bonus, because as you get older, insurance companies are more reluctant to accept and make many exclusions, not to mention pre existing conditions and super high premiums.

I joined private fund at the age of 38, the only precondition i have so far is my operated shoulder. so anything else would be covered.

[off road pat]

I have 2 stroke story's,.....one of my friends had a stroke in Hua Hin a few months ago, he was transported to San Paolo hospital, the worst choice in Hua Hin.

he had Bupa insurance and after a few days they stopped covering his costs .....they got over the one million thb ....he was transported to Bumrungrad hospital in Bangkok were they took beter care of him, but has drained his money a lot.........he had to be repatriated to his home country at his own expenses...he is doing fine now. but it had cost him a fortune...

Personally just one year ago I had a stroke when I was 200 km south of Hua Hin....to make a long story short ,.. My European Travel insurance contacted the best hospital around and that was Bangkok Hospital in Hua Hin. A ambulance came to pick me up and, a professional team took charge of me from the moment i was in the ambulance.....I recovered fast enough but had to stay a 20 days in hospital to take more scans and tests before to be repatriated to my country....with a medic picking me up from my country . we flew business my wife the nurse and I. the full hospital cost of the insurance was 330 000 thb.....And I was happy the insurance paid everything...including the repatriation...

PS: The fact that I recovered in a few days is due to a overdose of blood diluting pills I took when I realised what was happening...

And I to, don't drink or smoke.....

Edited April 16, 2015 by off road pat

[nongsangcity]

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My friend in Pattaya had a heart attack about 6 weeks ago.....got fitted with a stent...felt better in seconds....got charged 4500000 baht....couldn't pay...they have his passport....hes been back to see a doctor, blood test, tablets...25000 bht...he went back last week more tablets....15000 bht......costing more and more......

If you did meant to write 4.5 million Bhat, then your friend was at the wrong end of a colossal rip off, to the tune of 2.2 million Bhat. He needs to go see a lawyer and raise hell on social media.

sorry 4 hundred and 50 thousand baht.............too many 00000s............

[robblok]

I have 2 stroke story's,.....one of my friends had a stroke in Hua Hin a few months ago, he was transported to San Paolo hospital, the worst choice in Hua Hin.

he had Bupa insurance and after a few days they stopped covering his costs .....they got over the one million thb ....he was transported to Bumrungrad hospital in Bangkok were they took beter care of him, but has drained his money a lot.........he had to be repatriated to his home country at his own expenses...he is doing fine now. but it had cost him a fortune...

Personally just one year ago I had a stroke when I was 200 km south of Hua Hin....to make a long story short ,.. My European Travel insurance contacted the best hospital around and that was Bangkok Hospital in Hua Hin. A ambulance came to pick me up and, a professional team took charge of me from the moment i was in the ambulance.....I recovered fast enough but had to stay a 20 days in hospital to take more scans and tests before to be repatriated to my country....with a medic picking me up from my country . we flew business my wife the nurse and I. the full hospital cost of the insurance was 330 000 thb.....And I was happy the insurance paid everything...including the repatriation...

PS: The fact that I recovered in a few days is due to a overdose of blood diluting pills I took when I realised what was happening...

And I to, don't drink or smoke.....

Being overweight.. diabetic and eating unhealthy also contributes (ps not saying you fit that category) but just smoking and drinking are not the only reasons for a stroke.

[konying]

I have 2 stroke story's,.....one of my friends had a stroke in Hua Hin a few months ago, he was transported to San Paolo hospital, the worst choice in Hua Hin.

he had Bupa insurance and after a few days they stopped covering his costs .....they got over the one million thb ....he was transported to Bumrungrad hospital in Bangkok were they took beter care of him, but has drained his money a lot.........he had to be repatriated to his home country at his own expenses...he is doing fine now. but it had cost him a fortune...

Personally just one year ago I had a stroke when I was 200 km south of Hua Hin....to make a long story short ,.. My European Travel insurance contacted the best hospital around and that was Bangkok Hospital in Hua Hin. A ambulance came to pick me up and, a professional team took charge of me from the moment i was in the ambulance.....I recovered fast enough but had to stay a 20 days in hospital to take more scans and tests before to be repatriated to my country....with a medic picking me up from my country . we flew business my wife the nurse and I. the full hospital cost of the insurance was 330 000 thb.....And I was happy the insurance paid everything...including the repatriation...

PS: The fact that I recovered in a few days is due to a overdose of blood diluting pills I took when I realised what was happening...

And I to, don't drink or smoke.....

You will find travel insurance works different to health insurance.

Primary concern of travel insurance is to stabilize you and take you back home where they no longer need to pay.

[BKKSnowBird]

I have medicare in the US so if I found out something major I would go back.

That obviously will not cover a heart attack or accident were A big bill would need to be paid. I do have a credit card but only a $5000 limit.

Is there a type of long term travel insurance?

[konying]

I have medicare in the US so if I found out something major I would go back.

That obviously will not cover a heart attack or accident were A big bill would need to be paid. I do have a credit card but only a $5000 limit.

Is there a type of long term travel insurance?

I believe max is 1 year but can be renewed/repurchased should you do a return trip.