Health Insurance

[ThaiPauly]

Do any TV members have health insurance?

Is it any good and not let you down when you claim?

I have just had a quote of 235 GBP per month from a very reputable company, but it does not cover me for anything related to my Type 2 diabetis, or my Ulcerative Colitis problems.

I am also concerned that it is a one year contract and worry that if I was in trouble they would not renew, they say they would but why would they? They are not obliged to.

If I take this step it would be a big one ...it's a lot of money, but so are healthcare costs if you get sick here.

Thoughts anyone?

[Upnotover]

I have an inpatient only policy with AXA, about THB85K/year. Last year I cost them well over THB1.2M but have recently renewed without a significant increase in the premium nor any additional exclusions over my original pre-existing conditions. No complaints from me.

[Sheryl]

Actually if it is a policy issued in a Western country they are obligated to renew as long as you have not been fraudulent in your applictaion and maintained the payments.

Some policies will cover pre-existing conditions after a certain waiting period (typically 2 years, though it may vary by the condition) and a number will cover "acute exacerbations". Given that you have these conditions, would be wise to work with a broker to find the best policy.

Many TV members have insurance. And many TV members without it have suffered badly as a result....as well as gther extended families who have sometimes gone into debt or lost assets in order to pay off hospital bills.

[Chivas]

Actually if it is a policy issued in a Western country they are obligated to renew as long as you have not been fraudulent in your applictaion and maintained the payments.

Some policies will cover pre-existing conditions after a certain waiting period (typically 2 years, though it may vary by the condition) and a number will cover "acute exacerbations". Given that you have these conditions, would be wise to work with a broker to find the best policy.

Many TV members have insurance. And many TV members without it have suffered badly as a result....as well as gther extended families who have sometimes gone into debt or lost assets in order to pay off hospital bills.

Sorry that totally incorrect. I use to work within Insurance covering this type of Policy..... Cover can be withdrawn at any time with the only requirement being a refund of a percentage of Premium if in this case 1 year hadn't elapsed

[Sheryl]

That is certainly the case in Thailand but not in most Western countries where the insurance sector is more tightly regulated.

It is definitely illegal to do what you describe in the US, the UK and I believe also in most if not all EU countries.

[banK]

HI

I started a policy with Cigna Global.2 years 9 months ago. At that time the Gold membership was about 2500gbp, I didn't use them in the first year.

The renewal price the following year was about 2900gbp. I opted to pay an excess of 1000gbp in each of years (not per condition).

I have had occasion them in October just gone - cost down to me so I paid the 33,000 baht bill.

In December just gone I had the occasion to use the policy again. I duly paid the balance of the excess. Now it's all for them to pay and so far they have forked out about 1.5 million Baht. I envisage the final bill, even if the outlook is good, there is still another operation to do, which could amount to another million.

I await the renewal price in February - the policy expires March 23rd.

The cover is for 1.3 million pounds. The silver is for 625,000 pounds cover.

We will see.

banK

[banK]

By the way I am 67 yo. And there you can pay monthly.

banK

[banK]

Also forgot to say that I opted for inpatient, but cancer is covered in/out/day patient.

banK

[Suradit69]

I have an inpatient only policy with AXA, about THB85K/year. Last year I cost them well over THB1.2M but have recently renewed without a significant increase in the premium nor any additional exclusions over my original pre-existing conditions. No complaints from me.

"I have an inpatient only policy"

Yes, people speak of "health insurance," but in most cases local insurance is only for inpatient care, so it's really hospital insurance.

If you want to include outpatient care, the additional premium will cost you about as much as you could ever hope to collect for outpatient charges. And anything else associated with "health" is just not covered.

My US based insurance that I use in Thailand covers in-patient, out-patient, prescription drugs, dental, eye, etc which is what I would think better qualifies as "health insurance" ... and it cannot be cancelled.

Edited January 12, 2016 by Suradit69

[loppylugs1]

HI

I started a policy with Cigna Global.2 years 9 months ago. At that time the Gold membership was about 2500gbp, I didn't use them in the first year.

The renewal price the following year was about 2900gbp. I opted to pay an excess of 1000gbp in each of years (not per condition).

I have had occasion them in October just gone - cost down to me so I paid the 33,000 baht bill.

In December just gone I had the occasion to use the policy again. I duly paid the balance of the excess. Now it's all for them to pay and so far they have forked out about 1.5 million Baht. I envisage the final bill, even if the outlook is good, there is still another operation to do, which could amount to another million.

I await the renewal price in February - the policy expires March 23rd.

The cover is for 1.3 million pounds. The silver is for 625,000 pounds cover.

We will see.

banK

Problem is the age,it sure gets expensive.

I have followed your thread re lung cancer,and you sure are lucky,perhaps a trip back home would have done the trick too.

The procedures you followed I copied them and asked at around three cancer specialty hospitals knowing Thailand is on the expensive side asked for quotes for what you undertook,two did not answer,the third hesitantly replied,but I pressed them again,the costing dept. came up with a figure of around one seventh,probably could be reduced if not taking suite

Anyway good luck

[Sheryl]

One seventh the cost, either it was a govt hospital or they did not really understand what you were talking about. Bear in mind his bill includes a PET scan etc as well as the surgery.

Or do you mean you asked hospitals in India?

[loppylugs1]

One seventh the cost, either it was a govt hospital or they did not really understand what you were talking about. Bear in mind his bill includes a PET scan etc as well as the surgery.

Or do you mean you asked hospitals in India?

yes do not like mentioning India,seems as I get my arse booted

I did include PET scan and all the procedures you stated ,even possible stage 1,doctor or whoever kept asking for case notes,put him off by saying I'm coming over (which I am in few weeks)

Edited January 12, 2016 by loppylugs1

[Mobi]

It is a very worrying situation for us older residents - particularly when access to free medical care back home is also becoming ever more difficult.

I held health care insurance out of the UK up to the age of 65 when they more than doubled my rates. As even that coverage excluded pre-existing conditions, which for me included diabetes and a heart condition, it really only covered me for something like cancer or accident injuries. Fortunately, there is no history of cancer in my family but I would never rule it out completely.

For the past 5 years, I've gone it alone, but I've always had in excess of million baht available for medical emergencies - enough for some things but not enough for others. If I had cancer or some other serious condition but was still able to get on a plane I would fly back to the UK and throw myself at the mercy of the NHS service. They won't refuse to treat me and I can argue about who pays later.

If I am too ill to fly out, I will go to one of the top government hospitals in Bangkok - Rajavithi, Siriroj or Chulalongkorn. They have the best doctors and surgeons in Thailand and their rates are around one-third the cost of private hospitals. My aorta valve replacement at Rajavithi cost me less than 300,000 Baht, which included a VIP room, whereas Bumrungrad would have charged me close to a million for the same op. Nowadays, maybe even more.

I am currently under the care of the top GI specialist at Siriroj - he is a professor and does no outside work. His fees are ridiculously low, even at the private wing and he lets me buy all my meds outside.

But access to these hospitals cane be a bureaucratic nightmare and you need a strong Thai to see you through it all - not one who just says yes sir and no sir, three bags full sir…

There's no easy answer and I am always prepared for the worst. The sad fact is that the older you get, and the more chronic medical conditions you develop, the harder it is to obtain any kind of half-way decent medical insurance.

Hope this has been of some help.

Good luck.

Mobi

[Chivas]

That is certainly the case in Thailand but not in most Western countries where the insurance sector is more tightly regulated.

It is definitely illegal to do what you describe in the US, the UK and I believe also in most if not all EU countries.

I can utterly assure you its not. The only Coverage that can never be pulled as long as premiums paid is death and Terminal illness coverage

All other types of Coverage Insurance company can take you "off risk" at any time refunding premium as required.

Cars Accident Sickness Property etc etc coverage can be pulled at any time. I worked for Axa I know !

Edited to add.......Ask the Owners of Property flooded by water that were taken off risk "mid contract" over last few years in uk

Edited January 13, 2016 by Chivas

[Mobi]

There may be some confusion here with insurance companies in the USA who are partnering the government on the Obama health care programme. I don't know too much about it, but participating insurers' health cover business is strictly controlled as far as renewals and other policy matters are concerned.

The whole idea to is provide free healthcare to people who were previously not protected, due to their bad health and/or their inability to pay insurance premiums. We have to understand that Obamacare is America's version of a state health care system and as such the State calls the shots.

I was a senior executive in a major international insurance/reinsurance conglomerate for nearly 20 years and I can assure you that in the free insurance markets outside of USA, any insurer can refuse to renew any policy at any time, be it healthcare, flood insurance or whatever. I can also tell you that is is very difficult to make money from healthcare, as many insurance companies have found to their cost. I have seen both sides of this problem.

They can also treble or quadruple the rates, and increase the deductibles and exclusions to make the policy worthless. It's no different to any other capitalist business, they are not obliged to sell to anyone - if they were the shareholders would soon be up in arms. Insurance companies are in business to make money, not help old duffers like me receive free operations in my dotage.

Sad, but true.

[Mobi]

One thing has occurred to me. If you were already sick or injured at the date of your insurance renewal, and the renewal is refused, the insurance company would still be liable to pay any medical bills in respect of your ongoing sickness or injury which occurred during the period of your cover. Any new events that occurred after the cover expired would not be protected.

This is one of the reasons that healthcare is a difficult business for insurers to make money.Claims can continue to flow in years after cover has expired, as they relate to conditions that occurred during the period of cover.

End of insurance lesson....

[Sheryl]

The EU has regulations against "unreasonable contract terms" in health insurance. Which would include policy cancellation without just cause.

If insurance companies really could drop any policy at will, none of them would continue to insure anyone who developed a chronic illness. Yet they do, even with things as costly as cancer and renal failure.

BUPA Thailand contracts clearly state they can stop the insurance at any time and also raise rates as they see fit (unrelated to normal age increases) if in their opinion you have moved into a higher risk category, and I thiunk you will find this in all Thai based policies.

Cigna Global (out of UK) contract quite clearly does not allow for this; they can terminate only if premiums not paid, there was fraud (including any lying in the original application), or they go out of the market, and I think you will find the wording in other EU country-issued policies to be the same.

"Obamacare" tightened it grounds for cancellation even further, but cancelling health insurance because someone developed a chronic health problem has long been illegal in the US.

Do not however rely soley on what country the insurer is based in. It is critical to read the fine print, which means that you have to get a copy of a standard contract to review before you buy a policy.

[ThaiPauly]

Right now after what I have read here I am inclined not to take out a policy but transfer 2m baht to a savings account that should cover me for any disasters that may befall me in the future, if it's not enough I guess I will have to sell one of my rentals in the UK, or as Mobi has said ,go home and throw myself at the NHS and hope for the best. Last March I was in the UK and had health problems, went to the emergency room ,gave them my name and the guy confirmed my last address here. I did not contradict him.

As Mobi has said Insurance companies want to make money, why wouldn't they?

I was going into this thinking I could beat the system, but it seems like it's just like putting a bet on a horse.

You never see a poor bookie, how did these companies get to be multi-billion pound concerns? Also I am not happy about the exclusions, which are the things I have wrong with me right now.

It really does not make any difference to say that Cigma are the company I have been in contact with, I am not saying anything bad about them, they are probably no different to any other insurance company.

[Mobi]

If there was no proper actuarial basis for an unreasonable change in the contract terms that is one thing. But If an actuary can establish that a particular policyholder is a very high risk, then any onerous terms placed upon renewal, like doubling the premium, increasing the deductibles and increasing the exclusions would not be considered unreasonable.

It would be the same for motor insurance for a driver who has many accidents or property insurance for a building built on a flood plain and is subject to regular flooding.

In any event, it would be very difficult to establish what is 'unreasonable' They would be in the courts for years, with actuaries and lawyers on both sides making a fortune.

Declining to renew an insurance policy is quite another.

An insurance policy is normally written for one year. That is a one-year contract. At the end of the policy period, the policy is no longer valid and that is that. If the insurer, in their opinion, deems the insured risk to be too high risk, they can decline to renew. They can also cease to write any line of business at any time if it is unprofitable.

All European Insurance companies are strictly regulated and they simply would not be allowed to write any line of business that regularly makes huge losses, which is what would happen if they were obliged to renew policies, no matter what.

Indeed, many have ceased offering healthcare insurance cover in recent years as the costs of medical care are becoming astronomical, as many state health schemes are finding out. There may well come a day when only the very rich will be able to afford healthcare insurance which means the state will have to pick up more and more of the tab.

If I recall correctly, many healthcare policy holders in the USA found themselves without cover when Obamacare came in. Many people had their renewals refused or had the premium price and deductibles go through the roof. They were forced to look around for new cover under the auspices of Obamacare.

With the State setting the rules, I'm not all convinced this commercial/state healthcare partnership in America is going to work in the long term. Watch for insurers exiting the business in increasing numbers, and the premiums going higher and higher in the coming years.

[ThaiPauly]

HI

I started a policy with Cigna Global.2 years 9 months ago. At that time the Gold membership was about 2500gbp, I didn't use them in the first year.

The renewal price the following year was about 2900gbp. I opted to pay an excess of 1000gbp in each of years (not per condition).

I have had occasion them in October just gone - cost down to me so I paid the 33,000 baht bill.

In December just gone I had the occasion to use the policy again. I duly paid the balance of the excess. Now it's all for them to pay and so far they have forked out about 1.5 million Baht. I envisage the final bill, even if the outlook is good, there is still another operation to do, which could amount to another million.

I await the renewal price in February - the policy expires March 23rd.

The cover is for 1.3 million pounds. The silver is for 625,000 pounds cover.

We will see.

banK

BanK, I know you are going through a really tough time right now and if I was a religious guy I would certainly be praying for you, but I do hope you make a full recovery I really do. I would be interested to know what happens when your insurance is up for renewal? Will the re-insure you pull the plug?, or jack the price?

With kindest wishes for your recovery, I don't want to come across as insentative but you are the only person on this thread with first hand experience of how health insurance from your provider is working right now

[TheCruncher]

The EU has regulations against "unreasonable contract terms" in health insurance. Which would include policy cancellation without just cause.

If insurance companies really could drop any policy at will, none of them would continue to insure anyone who developed a chronic illness. Yet they do, even with things as costly as cancer and renal failure.

BUPA Thailand contracts clearly state they can stop the insurance at any time and also raise rates as they see fit (unrelated to normal age increases) if in their opinion you have moved into a higher risk category, and I thiunk you will find this in all Thai based policies.

Cigna Global (out of UK) contract quite clearly does not allow for this; they can terminate only if premiums not paid, there was fraud (including any lying in the original application), or they go out of the market, and I think you will find the wording in other EU country-issued policies to be the same.

"Obamacare" tightened it grounds for cancellation even further, but cancelling health insurance because someone developed a chronic health problem has long been illegal in the US.

Do not however rely soley on what country the insurer is based in. It is critical to read the fine print, which means that you have to get a copy of a standard contract to review before you buy a policy.

If insurance companies really could drop any policy at will, none of them would continue to insure anyone who developed a chronic illness. Yet they do, even with things as costly as cancer and renal failure.

But isn't that what Mobi explained in the post above yours? That if you develop a chronic illness, dropping the policy doesn't relieve them from having them to pick up future bills. So they better can continue the policy and recover as little as they can get.

[Sheryl]

Insurance policies are contracts. The insurer is liable for adherence to the terms within..

I have in front of me right now a Cigna policy. It guarantees lifetime renewal if premiums are paid and no fraud. It also clearly sets forth conditions for premium increases.

Have seen same in other policies.

Health insurance is more tightly regulated, for obvious reasons, than property insurance.

As to the idea that companies would have to raise premiums in people who develop serious health problems in orfer to stay afloat, this overlooks the fundamental principal of health insurance which is risk sharing. They do not have to raise premiums on the sick policyholder because increased pay outs to them are offset by no payputs or low payouts to others.

This thread is creating serious misperceptions about the value of health insurance and unnecessarily discouraging people from getting it. Not helpful.

[banK]

HI

I started a policy with Cigna Global.2 years 9 months ago. At that time the Gold membership was about 2500gbp, I didn't use them in the first year.

The renewal price the following year was about 2900gbp. I opted to pay an excess of 1000gbp in each of years (not per condition).

I have had occasion them in October just gone - cost down to me so I paid the 33,000 baht bill.

In December just gone I had the occasion to use the policy again. I duly paid the balance of the excess. Now it's all for them to pay and so far they have forked out about 1.5 million Baht. I envisage the final bill, even if the outlook is good, there is still another operation to do, which could amount to another million.

I await the renewal price in February - the policy expires March 23rd.

The cover is for 1.3 million pounds. The silver is for 625,000 pounds cover.

We will see.

banK

BanK, I know you are going through a really tough time right now and if I was a religious guy I would certainly be praying for you, but I do hope you make a full recovery I really do. I would be interested to know what happens when your insurance is up for renewal? Will the re-insure you pull the plug?, or jack the price?

With kindest wishes for your recovery, I don't want to come across as insentative but you are the only person on this thread with first hand experience of how health insurance from your provider is working right now

I'm quite cynical when it comes to things like this.I hope that the renewal premium will be reasonable, then of course I'll renew - I'm not asking them the question. I've been pleasantly surprised with the help so far from Cigna, Although their office procedures and coordination could be improved. But on the whole good.

Had a PET-CT that discovered that I have an unrelated condition that will need urgent attention. I'm waiting in hospital still recovering from the lung op, meanwhile the doctors are deciding what is the best way forward for this other condition. The hospital are liaising with Cigna.

Depending on method the price between 1 - 3 million baht

And thanks for the thoughts

[ThaiPauly]

Insurance policies are contracts. The insurer is liable for adherence to the terms within..

I have in front of me right now a Cigna policy. It guarantees lifetime renewal if premiums are paid and no fraud. It also clearly sets forth conditions for premium increases.

Have seen same in other policies.

Health insurance is more tightly regulated, for obvious reasons, than property insurance.

As to the idea that companies would have to raise premiums in people who develop serious health problems in orfer to stay afloat, this overlooks the fundamental principal of health insurance which is risk sharing. They do not have to raise premiums on the sick policyholder because increased pay outs to them are offset by no payputs or low payouts to others.

This thread is creating serious misperceptions about the value of health insurance and unnecessarily discouraging people from getting it. Not helpful.

I think it is helpful Sheryl to see things from different people's perspective. Yesterday I was convinced by what I had read that I would not take out insurance, today, after having read more, a reply from banK and your thoughts I am more inclined to take a policy out with Cigna, once I see a copy of the contract.

[loppylugs1]

It sure is from a personnel perspective For smokers past and present I think its a must,most defiantly, for the rest I think not if in decent health at 50 or 60 plus.

,somethings going to kill you eventually but I do not intend to pay unlimited amounts for what may never happen,unplanned that is

Three friends recently died one just before last Christmas , just 60 years old,could not give up the roll-ups,another,two years before past smoker,lung cancer ,another smoker couple of years before him,used to complain he was starving,two mouthfuls of food full,six weeks later pushing up the daisies Ive known others who have been through cancer operations,major ones too,but there was always something that came along quite rapidly afterwards that smacked them down again,whether resistance was weakened I know not

I'm not bothering,there are loads of far cheaper options than taking the overly expensive insurance route at 65 plus years of age ,it is quite humbling though to read a potential life or death situation unfold, and all the best to him

[thaiduncankk]

You try and sue a Multinational company that refuses to re-insure you. Not a chance.

[oneton]

Ha Ha Ha - had to post this as I have just been informed today by Pattaya BUPA office on Sukhumvit that I cannot have Health Insurance d/t my BMI > 35. According to the sales person all Thai health insurers apply this rule. They were not interested in any other factors at the initial stage and smoking and alcohol is not an issue. So fatties - no insurance for you, but no problem for chain smokers and alcoholics! Also she was not forth coming about the Thailand only insurance 'Crystal' (I was with my Thai wife and I can also apply on retirement visa). Average to poor service in my opinion.

[ThaiPauly]

Try another insurer, ie Cigna