Uninsured foreigners burdens Thai public hospitals

[cyberfarang]

Government hospitals charge a fraction of the extortionate private hospitals, I use them, and never fail to pay the final bill.

Why doesn't the Government, or a company within Thailand, introduce an insurance for people restricted to using public hospitals only ?

I am sure the premiums would be a lot more affordable for people here.

With regards to making it compulsory for arrivals to have insurance, this would be impossible to police. With modern technology, it is not rocket science to forge a bill head,from an overseas insurance company, quoting a blag policy number, indicating that the person is insured. Proving that every document people show on arriving is genuine would be impossible.

You use the government hospitals and never fail to pay your bill. That`s because standard health care is dirt cheap at the government hospitals. Issues arise when Farlangs are struck down with serious medical problems or involved in bad accidents. Sometimes government hospitals don`t have the necessary drugs and equipment to facilitate serious health problems and have to be referred to the private health sector and as many of us are aware once in the hands of the private health sector they have a free hand to charge what they like, highly suspect of inflating their fees for Farlangs. Other problems for expat retirees over the age of 60, health insurance premiums rise up to ridiculous amounts and a lot of insurance companies won`t insure them at all.

I agree with the lady that all tourists should have mandatory medical and accident insurance, but for the expat retirees this is a very grey area because as retirees in Thailand there are no concessions laid on for us whatsoever, it`s all left to a matter of chance. This is an issue I think has to be addressed.

[mango66]

My Thai wifes company pay per month about 550,- thb for insurance,

and she can even use a private hospital !

So, to be fair , and acceptable -

every tourist for 15 days should pay 15 euros,

for 30 days, 30,- Euros !

even this is double than thais pay,

but on my mind acceptable for any tourist,

and to pay on entering Thailand,

if he not show an travel insurance from his departure country ;

Discussion finished,

collect it !!

[Rorri]

So you want to blame the hospitals because foreigners rip them off. It is not the hospital’s fault if a foreigner doesn’t have any money or refuses to pay his bill. This could easily lead to restrictions on the care of foreigner, which no one wants.

It works out to approx. US$80,000 a year, think about how much the tourist bring into Thailand, I think Thailand is coming out way in front. This is an old reused, time and time again story, simply for some bureaucrat to get their name, and face, in the news. Poor Thailand, and its expensive hospitals, I shed no tears. Go ask TAT for 30 baht for each tourist, that should keep the whinging money pinches quiet. But hey, instead of complaining about non payers, why not investigate the corrupt over charging of insured patients.

Edited March 7, 2016 by Rorri

[madmitch]

How many times has this old chestnut been roasted? Getting medical insurance is perfectly possible (ask Sheryl) even for 90-year-olds - see threads I referenced above.

www.CignaGlobal.com

Charging 30/40/50 baht per head at the airport is ridiculous since some people only stay a week and others 3 months or a lot more. Asking already hard-pressed immigration offices to check incomers medical insurance is equally ridiculous. Check against what database, format, standards? It is actually CHEAPER for Thailand to pay the bill in the cases where the farang can't/won't pay,,,,,

I have just got an online quote from Cigna.

Their cheapest rate plan, Silver, comes to £341.01 per month or a little over 17,000 thb per month or 204.606 thb per year using 50thb/£1 as an exchange rate.

The Gold plan is £426,27 or 21,310 thb per month and 255,760 thb per year.

The Platinum plan is £532.83 or 26,640 thb pcm and 319,700 thb per year.

You're over 65 and it's a first time policy. No underwriter wants this business, that's why it's so expensive. You're lucky to get a quote in the first place.

[chiang mai]

Why do people continually call a lump sum put away for Hospital care as "Self Insure" perhaps they need to look up the definition of Insurance.

And perhaps you need to get a life Alfred, it's perfectly clear to everyone what that expression is intended to convey!

[chiang mai]

My Thai wifes company pay per month about 550,- thb for insurance,

and she can even use a private hospital !

So, to be fair , and acceptable -

every tourist for 15 days should pay 15 euros,

for 30 days, 30,- Euros !

even this is double than thais pay,

but on my mind acceptable for any tourist,

and to pay on entering Thailand,

if he not show an travel insurance from his departure country ;

Discussion finished,

collect it !!

Insurance premiums are calculated based on risk, the older the person the higher the risk, 30 Euro's per day might cover the average aged traveler but not the average retiree by virtue of age.

[jpinx]

How many times has this old chestnut been roasted? Getting medical insurance is perfectly possible (ask Sheryl) even for 90-year-olds - see threads I referenced above.

www.CignaGlobal.com

Charging 30/40/50 baht per head at the airport is ridiculous since some people only stay a week and others 3 months or a lot more. Asking already hard-pressed immigration offices to check incomers medical insurance is equally ridiculous. Check against what database, format, standards? It is actually CHEAPER for Thailand to pay the bill in the cases where the farang can't/won't pay,,,,,

I have just got an online quote from Cigna.

Their cheapest rate plan, Silver, comes to £341.01 per month or a little over 17,000 thb per month or 204.606 thb per year using 50thb/£1 as an exchange rate.

The Gold plan is £426,27 or 21,310 thb per month and 255,760 thb per year.

The Platinum plan is £532.83 or 26,640 thb pcm and 319,700 thb per year.

You're over 65 and it's a first time policy. No underwriter wants this business, that's why it's so expensive. You're lucky to get a quote in the first place.

Please stop BS-ing about something which has been explained in detail already. I got the quote and I am a first-timer and 69 years old. Now - - before anyone else poo-poos the policy offers - get your own quote !!!!

[JLCrab]

Why do people continually call a lump sum put away for Hospital care as "Self Insure" perhaps they need to look up the definition of Insurance.

And perhaps you need to get a life Alfred, it's perfectly clear to everyone what that expression is intended to convey!

True -- but would be better called a reserve. With insurance, you at least have the possibility of getting back in claims paid more than you put in.

[eggers]

What moron goes to Thailand without travel insurance?

I used to pay about US$60 for a single trip

I think they should be locked up after their treatment till the family or someone else pays.

Thats what would happen if they didnt pay their hotel bill, whats the difference?

Many expats who have lived here for the past ten years or more chose to self insure, I'm one of them, it's cost effective if you have savings put aside for such an emergency and my past twelve years here have proved that to be true. Forcing me to buy insurance does nothing more than improve insurance company profits and reduce the quality of my treatment and care, at age 66, pre-existing conditions are unlikely to be covered thus money spent on premiums would otherwise have been spent on treating those conditions.

I imagine what will happen with this at some point is that a government charge will be levied on those who do not have health insurance, that levy is likely to be substantial but only entitle the patient to be treated at government hospitals.

At age 66, you most likely wouldn't get health insurance, as for travel insurance doesn't apply to Expats living here. Researched possible cover & all refused to insure after 65.

Plus, if had any prior serious illness, i.e. heart, cancer, irrespective of time or no ongoing problem, you won't be covered for any illness slightly related to the original illness.

As for the premium, exorbitant, even though cover has exclusions, so self insure & have paid own way at private hospitals, that aren't that expensive compared to Western countries.

Edited March 7, 2016 by eggers

[balo]

Real tourists who intend to stay here for up to 2-3 months should not be allowed to travel without an insurance .

A simple check could be done at the airport , no insurance and you're not allowed to enter the plane.

For the rest of us living here without insurance, stupidity comes first in my mind.

[chiang mai]

Why do people continually call a lump sum put away for Hospital care as "Self Insure" perhaps they need to look up the definition of Insurance.

And perhaps you need to get a life Alfred, it's perfectly clear to everyone what that expression is intended to convey!

True -- but would be better called a reserve. With insurance, you at least have the possibility of getting back in claims paid more than you put in.

I can accept that verbiage although I'm not sure about the rest of it, I think it's eminently possible that I could get back more from my reserve than I put into it by virtue of investment returns over the years, especially true if I drop down dead suddenly without needing to use that reserve - I hear Alfred saying yes, please! .

[sjaak327]

In case of tourists, everyone should be required to have a health insurance when entering Thailand. What's difficult about this?

They require the same for Thais applying for schengen visa.

If someone has unpaid bills after the treatment just lock them in here until they pay.

Also same situation in Europe.

You are correct that Thai citizens wanting to visit Schengen need a visa, and indeed a health insurance is mandatory.

However people travelling to Schengen, who do not require a visa, will gain entry without proof of insurance.

I don't think it would be practical to check for proof of insurance at Thailand's border checkpoints. Especially considering that most people enter visa exempt.

[chiang mai]

Real tourists who intend to stay here for up to 2-3 months should not be allowed to travel without an insurance .

A simple check could be done at the airport , no insurance and you're not allowed to enter the plane.

For the rest of us living here without insurance, stupidity comes first in my mind.

You say that but my reserve fund is almost 5 million baht currently and it's off my spending radar, a combination of avoided premiums and investment returns, I can get a lot of sick treated for 5 mill.!

[SOUTHERNSTAR]

So mr. Farang come to visit Thailand, he rents a mc without a dl and due to dui makes an accident. Ends up in a hospital but can't pay his way. Please explain to me how this relates to overcharging at hospitals as some of the hospitals mentioned where government hospitals, with no incentive to overcharge. Charge each tourist B 500/30 days ($ 15 /30 days)or for retirement visa holders B 6000 per year, unless the tourist can prove they have travel insurance or Thailand based health cover.

[alfieconn]

Why do people continually call a lump sum put away for Hospital care as "Self Insure" perhaps they need to look up the definition of Insurance.

And perhaps you need to get a life Alfred, it's perfectly clear to everyone what that expression is intended to convey!

Perhaps it's not perfectly clear to someone new on here,anyway why not call it "Hospital Savings" or something similar instead of something mis-leading.

[chiang mai]

Why do people continually call a lump sum put away for Hospital care as "Self Insure" perhaps they need to look up the definition of Insurance.

And perhaps you need to get a life Alfred, it's perfectly clear to everyone what that expression is intended to convey!

Perhaps it's not perfectly clear to someone new on here,anyway why not call it "Hospital Savings" or something similar instead of something mis-leading.

We agreed earlier we're going to call it a "reserve" just to keep you happy, do try and keep up.

[soalbundy]

I have a Thai health insurance linked to a small life insurance, 60,000 Baht a year. I got that when i was 60 but they don't insure you for health past 70. I use a private hospital in Surin who are reasonable with their prices ( i checked my bill once with that of a Thai from my village who was in for the same thing, my bill was 460 Baht less ! ) of course one has to pay up front and apply for reimbursement from the insurance, never had any problems. Once, when i had dengue fever they charged me 48,000 Baht, 5 days in a private room, i couldn't pay up front so they gave me the bill as paid so i could send it off to the insurance.

[alfieconn]

Real tourists who intend to stay here for up to 2-3 months should not be allowed to travel without an insurance .

A simple check could be done at the airport , no insurance and you're not allowed to enter the plane.

For the rest of us living here without insurance, stupidity comes first in my mind.

You say that but my reserve fund is almost 5 million baht currently and it's off my spending radar, a combination of avoided premiums and investment returns, I can get a lot of sick treated for 5 mill.!

Well 5m wouldn't cover 2 or 3 major events

[Sheryl]

How many times has this old chestnut been roasted? Getting medical insurance is perfectly possible (ask Sheryl) even for 90-year-olds - see threads I referenced above.

www.CignaGlobal.com

Charging 30/40/50 baht per head at the airport is ridiculous since some people only stay a week and others 3 months or a lot more. Asking already hard-pressed immigration offices to check incomers medical insurance is equally ridiculous. Check against what database, format, standards? It is actually CHEAPER for Thailand to pay the bill in the cases where the farang can't/won't pay,,,,,

I have just got an online quote from Cigna.

Their cheapest rate plan, Silver, comes to £341.01 per month or a little over 17,000 thb per month or 204.606 thb per year using 50thb/£1 as an exchange rate.

The Gold plan is £426,27 or 21,310 thb per month and 255,760 thb per year.

The Platinum plan is £532.83 or 26,640 thb pcm and 319,700 thb per year.

Dunno what happened to you -- I'm 69 and my quote was...

1 monthly payment of £ 95.48 then 11 monthly payments of £ 95.51 inc tax

I was quoted triple that, and I am 55.

Also, within 5 minutes of receiving the quote, a knob was on the phone from the UK trying to sell me the policy.

I told him I was not interested and hung up on him.

Your quote must have been for both inpatient and outpatient, and without deductible. It is necessary to look carefully at the myriad of options. Even the Thai-based insurance plans are quite expensive if including outpatient.

Try it again selecting inpatient only, a deductible of $750-$1000 per year and copay of 20% up to a maximum out of pocket (deductible + copay) per year of $5,000. The rate will be vastly different. This does not, by the way, mean that you have to pay $5,000 yourself before insurance pays anything. You have to pay only $750 before the insurance kicks in. Then you pay just 20% of total but not in excess of $4,250 that calendar year. Examples:

1. Total cost $3,000 (105,000 baht, typical of an uncomplicated routine hospitalization in a private hospital or more extensive -- but not catastrophic - stay and surgery at a government hospital): you pay $750 plus 20% of $2,250 = $450, for total out of pocket $1,200; the insurance pays the other $1,800. And the $1,200 you paid counts towards your out of pocket costs for anything else in that same calendar year, i.e. if you have another hospitalization no need for the $750 deductible and your future copays in that year cannot exceed $3,800 since annual out of pocket expense is limited to no more than $5,000.

2. Total cost $10,000 (350,000 baht, typical of major but uncomplicated surgery at a private hospital or more extensive/complicated care at a government hospital): you pay $750 plus 20% of $9,250 = 1,850 = total $2,600 and the insurance pays the other $8,150.

3. Total cost $60,000 (2.1 million baht, typical of highly specialized surgery with ICU stay at a private hospital, or multiple specialized surgeries and long ICU stay at a government hospital). You pay the $5,000 maximum and the insurance pays the other $55,000, and will pay 100% of any additional inpatient costs that occur in that same calendar year.

The premium for something like this in a person over age 55 will be around $2,000-$3,000 per year.

You can make similar online calculations for the many other companies based in Europe offering expat health policies, though AFAIK CIGNA is the least costly one that has a high age of enrolment and worldwide cover.

Just input a string of 9's or 1's for phone number, that will prevent the annoying sales calls.

[godden]

Could be the sprat to catch the makrel

[jpinx]

I have just got an online quote from Cigna.

Their cheapest rate plan, Silver, comes to £341.01 per month or a little over 17,000 thb per month or 204.606 thb per year using 50thb/£1 as an exchange rate.

The Gold plan is £426,27 or 21,310 thb per month and 255,760 thb per year.

The Platinum plan is £532.83 or 26,640 thb pcm and 319,700 thb per year.

Dunno what happened to you -- I'm 69 and my quote was...

1 monthly payment of £ 95.48 then 11 monthly payments of £ 95.51 inc tax

I was quoted triple that, and I am 55.

Also, within 5 minutes of receiving the quote, a knob was on the phone from the UK trying to sell me the policy.

I told him I was not interested and hung up on him.

Your quote must have been for both inpatient and outpatient, and without deductible. It is necessary to look carefully at the myriad of options. Even the Thai-based insurance plans are quite expensive if including outpatient.

Try it again selecting inpatient only, a deductible of $750-$1000 per year and copay of 20% up to a maximum out of pocket (deductible + copay) per year of $5,000. The rate will be vastly different. This does not, by the ay, mean that you have to pay $5,000 yourself beforei nsurance pays anything. You have to pay only $750 before the insurance kicks in. Then you pay just 20% of total for a while. Examples:

1. Total cost $3,000 (105,000 baht, typical of an uncomplicated routine hospitalization in a private hospital or more extensive -- but not catastrophic - stay and surgery at a government hospital): you pay $750 plus 20% of $2,250 = $450, for total out of pocket $1,200; the insurance pays the other $1,800. And the $1,200 you paid counts towards your out of pocket costs for anything else in that same calendar year, i.e. if you have another hospitalization no need for the $750 deductible and your future copays in that year cannot exceed $3,800 since annual out of pocket expense is limited to no more than $5,000.

2. Total cost $10,000 (350,000 baht, typical of major but uncomplicated surgery at a private hospital or more extensive/complicated care at a government hospital): you pay $750 plus 20% of $9,250 = 1,850 = total $2,600 and the insurance pays the other $8,150.

3. Total cost $60,000 (2.1 million baht, typical of highly specialized surgery with ICU stay at a private hospital, or multiple specialized surgeries and long ICU stay at a government hospital). You pay the $5,000 maximum and the insurance pays the other $55,000, and will pay 100% of any additional inpatient costs that occur in that same calendar year.

The premium for something like this in a person over age 55 will be around $2,000-$3,000 per year.

You can make similar online calculations for the many other companies based in Europe offering expat health policies, though AFAIK CIGNA is the least costly one that has a high age of enrolment and worldwide cover.

Just input a string of 9's or 1's for phone number, that will prevent the annoying sales calls.

Yes -- I forgot to assume that folks in here want something for nothing so I didn't tell them to put in for maximum deductibles and shared payment options. Silly me!

I fell for the phone number too, but got an email where I was able to tell them to stop pestering me. It worked

[chiang mai]

Real tourists who intend to stay here for up to 2-3 months should not be allowed to travel without an insurance .

A simple check could be done at the airport , no insurance and you're not allowed to enter the plane.

For the rest of us living here without insurance, stupidity comes first in my mind.

You say that but my reserve fund is almost 5 million baht currently and it's off my spending radar, a combination of avoided premiums and investment returns, I can get a lot of sick treated for 5 mill.!

Well 5m wouldn't cover 2 or 3 major events

I'll try to keep it down to one then!

More seriously, having now seen the internal workings of the Provincial Hospital here I would be quite happy to put myself in their hands rather than in a very expensive private hospital that has marble walls and fountains in the lobby so yes, 5 million may actually cover more than one significant episode. And actually, I could afford to have two major events at private hospitals before my self insured reserve approach became uneconomical compared to traditional medical insurance, simply, I would end up paying an amount that is equal to the premiums I would have paid anyway.

[Stan7444]

This is already a very old debate and has been covered many times in TV. The issue at hand in the quoted instances is that fact that the hospitals overcharge and apply inappropriate treatments in many cases. Go to a government hospital and the bill will usually be reasonable.

When I arrived into Thailand several years ago I purchased international health insurance from a UK company. Paid about 10,000 baht per month with 15,000 baht deductible. For minor treatments even with an overnight stay in a private hospital in Phuket, could never come close to this deductible, so dropped it as wasted expense. Now at my age, could not even apply for heath insurance, so have to pay out of pocket for treatment. In Bangkok now and going a few times to public national health hospitals, and the expenses are very cheap. Broke a finger last year and with 4 x-rays, ER, two different casts on my hand, 5 different prescription medicines, at least 8 visits to the Dr. who spoke good English, total cost was less than $80. Only problems are that the rest of nursing staff mostly do not speak English, so nice to have a Thai with you, and also there are long lines so the average wait period is 2 hours per visit.

Noticed recent change with this hospital in that they use to treat me then afterwards would give me the billing, which I then paid at the cashier desk. Now they give me the billing, I have to pay first and then they treat me. Maybe because of all these other problems with farangs not paying their hospital bills. Don't know what they might do if it were a real serious emergency for me with hospitalization and not sufficient money to pay for it or I was unconscience.

[JeffreyO]

Just a matter of time before the government runs off more retirees by requiring that they have insurance that would wipe out a third of some monthly incomes. Universal coverage is the answer but no one is asking the question.

Universal coverage for non-immigrants? Maybe if the country had an immigrant visa option it would be applicable but a non-immigrant visa? Is this a joke?

[Dublin]

I have been in public hospitals mostly up country due to lack of private I was never charged more than 7000 THB and that bill was for a shit load of tests and 2 night stay I paid and left too easy. Firstly if you can afford to be in holidaying in Thailand you can afford a bill of less than 10,000THB & secondly how do you leave the hospital with out paying....those who never paid send there names to emigration ban them or wait till they come back and hit them up giving the rest of us a bad name.

Edited March 7, 2016 by Dublin

[CLW]

In case of tourists, everyone should be required to have a health insurance when entering Thailand. What's difficult about this?

They require the same for Thais applying for schengen visa.

If someone has unpaid bills after the treatment just lock them in here until they pay.

Also same situation in Europe.

You are correct that Thai citizens wanting to visit Schengen need a visa, and indeed a health insurance is mandatory.

However people travelling to Schengen, who do not require a visa, will gain entry without proof of insurance.

I don't think it would be practical to check for proof of insurance at Thailand's border checkpoints. Especially considering that most people enter visa exempt.

Agree with you, most tourists are on visa exemption and also I see no practical way to check for their insurance at arrival.

Basically that could present any document, also mostly not in English...

But in my opinion this could be a measure to reduce the hospital debts as mentioned in the article.

[Sheryl]

... Researched possible cover & all refused to insure after 65.

Plus, if had any prior serious illness, i.e. heart, cancer, irrespective of time or no ongoing problem, you won't be covered for any illness slightly related to the original illness...

You did not research very thoroughly, or perhaps limited yourself to Thai companies. A number of international companies will insure well past 65, some even at age 100.

Statement about pre-existing is also not true of all companies. Many will cover in full if the condition has been stable for several years. others will insure for just "acute exacerbations" of pre-exisitng conditions. And often exclusions will be dropped if no related claims in the first few years.

As for what is considered related to a pre-existing condition, that varies with the underwriter and company. In my experience European based insurers are quite reasonable. Someone with simple hypertension, for example, will not have heart conditions or stroke excluded, and even direct complications of the hypertension will not be excluded if it has well controlled for say 2 years prior to getting the policy. But it does depend on the company.

The services of a broker in navigating all this are very helpful.

[Roomuck]

Thailand isn't a nanny state.

If people want to take the chance and come without insurance, up to them, but it is also up to them if they need treatment to pay and not bludge off the Thais. It is like a bet, if you win, then good for you, if you lose, pay up and don't whine and cry about it.

The government doesn't need to bring in new rules for the nanny state citizens who are too tight to pay for their own insurance and then want to bludge of the Thais. The Thais should look after their own, others should have to pay.

Medical treatment here is cheap compared to other countries. And IMO the nurses are way cuter.

[JLCrab]

We've been through this one before -- but people (at least in USA) who have enough money to donate for a new wing to the hospital still buy health insurance.

But when someone gets to the point where they don't have any conditions that aren't pre-existing, the whole thing about whether to buy health insurance becomes moot, anyway.

Edited March 7, 2016 by JLCrab

[alfieconn]

Why do people continually call a lump sum put away for Hospital care as "Self Insure" perhaps they need to look up the definition of Insurance.

And perhaps you need to get a life Alfred, it's perfectly clear to everyone what that expression is intended to convey!

Perhaps it's not perfectly clear to someone new on here,anyway why not call it "Hospital Savings" or something similar instead of something mis-leading.

We agreed earlier we're going to call it a "reserve" just to keep you happy, do try and keep up.

Thats ok then, just don't call it self insure again