Living in Thailand with no health insurance

[LivinLOS]

^^ As I said early on.. If someone cant put their hands instantly on large liquid assets.. They better buy insurance.

But insurance is for the poor, the wealthy dont need it.

Thats the point that JLCrab has been argueing against since the start.. Claiming theres 'many other conveniences' etc etc.. The only convenience of insurance is taking the fear of not being able to easily meet a cost, away from someone. Thats what its for, thats why you pay a premium, to cover that fear.

I dont have that fear, I can meet any bill, simple logic says why support that industry if its charging for a service I dont need.

[JLCrab]

I've said this now several times over these 13 pages: For the truly wealthy people, the premiums are negligible and the notion of paying 100% of the cost of anything when they could have had it for 10% of that cost is not how they manage their affairs. That is based on the truly wealthy. The guy here says that he has no problems paying for something in full that could have cost him much less. That is not how the wealthy people that I know view the world.

As for the 90%/10% in that the 90% will probably break even at best on their premiums,that's true -- but everyone has an equal chance of being in that 10% and those who wind up there probably never expected to be there either.

The guy says that dealing with finances at the hospital is easy. To me, not having to deal with finances at the hospital is even easier.

[luther]

In the last year, I’ve eaten lunch with several young Thai doctors. All said healthcare costs in Thailand are set to soar during their careers. They sited the rising cost of drugs. They mentioned that the algorithms established to determine what drugs cost in different countries are constantly being tweaked, never in Thailand’s favor. They also sited the large number of private hospitals being built, claiming that hospitals attracting the rich and upper middle class are putting pressure on the tier below to raise prices in a myriad of ways.

Cancer treatment in Thailand for those going to private hospitals can cost several million baht, and chemo doesn’t get much cheaper at government hospitals such as Shripat. My Thai landlord said she had a Thai friend who died of cancer and spent his last 20-30 days in Bumrungrad. They were asking something around 30,000 baht per day, just for hospice type care.

I’ve bumped into two Thai people visiting Chiang Mai to consider building “retirement homes.” They had everything going for them. They already owned the land, knew some doctors up here who could advise them, etc. Both quickly retreated from the idea.

When I mentioned to the doctors above that foreigners must keep 800,000 baht (or have a pension) they all knew the exact numbers and predicted they will rise.

Buying insurance depends on your age, wealth, and health.

Car insurance here seems very expensive. For a 5-6 year old truck or plain car, buy the liability and take the risk on collision.

Health insurance for now is extremely cheap especially if you are 50 - 65 years old.

[LivinLOS]

I've said this now several times over these 13 pages: For the truly wealthy people, the premiums are negligible and the notion of paying 100% of the cost of anything when they could have had it for 10% of that cost is not how they manage their affairs. That is based on the truly wealthy. The guy here says that he has no problems paying for something in full that could have cost him much less. That is not how the wealthy people that I know view the world.

As for the 90%/10% in that the 90% will probably break even at best on their premiums,that's true -- but everyone has an equal chance of being in that 10% and those who wind up there probably never expected to be there either.

You dont pay 100% for something you could of got for 10%.. On aggregate insurance costs more. ALWAYS. Its a business, if it didnt it would be out of business.

I dont buy insurance for many reasons.. One big one is I would have to assume being under average, something I have never entertained. That mindset is part of why I can make many successful businesses and trades, so that mindset itself has made me millions. If it were to cost me a few 1000 or even 10s of 1000s, to keep that kind of mindset it would still be paying off 100 fold. I know that doesnt apply to most people, hence the average thing again, but thats fine by me.

Fact is, precisely as I said in the very first reply in the thread.. If you scared of meeting the cost, even a little bit, get it. Sleep well.. But insurance is a tax on the poor.

[BritManToo]

Cancer treatment in Thailand for those going to private hospitals can cost several million baht, and chemo doesnt get much cheaper at government hospitals such as Shripat. My Thai landlord said she had a Thai friend who died of cancer and spent his last 20-30 days in Bumrungrad. They were asking something around 30,000 baht per day, just for hospice type care.

I know several Thai citizens with cancer, first class service from the government hospitals in CM at no charge.

I would suggest your Thai landlord is doing the usual Thai bragging about how much money he can afford to waste on unnecessary private treatment.

The only high hospital prices in Thailand are for fleecing foreigners.

If I were to have potentially life threatening hospital treatment, I would want to have it on a country where doctors couldn't buy their way through medical school.

[JLCrab]

I've said this now several times over these 13 pages: For the truly wealthy people, the premiums are negligible and the notion of paying 100% of the cost of anything when they could have had it for 10% of that cost is not how they manage their affairs. That is based on the truly wealthy. The guy here says that he has no problems paying for something in full that could have cost him much less. That is not how the wealthy people that I know view the world.

As for the 90%/10% in that the 90% will probably break even at best on their premiums,that's true -- but everyone has an equal chance of being in that 10% and those who wind up there probably never expected to be there either.

You dont pay 100% for something you could of got for 10%.. On aggregate insurance costs more. ALWAYS. Its a business, if it didnt it would be out of business.

I dont buy insurance for many reasons.. One big one is I would have to assume being under average, something I have never entertained. That mindset is part of why I can make many successful businesses and trades, so that mindset itself has made me millions. If it were to cost me a few 1000 or even 10s of 1000s, to keep that kind of mindset it would still be paying off 100 fold. I know that doesnt apply to most people, hence the average thing again, but thats fine by me.

Fact is, precisely as I said in the very first reply in the thread.. If you scared of meeting the cost, even a little bit, get it. Sleep well.. But insurance is a tax on the poor.

Millions? I'm talking hundreds of millions. And some of these people are so average you could be sitting across from them at restaurant -- or in Oklahoma a cafeteria -- and you wouldn't have the slightest idea as they are totally without pretense.

[Social Media]

I have known over the years some extremely wealthy people, none of which would even discuss "money", those that "think" they are wealthy, and thereby gain and assert this misguided air of superiority often do.

Bottom line, personal choice, based on personal circumstances. In Thai tradition "up to you"

[suzannegoh]

BUPA Platinum is structured on a limit per incident basis with no limit to annual amounts or lifetime payments. There are no deductibles for outpatient only coverage.

What happens when the "incident" is a chronic condition that will incur expenses on an ongoing basis?

[suzannegoh]

"they are determined by demographics and statistics", of which your actual medical expenses form a part - Bumrungrad is one of the the most expensive private hospitals in the country. If you lived in the US you wouldn't automatically have al your health care issues taken care of at North Okaloosa Medical Center (FL), so why do similar in Thailand.

http://www.menshealth.com/health/50-most-overpriced-hospitals

You're not the first farang to object to my spending habits and I doubt that you will be the last. It's not just me that is causing this problem, everyone with insurance is contributing to rising medical costs to some degree. If no one had insurance there is no way that private hospitals would be able to charge as much money as they do.

You misunderstand, I'm not in a position to object to your spending habits, that's your business not mine, I was merely pointing out something that may not have been obvious. In fact I used to use Bumrungrad for all my medical needs when I first came to Thailand and then I started to realise that there are alternatives that are just as good if not better but also substantially cheaper.

I made it sound like we were using exclusively Bumrungrad and wantonly running up the bill but that's not the case. We have certain routine tests and MRIs done at other places for reasons of convenience, we've used BNH in Bangkok a couple of times for minor surgeries, and I cut the insurance company a break on prescription costs by having them filled at an independent pharmacy instead of at the hospital.

I'm well aware that Bumrungrad is not the only place with good doctors, but I think that Bumrungrad is the gold standard in Thailand. Almost all of the doctors that they have on staff have rock-solid credentials, most of their doctors are good at explaining treatment option to patients, and I think that the odds of receiving successful treatment there are as high as anywhere in SE Asia. And they can direct bill to foreign insurance companies.

The point that I was inelegantly trying to make is that if your insurance company is willing to pay for even the most expensive hospital in Bangkok then you don't have much incentive to beat the bushes looking for cheaper alternatives, for anything complicated you might as well go straight to the hospital that you trust most. And that means that your medical costs are apt to be more expensive than if you didn't have insurance or if you had a less comprehensive policy.

I think that National University Hospital in Singapore is probably the gold standard for the region but that's an aside. Libel laws prevent me from detailing my experiences with Big B. over many years but I think if you had the entire picture you would change your views. Anyway, you must seek treatment where you feel comfortable doing so.

All of us form our opinions of hospitals based upon anecdotes and anecdotes are not data. I don't know a way around that, nor do I know why you've had bad experiences with Bumrungrad while I've have good ones.

[JLCrab]

BUPA Platinum is structured on a limit per incident basis with no limit to annual amounts or lifetime payments. There are no deductibles for outpatient only coverage.

What happens when the "incident" is a chronic condition that will incur expenses on an ongoing basis?

I don't know -- my coverage is hospital Inpatient only up to the limit per incident. i am assume that a chronic condition is one that is treated on outpatient or ex-hospital basis.

[suzannegoh]

To the case above, either this is a total fabrication and rip-off on the part of the hospital /insurer or there was something that led them to believe that an accurate medical history had not been provided by the friend. Say tuned.

It is not a fabrication. Look at my post history previously. I sure so not go off making 'fairy stories.'

The above has happened, and I will report the outcome in the future when I know more. I have known this guy for well over eight years: he is fit as, and this was his first claim ever.

From what I can gather is that the hospitals here are all inter-connected, and the Insurance has access to this information. He seems confident to getting his money back but in reality, being told one thing and then given another is not on.

BUPA Platinum is structured on a limit per incident basis with no limit to annual amounts or lifetime payments. There are no deductibles for outpatient only coverage.

What happens when the "incident" is a chronic condition that will incur expenses on an ongoing basis?

I don't know -- my coverage is hospital Inpatient only up to the limit per incident. i am assume that a chronic condition is one that is treated on outpatient or ex-hospital basis.

Thanks for your advice and patience. My concerns are mostly about chronic conditions, a one-off expense is something that I could whether.

[JLCrab]

I don't know about such chronic treatment here in Thailand, but I am Medicare eligible and if something were to hit me that would just be too much out-of-pocket or not available here in Thailand, it would be time for me to spend a good deal more time in US of A.

[tonray]

I don't know about such chronic treatment here in Thailand, but I am Medicare eligible and if something were to hit me that would just be too much out-of-pocket or not available here in Thailand, it would be time for me to spend a good deal more time in US of A.

The problem is your condition may render you unable to fly commercially, requiring a multi million baht med evacuation. You can't easily determine now that you will be healthy enough to travel back or even to make the decision to travel back.

Everyone should have an emergency repatriation policy AND a living will stipulating who can make your decisions for you in the event you cannot do so. I simply plan to muster enough strength to crawl into the corner of my room and hope for the best.

[suzannegoh]

I don't know about such chronic treatment here in Thailand, but I am Medicare eligible and if something were to hit me that would just be too much out-of-pocket or not available here in Thailand, it would be time for me to spend a good deal more time in US of A.

Yes, that occurred to me too (that one I reach 65yr old I could go back to the US and claim medicare). But in many cases that's easier than said than done. Some medical conditions might make flying inadvisable or expensive.

[JLCrab]

I don't know about such chronic treatment here in Thailand, but I am Medicare eligible and if something were to hit me that would just be too much out-of-pocket or not available here in Thailand, it would be time for me to spend a good deal more time in US of A.

Yes, that occurred to me too (that one I reach 65yr old I could go back to the US and claim medicare). But in many cases that's easier than said than done. Some medical conditions might make flying inadvisable or expensive.

Y+True -- but that's why I keep insurance here.

[balo]

If it's a chronic condition there's not much you can do anyway, I have a back problem that comes and goes, all I can do is visit a chiropractor or physio to get it threated . I do not expect insurance to cover that. Still I would never live here without an insurance , tomorrow you could regret it.

[Spaniel]

I don't know about such chronic treatment here in Thailand, but I am Medicare eligible and if something were to hit me that would just be too much out-of-pocket or not available here in Thailand, it would be time for me to spend a good deal more time in US of A.

Are you aware that if you do not sign up for Medicare when first elgible at 65 then their is a waiting period to sign up later? The sign up period is Jan, Feb and March. Then once you have signed up the Medicare coverage doesn't start until 1 July. Also you will pay a 10% penality for each year that you could of had coverage but didn't. If your timing was real bad and had an emergency in April then you wouldn't even be able to sign up for a year. Of course you will have Part A. This procedure is for Part B.

[JLCrab]

I don't know about such chronic treatment here in Thailand, but I am Medicare eligible and if something were to hit me that would just be too much out-of-pocket or not available here in Thailand, it would be time for me to spend a good deal more time in US of A.

Are you aware that if you do not sign up for Medicare when first elgible at 65 then their is a waiting period to sign up later? The sign up period is Jan, Feb and March. Then once you have signed up the Medicare coverage doesn't start until 1 July. Also you will pay a 10% penality for each year that you could of had coverage but didn't. If your timing was real bad and had an emergency in April then you wouldn't even be able to sign up for a year. Of course you will have Part A. This procedure is for Part B.

Yes I am aware but I qualify for a waiver on Part B enrollment penalty. Not I will have Part A -- I have Part A.

[Aussie69]

I am yet to make the move to LOS, but this topic is still the big question mark for me. As you stated I don't believe anyone can answer this question. I will be relatively young when I move, but even at 50 the insurance is costly. I was thinking self insure, I can access a certain amount of funds - but if I had to it would alter my long term plans. I was thinking I could get myself repaired enough to get back to public healthcare in Australia - but what if I have something that keeps me in hospital bound, plus who knows (in my situation) if public healthcare will even exist in my country in 10 years - all indications are that it won't.

[Spaniel]

I don't know about such chronic treatment here in Thailand, but I am Medicare eligible and if something were to hit me that would just be too much out-of-pocket or not available here in Thailand, it would be time for me to spend a good deal more time in US of A.

Are you aware that if you do not sign up for Medicare when first elgible at 65 then their is a waiting period to sign up later? The sign up period is Jan, Feb and March. Then once you have signed up the Medicare coverage doesn't start until 1 July. Also you will pay a 10% penality for each year that you could of had coverage but didn't. If your timing was real bad and had an emergency in April then you wouldn't even be able to sign up for a year. Of course you will have Part A. This procedure is for Part B.

Yes I am aware but I qualify for a waiver on Part B enrollment penalty. Not I will have Part A -- I have Part A.

How do you get a waiver on the Part B enrollment penalty? Is this waiver available for one and all?

[JLCrab]

Deficit Reduction Act of 2005 Section 5115 -- As of February 28, 2006:

Waiver of part B late enrollment penalty for certain international volunteers. Provides for the waiver of the Part B late enrollment penalty and establishment of a special enrollment period for beneficiaries who are

- volunteering outside of the U.S. through a 12 month or longer program sponsored by a tax-exempt organization defined under section 501_c(3) of the Internal Revenue Code and

- who have other health insurance coverage.

So I am Director of a US 501_c3 Corporation with an international program and fully insured in Thailand.

[Spaniel]

Deficit Reduction Act of 2005 Section 5115 -- As of February 28, 2006:

Waiver of part B late enrollment penalty for certain international volunteers. Provides for the waiver of the Part B late enrollment penalty and establishment of a special enrollment period for beneficiaries who are

- volunteering outside of the U.S. through a 12 month or longer program sponsored by a tax-exempt organization defined under section 501©(3) of the Internal Revenue Code and

- who have other health insurance coverage.

So I am Director of a US 501_c3 Corporation with an international program and fully insured in Thailand.

Thanks for sharing. Looks like I won't qualify for the waiver! I enrolled for the Part B in January and my new premium will be $159 per month starting in July.

[JLCrab]

Deficit Reduction Act of 2005 Section 5115 -- As of February 28, 2006:

Waiver of part B late enrollment penalty for certain international volunteers. Provides for the waiver of the Part B late enrollment penalty and establishment of a special enrollment period for beneficiaries who are

- volunteering outside of the U.S. through a 12 month or longer program sponsored by a tax-exempt organization defined under section 501©(3) of the Internal Revenue Code and

- who have other health insurance coverage.

So I am Director of a US 501_c3 Corporation with an international program and fully insured in Thailand.

Thanks for sharing. Looks like I won't qualify for the waiver! I enrolled for the Part B in January and my new premium will be $159 per month starting in July.

Well this was one of those every now and then things in this life when things go your way as I had started the Non-Profit and been fully insured long- before I knew anything about the waiver.

[Kwasaki]

I am yet to make the move to LOS, but this topic is still the big question mark for me. As you stated I don't believe anyone can answer this question. I will be relatively young when I move, but even at 50 the insurance is costly. I was thinking self insure, I can access a certain amount of funds - but if I had to it would alter my long term plans. I was thinking I could get myself repaired enough to get back to public healthcare in Australia - but what if I have something that keeps me in hospital bound, plus who knows (in my situation) if public healthcare will even exist in my country in 10 years - all indications are that it won't.

You sound like someone who should get insured.

[Aussie69]

I have very minimum insurance here in Chiang mai .If the worse comes i am prepared for the balcony jump .Had a good life up to now ( 63 years ) ,and have been blessed with good health so far .

What if you no longer have the capability of getting to the balcony?

[Aussie69]

Well I for one am even more conflicted on the topic, plus this is depressing.

How much does a gun cost in Thailand?

[ammagic]

I need hip replacement surgery - TB 500,000 - 600,000 at Bangkok Hospital. Very glad I have insurance!

[NancyL]

BlackOps raises the important point that the hospital KNOWS it's going to get paid when they see the insurance card, but they have no guarantee when they're presented with your unconscious body and a wallet full of bank cards. You may never regain full capability to make appropriate arrangements for care, either. A private hospital is taking a gamble when they accept an unknown unconscious patient with no payment history, no insurance card and only a wallet-full of bank cards to his name. Often those cards are expired, over-limit, or the patient won't be able to access them. The prudent course for the hospital is to bundle the patient off to the nearest gov't hospital and there, they'll stabilize the patient and keep him alive, but they won't go to extremes until they make contact with the family and get assurances of payment.

I've known foreigners to be here at the gov't hospital, in a coma, for 3 or 4 weeks while the hospital staff tries to figure out if they're going to get paid. And I've seen foreigners try to use bank cards and not remember PINs or find they're over their limit or need some gizmo to receive a PIN or have some problem where they're basically up the creek unable to access the fortune they say they have overseas.

[NancyL]

Nobody accepts AMEX in CNX I believe. Cancelled my card last year, useless.

Central Dept. store does. I use mine there from time-to-time just to keep it active. Hotels usually do, also.

Hospitals, no, I don't think any hospitals do.

[MadMac]

Last place I could use it was Shell, they stopped last year. Same time AMEX refused the fee waiver. I don't shop in Central if it's not an emergency .