Health Insurance - what to watch out for

[Sheryl]

Minimum 5 million baht apiece if you want the option of using private hospitals

1-2 million apiece if willing to only use government hospitals

 

Note these amounts would be for a single episode and would need to be replenished.

[jmd8800]

Recently I had chest pains and I knew right away what it was. Same as 16 years ago at age 44. I was 10 minutes from the hospital and went straight to ER. The doc say you have a blockage and we should first look with with an angiogram and then place a stent if necessary. Fine by me. What is the cost? About 200,000. I have 150,000 here in Thailand now, and can have the rest sent by end of the week. Reply was: Come back when you have the money.  I transferred the money and got the surgery done.

 

I thought wow they'd only be on the hook for 50,000 and get 150,000 at discharge. I suppose enough people have gamed the system they don't do was the common response. But I know a person who claims he had a gastric bypass fully financed by the same hospital. He makes payments for 2 years. I don't think anything is predictable here.

 

Now I've pretty much depleated my 'what if something goes wrong' money and have to move on to plan B. So I have a couple of questions. 1) is there any Thai insurer that cover pre-existing conditions? 2) Are there any hospitals that will do surgeries or fairly expensive treatments and allow the patients to make payments (doesn't have to be 100% of total cost)

 

It seems to me my best case is to maintain a bank account here with 500,000 plus a repatriation insurance policy with a place like World Nomads and keep a minimal Obamacare policy in the USA. 

 

I have not found an international insurer that will cover my heart. I've only checked a few though.

[Sheryl]

14 hours ago, jmd8800 said:

.... So I have a couple of questions. 1) is there any Thai insurer that cover pre-existing conditions? 2) Are there any hospitals that will do surgeries or fairly expensive treatments and allow the patients to make payments (doesn't have to be 100% of total cost)
 

 No and no.  Hospitals here will agree to payment arrangements only as a last resort when a patient has already run up a bill they cannot afford to pay. They will do everything they can to avert that from happening by getting assurrances up front of ability to pay. Though government hospitals are usually less vigilant than private ones in this regard (and also cost far less).

 

International insurers will also not cover pre-existing conditions though some will cover  "acute exacerbations" and others will drop an exclusion if a certain number of years pass without  need for further treatment. A few will also, on a case by case basis, include coverage for a pre-existing condition at a higher than normal premium cost. I know Cigna Global does, for example. I would suggest you work with a broker to see what is available for someone with your history.

 

The problem with just getting repatriation insurance is that even when it is high enough to cover being flown with medical attendants and equipment, you can still be too ill for it and by the time you are stabilized enough, have run up a huge bill. Worse yet, you may suffer serious damage or death because expensive interventions needed immediately were not done due to lack of assurrance you could pay.

 

Don't focus just  on cardiac issues, they  are not the only thing that can happen and indeed, as you have just had an angiogram and stent placement you should be OK in that department for at least some years to come. Plenty of other serious things, both accidents and illnesses, could happen for which you do not have a pre-existing condition. So even if you have to settle for a policy that excludes CAD it is still worth having.

 

From what I have seen, Cigna Global tends to be more reasonable with regard to pre-existing conditions than most. I'm sure they would still not give you full coverage for CAD at normal premium for your age but they might for an additional cost, or they might give limited cover it, or lift the exclusion if time passes without related claims. Worth discussing with them.

 

International policies do cost more than local ones but premiums can be reduced through deductibles and copays.

 

 

[siam2007]

On 18/11/2016 at 8:20 PM, Sheryl said:

That appears to include outpatient cover as well as other expensive optional "add ons" (dental, optical). . Ask again for inpatient only, no add ons - that is all you need and the cost will come down dramatically.

 

 

Indeed it was just a quick online quote and included all outpatient treatment.

Unfortunately, both insurance brokers I talked to (at different provinces and they don't know each other) told me just a few days ago they will not issue new contracts with ACS due to severe problems in the case of claim settlements recently.

So maybe it is CIGNA GLOBAL for me then, will look into that

[HampiK]

For the people who like to have self insurance, I still would  advise that they use of an accident insurance. Because I think if a car hit you and disappear.. then this accident insurance should pay...

In my opinion this is also a big danger in Thailand.

For health insurance I see the following sickness as expensive.. and many sickness come up cheap.

- Cancer

 

There could be possible more, but most sickness I can think right now are not that expensive. I am more scared about some accidents, which could come out with long hospital nights and therefore expensive.

 

The accident insurance is also much cheaper than a health (sickness) insurance...

I grow up in Switzerland, and there it's normal to have insurance for almost everything. Because of this I still strugle for self insurance... But I can see some advantages.

But a insurance should in my opinion help for bigger problems.. not for a flu.

My biggest concern with a insurance when I stay in Thailand is, that I pay for it for the next 20 years and then when I start to have problems, the insurance kick me out or raise the fee so much, that it's not worth to go on with the company. WHen you reach 60 or 65 years old.. it's not possible to change the insurance company.. Before the age of 60 it's not so a big problem as long you not had some preconditions which should be covered.....

[ClutchClark]

On November 19, 2016 at 7:42 AM, jmd8800 said:

Recently I had chest pains and I knew right away what it was. Same as 16 years ago at age 44. I was 10 minutes from the hospital and went straight to ER. The doc say you have a blockage and we should first look with with an angiogram and then place a stent if necessary. Fine by me. What is the cost? About 200,000. I have 150,000 here in Thailand now, and can have the rest sent by end of the week. Reply was: Come back when you have the money.  I transferred the money and got the surgery done.

 

I thought wow they'd only be on the hook for 50,000 and get 150,000 at discharge. I suppose enough people have gamed the system they don't do was the common response. But I know a person who claims he had a gastric bypass fully financed by the same hospital. He makes payments for 2 years. I don't think anything is predictable here.

 

Now I've pretty much depleated my 'what if something goes wrong' money and have to move on to plan B. So I have a couple of questions. 1) is there any Thai insurer that cover pre-existing conditions? 2) Are there any hospitals that will do surgeries or fairly expensive treatments and allow the patients to make payments (doesn't have to be 100% of total cost)

 

It seems to me my best case is to maintain a bank account here with 500,000 plus a repatriation insurance policy with a place like World Nomads and keep a minimal Obamacare policy in the USA. 

 

I have not found an international insurer that will cover my heart. I've only checked a few though.

 

Repatriation insurance Policy.

 

Look into MEDJET.

[pj123]

You also need to have a look at how the premiums will increase over the years. Two examples from the same company, Pacific Cross. Both offer guaranteed renewal but "Premiums may be revised based on claims experience and other criteria which the Company, at its sole discretion, may determine."

 

Their International Major Medical Policy. $250,000 per illness. $1,000 deductible per year, 100% oncology that includes OPD. No other OPD but covers 90 days OPD follow-up after discharge. Aged 48: 38,000 THB, aged 70: 134,000 THB.   Premium increases by about 350%.

 

Compare this to their Ultima Policy. Higher cover (20,000,000), no deductible and 100% IP & OPD, including OPD oncology.

At 48, 70,368. At 70, 143,000 THB.  Premium increases by about 100%.

 

They have cheaper versions of the Ultima, their Maxima looks like good value (55,000 for 48 year old) but the age listed in the brochure only goes to 65.

 

 

[Sheryl]

" "Premiums may be revised based on claims experience " is exactly the sort of thing you want to completely avoid!

 

Increases by age are universal, though extent will vary and you can find out, if you ask, what the current premiums are for different age groups just to get an idea.

 

But if there is a clause letting them raise your premium not just according to age but individualized to your "claim history" or "risk profile", all bets are off. Your premium could be many fold that of someone else the same age.  Should absolutely not take out a policy which allows for this, unless you are young and have some sort of fall back in case of developing a chronic condition or having large claims.

 

Should also not even look at a policy with a per illness cap as low as 250,000. Miniimum should be 5 million baht if you want to use private hospitals, say 2 million if you are willing to use only government hospital;s (referring to IPD only).

[pj123]

8 hours ago, Sheryl said:

" "Premiums may be revised based on claims experience " is exactly the sort of thing you want to completely avoid!

 

Increases by age are universal, though extent will vary and you can find out, if you ask, what the current premiums are for different age groups just to get an idea.

 

But if there is a clause letting them raise your premium not just according to age but individualized to your "claim history" or "risk profile", all bets are off. Your premium could be many fold that of someone else the same age.  Should absolutely not take out a policy which allows for this, unless you are young and have some sort of fall back in case of developing a chronic condition or having large claims.

 

Should also not even look at a policy with a per illness cap as low as 250,000. Miniimum should be 5 million baht if you want to use private hospitals, say 2 million if you are willing to use only government hospital;s (referring to IPD only).

 

But are there any policies that do NOT penalise you for claims made in previous years? If yes, can you please name them?

[Sheryl]

Most internationally issued policies do not do this.

 

I have not found any Thai-issued ones that don't, though.

 

The reasons lie in the legal regulations in different countries. Most Western countries would not allow such a clause in an insurance contract. Thai law does.

 

 

[Grumpy Old Man]

I dropped into this "Health Insurance" thread with the hope of finding a list of the good, bad and the ugly of "Health Insurance" companies along with the "What to look out for" and after reading through I'm still no wiser ! 

 

As of December 1st 2016 my UK based "Travel Insurance" becomes VOID as I'll be on an "Extension to stay / Retirement Visa" and no longer a tourist Etc.

 

A simple question if there is such a thing; what "Health Insurance" / "Medical Emergency Insurance" companies can you recommend ?

 

• I'm not looking for basic dental cover; I have a local dentist. 
• I'm not looking to cover the odd trip to my GP for a cough and cold Etc.

 

Thank you for your help and advise

[Sheryl]

Everyone's needs, situation etc are different. Furthermore, nobody should purchase health insurance just based on someone else's recommendation without themselves having read through the policy language etc and understood clearly what it does and does not cover, what the rules are regarding renewal and premium rates.

 

You'll easily get recommendations from people who are happy with their insurance because thus far they've had no problems.  The operative word is "thus far". Unless those people have had really large  claims for a condition that puts them at risk of future large claims, this tells you nothing about what would happen in such a case.

 

MOST insurance, if  issued by a reputable company that specializes in health insurance, will perform well for  claims that are clearly a one-off thing with no increased risk for similiar in future,  and no reasonable possibility that the condition or conditions leading to it were already present at the time of taking out the policy, especially if the first claim comes at least a year after taking out the policy. (In case of accidents the timing is not important, but for illness any company will scrutinize closely claims in the first year or two.)

 

"health insurance" issued by banks and the like are another matter, policies are often written only in Thai and coverage extremely limited - and an astonishing number of people take these out (usually at the urging of a Thai relation or friend who is an agent) only to find out later that the coverage is less than a fraction of even a minor hospitalization cost, or was only for accidents, etc etc.

 

There is no getting around the need to do some research. You can work through a broker and have them to the leg work so to speak, but you still need to carefully read policy documents before making a decision.

 

Factors to consider include:

 

- Are you planning to stay permanently in Thailand?

- Do you have a fall-back in case you develop a chronic health condition (i.e. would you be able to permanently return to your home country and have health coverage there? 

 

If the answers to the above are 1) yes and 2) no, then  guaranteed lifelong cover and protection against premium hikes etc become very important.

 

- your age: If you are over 55, that alone will narrow the field of available policies

 

- Can you afford to upfront costs and be reimbursed later, or do you require insurance that has direct payment arrangements with Thai hospitals?

 

- do you have any pre-existing conditions? That greatly complicates matters though insurers do vary in how flexible they are.

 

I suggest you sift through all that, make a list of your requirements and then contact a broker. But do not make final purchase without yourself reading and understanding the policy documents.

 

For example, my personal requirements are:

 

- will newly enroll someone my age

-guarantee of lifetime renewal provided premiums paid and no fraud on my part

-premium hikes based only on age and inflation, not affected by claims history or "risk profile"

-inpatient cover only but including day care in hospital, inc. cancer treatment etc

-no exclusion for chronic diseases

-if second opinion required, choice of physician for that i.e. not required to use doctor selected by insurance company. Preferrably second opinion not required or required only for a few specific things.

-direct payment arrangement with Thai hospitals

 

That's my list...but yours might be different. Some of the items on mine might not be necessary for you. You might have some to add that I don't (i.e. I have no pre-existing conditions).

 

 

 

 

 

 

 

[Grumpy Old Man]

1 hour ago, Sheryl said:

Everyone's needs, situation etc are different. Furthermore, nobody should purchase health insurance just based on someone else's recommendation without themselves having read through the policy language etc and understood clearly what it does and does not cover, what the rules are regarding renewal and premium rates.

 

You'll easily get recommendations from people who are happy with their insurance because thus far they've had no problems.  The operative word is "thus far". Unless those people have had really large  claims for a condition that puts them at risk of future large claims, this tells you nothing about what would happen in such a case.

 

MOST insurance, if  issued by a reputable company that specializes in health insurance, will perform well for  claims that are clearly a one-off thing with no increased risk for similiar in future,  and no reasonable possibility that the condition or conditions leading to it were already present at the time of taking out the policy, especially if the first claim comes at least a year after taking out the policy. (In case of accidents the timing is not important, but for illness any company will scrutinize closely claims in the first year or two.)

 

"health insurance" issued by banks and the like are another matter, policies are often written only in Thai and coverage extremely limited - and an astonishing number of people take these out (usually at the urging of a Thai relation or friend who is an agent) only to find out later that the coverage is less than a fraction of even a minor hospitalization cost, or was only for accidents, etc etc.

 

There is no getting around the need to do some research. You can work through a broker and have them to the leg work so to speak, but you still need to carefully read policy documents before making a decision.

 

Factors to consider include:

 

- Are you planning to stay permanently in Thailand?

- Do you have a fall-back in case you develop a chronic health condition (i.e. would you be able to permanently return to your home country and have health coverage there? 

 

If the answers to the above are 1) yes and 2) no, then  guaranteed lifelong cover and protection against premium hikes etc become very important.

 

- your age: If you are over 55, that alone will narrow the field of available policies

 

- Can you afford to upfront costs and be reimbursed later, or do you require insurance that has direct payment arrangements with Thai hospitals?

 

- do you have any pre-existing conditions? That greatly complicates matters though insurers do vary in how flexible they are.

 

I suggest you sift through all that, make a list of your requirements and then contact a broker. But do not make final purchase without yourself reading and understanding the policy documents.

 

For example, my personal requirements are:

 

- will newly enroll someone my age

-guarantee of lifetime renewal provided premiums paid and no fraud on my part

-premium hikes based only on age and inflation, not affected by claims history or "risk profile"

-inpatient cover only but including day care in hospital, inc. cancer treatment etc

-no exclusion for chronic diseases

-if second opinion required, choice of physician for that i.e. not required to use doctor selected by insurance company. Preferrably second opinion not required or required only for a few specific things.

-direct payment arrangement with Thai hospitals

 

That's my list...but yours might be different. Some of the items on mine might not be necessary for you. You might have some to add that I don't (i.e. I have no pre-existing conditions).

 

 

 

 

 

 

 

 

Thank you for comprehensive reply and advise . . . Your personal requirements listed above covers just what I'm looking for; who is your Health / Medical Insurance Company and I have a starting point ?

[Sheryl]

My current company is BUPA Thailand (Platinum Plan) but I am looking to change as they do not meet criteria #2 and 3. I want to switch to a policy which does while I am still healthy, one I can expect to stay with for life.

 

Still searching, just emailed a broker to help me. My "short list" was (in no particular order)

• Cigna Global
• A+ (SEA plan)
• Globaility
• William Russell
• April

 

Though the last one looks iffy as it seems, if I read correctly, that they require a second opinion by a doctor of their choosing. If so, that is out as I am not going to give an insurance company veto power over my health care, which is what that would amount to. But I may have misunderstood that provision.

 

It is also possible I have overlooked some, this is just what I have unearthed so far that looks possible.

 

 

[xylophone]

On 11/19/2016 at 8:42 PM, jmd8800 said:

So I have a couple of questions. 1) is there any Thai insurer that cover pre-existing conditions? 2) Are there any hospitals that will do surgeries or fairly expensive treatments and allow the patients to make payments (doesn't have to be 100% of total cost)

 

As for question number one, well I had a pleasant surprise with BUPA this past month regarding this because although they ask you to list pre-existing conditions, which I did, they then put them as exclusions on my policy, which most insurance companies do.

 

However having just come out of hospital for some surgery, I was browsing through the policy document wording and came upon something which brought much happiness to my aching body – – there are couple of clauses in this document which state that even though they have included the exclusions in your policy, if nothing happens as regards these pre-existing conditions for two years after the event, then one will be covered should similar/related illness occur!

 

This was certainly the case when they agreed to pay my hospital bill and I have to say I was very pleasantly surprised, and grateful of course!

[Grumpy Old Man]

4 hours ago, Sheryl said:

My current company is BUPA Thailand (Platinum Plan) but I am looking to change as they do not meet criteria #2 and 3. I want to switch to a policy which does while I am still healthy, one I can expect to stay with for life.

 

Still searching, just emailed a broker to help me. My "short list" was (in no particular order)

• Cigna Global
• A+ (SEA plan)
• Globaility
• William Russell
• April

 

Though the last one looks iffy as it seems, if I read correctly, that they require a second opinion by a doctor of their choosing. If so, that is out as I am not going to give an insurance company veto power over my health care, which is what that would amount to. But I may have misunderstood that provision.

 

It is also possible I have overlooked some, this is just what I have unearthed so far that looks possible.

 

 

 

Please keep me updated with how you get on with your search; your attached list gives me an excellent starting point !

[JLCrab]

After being with BUPA Platinum for almost 10 years, before age 60, I decided to apply to 4 international health care coverages, including some listed above, with the USA option included. All 4 denied coverage for reasons they would not specify but said that it was consistent with their underwriting pratices. As this one:

 

Thank you for the above Application. Naturally, we try to extend coverage to every applicant. However, under certain circumstances we are unable to accept some applicants. At this time, we are declining the above applicant for the following reason(s):

 

(X) The applicant does not meet our underwriting guidelines 

 

[TBKK]

On 11/26/2016 at 3:07 AM, Sheryl said:

My current company is BUPA Thailand (Platinum Plan) but I am looking to change as they do not meet criteria #2 and 3. I want to switch to a policy which does while I am still healthy, one I can expect to stay with for life.

 

Still searching, just emailed a broker to help me. My "short list" was (in no particular order)

• Cigna Global
• A+ (SEA plan)
• Globaility
• William Russell
• April

 

Though the last one looks iffy as it seems, if I read correctly, that they require a second opinion by a doctor of their choosing. If so, that is out as I am not going to give an insurance company veto power over my health care, which is what that would amount to. But I may have misunderstood that provision.

 

It is also possible I have overlooked some, this is just what I have unearthed so far that looks possible.

 

 

 

I have also been shopping for an international health insurance plan.

 

You might want to look at IMG Global and Geo Blue (Blue Cross Blue Shield Network).

 

My short list is:

* IMG Global

* Cigna Global

* Allianz

* Geo Blue 

[xylophone]

1 hour ago, TBKK said:

 

I have also been shopping for an international health insurance plan.

 

You might want to look at IMG Global and Geo Blue (Blue Cross Blue Shield Network).

 

My short list is:

* IMG Global

* Cigna Global

* Allianz

* Geo Blue 

 

Below is what I wrote in 2012 when looking around and to poss change from Bupa........you may want to do your own research, but look deep and extensively.

 

I have been searching for an alternative to my current Bupa policy, as outlined in another post of mine and I have looked IMG as a possible alternative because the price was very reasonable.

I did some research on the Internet about IMG and the feedback was not very promising with one particular trend evident throughout the complaints………the non-payment of claims on the basis that they were "pre-existing conditions", however when some complainants had stated the circumstances of the claim, most of them could never be construed as "pre-existing".

One actually suggested that because the company was registered in Indiana, USA, and the company states in its policy that any liabilities/claims against the company will be handled by the legal system in Indiana, then there is not a lot that one can do to try and overturn what is seen to be an incorrect policy decision by the company, i. e. once the company has made its decision you are pretty well helpless to challenge it.

One or two posts regarding poor service I could handle, but the more I searched the more I found so that did not give me any confidence.

[TBKK]

2 hours ago, xylophone said:

 

Below is what I wrote in 2012 when looking around and to poss change from Bupa........you may want to do your own research, but look deep and extensively.

 

I have been searching for an alternative to my current Bupa policy, as outlined in another post of mine and I have looked IMG as a possible alternative because the price was very reasonable.

I did some research on the Internet about IMG and the feedback was not very promising with one particular trend evident throughout the complaints………the non-payment of claims on the basis that they were "pre-existing conditions", however when some complainants had stated the circumstances of the claim, most of them could never be construed as "pre-existing".

One actually suggested that because the company was registered in Indiana, USA, and the company states in its policy that any liabilities/claims against the company will be handled by the legal system in Indiana, then there is not a lot that one can do to try and overturn what is seen to be an incorrect policy decision by the company, i. e. once the company has made its decision you are pretty well helpless to challenge it.

One or two posts regarding poor service I could handle, but the more I searched the more I found so that did not give me any confidence.

 

Thanks for the info.

Will have to look at IMG with more caution! 

 

 

[siam2007]

SHERYL, did you eventually sign up with any of those companies or how did your research end up ?

[jpinx]

For those over 70 who travel from UK to Thailand once a year, maybe for a long winter holiday,  this seems to be worth a look.

https://travelinsurance.staysure.co.uk

 

 

 

Policy key points and policy wording here....

 

StaysureKeyfacts.pdf

 

StaysurePolicyWording.pdf

 

 

[jpinx]

Following on from that --  here's what Cigna said to a 70-year old for annual insurance with deductibles.

https://www.cignaglobal.com

 

 

 

 

 

Things that are not included but offered as add-ons..

Select your additional benefits

Outpatient

£ 225.64 per month

VIEW BENEFITS

ADD

Medical Evacuation

£ 80.76 per month

VIEW BENEFITS

ADD

Health and Wellbeing

£ 22.45 per month

VIEW BENEFITS

ADD

Vision and Dental

£ 71.42 per month

VIEW BENEFITS

ADD

 

ADD

US Cover

£ 148.11 per month

[jpinx]

They are different policies - one is travel insurance and the other is medical insurance.  The travel insurance worked out at £444 for 5 months, and the medical insurance with big deductibles is £100 per month for an annual policy.

 

I hope this information is some help to people.

[brewsterbudgen]

On 11/13/2016 at 3:12 PM, Sheryl said:

It was ACS (ALLIANZ) but note that I did not read any further so can't say re other terms/conditions.

 

http://www.acs-ami.com/en/expatriate-health-insurance/acs-asia-lifetime-docs

 

(they have 2 plans, one gives  lifetime cover and the other covers you only up to a certain age. the latter  would not make sense if one was planning ot staty permanently abroad).

 

Having niow waded through a number of international policies, I can tell you that there are a lto of differences among them and close reading of policy documents is essential.

 

For example, I found one that excludes coverage for all chronic diseases even if newly developed afterwards. That basically rules out all the illness to which an older person is subject...heart disease, cancer etc.

 

Another policy required a second opinion for all hospitalizations costing more than US 2,000 (i.e. most hospitalizations) and it looks like the doctor will be of their choosing, or possibly employed by them...

 

The above 2 things are not universal, in fact they were each found in only one policy examined. the point is, one has to read carefully and policies do differ, significantly.

 

 

My policy is with a UK based International Healthcare company and they have a "Dread diseases" clause that concerned me, as the way I read it, it seemed to suggest that cover for such diseases had only limited cover.  When I queried it with them they said:

 

"the Dread/Chronic benefit of £13,500 is applicable only if there is no possible cure for the condition and you are merely receiving palliative/end of life/pain or symptom relief care. Therefore if you were to have heart disease or cancer and were receiving active treatment for these conditions they would be covered under the £350,000 annual allowance for in-patient or day-patient treatment."

[dr_lucas]

I have been insured with BUPA International since 2003, when I was 26 years old.

I used to pay around $200 USD per month (on annual basis, ie. $2,400/pa) for the widest coverage at the time.

Ever since then I kept on paying annually and never really checked the bills.

2 years ago they sent me the renewal letter as usual. I then noticed that the premium for the upcoming year is around $10,000 USD (!!!) at the age of 39.

I could have reduced it somewhat by adding deductibles and removing some modules of course, but I wasn't ready to reduce my coverage yet.

So I started to shop around, comparing many international insurance companies and reading all the fine prints (which as @Sheryl pointed out - are super important).

I also called a few major private hospitals 3rd party departments here in Bangkok to find out which  insurance companies they recommend and which they have issues with.

Frankly, I must first say, other than the (IMHO) very high premium, I had no issue with BUPA INTL. They were excellent and were always very prompt with GOPs issuance, payments to the hospitals or reimbursements to me. One more notable point is that they always sent me a 30 days Guarantee of Payment for every Outpatient condition I needed, ie. I didn't have to contact them again for the same condition after the first letter, for 30 days, even if I go to see specialists multiple times within the 30 days period. Quite liberal in comparison with my current insurer.

 

After shopping around, I ended up with a short list of 2 companies: Allianz INTL and Cigna Global.

I ended up with Cigna Global Platinum with all their modules, at $610 USD per month for my nationality and residence country, gender and age combination.

The reasons I chose Cigna over Bupa were:

- Cheaper monthly premium.

- On paper - much wider coverage and much better terms (comparing both companies' policies and fine letters).

- Quite extensive network

- Easy way to find out and compare policies (their online calculator is brilliant. BUPA INTL is unfortunately and absolutely intentionally very vague and it's nearly impossible to easily find out if they are overcharging you personally or that just their real premium price for your age/location/gender/nationality combination).

 

After the first year with Cigna, they sent me a renewal email that showed an increase of around 20%.

That was still much lower than BUPA charged me before, but I obviously didn't appreciate the huge spike, so I called them, after first comparing the price in their calculator and confirming the prices indeed hiked a lot (Just to be cautious, I used a different country IP with different browser and input slightly different details than my real ones to make sure I am not being shown fake results tailored for me. The results were the same.). 

After quite a long negotiation, I was offered some discounts and signed up for another year, so hopefully the next increases are not going to be as high.

 

Compared with BUPA INTL, Cigna Global seems to be quite slower in processing & releasing payments to the hospitals and they are quite strict when it comes to most outpatient procedures which are beyond specialist's consultation. 

For example, they require a medical report from the specialist showing I was referred to do an outpatient procedure (such as MRI, CT) and the reasons for it and then they send that to their medical team for approval, which usually takes an hour.

With BUPA I never experienced that. I just called them up and said I was referred to MRI and got the GOP within minutes.

 

Also their In-patient seem to be quite slow. I was admitted in the hospital waiting for a CT for many hours as the hospital was waiting for their GOP.

Called them to ask why they don't send it and they said that in-patient procedures may take 24-48 hours to be approved by them, in contrast with ~1 hour for outpatient.

I explained to them that they are paying for my time in the hospital and the 1-2 days they take may cost them quite a lot of money that they can save if they work faster. Luckily that convinced them to send me the approval quickly, but I do feel that I am much much more involved in the whole communication between them to the hospital than I was when I used BUPA. With BUPA everything felt much smoother, easier and faster.

That said, I don't regret switching to them and I hope things will improve there.

 

P.S. The hospital I usually go to is Bumrungrad which is a member/provider in Cigna's network, which is obviously a plus. That said, they are possibly the most expensive hospital in Thailand without any real justification IMHO and I would gladly use another cheaper private hospital, but unfortunately no hospital in Thailand have such an excellent online system as they do, especially their "find a doctor" section that shows full details of each doctors including dates of certifications etc.

They also have a brilliant third party department that makes working with them very fast and simple when having an international insurance.

 

 

 

 

 

 

[4evermaat]

@dr_lucas and others, is there any reason why you just dont put the premium money into a separate savings account and self-insure?  It seems like the premiums are such that you might as well just put the funds into a savings account and just self insure 

 

Especially as you get older, the premiums are only going to increase.  Obviously this depends on the likelihood of a health issue.  A friend with a known heart condition considered the cost of getting insurance vs the cost of heart surgery at one of the top hospitals in Bangkok.  It was like 500k baht or so.  The premium from his employer would work out to be 120k/year...but then he would be locked into that employer.  So he decided on the independent contractor route for the same employer, and put the extra money he made into a saving acct.  I think this is the 6th or 7th year he needed to do some surgery or workup on his heart.

[stevenl]

Quote

Especially as you get older, the premiums are only going to increase. 

Insurance is all about averages.

 

In general for younger people the premiums are higher than necessary, for older people the premiums are lower than necessary. So the young are subsidizing the old.

 

This means that on average self insurance is a good idea for the young, not for the old. Despiote the high premiums for the old.

[HampiK]

I also was thinking many times about self insurance. But an Insurance should be in normal life something where you put in more than you get out. An Insurance is not there (in my opinion) for can go to doctors easily and with every small problem. I want an Insurance for security, when something big happens. I don't care to pay for 2'000 baht doctor fees myself. But what is when you have a bigger Issue where you stay in ICU for a few days/week and then also need some operations, MRT and other special Instruments?

Yes self Insurance will work if you have to pay 500'000 baht, but when the bill is like 5 million baht and the next year again 5 million? you still can pay this amount with the self insurance bucket? for this money you could pay the premiums your whole life!

 

But as many told don't use local thai insurances, as they are allowed to raise after an issue the premiums of 25% per year! so mean after only 3 years of using it, because of maybe a chronic disease, your premiums will already be almost doubled, after 5 years 3 times the original premiums.  And after such a condition it's mostly not possible to change to another company as nobody wants you anymore! So check good how the company handles the premiums after using them. 

As far for example Pacific Cross tells (if you ask them) that they will raise premiums when you use more than 200% of the yearly cost but there is no really rule how much they will raise and under which conditions. But mean if you pay for an 10 million per year insurance 40'000 baht... and you have an accident which costs 100'000 they will already raise the premiums (maybe, maybe not)....

[Sheryl]

The issue with self insuring is what will you do when a large expense wipes out or substantially reduces the amount you set aside? How will you replenish it? Andd, if you "self insure" by paying an amount equivalent to insurance premiums into a savings account, what will you do if a large expense occurs early on before the amount has accumulated to much?

 

Actually paying the equivalent of an insurance premium into a savings acct is not self-insuring. Self insuring would be putting aside at least 1-2 million baht first, with some clear plan/systemfor replenishing it.

 

Dr_lucas: your premiums would be substantislly less, possibly by as much as half, if you dropped the outpatient cover which is seldom worth it as the increased premium is often about the same as the maximum opd cover. Note that inpt only cover will still cover day surgeries, expensive scans and the like.

 

Of course if you switch to self pay for opd you will want to stop getting meds from the hospital and rather buy at an outside pharmacy. Hospital mark ups on drugs are huge (300% or more in most cases).

 

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