On Thai Government Hospitals.

[mommysboy]

Thai Government Hospitals.  What are your experiences?  How are they for really bad events, such as heart attacks, etc?  What did you pay?

 

I finally realised these are an option for people like me who are not exactly poor, but really can't afford expensive health insurance policies.  Sheryl did say a couple of years ago, but it's taken a while to sink in.  I have a wife, a baby, and a step daughter.  Decent policies are well out of my means.  And a terrible event would wipe out our savings if a private hospital is used.

 

I have health insurance for my baby and I intend to splash out on that one to say 1 million coverage, hoping that would cover a protracted event, which of course I pray won't happen.

 

Up until now I have been using very basic Thai Health Policies, which just about cover something like appendicitis. They are 15000 baht for me, about same for baby, and a few thousand each for the wife, and grown up daughter.

[NancyL]

Where do you live?  

[mommysboy]

I live in Surat Thani and have started using the local government hospital. I have already received good treatment for an out patients eye condition.  So far it has been about the same standard as NHS UK, although the surroundings are about on par with hospitals from 50 years ago.  Mind you, this was the side clinic, and I think the main building is likely better.

 

Given I have a family and limited means, I am wondering whether I can entrust the gov. hospital for most of our health needs, which is why I am posting.  I will still maintain an expensive policy for our baby throughout her childhood, just in case she has a million baht event.

[colinneil]

My experience with Thai government hospitals, first class.

Khonkaen hospital i was there for 7 months, good care/service.

I go to Banphai hospital every 3 weeks, for catheter change and physio.

Last time i went in er room 13 minutes job done.

Physio department staff best there is, they always go out of their way to assist me.

[lopburi3]

You really need to make the decision and if it is a matter of funds indeed that may be the deciding factor.  As for good or bad you have some experience in the wait and old facilities that are often the norm.  There also may be less choice as to doctors and timing.  Some of the doctors are the best in there fields but most likely will not be directly treating you.

 

I know many consider some specialized queue waits, especially cancer, to be a threat to there lives but suspect for most routine/emergency care it is a reasonable option.

 

[jak2002003]

I suppose they are all different. 

 

I can say, however, that my treatment at my small government hospital in Chiang Mai area was vastly more pleasurable, staff more competent, massively less cost, shorter waiting times and closer to my house, than was my experience at the Bangkok Hospital in Chiang Mai.

 

However, you will need to be able to speak some Thai, or take someone with you who is Thai... as many of the staff at the Government hospital I went to could not speak English.

 

 

 

 

I

Edited March 1, 2017 by jak2002003

[NancyL]

If comprehensive medical insurance is too expensive for you, please consider getting personal accident insurance, at least.  Don't assume that your motor vehicle insurance will be sufficient.  Besides, not all accidents occur while driving.  The personal accident rate in Thailand is at least twenty times higher than in the west.  PA policies are very cheap, usually don't have a deductible and no exclusions for "pre-exisiting conditions".  Of course, they're not going to cover illnesses, but many of the expensive hospitalizations I've seen with younger people have been due to accidents, not illnesses.

[mommysboy]

1 hour ago, colinneil said:

My experience with Thai government hospitals, first class.

Khonkaen hospital i was there for 7 months, good care/service.

I go to Banphai hospital every 3 weeks, for catheter change and physio.

Last time i went in er room 13 minutes job done.

Physio department staff best there is, they always go out of their way to assist me.

Can I ask about prices?

[mommysboy]

52 minutes ago, lopburi3 said:

You really need to make the decision and if it is a matter of funds indeed that may be the deciding factor.  As for good or bad you have some experience in the wait and old facilities that are often the norm.  There also may be less choice as to doctors and timing.  Some of the doctors are the best in there fields but most likely will not be directly treating you.

 

I know many consider some specialized queue waits, especially cancer, to be a threat to there lives but suspect for most routine/emergency care it is a reasonable option.

 

Yes, fact is I can't sustain expensive health plans, and a 1 million plus event at a private hospital would wipe out our cash reserve.

[lopburi3]

27 minutes ago, mommysboy said:

Yes, fact is I can't sustain expensive health plans, and a 1 million plus event at a private hospital would wipe out our cash reserve.

I had a bit over one million last year - but had insurance.  At government hospital it would have been only a bit over 80,000 baht.  I had been strongly advised to use the government doctor but operation had to be canceled with me on OR table due the large hospital not having ICU available that day and and a reschedule would entail waiting 3 month queue again (which with stage 2 cancer was not something I was prepared to do).  Had I not had insurance not sure which direction I would have taken. 

[mommysboy]

49 minutes ago, lopburi3 said:

I had a bit over one million last year - but had insurance.  At government hospital it would have been only a bit over 80,000 baht.  I had been strongly advised to use the government doctor but operation had to be canceled with me on OR table due the large hospital not having ICU available that day and and a reschedule would entail waiting 3 month queue again (which with stage 2 cancer was not something I was prepared to do).  Had I not had insurance not sure which direction I would have taken. 

 

That is a dilemma.  I hope you are ok.

 

The downside is of course that I will not be receiving the best or quickest, and may face a situation like this.  But it really is a case of having to choose according to my pocket.

 

 

[tutsiwarrior]

I can't complain too much with my local military hospital:

 

note that I have no insurance...

 

 

Edited March 1, 2017 by tutsiwarrior

[Sheryl]

If even a million baht would wipe out your cash reserves then you have a problem, even using only government hospitals.

 

It is quite possible to wrack up a million baht bill at a government hospital if you are in a major accident with multiple trauma, or have a catastrophic medical event requiring prolonged ICU care, specialized surgeries etc.

 

And that would be in just one event.  Which is the big catch with self-insuring: once you have spent the money, it is gone. Unlike insurance, where the maximum payment is either epr event or per year, not for life.

 

see http://www.abc.net.au/news/2017-01-27/injured-australian-woman-dawn-weldon--stuck-in-thai-hospital/8218036

 

For just one example.

 

 

[mommysboy]

6 minutes ago, Sheryl said:

If even a million baht would wipe out your cash reserves then you have a problem, even using only government hospitals.

 

It is quite possible to wrack up a million baht bill at a government hospital if you are in a major accident with multiple trauma, or have a catastrophic medical event requiring prolonged ICU care, specialized surgeries etc.

 

And that would be in just one event.  Which is the big catch with self-insuring: once you have spent the money, it is gone. Unlike insurance, where the maximum payment is either epr event or per year, not for life.

 

see http://www.abc.net.au/news/2017-01-27/injured-australian-woman-dawn-weldon--stuck-in-thai-hospital/8218036

 

For just one example.

 

 

Right. Thanks for the heads up Sheryl.  I can't maintain expensive policies.  I'll look in to accident insurance. 

[mommysboy]

6 hours ago, NancyL said:

If comprehensive medical insurance is too expensive for you, please consider getting personal accident insurance, at least.  Don't assume that your motor vehicle insurance will be sufficient.  Besides, not all accidents occur while driving.  The personal accident rate in Thailand is at least twenty times higher than in the west.  PA policies are very cheap, usually don't have a deductible and no exclusions for "pre-exisiting conditions".  Of course, they're not going to cover illnesses, but many of the expensive hospitalizations I've seen with younger people have been due to accidents, not illnesses.

Sounds like you know your stuff: any idea where I might start with personal accident insurance?

[Denim]

1 hour ago, Sheryl said:

If even a million baht would wipe out your cash reserves then you have a problem, even using only government hospitals.

 

It is quite possible to wrack up a million baht bill at a government hospital if you are in a major accident with multiple trauma, or have a catastrophic medical event requiring prolonged ICU care, specialized surgeries etc.

 

And that would be in just one event.  Which is the big catch with self-insuring: once you have spent the money, it is gone. Unlike insurance, where the maximum payment is either epr event or per year, not for life.

 

see http://www.abc.net.au/news/2017-01-27/injured-australian-woman-dawn-weldon--stuck-in-thai-hospital/8218036

 

For just one example.

 

 

 

Agreed. To be on the safe side against all eventualities for both you and your family , it's best to set aside about 5 million in baht cash to ensure that if a life threatening crisis arrives you have the means to deal with it quickly.

 

This , because as you get older it becomes increasingly more difficult to get insurance that covers all eventualities. I was in the Pattaya Bangkok hospital a few years back with a life threatening problem. When I checked in they asked how I would pay. When I said cash I got immediate attention that saved my life. At the same time I noticed half a dozen other ex pats with insurance sweating it out at reception while the hospital went through their policies with a fine comb , telephoning overseas to make sure they would be reimbursed for any treatment given.

[mommysboy]

2 minutes ago, Denim said:

 

Agreed. To be on the safe side against all eventualities for both you and your family , it's best to set aside about 5 million in baht cash to ensure that if a life threatening crisis arrives you have the means to deal with it quickly.

 

This , because as you get older it becomes increasingly more difficult to get insurance that covers all eventualities. I was in the Pattaya Bangkok hospital a few years back with a life threatening problem. When I checked in they asked how I would pay. When I said cash I got immediate attention that saved my life. At the same time I noticed half a dozen other ex pats with insurance sweating it out at reception while the hospital went through their policies with a fine comb , telephoning overseas to make sure they would be reimbursed for any treatment given.

 

See the thing is I don't have 5 million spare!  Is that a private hospital?

 

This is why I will need to go the government hospital route.

 

And I am resigned to the fact that there will be no life support machine if needed.

 

 

[mommysboy]

1 hour ago, mommysboy said:

 

See the thing is I don't have 5 million spare!  Is that a private hospital?

 

This is why I will need to go the government hospital route.

 

And I am resigned to the fact that there will be no life support machine if needed.

 

 

 

Anyway. Let's be a bit more positive: I might drop dead tomorrow.

[NancyL]

2 hours ago, mommysboy said:

Sounds like you know your stuff: any idea where I might start with personal accident insurance?

Well in Chiang Mai, you'd start with https://www.aia.co.th/th/index.html and http://cnxinsure.com/credentials.pdf  They can probably write policies all over Thailand.  Bangkok Bank also offers Personal Accident Insurance.  It's really pretty readily available.

[Sheryl]

Bear in mind that it is not only accidents you have to worry about.

 

And it is not so simple as "no life support".

 

You really should look at getting health insurance. International policies will let you take excesses and co pay options which significantly lower your premiums.

 

Barring that, and if you can get care back in your home country for free, could look at a medical evacuation policy plus personal accident policy. But I am not sure that the two together won't cost as much as a good comprehensive policy with maximum deductible.

 

 

[mommysboy]

26 minutes ago, Sheryl said:

Bear in mind that it is not only accidents you have to worry about.

 

And it is not so simple as "no life support".

 

You really should look at getting health insurance. International policies will let you take excesses and co pay options which significantly lower your premiums.

 

Barring that, and if you can get care back in your home country for free, could look at a medical evacuation policy plus personal accident policy. But I am not sure that the two together won't cost as much as a good comprehensive policy with maximum deductible.

 

 

You see Sheryl it is very much a case of affordability.  For me yes I could probably hot foot it home, but were having to sell family home to pay nursing home costs for sick mum, so it isn't easy as before.

 

It does seem rather hopeless.  I don't like taking risks, but I think I have to this time.

[NancyL]

3 hours ago, mommysboy said:

You see Sheryl it is very much a case of affordability.  For me yes I could probably hot foot it home, but were having to sell family home to pay nursing home costs for sick mum, so it isn't easy as before.

 

It does seem rather hopeless.  I don't like taking risks, but I think I have to this time.

Have you ever sat down and talked with an insurance rep?  Sadly, people from countries with "free" health care often don't have a good idea of how to shop for insurance.  You've received some good advice here.  The sort of insurance Sheryl and I have talked about can be had for less than 1000 baht/month, depending on your age and the amount of "excess" or "deductible".  It's a matter of actually talking with the people selling the insurance and not just doing some on-line insurance company's quote quiz.

[Sheryl]

Cost does vary with age.

 

A 65 year old will usually have to pay around 3,000 US (a little over 100,000 baht) for decent insurance with maximum deductible/copays (which are generally capped sat no more than US 5,000 out of pocket and come in various permutations e.g. anywhere from 750 - 2000 up front and excess and then 10-20% copays thereafter but not exceeding total per year of 5-5,000. BIT for that you get at least US 1 million in coverage, worldwide, including costs of med evac if you take ill in a place without adequate treatment facilities.

 

So you have to pay annually say 100,000 baht and then have say 200,000 more tucked away, that you can gradually replenish if and as used.

 

That still beats having your savings wiped out in one go or, worse yet, being stuck in a hospital with a bill that exceeds your total savings...and keeps mounting, because they will not let you out until you pay.  As for just going back home, the problem is you may not be in a condition to do so (and if you are in condition to, then the costs were probably not that high anyhow). 

 

If you are from other than the US, there may be expat insurance policies issued out of your country that would include the cost of med-evacing you back home so look into that, they can be pretty reasonable because the insurance company counts on being able to haul you back to free care for anything major, and wil also expect you to fly yourself home for anything purely elective ie. what they will cover in Thailand will be urgent care that can't wait.

 

The basic problem is that people who cannot afford insurance absolutely cannot afford to pay for treatment for anything major either.  And a lot of really tragic and horrific scenarios unfold, every year, among them.

 

It may sound harsh but I would say, either find a solution or move back to your home country....if you can't afford health insurance then you can't afford to live here, to be blunt.  "I won't get seriously sick or hurt", or "I'll only use government hospitals" are not solutions. Neither is "I'll just go untreated and die", I've yet to see anyone actually follow through on that for a non-terminal illness.

[al007]

Well I have probably had more experience than most in the last two years, sirnakin khon kaen, Bangkok hospital KK, Rachapreux KK,  Bangfang Hospital KK, Bangkok hospital Bangkok, Chula Bangkok,  Christian Hospital Bangkok, Bangkok hospital Phuket, Fortis Dehli, RG Stone Goa Mapusa Goa, Bumrungrad Bangkok,  Udon Thani Cancer hospital,  Royal Marsden london, 3MRI scans, three Cat scans, four ultrasounds, many many blood tests, seven weeks radiation and seven weeks chemo, four colonoscopies, holep surgery for prostate at least five biopsies cancer of the prostate, and different cancer of the colon, and that is only part of the list, but I am alive!! and happy  !! today but also gone through some deep depression

 

My blood count is only very slowly recovering

 

I have had some very experienced and advanced cancer treatment, with the most wonderful doctors  and very upto date equipment from the USA and UK, all at very reasonable cost, I am self insured, and so far probably around 700,000 baht plus a bit for everything, including India

 

Yes I have had good guidance from Sheryl but I consider it all very reasonably priced, I have received all treatment without waiting lists, had doctors of my choice, yes sometimes appointments run 4 hrs plus late but do not forget all at affordable cost, but you have to shop carefully and diligently  to save money

 

In the early days I had some instances where doctors missed things because I was not persistent enough, and over trusted

 

I dealt with three lots of lawyers in Bangkok, a couple in khon Kaen and one in Udon, I settled a dispute with one hospital on an amicable and fair basis, and would go back there for treatment again, in the end I did not use lawyers they were worse than some of the doctors, and the chief executive of this hospital is and remains a trusted friend

 

But the best of all the hospitals was Chula in Bangkok, and I will be going back there regularly I can not praise them highly enough

 

My conclusion is medical care in Thailand can be excellent and competitively priced, and quicker than the UK where you also have no choice of doctors, BUT choose your doctors carefully here in Thailand, and use TV to get recommendations and suggestions

 

To self insure if you come from the UK you need to be able to fund say 1.5M baht, with the further failsafe if it is going to go higher and you can not afford it you fly back to the UK, so far I have avoided surgery that would add another 350,000 to 500,000 baht I guess and if it becomes necessary my choice would be to have it here, India also had very advanced surgery cheaper than thailand, and in some cases more advanced

 

My wife who looks after me so well said a couple of nights ago God has kept me on planet earth because I would at the moment be too difficult for him to handle, and maybe there is some truth in this

 

Thank you God

[Sheryl]

MB - take note of the above, if he needs surgery his total bill will reach somewhere between 1.05 - 1.25 million baht and this is in govt hospital with much of the care outpatient, no ICU stays etc.

 

People in accidents requiring ICU care and neurosurgery --> easily 2 million or more, govt hospital

 

And also remember that the big catch with self-insurance is that once you spend it, it is gone. So the amount you put away has to also be an amount you can readily replenish, which most retirees cannot. Either that or you need to put aside many times the maximum you think one major illness/accident could cost you. 

[al007]

4 hours ago, Sheryl said:

MB - take note of the above, if he needs surgery his total bill will reach somewhere between 1.05 - 1.25 million baht and this is in govt hospital with much of the care outpatient, no ICU stays etc.

 

Sheryl is very correct although of my 700,000 to date some nearly 200,000 relates to air fares and hotel costs in both thailand and India, and I chose to indulge us here could have saved maybee I00,000, I was outpatient for the chemo and radiation for seven weeks

 

I also chose to go to Bangkok for chemo and radiation because I was not waitlisted as I would have been in KhonKaen

 

One of the secrets of keeping costs down is find out where the best doctors do clinics, when we first got to our colorectal surgeon I had emailed him but had no response we were then told he did a clinic at Bangkok Christian Hospital and my wife went to the queue at 5.00 am  am for a two pm clinic   I went around 1.00pm

[Denim]

One other consideration for British expats is that if serious illness occurs and you somehow manage to struggle back to the UK , when you get there you are likely to discover that you are no longer entitled to NHS treatment unless you take up residence there again and stay a year. 

[Sheryl]

47 minutes ago, Denim said:

One other consideration for British expats is that if serious illness occurs and you somehow manage to struggle back to the UK , when you get there you are likely to discover that you are no longer entitled to NHS treatment unless you take up residence there again and stay a year. 

 

From what I hear, similiar situation in Australia. Though I think in both countries, exception would be made for a life and death emergency. But indeed, unless you have somehow maintained an address in these countries, it will not work to pop back there for a hip replacement or other elective surgery.

[mommysboy]

18 minutes ago, Sheryl said:

 

From what I hear, similiar situation in Australia. Though I think in both countries, exception would be made for a life and death emergency. But indeed, unless you have somehow maintained an address in these countries, it will not work to pop back there for a hip replacement or other elective surgery.

 

It's a tricky one to be sure of regarding UK citizens. Yes, the rules are there, but currently they do not check up on your status. 

 

For instance, I returned to UK after 5 years, and nobody mentioned anything at the doctor's surgery.

 

I think there have been cases where people who retired to Turkey, and got airlifted back, suddenly found themselves with a bill.

 

I don't know what the situation would be if someone who is seriously ill, and homeless, rocked up at the hospital.  I can't think for one minute they would be refused full treatment, and a patient would not be discharged without a place to live.  I suspect nobody would look further.

 

 

 

 

 

 

 

 

 

Edited March 3, 2017 by mommysboy

[al007]

4 hours ago, Denim said:

One other consideration for British expats is that if serious illness occurs and you somehow manage to struggle back to the UK , when you get there you are likely to discover that you are no longer entitled to NHS treatment unless you take up residence there again and stay a year. 

I believe so long as you say you are returning permanently you will be immediately picked up

 

An old Englishman from KhonKaen recently returned to the UK penniless and was immediately picked up by social services