Health Insurance with OPD Cover in Thailand

[travelman]

After watching so many sufferings about foreigners in Thailand on daily basis especially Health care issue.  I think it is a valid time for to me get a Health cover at 44.

 

Therefore you all are requested to kindly let me know a comprehensive Health Insurance Plan + OPD that I can have in Thailand with less possible problems.

[CharlieH]

BUPA Thailand.

 

Good choice of "plans" and levels of cover available to suit a range of budgets.

 

http://www.bupa.co.th/en/individuals.aspx

[wpcoe]

With my BUPA policy at my age (B2 million inpatient coverage, in my early 60s) I compared the price of coverage with and without outpatient care, and the maximum reimbursement for outpatient care for the year was within B300 of the cost of the coverage.  I politely declined outpatient coverage.

[Sheryl]

I have yet to see a policy for thsi part of the world (or international expat policy) where OPD cover was worth it, given what OPD costs are in Thailand.

 

Vastly increases the premium, by far more than you would ever be likely to spend out of pocket.

 

Stick to IPD is my advice. These usually cover day surgeries and many aso cover rpocedures like CT, MRI etc.

 

MSH or Cigna Global would be my recommendations,. If you are planning to grow old here, be aware that MSH and all other Thai-issued policies reserve the right to adjust premiums based on your "risk profile" (state of health, prior claims) which means that even though they guarantee lifetime cover, they can price you out if they want to. This won;t be an issue if you have claims that are clearly one-off sort of things but should you develop a long-term chronic condition, it could be.

 

Cigna costs more but will not do that - they can't, as they are governed by UK insurance regs.

 

[scubachild]

anyone have any experience with 

https://www.healthcareinternational.com

or

https://www.internationalinsurance.com/cigna

 

I would be interested to hear.

Thank you for your time

 

[Sheryl]

Many TV members have insurance with Cigna Global and feedback has been good; I recently switched over to them myself. But they have all gotten it from Cigna Glibal based in the UK. This seems to be a site for Cigna US. Suggest you google cigna global expat insurance.

Re HCI there have been a few posts over the years, do a google search and type in site:thaivisa.com (works better than the gorum search function).

[wpcoe]

Sheryl, when you switched over to Cigna how did they address pre-existing conditions?  Is there a waiting period of exclusion?

[simon43]

I just switched from BUPA Thailand to Health Care International.  I am working in Myanmar and the emergency evacuation cover offered by BUPA is only for my first 3 months in Myanmar.  since it is vital that my policy includes unlimited emergency medical evacuation (Myanmar hospitals are often 'sub-standard'), I changed to HCI.

 

HCI has a $2,000 USD excess, but I would only be caliming on the policy for serious accident or illness.  The premiums are competive ==> $61 USD per month at 58 years old with no pre-existing conditions and very good health.

[Sheryl]

Sheryl, when you switched over to Cigna how did they address pre-existing conditions?  Is there a waiting period of exclusion?

The only thing I have that could be considrted pre-existing is mild hypertension that is very well controlled. I declared it on my application and no exclusions were applied...but every case is different. In general though Cigna seems more reasonable than most on this score but of course someone who is diabetic, or has history of heart disrase or cancer, will likely have some exclusions.

[scubachild]

1 hour ago, simon43 said:

HCI has a $2,000 USD excess, but I would only be caliming on the policy for serious accident or illness.  The premiums are competive ==> $61 USD per month at 58 years old with no pre-existing conditions and very good health.

 

I assume you have the Emergency+ Plan then?  That looks good to me apart from the cover for Dread/Chronic Diseases (including cancer, heart disease and HIV/Aids) 100% of costs BUT ONLY up to $20,000 as a Lifetime Maximum

ComparisonPlans_USD.pdf.pdf

[simon43]

Yes, that's the policy that I have.  Note that there is $100,000 USD for organ transplant, which might be required if you had chronic heart or lung or liver etc disease.  HIV can usually be treated by drugs (unless you left it too late).

 

As for cancer, 100% of treatment costs (radiology, oncology, chemo) are covered.  IMHO, this $20,000 cover is really for end-of-life care.

 

To minimise my risk of 'dreaded' diseases and illness, I have recently and radically changed my lifestyle (fitness, diet etc), so as to reduce my risk of getting cancer, heart disease etc etc.  That's the subject of other threads in this Health forum.

[wpcoe]

10 hours ago, Sheryl said:

The only thing I have that could be considrted pre-existing is mild hypertension that is very well controlled. I declared it on my application and no exclusions were applied...but every case is different. In general though Cigna seems more reasonable than most on this score but of course someone who is diabetic, or has history of heart disrase or cancer, will likely have some exclusions.

That sounds a lot more liberal (for the applicant) than BUPA.  BUPA declined to pay for a septoplasty because I had an episode of aerotitis several years prior where the doctor mentioned chronic sinusitis in his notes.

 

I've now had a carcinoma removed and will have a "pre-melanoma" removed in a few weeks.  What's your educated guess:  If I switch to Cigna would they consider any future skin lesions as non-covered pre-existing conditions?

[Sheryl]

I really can't say, but as mentioned they are pretty reasonable.  To me personally, if you develop a melanoma at the same site as the removed "pre-melanoma" (i.e. the removal was not complete/successful) then that would be pre-existing, developing a skin cancer elsewhere on the body would not be. That is just my take on it, though. In any case if you apply they will specify any exclusions at that time.

 

Septoplasty - a deviated septum is unlikely to be a new occurrence so in that sense I can see BUPA point. Though BUPA does tends to be draconian in their interpretation of "pre-exisitng".

[scubachild]

22 hours ago, simon43 said:

IMHO, this $20,000 cover is really for end-of-life care.

 

I asked HCI and their reply confirms your humble opinion :-)

 

"Dread/Chronic only comes into use if the doctor has advised there is no more medical treatment available (i.e terminal cancer) while active treatment is still happening this would be covered under the benefits you mentioned."

 

[scubachild]

On 3/9/2017 at 8:15 PM, Sheryl said:

Cigna costs more but will not do that - they can't, as they are governed by UK insurance regs.

 

HCI are also UK based so I would hope they are also governed by UK insurance regulations - but they does not stop them telling me :

 

"Premiums do unfortunately increase with age and our underwriters may review large claiming clients from a pricing perspective".

 

Seems HCI could price me out if they wanted to...

[Sheryl]

With all insurers, premiums increase with age but the second part of that  sounds ominous. I would  have thought UK insurance regs would not allow them to price someone out by raising rates based on prior claims...but that is what that sounds like.

[banK]

I've just renewed my Cigna inpatient gold policy (1000 gbp deductable) - no pre-existing conditions. Age 68.

 

Cost last year was 3139 gbp, this year 4039 gbp. Quite a hike.

 

Queried this with them on the phone and they stated due to the cost of world wide increases in health care and of course being one year older. Asked whether Brexit and the pound exchange rate had affected the increase - they said no.

 

I just wonder whether my cancer/AAA operations year before last and last year a hernia operation had anything to do with it.

 

Also noted, (being cynical), that the account number that I paid the premium into was changed from the previous years - same bank but different account number (is there a bad boys account!).

 

Despite the above,  I am grateful that I started with Cigna when I did and have no complaints as to the service provided thus far.

 

banK

[wpcoe]

16 hours ago, Sheryl said:

I really can't say, but as mentioned they are pretty reasonable.  To me personally, if you develop a melanoma at the same site as the removed "pre-melanoma" (i.e. the removal was not complete/successful) then that would be pre-existing, developing a skin cancer elsewhere on the body would not be. That is just my take on it, though. In any case if you apply they will specify any exclusions at that time.

 

Septoplasty - a deviated septum is unlikely to be a new occurrence so in that sense I can see BUPA point. Though BUPA does tends to be draconian in their interpretation of "pre-exisitng".

You sound pretty comfortable with Cigna, and that's encouraging because I'm sure you did adequate research.  I've never really considered changing insurers because I assumed that during 16 years of medical treatment in Thailand that lots of things would be documented and now excluded as "pre-existing."  I've had bronchitis a few times, so fear any respiratory issues would be excluded -- things like that.

 

Re:  BUPA and the septoplasty, they didn't consider the septoplasty per se to be the problem with coverage, they said it was the doctor's notation of "chronic sinusitis" that triggered the pre-existing clause.  I went back to Bumrungrad and persuaded the doctor to amend my medical records to delete the reference to chronic sinusitis and then BUPA covered the septoplasty.  

[Sheryl]

Having had bronchitis will certainly not lead to any exclusions.  If yo uhad asthma there might be some exclusions as that is chronic.

[scubachild]

16 hours ago, Sheryl said:

With all insurers, premiums increase with age but the second part of that  sounds ominous. I would  have thought UK insurance regs would not allow them to price someone out by raising rates based on prior claims...but that is what that sounds like.

 

I have been searching online for a UK regulatory body dealing with health insurance.  I can't find anything.  There is Quality Care Commission regulating NHS and some private hospitals.  Then there is The Independent Sector Complaints Adjudication Service (ISCAS) provides independent adjudication on complaints about independent healthcare providers.  But I can't find any body voluntary or statutory regulating or monitoring the health insurance sector in the UK

 

Anyone with better information than me?

 

[alcamus]

On ‎3‎/‎28‎/‎2017 at 3:48 PM, scubachild said:

anyone have any experience with 

https://www.healthcareinternational.com

or

https://www.internationalinsurance.com/cigna

 

I would be interested to hear.

Thank you for your time

 

Avoid HCI like the plague! I have been with them 7 years and never used my coverage until 2 years ago. They rewarded me by waiting 5 months to process claims (not a big claim -- only about $150), ignoring my emails, and loading me 50% essentially for using my policy. The finally paid when I threatened legal action. It seems like maybe they're going bankrupt.

[alcamus]

On ‎3‎/‎31‎/‎2017 at 1:00 PM, scubachild said:

 

I have been searching online for a UK regulatory body dealing with health insurance.  I can't find anything.  There is Quality Care Commission regulating NHS and some private hospitals.  Then there is The Independent Sector Complaints Adjudication Service (ISCAS) provides independent adjudication on complaints about independent healthcare providers.  But I can't find any body voluntary or statutory regulating or monitoring the health insurance sector in the UK

 

Anyone with better information than me?

 

Try the FCA -- Financial Conduct Authority www.fca.org.uk or the Financial Obudsman www.financial-ombudsman.org.uk

[alcamus]

On ‎3‎/‎30‎/‎2017 at 5:14 PM, scubachild said:

 

HCI are also UK based so I would hope they are also governed by UK insurance regulations - but they does not stop them telling me :

 

"Premiums do unfortunately increase with age and our underwriters may review large claiming clients from a pricing perspective".

 

Seems HCI could price me out if they wanted to...

I got pretty much the same message. After 5 years with no claims, I had claims related to cancer treatment. For this, they loaded my premium 50%. When I questioned it, they replied very much the same as they did to you. Then, their Business Relationship Manager wrote internally:

"Regarding Mr. X's renewal, from what I have been informed, this increase cannot be avoided. Due to Mr. X's medical history it is almost certain that he will claim again, and this is a burning scheme already. We will still cover Mr. X for everything he is entitled to but we have to try to mitigate the loss, if just slightly.  I hate talking about someone's life, but Mr X had had over 40,000 USF paid in claims, which we have had no qualms with, but in hind sight a premium of this size is not as bad as it originally sounds."

There is SO MUCH wrong with this! I thought the idea of health insurance was to be able to use it when you need it. It seems as if HCI has a different outlook. I also feel they are trying to price me out and make me drop coverage, especially since they know I cannot get coverage anywhere else because of the cancer.

 

[Sheryl]

Suggest you contact the links mentioned above and file a complaint.

[music065]

On 3/28/2017 at 2:58 AM, Sheryl said:

Many TV members have insurance with Cigna Global and feedback has been good; I recently switched over to them myself. But they have all gotten it from Cigna Glibal based in the UK. This seems to be a site for Cigna US. Suggest you google cigna global expat insurance.

Re HCI there have been a few posts over the years, do a google search and type in site:thaivisa.com (works better than the gorum search function).

 

Does anyone know whether Americans that want to use Cigna have to use Cigna US or are they free to go through Cigna UK?

[Sheryl]

They can use Cigna Global based in UK -- assuming that what is wanted is expat policy.

 

 

 

 

[music065]

Thank you Sheryl, your knowledge has helped me a lot already. 

[DUS]

Just a quick thought, comment and question regarding Outpatient Coverage:

 

I am about to sign up with Cigna but plan to not opt for OPD since it seems too expensive (as Sheryl mentioned). I am nonetheless concerned that if I develop a chronic disease that is being treated on an outpatient basis then I would have to cough up the money for what I think might be extremely expensive drugs. I think insulin might be actually on the cheaper side but not sure for example about treatments such as HIV etc which will probably cost in access of 20,000 USD per year. Given that, in case of Cigna, even with their Silver and Gold plans their annual outpatient coverage limit would be fairly low (10k and 25k respectively). The Platinum plan would provide an unlimited annual benefit but the premium is too high for me. So in the end I will end up without OPD because a/ the standard outpatient costs in TH such as a consultation incl. a blood test etc are pretty low and b/ the annual limits set by the insurance companies wouldn´t, I believe,  cover me for the worst case OPD cases (chronic diseases that require regular consultations with a specialist and expensive drugs). But regarding the latter, here is a question for the forum:

 

Does anyone have information on what treatment of the most common chronic diseases costs in Thailand (consultations plus drugs)? I am thinking of annual costs for ailments such as:

 

- Asthma

- Hypertension

- Major depression

- Epilepsy

- HIV

- Hyperthyroidism

- Rheumatoid arthritis

 etc.

 

If I were to develop one or, god beware- more of these chronic conditions, will this bankrupt me and I end up as one of those farangs jumping off a building? I tried to google a few of those chronic diseases trying to find out the associated costs for treating those in TH but have been unsuccessful so far.

 

DUS

 

Edited September 7, 2017 by DUS

[Sheryl]

Actually it would be very hard to wrack up 10 K in outpatient charges in Thailand, especially since things like scans, endoscopies and cancer chemotherapy are covered in the inpatient plan even if received as outpatient.

 

You'd have to be on a highly expensive, new, imported medication and even then, hard to see it exceeding 10K.

 

Consultations - depends on the hospital and doctor, anywhere from 50 baht (government hospital using public channel; long waits and treatment by doctors still in training ) to about 1,500 baht (top specialist at a private hospital). Plus a couple hundred baht for hospital service charge in pvt hospitals.

 

The drugs needed to treat most chronic conditions are very inexpensive. Most people with hypertension, for example, spend only 100 baht a month for meds (using local brands).

 

Exception would be RA and to a lesser extent HIV.

 

HIV meds, depends which you are on, but if obtained at Thai red Cross and first-line drugs, maybe 2-3,000 baht.

 

RA meds, depends on what they are, the usual frontline drugs are very cheap.  The very new biological immune moderators though are expensive and can reach 10K a year if you use western brands, but there is are Indian brands that cost about 1/5 as much. This tends to be true for most really expensive meds e.g. those for Hepatitis C.

 

The problem with OPD cover, in addition to being unnecessary in most cases, is that the additional premium is often not much less than  the maximum cover. Plus the hassle of the paperwork to make an insurance claim for OPD is usually just not worth it.

 

My sister has epilepsy, elevated cholesterol, hypothyroidism, and hypertension, for which she is on 5 meds. Costs a total of about $1K a year for her meds.

[DUS]

Sheryl, thank you sooooooooo much for your detailed feedback! That´s greatly appreciated and really puts my mind at ease. With new drugs becoming more and more expensive (like that latest drug from Novartis at USD 475k or something like this; yes, cancer related so what theoretically be covered by the policy) I was becoming more and more concerned about this drug related expenses. But good to hear from you that meds still seem to be available at reasonable prices.

 

Thank you again!