Private Insurance for a Thai child / Is it worth it?

[Oohwan]

Hello forum,

 

I recently had a child with a Thai lady, and I am now contemplating getting the child private health insurance.

 

When a child is born to a foreigner are they not automatically registered under the Thai 30 baht scheme?   The child is not yet 6 months old.

 

We are also out of the district from where the child is registered in their house book.

 

At this time I am paying out of pocket for vaccinations, and I am worried if something major does happen I will not have enough money to cover the expenses.

 

Any information would be appreciated.

 

 

Thank you.

 

Ooowan

[offset]

You have to ask yourself would you be happy with your child going to a Thai hospital 

 

If you have health insurance I think you should give the same to you child and insure your child I not think the cost is very expensive for your child

[Oohwan]

I do not have any issues going to a Thai Hospital, but as I am not sure if social insurance would cover a life saving procedure / terminal illness treatment if ever needed. 

 

 

[Sheryl]

All Thai nationals not already covered under another scheme (such as Social Security) are covered under the 30 baht scheme.

 

And yes, most definitely it will cover life saving procedures and terminal illnesses.

 

In a life and death emergency care can be obtained at any government hospital (by law, also at a private hospital if the patient cannot safely be moved elsewhere but that is proving hard to enforce). Otherwise, care has to be gotten at the hospital which covers the area where the child is listed in a tabian baan  (housebook) or any higher level facility that it refers them to. Obviously, those whose residence is in a city or provincial town have an advantage over those way out in the boondocks in this respect.

 

Housebook registrations can be changed, by the way, and worth doing if you expect to live elsewhere long term, -- especially if that elsewhere puts you in the catchment area of say a provincial level or regional level government hospital. While changing the registration entails some hassle (personal trips to both the former and current ampur) that is a lot less than the hassle and problems that will be incurred if the child is ill and you have to trudge back to the original district for care or someone has to go there are request a letter of referral from them (which they might or might no give without first seeing and examining the child).

 

Vaccinations can be obtained, free, at any government health center, no need to go to a hospital (let alone a private one) for that.

 

 

 

 

[Bob12345]

On 4/16/2017 at 10:33 AM, offset said:

You have to ask yourself would you be happy with your child going to a Thai hospital 

 

If you have health insurance I think you should give the same to you child and insure your child I not think the cost is very expensive for your child

Agree there, ask yourself the question if you would be happy sending your child to a Thai government hospital.

My wife (Thai) and I both have health insurance so naturally we bought the same for our kids.

 

We are paying around 40K baht a year for our newborn kids, same as our health care costs per year.

[Oohwan]

55 minutes ago, Bob12345 said:

Agree there, ask yourself the question if you would be happy sending your child to a Thai government hospital.

 

I think I would be happy sending my child to a Thai government hospital.

 

I do not see any difference in the medical services/experience provided in private hospital opposed to a good Thai National Hospital. 

 

As Sheryl said on my other post "The terms of coverage compare very favorably to private insurance policies - with the sole (and notable) exception of lack of choice of hospital."

[thailand49]

On 4/19/2017 at 1:41 AM, Oohwan said:

I do not have any issues going to a Thai Hospital, but as I am not sure if social insurance would cover a life saving procedure / terminal illness treatment if ever needed. 

 

 

In my opinion it shouldn't be whether the social program will cover it, the concern should be whether the social program can provide your child with the necessary expertise if the child needed a procedure or need terminal illness treatment.  It is bad enough in some private hospital here we are talking about government care. I suggest you do research like visiting a number of government hospital. 

You can get some pretty basic private insurance with AIA, AXA, for a child the age you are talking about is a bit more since at that age they need more attention. As noted, if you have insurance at home and have already proven and register the child with your Embassy, you can include him in your policy pay in advance and get refunded from your job medical later. Of course, you most likely have to use a International Accredited hospital first.

Good luck

[al007]

The answer is pretty simple,( unfortunately an incorrect statement) your child is covered for free under the 30 batt scheme

 

The government hospitals vary from acceptable to excellent

 

If you have a surplus of money and it makes you feel better then pay private insurance

 

My wife's children also get free dental care as does she, (one day when one of them had bad toothache she said we have to go immediately to a dentist, I got a bill for Baht 1200, I then said I have no problem paying but what about the rest of the children in Issan, the following day I took her to the local small hospital and she asked what to do if she had no money, and they told her; both she and the children entitled to free dental, so over the years I save big money ! I am a happy man)

 

On the other hand put the same amount of money each month into a savings account for the child and watch the sum grow each year

 

On a personal note I have had the very best treatment at government hospitals in Bangkok, at reasonable cost, and on the other hand paid for private hospitals to give me negligent advice, because I was under the misapprehension if I pay I get better,   I  N  C  O  R  R  E  C  T

[al007]

3 hours ago, Bob12345 said:

 

 

We are paying around 40K baht a year for our newborn kids, same as our health care costs per year.

 

Wow big money, save it each year and by the time they are 21 maybe 1.0M Bhat enough to buy them a car, I know which one I would choose, of course if employer paying different answer

[Oohwan]

I agree with you al007.

 

I myself have been going to a Thai government hospital for almost 10 years, and have always received excellent service. The private hospitals are a lot nicer looking, but beside that I really do not see any difference. 

 

Of course some government hospitals will be better than others, but once you're in a Thai National hospital I think the medical expertise can be just as good as anywhere else. 

[khunPer]

I have a child, Thai national, together with my Thai GF. The child is covered by the Thai public healthcare system.

 

However, you may – at some point – wish a private personal accident insurance (some kindergartens and schools also require that), and you can supplement the government healthcare program with a private insurance; however the last is a question of risk and coverage, compared to "play-and-pay" at private clinics and hospitals.

 

I presume a new-born Thai still get the little booklet (as we did some 11-years ago) to update with vaccinations etc. I also presume that if the mother is under "Social Security"-system – i.e. from her work – that a newborn child is covered together with the mom; in that case the mom can claim expenses back, so keep all receipt from public hospitals/clinics; however not sure with private service, or a part of the expenses can be refunded.

 

Sheryl's post above is from an expert...

[Bob12345]

5 hours ago, Oohwan said:

I think I would be happy sending my child to a Thai government hospital.

 

I do not see any difference in the medical services/experience provided in private hospital opposed to a good Thai National Hospital. 

 

As Sheryl said on my other post "The terms of coverage compare very favorably to private insurance policies - with the sole (and notable) exception of lack of choice of hospital."

I do see a clear difference, based on first-hand experience of my wife who has worked in a government hospital and now works at a private hospital.

The main differences:

- private hospitals are less likely to use generic drugs and will tend to pick the most up-to-date version of each drug (as they can simply charge the insurer while a government hospital is spending public money and therefore has an incentive to save)

- the attention you get in private hospitals is often much better as staff is less overworked and has more time to give actual care

- facilities in private hospitals are better, see the recent article about patients in mosquito-ridden hallways in many public hospitals

- staff is often better in private hospitals; a public hospital will try to avoid firing bad staff members as it is hard to get a replacement while private hospitals have big money to offer to the best in the field to come work for them. Plus private hospitals have more budget for training and education. Plus in government hospitals you have a good chance of only being able to see an intern or someone recently graduated and fullfilling his/her debt to the government. 

- it is much harder to get admitted in a public hospital than in a private hospital; a new patient is a cost for a public hospital while it is a profit for a private hospital

- waiting times differ tremendously for non-emergency issues. In a public hospital you can easily spend half a day waiting in the heat for a 1 minute consult with a doctor.

 

On the flip side, all the extra's you get with a private hospital come with a price tag. Its for everybody to decide for themselves if they think it is worth it.

Edited April 23, 2017 by Bob12345

[Bob12345]

On 4/19/2017 at 3:59 PM, Sheryl said:

Vaccinations can be obtained, free, at any government health center, no need to go to a hospital (let alone a private one) for that.

While that is true you will get different shots. It will cover the same diseases but private hospitals use the more expensive shots that are combined (less shots for your kid) and have less negative side effects (chances on developing fever are much smaller).

[Bob12345]

2 hours ago, al007 said:

 

Wow big money, save it each year and by the time they are 21 maybe 1.0M Bhat enough to buy them a car, I know which one I would choose, of course if employer paying different answer

So you prefer to buy your kid a car over giving them the best health care available for a reasonable price?

Strange priorities you have and i guess you will come back to what you said as soon as your kid develops a serious disease (lets hope that will never happen).

[soalbundy]

7 hours ago, Bob12345 said:

Agree there, ask yourself the question if you would be happy sending your child to a Thai government hospital.

My wife (Thai) and I both have health insurance so naturally we bought the same for our kids.

 

We are paying around 40K baht a year for our newborn kids, same as our health care costs per year.

I do the same but i have found that the Thai insurance never pay's out in full, my last time in a private clinic (very reasonable prices) was for a hernia operation which came to 28,000 Baht, the insurance paid 20,000 i am starting to think that they base their charges on what it would cost in a government hospital and pay out accordingly.

correction, the missus has just told me that they paid out the 28,000 but in two installment's one 20,000 and the second 8,000, still pretty weird.

Edited April 23, 2017 by soalbundy

[al007]

3 hours ago, Bob12345 said:

So you prefer to buy your kid a car over giving them the best health care available for a reasonable price?

Strange priorities you have and i guess you will come back to what you said as soon as your kid develops a serious disease (lets hope that will never happen).

No sir wish to do the best for my children, will you regardless be buying them like nice Honda HRV when they are 21, I some how doubt it

 

A fool and his money is easily parted

 

Insurance companies are also a necessity; but generally not nice people, they will always take your money but often refuse to pay out or only reduced amount

 

Are you condemning the Govt care in Thailand to zero, I personally believe it to be excellent, having paid out 250,000 to 350,000 Baht in the last six months and at my young age 72 I have no medical insurance, all to top government hospitals, and all my many consultants also do a large proportion of their work at places like the Bumingrad, so I get the same man , and when I asked does it make any difference to the end result, where you do the surgery? he replied so long as he continues to like me NO !!! and some of the equipment in the govt hospitals is also more up to date

[Bob12345]

11 hours ago, al007 said:

No sir wish to do the best for my children, will you regardless be buying them like nice Honda HRV when they are 21, I some how doubt it

 

A fool and his money is easily parted

 

Insurance companies are also a necessity; but generally not nice people, they will always take your money but often refuse to pay out or only reduced amount

 

Are you condemning the Govt care in Thailand to zero, I personally believe it to be excellent, having paid out 250,000 to 350,000 Baht in the last six months and at my young age 72 I have no medical insurance, all to top government hospitals, and all my many consultants also do a large proportion of their work at places like the Bumingrad, so I get the same man , and when I asked does it make any difference to the end result, where you do the surgery? he replied so long as he continues to like me NO !!! and some of the equipment in the govt hospitals is also more up to date

will you regardless be buying them like nice Honda HRV when they are 21, I some how doubt it

I can take that doubt away already even though they are not even 1 year old; I will not buy my kids mid-size cars when they turn 21. Not even if I win the lottery and become a multi-millionaire.

My job as a dad is to let them reach adulthood healthy and ready to accomplish what they want, not to let them run unnessesary risks so I can buy them a car at age 21.

 

A fool and his money is easily parted

A fool and his good health are even quicker parted.

 

Are you condemning the Govt care in Thailand to zero

No i am not. I am just pointing out the differences between government care and private care based on the opinion of someone who worked in both and has over a hundred university friends and colleagues working in the same sector.

 

I personally believe it to be excellent, having paid out 250,000 to 350,000 Baht in the last six months and at my young age 72 I have no medical insurance, all to top government hospitals

I am happy for you that you are happy with your health care and haven't had the need to fork out amounts that go beyond your budget yet.

I do not see why that means you have to talk down to people ("a fool and his money is easily parted") who make a different choice because they do not mind paying a bit extra for a bit better quality. 

You can also just state your case and let everybody decide for themselves without trying to lash out at others with different opinions.

 

all my many consultants also do a large proportion of their work at places like the Bumingrad, so I get the same man

Lucky for you. But that is not the norm. In many cases the odds are against you to get the same or a better person.

 

and some of the equipment in the govt hospitals is also more up to date

Logic tells me that government hospitals work on a stricter budget and therefore have older equipment. That is also the experience of people working in that field who sometimes complain about the technical state of certain equipment. If you want to make the case that government hospitals have newer equipment than the larger private hospitals you will have to come with some pretty strong arguments (maybe sometimes they do when they just ordered new equipment but that wont be systematically be the case)

[al007]

43 minutes ago, Bob12345 said:

will you regardless be buying them like nice Honda HRV when they are 21, I some how doubt it

I can take that doubt away already even though they are not even 1 year old; I will not buy my kids mid-size cars when they turn 21. Not even if I win the lottery and become a multi-millionaire.

My job as a dad is to let them reach adulthood healthy and ready to accomplish what they want, not to let them run unnessesary risks so I can buy them a car at age 21.

 

A fool and his money is easily parted

A fool and his good health are even quicker parted.

 

Are you condemning the Govt care in Thailand to zero

No i am not. I am just pointing out the differences between government care and private care based on the opinion of someone who worked in both and has over a hundred university friends and colleagues working in the same sector.

 

I personally believe it to be excellent, having paid out 250,000 to 350,000 Baht in the last six months and at my young age 72 I have no medical insurance, all to top government hospitals

I am happy for you that you are happy with your health care and haven't had the need to fork out amounts that go beyond your budget yet.

I do not see why that means you have to talk down to people ("a fool and his money is easily parted") who make a different choice because they do not mind paying a bit extra for a bit better quality. 

You can also just state your case and let everybody decide for themselves without trying to lash out at others with different opinions.

 

all my many consultants also do a large proportion of their work at places like the Bumingrad, so I get the same man

Lucky for you. But that is not the norm. In many cases the odds are against you to get the same or a better person.

 

and some of the equipment in the govt hospitals is also more up to date

Logic tells me that government hospitals work on a stricter budget and therefore have older equipment. That is also the experience of people working in that field who sometimes complain about the technical state of certain equipment. If you want to make the case that government hospitals have newer equipment than the larger private hospitals you will have to come with some pretty strong arguments (maybe sometimes they do when they just ordered new equipment but that wont be systematically be the case)

First of all let me say in no way was I wishing to talk down to you or anyone, just expressing my views

 

I also believe putting some of this in writing helps us all think out the logic

 

Still a nice thought of mine to buy kids a car at twenty one, or deposit on house, especially if it can be achieved at easy cost

 

The Thailand healthcare system is probable rather unique

 

My comment a fool and his money is easily parted was not aimed at you, just a generalisation, money is a tough commodity to get and even harder to save and keep

 

You obviously have some very profound views and beliefs, which is very admirable, maybe you could elaborate more on the benefits of private vs government, is it just related to Thailand or globally, obviously with over a hundred friends working in the hospital sector you have a great wealth of experience, and maybe could show me the errors of my logic and judgement

 

Maybe you could tell us a little more about your age background and where originally come from

 

And one last thought if I had children here and they were to start experiencing major health care problem I would probably choose to return to my home country

 

I am but a rather simple, pretty old, 72,  Retired Chartered Accountant, originally from the Uk, on my fourth wife, this time 10 yrs, and can say I have never been more contented in my whole life

 

I wish you well BoB 12345, and thank you for posting a detailed reply

 

By way of PS The Chulalongkorn, has a state of the art cancer unit, that probably no private hospital could afford to fund and is currently building an even more advanced one at a cost of many billions again could only be done with government funding

Edited April 24, 2017 by al007

[Bob12345]

1 hour ago, al007 said:

...

maybe you could elaborate more on the benefits of private vs government

See post #12 where I made 6 specific points. Let me add to point number 5 that this also includes getting scans done in case of not clearly identifiable issues. A government hospital will not grant you a CAT-scan easily as they are hugely expensive while a private hospital will be more inclined to test everything as every extra test they do results in more profits. This is something that is hard to quantify as there are no statistics available, but my wife has come across cases where people went to a private hospital to get the scans they wanted only to find out they had a brain tumor after the government hospital saw no reason to allow for these scans.

 

is it just related to Thailand or globally

This is pure Thailand. I come from the Netherlands and there are practically no private hospitals there (except for plastic surgery and similar things). I am also not able to comment on neighboring countries as it might differ wildly.

 

if I had children here and they were to start experiencing major health care problem I would probably choose to return to my home country

Thats something important because that might not be an option everybody has. You have your pension while if I return to my homecountry I will be unemployed and will struggle to reach the same quality of life I have here. My wife is not allowed to work in the Netherlands (having a Thai medical license is worthless there plus she is not fluent in the language) meaning I will have to find a job to put bread on the table. While I did have a well-paying job before I doubt i can easily find something similar now. In case you were younger and had to work for your money (or do as I do and let your wife work for the money), would you still dismiss private health insurance that easily keeping in mind you will probably not be able to return to your home country that easily?

 

And i would want to ask you the following also:

What if you did not live in bangkok, would you still not consider private healthcare for your kids? If you lived in Hua Hin, Pattaya, Samui, or Phuket, would you still accept government hospitals as providing quality health care up to your standards? And what if you lived outside tourist destinations like Korat, buriram, or in the deep south?

 

My wife has worked several years in government hospitals to repay her study debts, and there is huge demand for positions in the bangkok area. A decent hospital in Bangkok can easily fill all it staffing needs and get replacement when someone leaves or gets fired. Hospitals in smaller places and further away from Bangkok do not have that luxury. Based on how easy a hospital can get staff the government pays a premium to whoever goes there to work. When my wife worked in the Korat area in a tiny town she got an extra 30-40K a month for picking that smaller hospital. The premiums are much higher in the deep south as you run serious risk working there (they do target health care professionals occasionally). Quality of staff is therefore often much lower outside of Bangkok as most doctors prefer to work in a city with access to shopping malls and movie theatres.

 

Another point to consider would be that the Thai population is aging and the government is running out of money. While your kids might be covered with the 30-baht scheme now this might very well change in the coming years. It might become a 100-baht scheme, a 1000-baht scheme, or funding will just not increase meaning longer waiting lists and worse care. For an outsider it will be extremely hard to determine when a tipping point is reached that the quality of care becomes so low that going private makes complete sense. You will only find out when its too late and private insurance will be out of reach due to the costs or just not cover pre-existing problems.

 

Btw, in no way I am trying to talk down government hospitals. Even though my wife gets free healthcare from her employer we sometimes do go to a government hospital if we are not happy with the staff at where she works. Plus we often consult specialists she knows from her university and specialisation time, or ask for feedback from her professors. The chances you get a below-standard doctor are just higher at a government hospital compared to a private hospital, but in no way you can say doctors at a private hospital are always better.

 

 

By way of PS The Chulalongkorn, has a state of the art cancer unit, that probably no private hospital could afford to fund and is currently building an even more advanced one at a cost of many billions again could only be done with government funding

Have to agree with you there. The government does have some very specialistic facilities that are of much higher standard than what private hospitals can offer.

[al007]

On 4/23/2017 at 11:13 AM, Bob12345 said:

 

We are paying around 40K baht a year for our newborn kids, same as our health care costs per year.

I like your replies, thank you Bob

 

BUT does not all make sense, your wife obviously has a very good job in healthcare, and you say gets free healthcare, generally this covers not only spouse but also children

 

But you also suggest you are paying for both of you the same amount, to my simple head something fishy

 

I do not dismiss easily private healthcare, insurance and for some it is pretty essential, I am only making the point do not blindly pay and think all will be well, and at least look at self insuring

 

I live in Issan and have to travel to Bangkok for my medical caring needs

 

Again if your wife is well involved in the private  health sector generally they help their own, which includes children, also nearly all doctors work in both Govt and Private sectors, so if a doctor were helping one of your children, he would I am sure be able to find a place for that child in the Govt sector

 

Blindly paying is maybe not the solution, just an observation, have you actually seen the insurance receipts ?, only enquiring ?

 

40,000 Baht times two for children's medical still seems out of place, 80,000 baht per annum total

 

With your wife as the main income generator, maybe you need PHI cover (permanent heath insurance), which in the event of her becoming incapacitated would replace the lost income

Edited April 24, 2017 by al007

[Bob12345]

2 hours ago, al007 said:

BUT does not all make sense, your wife obviously has a very good job in healthcare, and you say gets free healthcare, generally this covers not only spouse but also children

 

But you also suggest you are paying for both of you the same amount, to my simple head something fishy

The free healthcare does not cover spouse or children. It covers her, thats it.

In the past her parents, spouse, and kids would be covered if she worked for the government, that was overturned about 5-10 years ago.

One more reason why lots of good doctors switched to private hospitals around that time.

 

The free healthcare she gets from her employer is limited to a certain amount per year, and I am not sure if that has been included in her insurance policy. Otherwise it could simply be explained by the coverage she has, the higher amounts insured the higher the premiums. Nothing fishy.

 

Self-insuring only makes sense when you have build up the buffers. At the moment we just bought a house, have 2 newborn kids, and are planning to buy a new car. If we would self-insure now we need to keep our fingers crossed nothing happens the coming 10 years till we have buffers otherwise we are screwed. Self-insuring makes more sense when you are older, have your house paid off, and have some decent cash in the bank. That is not something people under the age of 50 have.