Medical cover in Thailand - Age 86

[Sheryl]

12 minutes ago, bazza73 said:

It's a gamble, as many things in life are.

Rajavej charges 4000 baht a day for a private room. I have 500,000 baht put aside for medical emergencies, which means I'm covered for 4 months. I doubt anyone could stay in a hospital for four months without either dying there, or getting the hell out.

My fallback is to get on a flight to Australia, assuming I can. I've kept on paying for private health cover there, so as soon as I get off the plane in Australia my hospital costs are zero.

IMHO the cost of cover for the over-seventies here is unrealistic. I'm willing to bet the actuaries and bean counters of the health funds offering cover have banded together to set premiums at the highest  level in order to maximize profit on the demographic. Greedy bastards.

Paying premiums of 250,000 baht a year is dead money. Once you spend it, it is gone. At least with self-insurance, you lose nothing until the medical event arrives. Which may be never.

 

 

No, it most definitely does not mean that.  Room charges are a tiny, tiny fraction of total hospital bills in any hospital and in no way indicative of what the total bill will come to. That amount is simply the cost of the room and the bed (and in some cases, meals). Nothing more. All the treatment you receive is additional to this -  Doctors fees, medications, use of operating room, all equipment and supplies used etc are additional to this.  You can easily run up a bill of 3 million baht or more within a month or less.

 

A coronary artery stent, for example , at Rajavej will likely cost at least 300,000 baht. With only 1 night stay involved, i.e. 296,000 of that for other than the room.

 

With only 500,000 baht on hand you are inadequately prepared to finance even one major event at a government hospital, forget about private.

 

As to a major illness or accident never arising: dream on. It is inevitable, if you intend to remain here for the rest of your life.

[wpcoe]

1 hour ago, Suradit69 said:

And, I believe, with BUPA, you have to start coverage before 55 (??) and then not let coverage lapse in order to be able to renew annually as you get older. When I had BUPA before my pension-related medical coverage began, I noticed that their annual premiums listed in their brochure didn't even appear above age 65 or so. You would be at their mercy depending on your individual claims record.

 

As mentioned in an earlier post, coverage for outpatient care is uneconomic since the added premium was usually nearly equivalent to the maximum amount you'd be allowed to claim.  And of course the cost of continued prescription medicine purchases would not be covered.

 

According to the BUPA web page with quotes, you need to start coverage by age 65.   At least that seems to be implied when you input an age older than 65 and the web site returns: "You are able to apply with Bupa until the age of 65 years"  

The comments about the BUPA's OPD coverage are spot on, too.  I worked out for my age/coverage that it was within a couple hundred baht to pay the annual OPD premium vs paying out-of-pocket with no OPD coverage.  OPD coverage is entirely not worth it, IMHO.

[bazza73]

23 minutes ago, Sheryl said:

 

No, it most definitely does not mean that.  Room charges are a tiny, tiny fraction of total hospital bills in any hospital and in no way indicative of what the total bill will come to. That amount is simply the cost of the room and the bed (and in some cases, meals). Nothing more. All the treatment you receive is additional to this -  Doctors fees, medications, use of operating room, all equipment and supplies used etc are additional to this.  You can easily run up a bill of 3 million baht or more within a month or less.

 

A coronary artery stent, for example , at Rajavej will likely cost at least 300,000 baht. With only 1 night stay involved, i.e. 296,000 of that for other than the room.

 

With only 500,000 baht on hand you are inadequately prepared to finance even one major event at a government hospital, forget about private.

 

As to a major illness or accident never arising: dream on. It is inevitable, if you intend to remain here for the rest of your life.

Point taken. As I keep 80% of my assets ( all liquid ) in Australia, if push comes to shove I can transfer enough to cover the costs you are stating. Although a gentleman in my condo who has multiple myeloma has had multiple spells in Rajavej, and he is nowhere near exhausting the 2 million baht cover he has. So perhaps you may be overstating the costs.

I have observed some stories on TV indicating medical insurance companies have been known to renege on policy claims.

You may be right; however, I'm comfortable with the strategies I have in place.

[eddysmit]

 He would be allowed emergency treatment, no Docs surgery though until he has informed the UK government,state pension office, he's back to stay, then his 'possibly' frozen state pension would be upgraded.

[Suradit69]

27 minutes ago, wpcoe said:

According to the BUPA web page with quotes, you need to start coverage by age 65.  

You're probably right. I started BUPA when I was only in country 3 or 4 months a year and had work related medical coverage in Abu Dhabi and then continued with BUPA when I was in Thailand full time until I turned 65 and my US based pension insurance kicked in. I knew that continued BUPA coverage at some point meant I could not let the coverage I had lapse. Thought it was earlier than 65, but at that point I got "free" coverage for life for all medical, dental, eyes and any prescription drugs so I no longer cared about BUPA. 

 

The US pension based insurance coverage I do have is no longer available to new hires. Obviously too expensive for my pension provider to continue. So it's nice I managed to get it as a condition of employment decades ago. Nice to occasionally have a bit of good luck.

 

 

[TheFishman1]

I use this Guy Andrew his insurance is out of the U.K. Nice guy

[offset]

I am 72 years old and with Pacific Cross, my premium this year was 120000 Baht for all cover not including existing problems, I have a 20% co pay for heart condition only, world wide cover excluding America and also out patient cover

 

I have never had a claim off them but my son also insured with them to has had 2 problems both were paid with no problem i not even see the bill

[cooked]

4 hours ago, homisch said:

Hi, I'm new here.

Maybe possible a Foreign travel health insurance. That may run for max one year.
He may have to return UK once the year and renew this insurance for one more year - or similar

homisch

Looks good in theory but although they will accept your money I don't think they will cough up when they find out that an insurance that is meant for temporary stays abroad is being used improperly.

 

[offset]

14 minutes ago, cooked said:

Looks good in theory but although they will accept your money I don't think they will cough up when they find out that an insurance that is meant for temporary stays abroad is being used improperly.

 

They also only cover 186 days in 1 year this is in the small print on most yearly travel cover

[Sheryl]

45 minutes ago, offset said:

I am 72 years old and with Pacific Cross, my premium this year was 120000 Baht for all cover not including existing problems, I have a 20% co pay for heart condition only, world wide cover excluding America and also out patient cover

 

I have never had a claim off them but my son also insured with them to has had 2 problems both were paid with no problem i not even see the bill

 

Without the outpatient cover, your premium will be much less.

 

Outpatient cover is usually not worthwhile in Thailand. If you travel to other countries where costs are higher, then it may make sense. Otherwise I would suggest checking to see how much you would save by dropping it.

[offset]

35 minutes ago, Sheryl said:

 

Without the outpatient cover, your premium will be much less.

 

Outpatient cover is usually not worthwhile in Thailand. If you travel to other countries where costs are higher, then it may make sense. Otherwise I would suggest checking to see how much you would save by dropping it.

Thank you for your advice I was going to ask next year and maybe even drop the travel part to because the insurance will only get more expensive for me

[wpcoe]

2 hours ago, Suradit69 said:

 

The US pension based insurance coverage I do have is no longer available to new hires. Obviously too expensive for my pension provider to continue. So it's nice I managed to get it as a condition of employment decades ago. Nice to occasionally have a bit of good luck.

 

That's a sweet deal you got.  My employer had free health care for retirees up until the early 2000s, and there was a deadline by which folks had to retire to qualify for it.  A *ton* of folks retired early to get the free medical insurance.  Couple years later the company changed its policies (can't remember if it was in bankruptcy court or not) and they started charging the retirees 2x what an active employee pays.  My BUPA policy was less than what I would pay for my company insurance as an active employee and I didn't have to fuss around with paying up front and submitting forms for reimbursement, so I canceled the company-provided option.  When I retired in 2010, it made double sense to just keep BUPA.

 

Did you decline Medicare when you turned 65?  I'm planning to grit my teeth and pay the premium for some of the optional Plans even though they can't be used overseas, "Just In Case" I end up moving back to the USA at some point.

[Suradit69]

1 hour ago, wpcoe said:

Did you decline Medicare when you turned 65?  I'm planning to grit my teeth and pay the premium for some of the optional Plans even though they can't be used overseas, "Just In Case" I end up moving back to the USA at some point.

I've never done anything with regard to Medicare as far as I can remember, so I guess I declined it. Have no expectation of ever return to the US. My insurance claims are paid directly by my former employer, but they do re-insure to cover catastrophic amounts so I'm pretty well covered. I do have to pay first and then submit a claim for reimbursement every few months. About 7 years now and Bangkok Pattaya Hospital charges as well as those for dental & eyeglasses and recurring prescription meds from Fascino have never been questioned. 

 

I do agree that I sort of won the lottery getting this sort of coverage. Never fully appreciated the importance of this when it was included in my compensation decades ago.

[theguyfromanotherforum]

6 hours ago, Sheryl said:

Chulalongkhorn, hands down. Rama IV road near Rajadamri.

 

There is an after hours clinic on the 13th floor of the OPD building where you can see specialists by appointment, only a couple hundred baht more than the very crowded public channel and well worth it. It runs from about 4 PM onward and also Saturday mornings.

 

 

 

Really? Any specialist?

 

[sangtip2]

I don't think anyone insures for "Pre-existing"  so if you have anything,  blood pressure,  cholesterol,  ---  anything  you will end up paying a lot and find the insurance will pay you nothing.      

[chas39]

I appreciate that the thread is about the costs of medical provision for expats in Thailand, but there have been references to getting home to the UK for free treatment. 

So it might be useful to refer to the rules now. So far as I understand them. 

Free treatment is given if you can convince the NHS Hospital Trust/ provider that you are  ' ordinarily resident ' in the UK.

Entitlement is not earned by paying tax, National Insurance -  nor holding UK passport, having citizenship nor, I understand, for just being in the UK for a given length of time. So don't waste your time having a row with anyone on these latter grounds. 

( However, emergency treatment will be free - so long, I guess, as you can show you haven't travelled to the UK specifically for treatment.) 

So the key thing you have to convince the NHS you are ' ordinarily resident '. The definition encompasses the phrase :-

     - a person is ' ordinarily resident ' for this purpose if lawfully living in the UK for a settled purpose as part of the regular order of his or her life for the time being. That is if they are normally residing in the UK ( apart from temporary or occasional absences) and their residence here has been adopted voluntarily and for settled purposes as part of the regular order of their life for the time being whether for short or long duration - .

 

Forgive me - but I am using the official words. 

 

This is just me pointing the direction in which someone should travel if they want to get free NHS treatment. I don't suggest dishonesty - just be aware of the guidelines that will be used. 

The best bet is to search online for one document in particular. It is headed Department of Health " TOOL : Determining if a person is properly settled in the UK in order to establish if they are ordinarily resident here." 

It spells out loads of questions/facts that might be asked by the NHS. 

God, this is all a bit boring, but you may need it some day. 

I will try to find the link. 

I come to Thailand for about 3 months each year. I was asked recently  to complete a questionnare/provide information and went for interview. I showed my passport, rent book, completed form and after a few questions was confirmed as ' ordinarily resident '. 

I refrained from saying that at 77 years old I have been alive for longer than the NHS has been in existence....! But that wasn't one of the criteria. 

[cooked]

58 minutes ago, sangtip2 said:

I don't think anyone insures for "Pre-existing"  so if you have anything,  blood pressure,  cholesterol,  ---  anything  you will end up paying a lot and find the insurance will pay you nothing.      

More important is that if you don't declare a pre-existing, when it comes to pay up time, the company may refuse even if it has nothing to do with your present problem. 

[IAMHERE]

The 86 year old will be exposed to a lot of viral colds that he has never encountered in the UK, they will make life difficult if not impossible for the first several years in Thailand. Colds are very hard on the aged.

[uptheos]

11 hours ago, Farang99 said:

If his father is out of the UK for more than one of the last 3 years he will not be eligible for treatment on the NHS.

That's absolutely correct on paper.

Reality is completely different (trust me)

[Sheryl]

2 hours ago, theguyfromanotherforum said:

 

Really? Any specialist?

 

 

Pretty much, yes. But there are often wait lists.

[Sheryl]

2 hours ago, sangtip2 said:

I don't think anyone insures for "Pre-existing"  so if you have anything,  blood pressure,  cholesterol,  ---  anything  you will end up paying a lot and find the insurance will pay you nothing.      

 

Insurance companies/underwriters vary greatly in how they treat pre-existing conditions. Any exclusions will be clearly spelled out in your policy.

 

It is certainly not the case that simply having high blood pressure, if it is well controlled, will lead to an exclusion. With some insurers it will but with many others it will not as long as it is well controlled and you have never suffered any complications from it.

 

I have mild hypertension, well controlled on medication. I declared this when I took out a policy from Cigna last year and there are no exclusions on my policy. None.

 

Other times an insurer may exclude certain conditions for just the first 1-2 years of the policy and then lift the exclusion if you have been free form complications/exacerbations during that time.

 

The Thai insurance companies are the worst in this regards in my experience, in no small part because the people doing this seem to lack any medical background and to work off of charts that list a symptom and then all the possible things it might be or might lead to rather than making an informed analysis of the individual person's actual risk profile. I have known them to exclude pre-exisitng conditions the person did not even remotely have, based on misinterpretation of simple information.  International companies are better about this. They will still usually exclude any major pre-existing condition (asthma, diabetes etc) but not to wild extremes.

 

You will though get in trouble with all of them if you failed to disclose a pre-exisitng condition.

 

[al007]

I do not know the statistics but many people die without having incurred heavy medical costs

 

However in  my view  bringing an 86 year old parent from the UK to thailand without medical insurance, or a million pounds sterling in the bank, and I mean sterling, is misguided and selfish, someones motives need to be looked at

 

I am 72 and currently undergoing treatment for two different cancers, and can not speak highly enough of the Chulalongkhorn in Bangkok, and have had surgery in India, all of them at sensible cost

 

Private hospitals in Thailand are financially out of my comfort zone but also not necessary, I am currently under four consultants and not complaining about the costs, very well qualified, and caring people, I have probably experienced more hospitals and medical here in Thailand than most

 

I self insure

 

Medical care must be considered, but maybe not let it rule your life, but risk evaluation must be done and a plan in hand to cover the worst scenario

 

Some of us are more comfortable with risk than others, I am neither wealthy nor poor

 

For those like me from the UK; that is a safety net, recently an old friend 89 returned to the UK no relatives there and he is now in a home all being paid for by the taxpayer

 

If I were down to less than a couple of million well maybe a different perspective, but so far so good

 

Live life and enjoy it, stay grateful, and say thank You God, not the thinking of many, but works for me

[New beginnings]

It is disappointing that you have assumed "someone's motives need to be looked at " and, furthermore that they are being "misguided and selfish" when you have no knowledge of the people concerned.  For your information it is the father that wishes to join his son and wife in Thailand. As a loving son he is making an appropriate enquiry to see if he can facilitate his fathers wishes.

[thailand49]

On 5/25/2017 at 11:16 PM, New beginnings said:

It is disappointing that you have assumed "someone's motives need to be looked at " and, furthermore that they are being "misguided and selfish" when you have no knowledge of the people concerned.  For your information it is the father that wishes to join his son and wife in Thailand. As a loving son he is making an appropriate enquiry to see if he can facilitate his fathers wishes.

Sir you are in a real tough situation, as a son, I've been entrusted with a number of family matter including my mother who is now 98. I've been living in Thailand for over 10 years and dealt with the insurance and hospital here.

I do understand your dad wish for him to come here and be with you and your family.   Aside from you and your family what is here for him.  If he was younger I wouldn't even bother to write, but he is 86, unless he is running 5K, a day he needs to stay put. I've seen my mother at 86, in the States, turn 360 in one year. for years she couldn't even leave her home, which was her wish to die there. Whatever you think of the medical system in your country, it is heaven in my opinion compare to Thailand. Lucky I was able to enroll her into a great community program that provided home visits 3 times a day with food, twice a week they picked her up to visit the center where she got all her medical needs. Each year it got worse while we continue to wait for a opening at a care facility in the community. Last year, I had to return and share duties with my brother who also lives in Thailand because she needed 24/7 care which we couldn't afford on our own. No matter where we turn the cost was around 10,000 USD a month.

Last, year tested me and my brother as to who I really was as a person because I never envision having to pick my mother up and carry her to the bathroom to clean her off from her having a accident.  The first time she just stare at me crying wanting to die, because she was so ashame that her son who she which change my diaper was now changing hers.

 

I cook and clean for her on top of her many temper swings which is common in seniors.  After 3 months it started to affect my own health, due to lack of sleep, there were times in the middle of the night I sat in the dark and cry, thinking I hope I never live that long so as to impose this on my own family.

 

After a few months a miracle happen, her waiting was over, she got accept into the community program that provides everything for her. She has a clean room of her own, with 24/7 caretakers. I was able to return to Thailand, after 6 months home I still have not recovered.

 

Unless, you have deep deep pockets I suggest he stays home unless there isn't anyone left in your family. Otherwise I wish you and your father the best in whatever choice you make.

[bbi1]

On 2017-5-24 at 9:46 PM, sangtip2 said:

I don't think anyone insures for "Pre-existing"  so if you have anything,  blood pressure,  cholesterol,  ---  anything  you will end up paying a lot and find the insurance will pay you nothing.      

Wrong, I've got one pre-existing conditions included in the insurance, but they charge me a 30% loading fee every year for this. What a ripoff but at least it's covered and gives piece of mind.

[bbi1]

On 2017-5-24 at 10:46 PM, cooked said:

More important is that if you don't declare a pre-existing, when it comes to pay up time, the company may refuse even if it has nothing to do with your present problem. 

I'm wondering how does the insurance company even know if you had a pre-existing condition? It's not like they're allowed to get access to your medical records back in your home country and check everything.

[bbi1]

On 2017-5-25 at 0:15 AM, Sheryl said:

 

Insurance companies/underwriters vary greatly in how they treat pre-existing conditions. Any exclusions will be clearly spelled out in your policy.

 

It is certainly not the case that simply having high blood pressure, if it is well controlled, will lead to an exclusion. With some insurers it will but with many others it will not as long as it is well controlled and you have never suffered any complications from it.

 

I have mild hypertension, well controlled on medication. I declared this when I took out a policy from Cigna last year and there are no exclusions on my policy. None.

 

Other times an insurer may exclude certain conditions for just the first 1-2 years of the policy and then lift the exclusion if you have been free form complications/exacerbations during that time.

 

That means I'm getting ripped off paying a 30% loading every year to be covered for asthma. I should try and negotiate this 30% loading to be taken off my premiums.

[steven100]

Medical cover at 86 .....    that's like trying to insure your car in a smash up derby competition.

[cooked]

2 hours ago, bbi1 said:

I'm wondering how does the insurance company even know if you had a pre-existing condition? It's not like they're allowed to get access to your medical records back in your home country and check everything.

Be assured that they WILL check if you have a pre-condition and WILL find out about them. The possibility that they will cancel your medical cover if they find out you didn't declare is also there.

[bbi1]

19 minutes ago, cooked said:

Be assured that they WILL check if you have a pre-condition and WILL find out about them. The possibility that they will cancel your medical cover if they find out you didn't declare is also there.

But how will they even know in the first place it is a pre-condition & how will they be able to check it? It's not like your medical records are in Thailand. They'd be in your home country.