Do Health and Insurance Concerns Reduce Your Enjoyment of Retirement in Thailand?

[music065]

Recent health issues I've experienced have got me thinking. I am curious about whether thoughts of future health & insurance issues seriously affect expat retirees' happiness or daily satisfaction, especially in the 65+ age group that may be facing challenges securing insurance and may not have a huge amount of funds available for medical emergencies. It seems to be one of the biggest challenges regarding planning to spend the rest of one's life in Thailand. 

 

Does this bother you much much on a daily basis?  What are some strategies you use to deal with the challenge?

[Suradit69]

2 hours ago, music065 said:

Does this bother you much much on a daily basis?  What are some strategies you use to deal with the challenge?

No it doesn't bother me on a daily, weekly, monthly or annual basis. Fortunately I've got it covered, but in a general way I do feel concern for the number of older expats here who are in denial about what could happen to them. And actually that concern extends to many younger expats and tourists who seem to think they are invulnerable to sudden illness or accident.

 

The best strategy is to have insurance or set aside some money in an account that you don't touch as a form of self-insurance. If neither is possible, you may have to reconsider whether your continued stay here is a good idea, especially if you would have insurance coverage in your home country. As painful as it may seem to do something now when you are reasonably healthy and have choices, it will be far worse to wait until you're left with no realistic options.

 

It's an unfortunate reality that once you get into your 60's or older, you will almost certainly have increased medical expenses even if you don't have some major event to deal with. Worrying about it or keeping your fingers crossed isn't a useful strategy. 

[abrahamzvi]

3 minutes ago, Suradit69 said:

No it doesn't bother me on a daily, weekly, monthly or annual basis. Fortunately I've got it covered, but in a general way I do feel concern for the number of older expats here who are in denial about what could happen to them. And actually that concern extends to many younger expats and tourists who seem to think they are invulnerable to sudden illness or accident.

 

The best strategy is to have insurance or set aside some money in an account that you don't touch as a form of self-insurance. If neither is possible, you may have to reconsider whether your continued stay here is a good idea, especially if you would have insurance coverage in your home country. As painful as it may seem to do something now when you are reasonably healthy and have choices, it will be far worse to wait until you're left with no realistic options.

 

It's an unfortunate reality that once you get into your 60's or older, you will almost certainly have increased medical expenses even if you don't have some major event to deal with. Worrying about it or keeping your fingers crossed isn't a useful strategy. 

A very good advice and warning!!!

[RBOP]

Yes. I'm early retired and health insurance cost is of great concern. In fact its my single most expensive item and will only keep increasing as I get older. Yeah many say health care is cheap in Thailand. Well its only cheaper when compared to USA, Canada and Europe but its still expensive.   No one knows or can predict what your health will be next year. So I'm already planning to return to my home country after 65 years or sooner where I can get free medical. 

[gamini]

If you have good Thai friends they can always inform you about which government hospitals have the best doctors and who they are. I am elderly and have a lot of different medical problems.  I go to 3 different government hospitals where I get first class treatment at a very reasonable price. The best doctor I've ever experienced in my life is a radiologist at a government hospital with all the latest equipment. I sea a marvellous orthopaedic doctor at an army hospital. I see two different doctors at a small provincial hospital.I see a very good cardiologist at his clinic. My medical expenses including a heart operation and many other smaller operations have costed far less in total than medical insurance.  It is just a question of doing a bit of research. Also I am friendly with all my doctors and I told them that I have no insurance and very limited funds and they are very sympathetic. Unfortunately it seems that most expats base their experience on the very expensive private hospitals. Some don't even bother to request a specific doctor, in which case the hospital assigns you probably the most unpopular and incompetent. Added to this, medicine is probably the cheapest of anywhere. You simply go to one of the Chinese pharmacies in Bangkok which are all much much cheaper than any chemist.

[masuk]

Medical insurance is not a worry for me - I simply can't afford it from my pension.  Even the airlines won't insure a customer after a certain age.

 

So I've opted for the next best thing and that is to return to my home country for what appears to be major concerns.   The problem with this is that the National Health Service is painfully slow, and renting a room while overseas becomes expensive, while also maintaining one's condo in Thailand.

 

Yes, I'm sure that those with adequate health insurance in Thailand will advise me to stay at home, but I happen to like Thailand, its people and the friends I've made.  It's also economical to rent in Thailand, and eating out is not a luxury.

 

A current cardiac problem resulted in tests at the government hospital in Chiang Mai, but I was unable to get estimates for treatment in spite of a number of requests.  If I had, I might have been able to compare air fares and rental costs v. medical costs, or even pay the hospital on a monthly basis. I have no worries about the quality of treatment.

 

 

[soalbundy]

From a certain age onward one expects that the candle will be snuffed out eventually, I certainly have got used to the idea, it is only a cause for fear if you are young. The best insurance wont stop your demise but I hope at least for a clean pain free exit. I have insurance and have used it for a minor OP but it would have been affordable without insurance. My opinion only but if you need an expensive serious OP near the age of say 70 then you are on the way out anyway, we are mortal.

[Pilotman]

Its an interesting question. I am moving to LOS to retire in the next 3 weeks, at the age of 69. It has been in my thoughts certainly. I will no doubt grow older and probably die in Thailand, but I refuse point blank to worry about it, allow it to impact my thought in my new life, or make me pay the stupid insurance rates on offer for health cover. I am fit, probably very fit for my age, I look after myself and I will continue to do that as my part in the game of life. I do have sufficient funds for major health issues, but whether I use them or not is an issue for me. I guess I accepted that living in Thailand just means I never will have the medical cover that I had/have in the UK and I guess that's fine for me. Better that than live in a cold inhospitable climate with miserable people around me, just on the off chance that I will need the NHS sometime. 

[Mburo]

Interesting posts. I am approaching 70. I have top drawer private health cover for overseas, so I don't worry . FYI the annual insurance cover costs me €5,000. Just keeping my fingers crossed , no problems so far. 

[NoshowJones]

Yes, but everything OK so far, I know being a non drinker and non smoker all my life and regular exercising does not guarantee anything, I hope

it gives me a better chance, the three main drinkers and smokers among my expat friends are dead, but in saying that, my best local expat friend

died only four weeks ago after a short illness, he was a non smoker and modest drinker, and I have to say it has scared me a bit.

[Fulwell53]

3 hours ago, gamini said:

If you have good Thai friends they can always inform you about which government hospitals have the best doctors and who they are. I am elderly and have a lot of different medical problems.  I go to 3 different government hospitals where I get first class treatment at a very reasonable price. The best doctor I've ever experienced in my life is a radiologist at a government hospital with all the latest equipment. I sea a marvellous orthopaedic doctor at an army hospital. I see two different doctors at a small provincial hospital.I see a very good cardiologist at his clinic. My medical expenses including a heart operation and many other smaller operations have costed far less in total than medical insurance.  It is just a question of doing a bit of research. Also I am friendly with all my doctors and I told them that I have no insurance and very limited funds and they are very sympathetic. Unfortunately it seems that most expats base their experience on the very expensive private hospitals. Some don't even bother to request a specific doctor, in which case the hospital assigns you probably the most unpopular and incompetent. Added to this, medicine is probably the cheapest of anywhere. You simply go to one of the Chinese pharmacies in Bangkok which are all much much cheaper than any chemist.

Great post however it will upset those who want to find fault with all things thai.

 

[1FinickyOne]

I think after passing 60, there is a certain feeling of vulnerability whether you can afford it or not. Being able to afford care only helps a little against the concerns of ageing. And yes, it is having some effect, maybe having me consider getting a 2nd home someplace where there is decent medical as I am a fair distance to what I would consider a decent hospital.

 

Other than those who go suddenly, medical issues are the future for most of us... 

 

 

[music065]

Interesting and varied responses, thank you. It seems that although people have a variety of philosophies they are approaching this from, all are well reasoned and logical within their own framework. One thought that many of the ideas expressed brings to mind is quality of life, not quantity. I only hope we that espouse this idea are still strong with it when the inevitable time draws near.

[bazza73]

In a word, no. I self-insure and drive defensively. I have full health cover in Australia.

I think the most important thing to have here is a supportive network of friends who can assist you if things go pear-shaped.

There is an element of risk for all retirees here. For example, if you have a stroke or are unconscious from an accident. All one can do is try to minimize that risk.

[retarius]

An interesting question. I self-insure. It's easier, no confusing forms to fill out and no exclusions for pre-exisiting conditions etc

[music065]

I can certainly relate to the choice some stated above of whether to live in a place where you are miserable but have virtually free medical coverage vs living in a place where you are happier but have more health insurance and medical treatment concerns. This dilemma seems to be where I'm at. Then there's the very real (imo) idea that if you're miserable in a place that probably will lead to more health problems.

Edited June 1, 2017 by music065

[tigermoth]

6 hours ago, masuk said:

Medical insurance is not a worry for me - I simply can't afford it from my pension.  Even the airlines won't insure a customer after a certain age.

 

So I've opted for the next best thing and that is to return to my home country for what appears to be major concerns.   The problem with this is that the National Health Service is painfully slow, and renting a room while overseas becomes expensive, while also maintaining one's condo in Thailand.

 

Yes, I'm sure that those with adequate health insurance in Thailand will advise me to stay at home, but I happen to like Thailand, its people and the friends I've made.  It's also economical to rent in Thailand, and eating out is not a luxury.

 

A current cardiac problem resulted in tests at the government hospital in Chiang Mai, but I was unable to get estimates for treatment in spite of a number of requests.  If I had, I might have been able to compare air fares and rental costs v. medical costs, or even pay the hospital on a monthly basis. I have no worries about the quality of treatment.

 

 

I am similar. On an Australian pension so can't afford health insurance here. I am covered by medicare , the govt, health insurance in Australia but only in govt. hospitals which are of a high standard. The problem is that even the simplest health problems generally require a fairly long waiting time. Anything more serious needing an operation the waiting time can be 6 months to more than a year. I recently had a skin cancer removed in Australia. The govt. hospital had a 3 month waiting list so i had to go to a specialist surgeon. Medicare payed about half but it still cost me almost $800. For those knockers I know will respond to this I was returning to oz for 2 weeks to visit family, 1st time in 2 years.

[ableguy]

8 hours ago, gamini said:

If you have good Thai friends they can always inform you about which government hospitals have the best doctors and who they are. I am elderly and have a lot of different medical problems.  I go to 3 different government hospitals where I get first class treatment at a very reasonable price. The best doctor I've ever experienced in my life is a radiologist at a government hospital with all the latest equipment. I sea a marvellous orthopaedic doctor at an army hospital. I see two different doctors at a small provincial hospital.I see a very good cardiologist at his clinic. My medical expenses including a heart operation and many other smaller operations have costed far less in total than medical insurance.  It is just a question of doing a bit of research. Also I am friendly with all my doctors and I told them that I have no insurance and very limited funds and they are very sympathetic. Unfortunately it seems that most expats base their experience on the very expensive private hospitals. Some don't even bother to request a specific doctor, in which case the hospital assigns you probably the most unpopular and incompetent. Added to this, medicine is probably the cheapest of anywhere. You simply go to one of the Chinese pharmacies in Bangkok which are all much much cheaper than any chemist.

This sounds just like me, I use the public hospital here in Korat but I visit at night where they charge me 150 baht plus fifty baht to see my doctor, the drugs cost no more than any pharmacy,  and I never wait more than twenty minutes.you want to use a private hospital they all insist on taking your blood pressure, weighing you and measurinlng how tall you are for every single visit cost 300 baht, refuse this they will not deal with you. In the public hospital walk in stick your arm in a machine it prints your blood pressure ticket free..I have also had several wrong diagnosis at a private hospital here , saw a second  doctor at the same hospital he simply said come see me at Maharat the public hospital and I can save you a  fortune which I did and he was true to his word.

what most ex pats do not understand is most of the doctors you will see in a private hospital also work in the public hospitals the only problem you will encounter is finding one you can trust, is competent and is genuinely concerned about your health, not simply interested in writing you prescriptions for which they get paid  a lot for each prescription ,once you see the cost of these to what you would pay for the same drug on the street you will understand what I am talking about.

hope this helps you sceptics about public hospitals, but be aware go in the daytime be prepared for an all day experience.

[Retiredandhappyhere]

8 hours ago, masuk said:

Medical insurance is not a worry for me - I simply can't afford it from my pension.  Even the airlines won't insure a customer after a certain age.

 

So I've opted for the next best thing and that is to return to my home country for what appears to be major concerns.   The problem with this is that the National Health Service is painfully slow, and renting a room while overseas becomes expensive, while also maintaining one's condo in Thailand.

 

Yes, I'm sure that those with adequate health insurance in Thailand will advise me to stay at home, but I happen to like Thailand, its people and the friends I've made.  It's also economical to rent in Thailand, and eating out is not a luxury.

 

A current cardiac problem resulted in tests at the government hospital in Chiang Mai, but I was unable to get estimates for treatment in spite of a number of requests.  If I had, I might have been able to compare air fares and rental costs v. medical costs, or even pay the hospital on a monthly basis. I have no worries about the quality of treatment.

 

 

If you return to the UK for free NHS treatment, you have to be able to show that you have returned permanently in order to qualify.

[sirineou]

8 hours ago, soalbundy said:

From a certain age onward one expects that the candle will be snuffed out eventually, I certainly have got used to the idea, it is only a cause for fear if you are young. The best insurance wont stop your demise but I hope at least for a clean pain free exit. I have insurance and have used it for a minor OP but it would have been affordable without insurance. My opinion only but if you need an expensive serious OP near the age of say 70 then you are on the way out anyway, we are mortal.

I try to think of everything, but staying alive is on the top of my list!!

Though we will all die we do hope to prolong the date of that eventuality.

I don't remember who it was who said: "I have nothing against old age, I hope to die from it"

I might add .and at the same time maintain a reasonable level of quality of life while here.

 

My advise is always,  Don't burn your bridges,

Bridges are great when the need arises for an orderly retreat , otherwise you might find your self swimming, and possible drowning..

If you need the proceeds from your home back home , perhaps you are not ready to come here, but if you must,

Downsize

Sell your big house, buy a small condominium and rent it. Use the balance of the proceeds and rent  to finance your great escape. But have a way back.

Most of your old age assistance, for most of as is back home

 

Edited June 1, 2017 by sirineou

[Ulic]

9 hours ago, RBOP said:

Yes. I'm early retired and health insurance cost is of great concern. In fact its my single most expensive item and will only keep increasing as I get older. Yeah many say health care is cheap in Thailand. Well its only cheaper when compared to USA, Canada and Europe but its still expensive.   No one knows or can predict what your health will be next year. So I'm already planning to return to my home country after 65 years or sooner where I can get free medical. 

My health care in Canada is much cheaper than Thailand. As a matter of fact it is free or more accurately included

in my taxes.

[Altalake]

Suradit 69 has it taped. Listen to his wise words People.

[khunPer]

I think we are many expats living in LoS on retirement status, where health is, if no a regular concern, then an important matter to consider. Passing the age of 65 year (plus/minus), the annual price tag of a heath insurance with reasonable cover can reach a level, where one begin to think seriously about it; or as some mention, not think at all, because the retirement pension payouts makes it impossible.  

 

Being in good health and coming from longevity family without health issues, I'm not worrying about it, but I needed to make some decisions when moving out to Thailand on early retirement. Coming from a country with free public health care, private insurance was something new for me. I could see, that signing up with a local insurance company, like Bupa, some preexisting conditions would not be covered – i.e. if anything happened to me, there was a risk it could be classified "preexisting condition" – and other cases might not be covered at all or only with limited cover. Furthermore there would still be some maximum limits. I could afford a reasonable priced insurance, and it would probably be to risky without anything, so I decided for the second best coverage, but paid the fee for best; meaning that the remaining balance I deposited in a "rainy day" bank account, so I always would have some cash available in case of emergency.

 

Passing the age of 60 the insurance fee went up, and as my health was of no concern, and my my "rainy day" thing began to have little savings, I decided after a few years to change to a lower cover, and put more aside. I was in a position where I also could move a small lump sum into my local emergency account – I was in fact partly self-insured, as the lower cover equals much lower limits – and began to consider, if I should give up being insured after next age-break. Looking at the fairly low cover per incident, and the annual maximum, compared to my own savings and overall health situation, I decided to take the risk, and only pay to myself.

 

I'm aware of, that I probably am going to use public hospitals rather than high end private, but even with an insurance the cover would need to be quite high to justify use of expensive private hospitals; i.e. with a lower cover I would still need to pay some, or even most of the expenses myself. The problem is, as also being pointed out when the subject has been discussed earlier in this forum, the problem is that some major incident where all, or just a major part of emergency account is used – what do you do if one more serious incident appears..?

 

What is enough emergency cash? What can I afford to set aside What is the risk? What shall I give up to afford a better, or the best health insurance – change my life-style, so life is not worth to live; or reduce the cost of my child's school and education? Yes, it's a challenge...

 

I decided to be self-insured at 65 – after almost 10-years unused health insurance – because I had little cash available in a "rainy day" account. However, I continued with a PA (Personal Accident) insurance, which can be obtained for a very affordable fee. In worst case scenario I have some other savings to take extra from, which however then will change my future life-style. But I'm not sleepless at night about my situation, and it's not bothering me much. Furthermore, the weather and life-style in Thailand probably does a lot better for my health, than if I had stayed home with free health-care. And yes, I have the option of returning to my home country and sign-in back there again – however, will I be in a condition so I can return, or can I afford to pay for my return in that condition? – but also thinking about how the public healthcare has developed "at home", I'm not sure I wish to consider that option...

 

Health insurance or not: No matter how little one may have, I believe one shall always be able to put some money aside for emergency – a few thousand baht a month, or just a few hundred baht a month, it all counts and sums up over time – and little savings are a huge lot more, than no savings at all.

[music065]

Seems like there's a surprising number of retirees here really living on the edge. I have an acquaintance who was going along fine no problems and in great health. Then he simply fell in the bathroom and this simple fall has resulted in an unbelievable amount of health complications. He has very little money, can't return home, can't pay for much medical treatment. In a lot of pain. Stuck. Not pretty at all. It's sad, and I think these cases may happen more often than we know. 

[Grumpy Duck]

18 hours ago, Suradit69 said:

No it doesn't bother me on a daily, weekly, monthly or annual basis. Fortunately I've got it covered, but in a general way I do feel concern for the number of older expats here who are in denial about what could happen to them. And actually that concern extends to many younger expats and tourists who seem to think they are invulnerable to sudden illness or accident.

 

The best strategy is to have insurance or set aside some money in an account that you don't touch as a form of self-insurance. If neither is possible, you may have to reconsider whether your continued stay here is a good idea, especially if you would have insurance coverage in your home country. As painful as it may seem to do something now when you are reasonably healthy and have choices, it will be far worse to wait until you're left with no realistic options.

 

It's an unfortunate reality that once you get into your 60's or older, you will almost certainly have increased medical expenses even if you don't have some major event to deal with. Worrying about it or keeping your fingers crossed isn't a useful strategy. 

Ya know, I am 65, Checked a few places and could not find thai insurance to cover anyone my age. I did find some US & Euro companies that would cover me at premium rates with high deductibles. 

 

I quit my $246 a month union medicare over ride plan that would cover me with min deductibles. But the bills must be in English. 

 

My GP back in the states was a good doctor except he was a pill pusher. He had me convinced I was going to die from diabetes, asthma, and who remembers what else. When I arrived here I weighed 240 Lbs was taking about 5 pills a day, I was forced to follow my doctors original suggestion and exercise, I walked all over the place. Once walking from Ekami to ASOK, then to Bangkapi about 18 km if I recall. In a couple of months I lost 40 lbs and quit all my medications. My blood sugar was in normal to slightly low range. But Often I don't drink enough water, and as a result the few Dr visits I had were for kidney stones. If I need serious care, I have some $ stashed to cover a return home. 

[abrahamzvi]

16 hours ago, Pilotman said:

Its an interesting question. I am moving to LOS to retire in the next 3 weeks, at the age of 69. It has been in my thoughts certainly. I will no doubt grow older and probably die in Thailand, but I refuse point blank to worry about it, allow it to impact my thought in my new life, or make me pay the stupid insurance rates on offer for health cover. I am fit, probably very fit for my age, I look after myself and I will continue to do that as my part in the game of life. I do have sufficient funds for major health issues, but whether I use them or not is an issue for me. I guess I accepted that living in Thailand just means I never will have the medical cover that I had/have in the UK and I guess that's fine for me. Better that than live in a cold inhospitable climate with miserable people around me, just on the off chance that I will need the NHS sometime. 

Only one correction from an expatriate who has been happily living here for over 15 years. The medical service and quality is by far better than the one offered by the NHS,  The international private hospitals offer a quality equal at least to the one offered in Harley Street clinics, as a matter of fact some of the physicians in such hospitals were trained by and/or worked for Harley Street hospitals. Others have been trained in the US and Germany by top hospitals and universities, I am over 70 and have had some bad health problems. I am just recovering now from a complicated hip operation, and I am happy to say that I very much doubt that I would get the same medical service and attention, which I have been receiving from the Bangkok Hospitals in Bangkok, Chiang Mai and Pattaya. If one has the financial means - insurance or own funds - one can rely here on a first class medical service, alebeit not cheap, although very reasonable compared to medical charges in most western countries

[crazydrummerpauly]

On 6/1/2017 at 8:12 AM, masuk said:

Medical insurance is not a worry for me - I simply can't afford it from my pension.  Even the airlines won't insure a customer after a certain age.

 

So I've opted for the next best thing and that is to return to my home country for what appears to be major concerns.   The problem with this is that the National Health Service is painfully slow, and renting a room while overseas becomes expensive, while also maintaining one's condo in Thailand.

 

Yes, I'm sure that those with adequate health insurance in Thailand will advise me to stay at home, but I happen to like Thailand, its people and the friends I've made.  It's also economical to rent in Thailand, and eating out is not a luxury.

 

A current cardiac problem resulted in tests at the government hospital in Chiang Mai, but I was unable to get estimates for treatment in spite of a number of requests.  If I had, I might have been able to compare air fares and rental costs v. medical costs, or even pay the hospital on a monthly basis. I have no worries about the quality of treatment.

 

 

So how do you get around the rules for returning Brits being denied free NHS treatment if they have been non-resident for 6 months or more in the year ?  A couple of years ago i had an appointment at Papworth heart hospital, and i was sent a long form to say where i had been traveling and requiring me to present my passport at the hospital for checking.  Given that a heart-scan could cost a 4-figure sum, i didn't attend !  

Edited June 2, 2017 by crazydrummerpauly

[crazydrummerpauly]

Biggest negative for me :  If they can see any way at all, the insurance 'Loss Adjusters' will refuse to pay out simply by connecting your health problem to a 'PRE-EXISTING CONDITION'.  Take a look at the long list of problems that can be connected to hypertension for example.  I can't think of anything more infuriating that paying out many thousands to a company that can easily evade helping when the sh-t hits the fan.

[crazydrummerpauly]

On 6/1/2017 at 4:34 PM, Retiredandhappyhere said:

If you return to the UK for free NHS treatment, you have to be able to show that you have returned permanently in order to qualify.

Yes, it has all changed.  But i hear from some people that it's all a bit dependent on which area in the UK your doctor and hospital are located.  I have asked 3 GPs if they know about the rule, and none of them did - looked completely confused.  On the other hand, a visit to a major hospital for a scan etc, and they insist on seeing your passport at the appointment.  I decided that the only totally safe way to get free hospital treatment was to wait until i'd been back in the UK for 12 months before going for a scan, which of course makes one 'resident' again.  That's a long time and very impractical for most ex-pats i imagine.

[bandito]

On ‎6‎/‎1‎/‎2017 at 1:08 PM, Suradit69 said:

No it doesn't bother me on a daily, weekly, monthly or annual basis. Fortunately I've got it covered, but in a general way I do feel concern for the number of older expats here who are in denial about what could happen to them. And actually that concern extends to many younger expats and tourists who seem to think they are invulnerable to sudden illness or accident.

 

The best strategy is to have insurance or set aside some money in an account that you don't touch as a form of self-insurance. If neither is possible, you may have to reconsider whether your continued stay here is a good idea, especially if you would have insurance coverage in your home country. As painful as it may seem to do something now when you are reasonably healthy and have choices, it will be far worse to wait until you're left with no realistic options.

 

It's an unfortunate reality that once you get into your 60's or older, you will almost certainly have increased medical expenses even if you don't have some major event to deal with. Worrying about it or keeping your fingers crossed isn't a useful strategy. 

 

Well, am I the lucky one!

Over 80 yrs of age and never been sick outside of the yearly colds.

Had one hernia operation, 3 days in hospital cost was Baht 11,000 (eleven thousand) a pittance.

Not insured, for these prices why should I ?

And it does'nt bother me in the least.