Large Medical Expense--best Way To Pay

[bruce3404]

My wife and I are having surgeries in a few weeks at Bumrungrad. Total expense will be around 600,000 baht. To my way of thinking, the best way to pay for this will be via my credit card, which converts at the interbank rate and only charges a 1% conversion fee, with no other bank fees added. I should mention that Bumrungrad does not assess a credit card surcharge, nor will they discount for a cash payment. I'm wondering if there's a more cost effective way to handle these large payments (besides hoping the baht further devalues!). Anyone?

[astral]

Do you have a credit limit high enough to cover that amount?

Ask the hospital for their bank details and TT the money over, this will minimise the costs.

[bruce3404]

Credit limit is not a problem but I'm wondering how I would save by wiring the funds over. As it stands today, that 1% fee would cost me around $160. Wire fees would be $50, but I'm not sure if I'd be getting the interbank rate on a transfer. Would certainly be worth looking into and I appreciate the tip. I'll contact the hospital and see if I can set up such a transfer and what my costs would be. I'll also need to factor in that a credit card would get me 16,000 air miles.

[farangene]

Also ask if the hospital will give you a discount if you use their preferred credit card. This happens often in restaurants, hotels, etc. It happened to a friend last year who got a 10% discount from his hospital bill at Bkk Hosp. for using his Amer Exp card. They do not usually mention this unless you ask.

[oxymoron]

Credit limit is not a problem but I'm wondering how I would save by wiring the funds over. As it stands today, that 1% fee would cost me around $160. Wire fees would be $50, but I'm not sure if I'd be getting the interbank rate on a transfer. Would certainly be worth looking into and I appreciate the tip. I'll contact the hospital and see if I can set up such a transfer and what my costs would be. I'll also need to factor in that a credit card would get me 16,000 air miles.

From doing some calcuations on the side I can only assume you are an American. Before I decided I would doubly check that the VISA fee will be 1 %. I used my VISA GOLD card, admittedly an Australian one, last month and the fee for a $AUD7000 expense was $AUD175 (approx 2.5%). When I screamed to Visa over this their response was Fees for International Transfers have been increased.

I accept you point about air miles never the less I would consider negotiating the bill into $US and doing a bank transfer to their account in $US. Thus you negate the exchange rate issue. The major hospitals doing International work here usually quote their fees on the internet as $US so the above should not be a problem

[ProThaiExpat]

I would be surprised if your card issuer hasn't joined many other banks, such as citibank that ads 3% fee to the use of its card overseas.

A wire transfer is definitely the way to go and you might consider timing things to take advantage of the exchange rate at the time.

Your surgeries must be major, as I saw an add lately for a tripple bypass surgery for 490KBaht at BKK Heart Hospital.

If you can delay your surgeries for a couple of months, you have a very good chance of seeing the Baht weaker as the government attempts to hit a target of about 38 to the dollar.

[lopburi3]

I should mention that Bumrungrad does not assess a credit card surcharge, nor will they discount for a cash payment

The last time I ever used, or will use, that hospital they accepted credit card but converted baht to dollars in Thailand at a very bad rate of exchange and billed my bank for USD.

[astral]

Your surgeries must be major, as I saw an advert lately for a triple bypass surgery for 490KBaht at BKK Heart Hospital.

At the Adventist hospital in Penang, a complete triple bypass costs MYR25,000 (250,000 baht)

and includes 3 months of post operative exercise, in a controlled environment, to get you back to the peak of fitness.

[bruce3404]

We could surely get our procedures done for less, but given the huge savings over having the same work done in the US, we opted to go with a Doctor who is considered the best in Thailand and is also Board Certified in the U.S., with 20 years experience working in California. Since the procedures involve general anesthesia, we don't want to take any chances.

>>>Payment for medical services is in Thai baht, and can be made in cash, traveler’s checks, credit card, or by wire transfer. The hospital has limited foreign currency exchange capabilities and FX rates are more favorable at the local area banks. <<<<

The above is the Bumrungrad policy regarding payments.

To Lopburi, I really appreciate your info regarding Bumrungrad billing in US Dollars at any inferior exchange rate when CCs are used. That's a truly unscrupulous practice that I'll need to look into. Under such a practice, they could set any rate they want for the baht (30/1, for instance). Bumrungrad uses Citibank for wiring, so I'll have to look into how they convert a wire transer. I suppose it's possible that Bumrungrad could still sink their fangs into my dollars if they have an arrangement with the bank to convert differently.

My card (Capital One) truly only charges 1%. This card is widely touted by U.S. travel writers as THE one to use for overseas purchases. I've purchased a couple of online Air Asia tickets and have confirmed that only 1% is charged.

[simcity]

If I use my visa in Thailand my cost is approximate 2.8 % extra charge but they give a good exchange rates compare if I am using cash .

If I use my Amex the cost is minim, but the exchange rates is not good

A transfer work the best for me : send Dollars to my bank in Thailand and get it change here !

[bruce3404]

A local bank account might make sense, but when I looked into it before, I was informed that I would have to open it in person in Thailand. Since the surgeries will be a few days after we arrive, I doubt if there will be enuff time to set up an account and get the funds transferred from my bank in the U.S. And I'm also not sure if the banks have different exchange rates based on wired funds and finally, would they let me open an account, then wire in a large sum which I would immediately withdraw?

[Meerkat]

I should mention that Bumrungrad does not assess a credit card surcharge, nor will they discount for a cash payment

The last time I ever used, or will use, that hospital they accepted credit card but converted baht to dollars in Thailand at a very bad rate of exchange and billed my bank for USD.

It's a sharp practice that is sadly happening in more and more places, but you would have been well within your rights to have refused to have signed the credit card chit until they had reverted the bill back to THB. There is a rider at the bottom of the receipt stating "I accept that I have been offered a choice of currencies for payment. I acknowledge I had a choice to pay in THB." or something similar (the quote above is from a receipt at Alpine Golf Club). For small payments, I usually let it go, but once refused to sign at HomePro for a load of stuff for the house as the rates they used would have put me out to the tune of USD 150. It took the best part of an hour and a couple of phone calls to their bank to teach them how to press the right button on their machine to bill me in THB, but it got done in the end. AFAIK it is only Visa and M/C that use this; Amex still bill in the domestic currency. The only merchant who actually asked me which currency to charge was the Sheraton on Sukhamvit, and kudos to the girl there for recommending that I be billed in THB.

I'd suggest to anyone using a foreign card anywhere in the world to state at the time you give the card over to bill in the domestic currency, not the card's home one.

[ProThaiExpat]

What is mystifying to me is why you are not talking this out with Brumregard Hospital. They are proud of treating over 300,000 overseas foreigners a year. Surely they have mechanisms in place to assuage your concers regarding payment and conversion rates.

They are the most expensive, I think, and profitable hospital in Thailand. Surely their fee structure is such that it allows for individual accomodation. Thailand is the land of discounts and I cannot believe Brumregard cannot accomodate your concerns.

[Phil Conners]

Credit card exchange rates are usually considerably lower than the banks.

[Meerkat]

Credit card exchange rates are usually considerably lower than the banks.

Correct, but these exchange rates are not the credit card's, but the individual merchants'. You could use the same card 5 minutes apart in 2 different stores and get wildly different rates.

If you insist on being billed in THB, you will get the card company's more reasonable rate.

[lopburi3]

The only time this has happened to me was at that hospital and indeed they did mention the exchange rate which made it legal but was in the process of hospital transfer (which they delayed many hours with inept delays for paperwork) so was not reading final paperwork closely. I regularly use at Lotus and Foodland and there is no such option - bill and payment is in baht.

It was only several weeks later, after wife had recovered, that I noticed this and by that time my receipt was unreadable and the amount not worth visiting that establishment again.

[bruce3404]

>>>>What is mystifying to me is why you are not talking this out with Brumregard Hospital. They are proud of treating over 300,000 overseas foreigners a year. <<<<<<<<<<<<<<

Oh, but I am, I am. First thing I did after reading Lopburi3's comment was to send an email to the hospital. If I don't receive a satisfactory response by Monday, I will call their accounting department. I also spoke with my surgeon and he offered that I could pay him directly via wire, but as was stated elsewhere, the best exchange would be via use of a credit card (with no foreign transaction fees)

Edited December 30, 2006 by bruce3404

[bruce3404]

Received a response back from Bumrungrad which is consistent with their website. They typically bill in baht at this time and would only convert if I asked them to (which I won't). Perhaps their policies were different when Lopburi3 dealt with them and they may have revised them as a result of people complaining. Thanks for all your help everyone.