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How much to put aside for major health issue (self insure)


Lazy Sod

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6 hours ago, lopburi3 said:

True but may not always be the best option.  For my bladder cancer original biopsy was low grade and advised to use govt hospital as team does many - queue in government hospital was 10 weeks and when unable to operate due no ICU room and estimate would have been another 3-4 months wait (although check on eve of operation showed cancer much worse than expected).  Operation next week at Bangkok Hospital found cancer testing high grade after removal.  Have had one operation since due spread which might not have happened with more timely treatment.  Post above as a caution - although government doctors are often first rate and they do their best private hospitals can be a positive option for some. 

I had made an appointment for abdominal surgery at Queen Sirikit  naval hospital several years ago. Saw two young doctors who had done post grad training in some US Navy program. Quite impressed by them. The appointment was made two or three months later. Literally the day before the scheduled surgery the hospital called to say the surgery had been postponed.

 

So I went to Bangkok Hospital Pattaya. They scheduled the surgery for the next day. One night in hospital. Excellent surgeon.  About baht 120,000.

 

Queen Sirikit would have been about two-thirds of that and I was thoroughly confident in the doctors, but the hospital was primarily intended for military personnel so the scheduling issue was reasonable, but more than a little frustrating and for some medical conditions it could be consequential. 

 

Also, using the same hospital for everything can also be beneficial. I had hypertension issues and the cardiologist who I see regularly was available for consultation.

 

 

 

 

 

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It is anyone guess as to how much a person needs!  We can continue to speculate to the end and someone will come on here and continue to speculate.

If you can afford the rates and don't care about the exclusion I say to each his own.

Based on what the ops posted starting at 1 million is a good start.  Then get some quotes to see what it would cost you for your age for one million baht coverage and take that payment and deposit into the bank each year and built the 1 million.

Consider cost of living meantime continue to do research on good Government hospital also consider the Government just past a law " duel pricing "  that government can charge expat or tourist prices higher than what they charge a Thai so it isn't just your local amusement park any longer.

 

Good luck people it is a mine field! 

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In the same boat when I arrived to retire in 2011. December 2015 I had a heart attack here in Chiang Mai. RAM Hospital stent and 2 angioplasties. At the end of the week I also had an Ischemic Stroke (fortunately cleared within 2 hours). Total bill was 110,000 Thai baht. I have a Medicare Advantage policy which pays up to $5000 USD annually overseas so in the end it cost me $6000 USD out of pocket. A bite but ...

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4 hours ago, kenk24 said:

That does not sound like a recent price... I would expect that one stent, no complications would be double that... 

 

Most hospitals provide lists of costs

 

but don't forget, you might not be insuring for one event, but many... 

Might want to read my post. December 2017, 110K baht all in.

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I was excluded by several companies for controlled hypertension.  Why get insurance if they don't cover circulation/heart issues.  I ended up with David Shields - no exclusions - who also covers me when traveling back to the USA.

 

I worry about when I get too old to afford this insurance.  But for now everything is OK.  I have gotten much healthier in Thailand living with my good Buddhist wife.

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8 hours ago, Lazy Sod said:

Aetna quoted me for health insurance, but excluded heart disease, stroke, and any vascular related diseases because I have high cholesterol (controlled by statins).

I was in the same boat as you when I first moved here 4 years ago, two major insurers would exclude my heart as I have a pre-existing condition and wanted almost 100,000 baht per annum for a then 57 year old.

 

Two years later I remembered that we used a broker for our house and car insurance and emailed them, came back to me with a recommendation, David Shield, they are an Israeli mob who only insured their own until they opened up a couple years ago.

 

They covered my stent which was put in 12 years ago, I have been on statins ever since, just had to give them a couple of past letters from my Cardiologist to my GP, a recent blood test and they covered the pre-existing condition as well for an additional amount, minimal, I think $60AUD per month, on top of the policy cover, all up it came to about $2,800AUD for up to 1.2 mil USD, and covers me in 4 neighbouring countries and emergency cover if I travel back to Oz for up to 90 days, no out patient cover, didn't opt for that, no excess, just straight up.

 

Now if you ask me if they will pay up in the event of an emergency, well I don't see why not providing I complied with the policy, and it's good for elective surgery as well.

 

About 20% more expensive for me now as the AUD has $hit itself, life most currencies ATM, that said, without cover, it could cost you an arm and a leg, so to speak, but each to their own, might even go back to self insuring next year as I will surpass the 55-59 bracket that I have been on and no doubt they will try to rise the cover, which will only help me make my decision easier come the time.

 

The cover also covers you for life, and you have to be a certain age, I think it's 65 is the cut off point, but would have to refer back to the policy to be sure.

 

If you want more info, send me a PM and I will dig up the brokers details, not pushy, and will do their best to give you everything you need, then it's up to you, naturally they make a cut and that's fine as the insurer pays them a trailer no doubt or a fee per customer, that's just business.

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5 hours ago, kenk24 said:

That does not sound like a recent price... I would expect that one stent, no complications would be double that... 

 

Most hospitals provide lists of costs

 

but don't forget, you might not be insuring for one event, but many... 

Mine was just about 400K in January at Samitivej/BNH

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8 hours ago, wgdanson said:

I just paid Bht 1.25k to Cigna for up to Bht 12M cover at 71 years old. It seems like enough.

that seems extremely cheap for a Cigna police. Even this are monthly figures this would be only 15'000 baht per year which is still very cheap! Or you missed the 1.25k as US$?

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9 hours ago, Lazy Sod said:

I am wondering how much I would need to put aside for a major event like heart attack/stroke/cancer treatment at a good hospital such as Samitivej.

Do you have insurance back home? 

If you do and you have a place to return if need be , then the amount you would need to self insure while in Thailand should be mitigated by the fact that in major health issues where you can travel you could and IMO should , go back home,

But IMO a minimum of a Million baht readily available. 

Right now I have Blue Cross Blue Shield that covers my whole family while in Thailand, 

(I am 62) in three years I will be going in to the Medicare system,(the more I read about it the more confused I get) and will look into supplemental programs to enhance it, but when In Thailand I plan to have at least a Million Baht available for local medical interventions, and posible repatriation (I will always maintain a home in the US) .

 

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Difficult topic

 

I am over 1.0 m bht spent so far

 

I am careful and check and double check, could easily have spent 5.0 m if had gone to first place that offered help

 

For me age 75 2.0 m  m maybe enough, in my current state

 

Be careful I have four lots of cancer and have said no to a lot of surgery and chemo on the basis I do not consider the cost vs survival worth it

 

Stay happy living is terminal !!!!!!!!!!

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9 hours ago, wgdanson said:

I just paid Bht 1.25k to Cigna for up to Bht 12M cover at 71 years old. It seems like enough.

1.25k Baht? Do you mean 1,250 baht or 125,000 Baht? 

   Where I come from, 1.25 means one and a quarter. So 1.25k Baht would be one thousand two hundred and fifty Baht. 

   But I figure you might mean 125,000 Baht, not 1,250 Baht.

Missing that coverage for a year?

   Which Cigna office did you use? Which location? And who did you speak to? 

   Thank you. 

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I used to believe in self insure, in combination with going home if needed (I live in a civilised country with national health insurance).

 

Last holiday in Belgium, I had a blood clot in my brain 2 (two) nights after arriving home - I was never aware that something was building up - I spent 7 days in ICU.

Had this happened a few hours earlier , in Thailand or on the plane, I would have been death.

 

Self insure only works for "slow" diseases, that give you time to fly home after the diagnosis.

And imagine living in Thailand in a wheelchair....

 

My conclusion: when you are old, either have many millions of baht (for self insure or proper insurance), or accept death when it comes, or go home.

My plan is: In about 6 years I will need a new ICD, after that I will come back to Thailand and accept what ever is coming (I will be 74 then) - and they surely won't see me in a Thai hospital.....

 

 

 

 

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11 hours ago, wgdanson said:

I just paid Bht 1.25k to Cigna for up to Bht 12M cover at 71 years old. It seems like enough.

You're trying to say 125,000. 125k. 

Anyway, the OP should set aside at least THB 3 million in case of cancer with ongoing care and long term need to purchase the expensive drugs. And that's for state hospital levels of billing. 

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15 hours ago, lopburi3 said:

My one week visit to Bangkok Hospital 3 years ago for bladder removal/ileal conduit was more than a million but if willing to use government hospitals one million should cover most things but without a means to replenish it is far from insurance - cancer treatment, if wanting to use drugs, can become extremely costly.

 

But it really is one of those 'how long is a piece of string' questions.

Problems such as cancer you can return to your home country for long-term treatment. Get accident coverage and budget for sudden debilitating health issues.

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11 hours ago, wwest5829 said:

I have a Medicare Advantage policy which pays up to $5000 USD annually overseas so in the end it cost me $6000 USD out of pocket.

so, 6k + 5k USD is about 300,000+ baht... which is about correct for 2017 and now I think similar will run you 400,000 baht ++

 

I didn't know medicare would pay anything overseas?? 

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5 hours ago, Mac98 said:

Problems such as cancer you can return to your home country for long-term treatment. Get accident coverage and budget for sudden debilitating health issues.

Often not a viable option for those married or from countries without free medical treatment however.  

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11 hours ago, Catoni said:

1.25k Baht? Do you mean 1,250 baht or 125,000 Baht? 

   Where I come from, 1.25 means one and a quarter. So 1.25k Baht would be one thousand two hundred and fifty Baht. 

   But I figure you might mean 125,000 Baht, not 1,250 Baht.

Missing that coverage for a year?

   Which Cigna office did you use? Which location? And who did you speak to? 

   Thank you. 

Sorry, I meant Bht 125,000. Phoned the Cigna Customer service in Scotland, but the International Sales office is in Dubai, a man named Joathan Cole. Very helpful.

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11 hours ago, HampiK said:

that seems extremely cheap for a Cigna police. Even this are monthly figures this would be only 15'000 baht per year which is still very cheap! Or you missed the 1.25k as US$?

Sorry again, I meant BHt 125,000, well £3131 actually.

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1 hour ago, kenk24 said:

so, 6k + 5k USD is about 300,000+ baht... which is about correct for 2017 and now I think similar will run you 400,000 baht ++

 

I didn't know medicare would pay anything overseas?? 

Kenk24. I reported my experience and costs at RAM Hospital here in Chiang Mai in December 2015. Again, the total cost was 110,000 baht. Different hospitals, locations, individual cases will vary but that was the fact in my case. Medicare will pay in some cases for immediate emergency services. Again, my BC/BS Seniors Policy is a private policy paid by my previous employer in the US.

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14 hours ago, wwest5829 said:

December 2017, 110K baht all in.

Guess this threw me off... but that was the date of your posting, not your work done... either way, the pricing is way dated... I can only guess that Bkk/CM is 400k+ [ 2 years ago, 300k + ] CM Ram might be a little less... 

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34 minutes ago, kenk24 said:

Guess this threw me off... but that was the date of your posting, not your work done... either way, the pricing is way dated... I can only guess that Bkk/CM is 400k+ [ 2 years ago, 300k + ] CM Ram might be a little less... 

Oops, my apology for the incorrect date and not proof reading before sending Just had my 6 month checkup with the Cardiologist at RAM. Bill was 4359 baht which included the 500 baht Doctor fee and the full blood panel workup)

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1 minute ago, wwest5829 said:

Oops, my apology for the incorrect date and not proof reading before sending Just had my 6 month checkup with the Cardiologist at RAM. Bill was 4359 baht which included the 500 baht Doctor fee and the full blood panel workup)

did they do an ekg as well? Sounds a bit high for blood work?? Hope it went well for you... 

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I go to India for my medical treatment. The latest equipment and England-trained surgeons who all speak fluent English and are able to listen to your requirements and competently explain what they are going to do all at a fraction of the price of Thailand. 

I keep US$20,000 on hand as "emergency" money and another $50,000 as "medical treatment" money in a high-interest account that requires 30-days notice. 
 

I had six coronary stents inserted in India last December at a cost of US$8,000. My friend was charged equivalent to US$16,500 for two at Bumrungrad last year. 
 

I had two additional iliac stents inserted in March to fix incorrect sized stents inserted in Australia four years ago and that cost US$6,000. 

Neither of these would have been covered by medical insurance as they are the result of cigarette smoking. 

 

US$50,000 buys a lot of quality medical treatment in India (not Mumbai) and it's only a three hour flight. 

 

 

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2 minutes ago, Yme said:

Neither of these would have been covered by medical insurance as they are the result of cigarette smoking. 

Medical insurance most surly does cover stents unless you have purchased a policy with exceptions due to pre existing conditions.

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7 minutes ago, Yme said:

I had six coronary stents inserted in India last December at a cost of US$8,000. My friend was charged equivalent to US$16,500 for two at Bumrungrad last year. 

While in agreement treatment in India can be good and much cheaper wonder if stents used were the same in above example?  Price can be much greater for some of the drug eluting types.

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14 minutes ago, lopburi3 said:

While in agreement treatment in India can be good and much cheaper wonder if stents used were the same in above example?  Price can be much greater for some of the drug eluting types.

The stents are Resolute Onyx DES. Top quality USA made.

 

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25 minutes ago, lopburi3 said:

Medical insurance most surly does cover stents unless you have purchased a policy with exceptions due to pre existing conditions.

Not when the existing diagnosis is peripheral artery disease. 

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30 minutes ago, Yme said:

I go to India for my medical treatment. The latest equipment and England-trained surgeons who all speak fluent English and are able to listen to your requirements and competently explain what they are going to do all at a fraction of the price of Thailand. 

I keep US$20,000 on hand as "emergency" money and another $50,000 as "medical treatment" money in a high-interest account that requires 30-days notice. 
 

I had six coronary stents inserted in India last December at a cost of US$8,000. My friend was charged equivalent to US$16,500 for two at Bumrungrad last year. 
 

I had two additional iliac stents inserted in March to fix incorrect sized stents inserted in Australia four years ago and that cost US$6,000. 

Neither of these would have been covered by medical insurance as they are the result of cigarette smoking. 

 

US$50,000 buys a lot of quality medical treatment in India (not Mumbai) and it's only a three hour flight. 

 

 

India has been mentioned frequently over recent years on these boards. Those of us who are interested can do our own research into what, where, why and how, but there's nothing like personal knowledge. So how about it? Could you give us some details of where to go and which hospitals to use? Would be much appreciated. Cheers.

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