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Insurance primer for those seeking health insurance policies who are aged 70 or over


pookiki

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For those of you who are aged 70 or over and are seeking health insurance so you can continue to reside in Thailand on your retirement ‘extension of stay, I want to offer you the following information:

1) The figures for annual premiums contained in the insurance company’s brochure for your relevant age group are probably ‘low’. After submitting an initial application for coverage, the company’s underwriters will most likely assess an extra ‘risk premium’ based solely on your age. This will likely occur no matter if you are in good health or not.

2) More than likely, the company has a list of ‘pre-existing’ conditions that are solely age related for which you will be unable to secure coverage. These conditions will not be disclosed in the company’s brochure and it will be next to impossible for you to find out exactly what these conditions are. For example, I found out that one company excluded all prostate related conditions after age 69 irrespective if the man had a pre-existing problem or not. Also, expect a long list of excluded ‘pre-existing’ conditions which, may, or may not, be based on the content of your physical exam.

3) The Thai government’s requirement for ‘out-patient’ coverage is the height of insanity and absurdity. For those of us in our age group, 99% of our visits to the doctor/hospital will involve our pre-existing conditions or preventive care, i.e. dental and vision exams, annual physicals, vaccinations, etc. None of these issues are covered by the policy. Current medications taken for pre-existing conditions are excluded as well even if these medications need to be changed.

4) You will be very fortunate if the company discloses to you the manner in which your annual premiums were calculated or be shown a copy of the policy without making an initial payment for your policy.

5) The premium for every ‘new’ policy year will be adjusted because of risk and/or utilization. If you are unfortunate enough to have to be hospitalized – for a condition that IS NOT pre-exisiting – be prepared for a hefty increase in your annual premium. You may not be able to afford it. As we age, I anticipate that annual policy premiums will increase solely on the basis of risk without utilization.

6) Limit the information required for the company’s physical only to the information requested by the company. However, you should fully disclose all pre-existing conditions for which you are currently aware. Failure to disclose all of your known pre-existing conditions could cause the cancellation of the policy.

7) The only way to reduce your annual premium is to increase your deductible or exclude other conditions that are not pre-existing. Most, if not all of us age 70 and over, know that if we are hospitalized, it will be related to our pre-existing conditions. Therefore, insurance offers no security for our future whatsoever. Each person must decide whether reducing the annual premium to its lowest possible price through the use of increased deductibles makes sense or not. In essence, you will pay for a policy that entitles you to continue to spend your own money for health care.

8. The government mandated insurance will cause you to spend more money without any attendant increase in security for your future. The ‘basic’ policy that is required by the Thai government is often referred to as ‘throw away’ policies by those in the insurance industry. Throw away policies for throw away people.

9) Getting old is no fun. If you need help with securing a health policy, use an insurance broker. If all else fails, use a broker to secure your next extension of stay who, I’m sure, will be able to navigate the Thai immigration system in respect to both income and insurance requirements.

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The only caveat I woukd add is that this post refers only to the Immigration mandated policies from lical companies.

 

Getting an expat policy from an international company is a very different experience.

 

So those thinking of "real" insurance (as opposed to meeting OA visa requirement) should not be deterred.  You will not be saddled with exclysions for conditions you do not have nor will yoyr premiums be increased based on claim history if you get a policy from a reluable international company. Abd many of them have direct payment arrzngements with Thai hospitals.

 

Also -' of the insuters on the Imm "list" I think only one (Pacific Cross) offers deductible option.

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43 minutes ago, pookiki said:

If all else fails, use a broker to secure your next extension of stay who, I’m sure, will be able to navigate the Thai immigration system in respect to both income and insurance requirements.

I have yet to see any confirmation that an agent can secure a retirement extension (based off an O-A entry) WITHOUT having an approved Thai Health Insurance policy.  I do recall someone posting that he had asked his agent and was told that he would need to have an approved policy for his next extension and that there was no way around that one (even while using an agent).

 

Do you have confirmation from a reliable agent that this is indeed possible?

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57 minutes ago, MeePeeMai said:

I have yet to see any confirmation that an agent can secure a retirement extension (based off an O-A entry) WITHOUT having an approved Thai Health Insurance policy.  I do recall someone posting that he had asked his agent and was told that he would need to have an approved policy for his next extension and that there was no way around that one (even while using an agent).

 

Do you have confirmation from a reliable agent that this is indeed possible?

I haven't discussed this issue with an agent but I know people who recently used an agent and bypassed the insurance requirement. I'm not in a position to refer you to an agent.

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8 minutes ago, pookiki said:

I know people who recently used an agent and bypassed the insurance requirement.

If true then that might be a welcome option for many who are either too old or cannot get an approved Thai policy (due to health conditions etc).  Thanks.

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1 hour ago, Sheryl said:

The only caveat I woukd add is that this post refers only to the Immigration mandated policies from lical companies.

 

Getting an expat policy from an international company is a very different experience.

 

So those thinking of "real" insurance (as opposed to meeting OA visa requirement) should not be deterred.  You will not be saddled with exclysions for conditions you do not have nor will yoyr premiums be increased based on claim history if you get a policy from a reluable international company. Abd many of them have direct payment arrzngements with Thai hospitals.

 

Also -' of the insuters on the Imm "list" I think only one (Pacific Cross) offers deductible option.

Yes, your post is correct with the 'caveat' noted and especially about 'real' insurance.  For those of us 70 and above, you would be doing us a great service in discussing the ability to obtain an initial policy, likely annual premiums, and any restrictions on age and renewal.

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International expat policies usually guarantee lifetime renewal.

 

While money cut off new enrollment at 75 there are some that will enroll later, even after 90. Premiums vary with the insurer and also whether you take a deductible/copay option. I strongly advise working through a broker, they will provide you with all these details, comparison charts, and also help afterwards if needed with claims.

 

Very roughly, if no deductible, you can expect to pay around USD $2500 - 3000/year in your 60's rising to about $3500 - 4000 in your 70's/early 80's and peaking at maybe $4500 - $5000. But that is very rough and deductibles will change the equation. Assumes inpatient only cover, though most such policies include day surgeries and outpatient cancer care and dialysis.  (Check for that, it is important - ordinary OPD is very affordable but dialysis and chemotherapy, etc are a whole other matter).

 

While this may seem a lot it, it should be doable for anyone who truly meets the financial requirements for retirement. ($7 - 16k a month out of 65). And if you can't afford that, you will also not be able to afford a hospitalization.

 

My broker is Jenny at AA Insure and she has done a great job for me. Highly recommend.

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On 12/5/2019 at 12:39 PM, steve187 said:

so a doom and gloom post,

It is.

I was insured by a Thai company, in eight years time claimed once for the grand total of 23,000 Baht, paid 25,000 Baht a year, inpatient only with a few exclusions.

I became 71, the insurance was cancelled because of age, but could now take out the new insurance for 400,000 inpatient only for a yearly payment of 107,000 Baht, of course with rather many exclusions.

I have extension of stay based on "O", still no problem, but have 440,000 in the bank for eventualities.

The whole story started because of the unpaid bills in state hospitals, while the only ones having any benefit from the solution are the insurance companies, the private healthcare, and with no benefit to the state hospitals, at all.

They will still be hit by the uninsured illegal workers.

It would have been better if the price for an 3xtension of stay would have been raised to 2500 baht, 2000 for immigration service and 500 for the state hospitals, or even better, as was the plan before, to create a state hospital insurance.

But one way or another it became a 1-2-3 kind of thing for private businesses without any benefit for the state hospitals.

Missed chance. I8

 

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On 12/5/2019 at 12:44 PM, pookiki said:

I think 'reality sucks' would be the better description. Do you see something factually wrong in my post?

I have no idea if there are any fallacies... but, at the moment, I have not been told that I need insurance, so, I have not been offered a policy to review... 

 

as far as I can see, you are telling me how awful a policy is that I am not currently required to buy... so, not sure I get this post or its relevance... 

 

Correct? Please let me know if not correct... 

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I know Pacific Cross  has a couple of things age related they add in addition to pre existing exclusions.  At age 62 an joint problems have a 30% copay.  And there is also a 30% copay for any cardiovascular problems. I am not sure what age it starts.  My wife has it and she is 69.  The copays cap out at 300K.  

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International expat polities guarantee life time renewal,my experience,i am 73 and cannot be accepted by any Thai insurance,i received in 2016 2 surgeries,inguinal hernia 3 days inpatient, and 1 stent in left coronary 3 days inpatient,both in private hospitals,price +- 500.000 baht and all the costs payed one month before the surgery and 3 months after+ all medications,i have a cover of +- 2000.000 baht /year,all bills pay by my insurance and never received a question,i have this insurance from my job when i was 25 and i pay more now since i am 65 +- 2600 euro/year,how can a Thai insurance give me the same conditions and at which price?It is not a also the OA expats not paying the bills but the tourist go and back,they are several comments on the net about this,it is a big mistake about the Thai authority to take the old expats like example,may be time to grandfather this pilot project and 100 baht insurance with all tourist stamps.

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3 hours ago, kenk24 said:

I have no idea if there are any fallacies... but, at the moment, I have not been told that I need insurance, so, I have not been offered a policy to review... 

 

as far as I can see, you are telling me how awful a policy is that I am not currently required to buy... so, not sure I get this post or its relevance... 

 

Correct? Please let me know if not correct... 

Think the original post was well explained.

Further to the quoted post, I relate a recent experience.

Having obtained a O-A Visa in Australia with an assurance that providing it was processed and granted in October, I would fall under the pre- health insurance requirements.

Returned via BKK and was told I needed to be in LOS before November as well as holding O-A

I rather think this was a 'local ruling' or one which was interpreted incorrectly - still waiting for an appeal to decided . . . . . . . . . . With no more than 6/7 months per year in Thailand and free medical service ( DVA ), I am disinclined to shell out AUD 6K plus pa, if I can get it.

My point here being what seems assured is seldom so in Thailand

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On 12/6/2019 at 7:26 AM, hansnl said:

It is.

I was insured by a Thai company, in eight years time claimed once for the grand total of 23,000 Baht, paid 25,000 Baht a year, inpatient only with a few exclusions.

I became 71, the insurance was cancelled because of age, but could now take out the new insurance for 400,000 inpatient only for a yearly payment of 107,000 Baht, of course with rather many exclusions.

I have extension of stay based on "O", still no problem, but have 440,000 in the bank for eventualities.

...

With name HANSNL, I presume you are a dutch national.

If so, and your official residence is still in the Netherlands, you are probably well-covered health-insurance wise when being in Netherlands.  When that's the case, you could consider simply taking a travel-insurance policy for your time in Thailand.  That will typically cover accidents and illness that require immediate treatment, as well as re-patriation for serious cases.  The above works well for me (Belgian resident), so might be useful to check out whether that could also work in your case.

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2 hours ago, Peter Denis said:

With name HANSNL, I presume you are a dutch national.

If so, and your official residence is still in the Netherlands, you are probably well-covered health-insurance wise when being in Netherlands.  When that's the case, you could consider simply taking a travel-insurance policy for your time in Thailand.  That will typically cover accidents and illness that require immediate treatment, as well as re-patriation for serious cases.  The above works well for me (Belgian resident), so might be useful to check out whether that could also work in your case.

Would suggest with him having an O Visa he is living in Thailand and so he is a Thai resident

Also living here would also negate Travel Insurance and so would void a Travel policy

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37 minutes ago, canopus1969 said:

Would suggest with him having an O Visa he is living in Thailand and so he is a Thai resident

Also living here would also negate Travel Insurance and so would void a Travel policy

Not necessarily, myself being living proof, and that;s why I made the suggestion.

1. I am living in Thailand on an OA retirement Visa, but my official residence i still in Belgium.

2. I have a Belgian travel-insurance policy which covers me while staying in Thailand.  Also, you can buy travel-insurance on-the-fly (simply stating your home-country - where you will be repatriated if necessary - as well as the country/countries you are visiting).

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2 hours ago, Peter Denis said:

Not necessarily, myself being living proof, and that;s why I made the suggestion.

1. I am living in Thailand on an OA retirement Visa, but my official residence i still in Belgium.

2. I have a Belgian travel-insurance policy which covers me while staying in Thailand.  Also, you can buy travel-insurance on-the-fly (simply stating your home-country - where you will be repatriated if necessary - as well as the country/countries you are visiting).

You can be well insured but will your insurance meet the Thai standards to do your next extension of stay if you want to reside in Thailand? Most, if not all, foreign policies will not meet the Thai government's requirements for 'insurance' on an O-A non-immigrant visa.

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12 hours ago, pookiki said:

You can be well insured but will your insurance meet the Thai standards to do your next extension of stay if you want to reside in Thailand? Most, if not all, foreign policies will not meet the Thai government's requirements for 'insurance' on an O-A non-immigrant visa.

Obviously not, but that's not the point. 

The ONLY reason people are signing up for the expensive and basically worthless thai-approved health-insurance is that it is now required for extension of their stay based on a Non Imm OA for reason of retirement.

And many on extension of an OA - retirement Visa are looking now for alternatives to dodge this ridiculous thai-approved health-insurance.  E.g. by changing their reason for extension from retirement to marriage, or by converting their OA Visa to an O Visa which does not require insurance.

Of course, not being insured while in Thailand on long-stay (or short stay for that matter) is a risky undertaking.

And there are several options to get worthwhile insurance that actually meets the needs of foreigners staying in Thailand, but for sure it is NOT the ridiculously low-coverage and very expensive policies that are accepted by IO for your extension of stay on a Non Imm OA Visa - retirement.

On all levels, the present mandatory thai-approved health-insurance is a total shambles and a missed opportunity to ensure that people are well covered for their actual risks and needs.

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12 hours ago, Peter Denis said:

Obviously not, but that's not the point. 

The ONLY reason people are signing up for the expensive and basically worthless thai-approved health-insurance is that it is now required for extension of their stay based on a Non Imm OA for reason of retirement.

And many on extension of an OA - retirement Visa are looking now for alternatives to dodge this ridiculous thai-approved health-insurance.  E.g. by changing their reason for extension from retirement to marriage, or by converting their OA Visa to an O Visa which does not require insurance.

Of course, not being insured while in Thailand on long-stay (or short stay for that matter) is a risky undertaking.

And there are several options to get worthwhile insurance that actually meets the needs of foreigners staying in Thailand, but for sure it is NOT the ridiculously low-coverage and very expensive policies that are accepted by IO for your extension of stay on a Non Imm OA Visa - retirement.

On all levels, the present mandatory thai-approved health-insurance is a total shambles and a missed opportunity to ensure that people are well covered for their actual risks and needs.

I'm in total agreement with you. But I'm on an O-A visa and I really have to no other options according to my insurance broker and there are many other people like me in same boat. I have two choices, shamble insurance or leave. I consider Thailand my home so I will get a 'throw-away' policy.  I would also posit, that those who think that O visas will give them shelter, this will not last for long. Is marriage just for the sake of avoiding the insurance requirement a good choice? Not for me, thanks. I think the 'snow-birds' who use the O-A visa to come to Thailand on convenient vacations, will find this new requirement a more bitter pill than I do.

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12 hours ago, pookiki said:

I'm in total agreement with you. But I'm on an O-A visa and I really have to no other options according to my insurance broker and there are many other people like me in same boat. I have two choices, shamble insurance or leave. I consider Thailand my home so I will get a 'throw-away' policy.  I would also posit, that those who think that O visas will give them shelter, this will not last for long. Is marriage just for the sake of avoiding the insurance requirement a good choice? Not for me, thanks. I think the 'snow-birds' who use the O-A visa to come to Thailand on convenient vacations, will find this new requirement a more bitter pill than I do.

When you are over 75 years of age or with pre-existing conditions, NONE of the thai-approved insurance-companies will provide you with a policy.  And if you signed up early, the premiums for those thai-approved policies can run up to more than 400.000 THB per year at age 84 (yes, premium more expensive than the actual coverage!).

So no thank you, I will wait how this mess evolves and will probably switch to a Non Imm O - retirement in the last month before my permission to stay expires.

I am not so sure - with the present debacle and bad publicity / diplomatic pressure - that thai authorities will be very keen to quickly impose the health-insurance requirement also for Non Imm O - retirement Visas.  And if they do, for sure it will not be done in the same incommunicado bulldozer-way they have done it for Non Imm OAs.

 

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It seems like many O-A elder retirees, not being able to get the required Thai Company issued insurance or else at extortionate cost will have to either get an O visa or go back to the old country.

Years back I remember reading about Senior Retired Norwegians being sent out to Hua Hin by their Govt for a cheaper way of taking care of them.

I wonder if they're still around and if they are what they're going to do about this new scam insurance policy.

Not only these Norwegians but also the foreign pensioners in the few and rather costly retirement homes for senior farangs set up here in Thailand.

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