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Health insurance (74) but we already have cast iron BUPA ...


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We went to Samui Immigration today to renew our retirement visa for the first time.   Having jumped through the hospital and bank hoops and taken great care with paperwork I was confident.   But our application was rejected as our insurance was not Thai.  My bad - I must have missed the memo.   But it looks like my 74 year old husband will be a problem.   Any magic wands?   We have 1.5m in worldwide BUPA cover so it really is just lip service.   But the forms and medicals on my first look over are very onerous.   Help.  I am writing this before investigating too much on the forum - forgive me but the clock is ticking now ...

 

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55 minutes ago, ubonjoe said:

There are Thai insurance companies that will issue insurance up to the age of 75. 

This company that is on the list of approved companies offers a policy that is less costly since it has a 200k baht deductible. See: https://www.lmginsurance.co.th/en/Products/Pages/Universal-Longstayvisa.aspx

 

Out of interest, is it the case that insurance is restricted to the approved Thai insurance companies? If not,I would have thought that since Marjf has full cover from BUPA, all that would be needed is a confirmation -with certified translation if nececessary - from the company that there is appropriate cover.

 

I'm probably missing something..

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1 minute ago, jayboy said:

 

Out of interest, is it the case that insurance is restricted to the approved Thai insurance companies? If not,I would have thought that since Marjf has full cover from BUPA, all that would be needed is a confirmation -with certified translation if nececessary - from the company that there is appropriate cover.

 

I'm probably missing something..

When applying for the Non Imm O-A Visa in your home-country, you can make use of foreign/international insurance that meets the 400K/40K in/out-patient requirement PROVIDED that your insurer is willing/able to fill in the mandatory Foreign Insurance Certificate (FIC) that needs to be submitted with the application.  That has proven difficult as that FIC-form refers to Thai legislation with which your insurer will not be familiar, and hence reluctant to fill-in/sign that document.

You can of course also make use of one of the IO-approved TGIA-associated Thai insurers to subscribe to a policy that has the Non Imm O-A compliant seal.

- - - --

Once in Thailand, and wanting to apply for the 1-year extension for reason of retirement based on your original Non Imm O-A Visa, the PoliceOrder that governs such application ONLY allows for such a Thai IO-approved 400K/40K in/out-patient insurance issued by a TGIA associated insurer.

There have been several reports of applicants being refused their extension because their insurance policy (which did meet the 400K/40K in/out-patient requirement) was issued by:

- a foreign/international insurer; or

- a non-TGIA associated Thai insurer.

 

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7 minutes ago, jayboy said:

 

Out of interest, is it the case that insurance is restricted to the approved Thai insurance companies? If not,I would have thought that since Marjf has full cover from BUPA, all that would be needed is a confirmation -with certified translation if nececessary - from the company that there is appropriate cover.

 

I'm probably missing something..

Thee is an online database that MUST contain details of your coverage for your extension to be approved. Non Thai companies have no access to this database, jointly maintained by insurance industry and immigration Ministry.

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6 minutes ago, jayboy said:

 

Noted but the requirement seems unjust and unhelpful if the necessary cover is held albeit from a foreign company.

 

Absolutely agree!

 

Thing is even if you wanted to get the Thai insurance, you would probably still need an insurance from the Foreign Company.

 

From my point of view, it now looks like Thailand could be absolutely over as a destination, for an extended stay, after the next 17 years, due to the insurance aspect.  So as I'll be limited to being a tourist for at least the next 4 years (due to the son's education), only 13 possible years after that.

But the insurance just makes it awkward, as the specified TGIA insurance would likely just be an extension of a Visa Fee....and is required for the current COE, so no-way I'll be booking a trip to Thailand as a Tourist whilst that connection is maintained 😎  . (Their other attempt at the COVID insurance seemed a better attempt). It is also blocking Father from going, as no way at 87 he will get the 40/400 "insurance" and the future travel vouchers for his two cancelled flights are counting down to expiry. 

 

 

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1 hour ago, jayboy said:

 

Out of interest, is it the case that insurance is restricted to the approved Thai insurance companies? If not,I would have thought that since Marjf has full cover from BUPA, all that would be needed is a confirmation -with certified translation if nececessary - from the company that there is appropriate cover.

 

I'm probably missing something..

Thailand restricts the sale of insurance to the Thai public (Thai public is anyone physically in Thailand) to insurers that are licensed by the Office of the Insurance Commissioner.  When you apply for your visa overseas, you are not yet part of the Thai public, so you can purchase insurance from a non-Thai insurer and satisfy the requirement.  Once you are physically present in Thailand, it is not allowed under Thai regulations for a foreign insurer to sell insurance to you. It would be difficult to imagine the Immigration Department allowing people to satisfy a government insurance requirement with insurance from a foreign insurer that is technically not allowed to sell to you, especially with the OIC aware of the insurance requirement.

 

Almost all countries have similar regulations restricting cross-border insurance sales and Thai insurers are probably not permitted by your home country's regulator to sell you insurance while you are in your home country. That's why Thai insurers require a Thai address when taking out a policy. 

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3 hours ago, Etaoin Shrdlu said:

Thailand restricts the sale of insurance to the Thai public (Thai public is anyone physically in Thailand) to insurers that are licensed by the Office of the Insurance Commissioner.  When you apply for your visa overseas, you are not yet part of the Thai public, so you can purchase insurance from a non-Thai insurer and satisfy the requirement.  Once you are physically present in Thailand, it is not allowed under Thai regulations for a foreign insurer to sell insurance to you. It would be difficult to imagine the Immigration Department allowing people to satisfy a government insurance requirement with insurance from a foreign insurer that is technically not allowed to sell to you, especially with the OIC aware of the insurance requirement.

 

Almost all countries have similar regulations restricting cross-border insurance sales and Thai insurers are probably not permitted by your home country's regulator to sell you insurance while you are in your home country. That's why Thai insurers require a Thai address when taking out a policy. 

Just an example: live in Austria but cannot buy German insurance. They will not sell it. Can look across the river to Germany. This is EU. Thailand is not unusual.

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12 hours ago, Etaoin Shrdlu said:

Thailand restricts the sale of insurance to the Thai public (Thai public is anyone physically in Thailand) to insurers that are licensed by the Office of the Insurance Commissioner.  When you apply for your visa overseas, you are not yet part of the Thai public, so you can purchase insurance from a non-Thai insurer and satisfy the requirement.  Once you are physically present in Thailand, it is not allowed under Thai regulations for a foreign insurer to sell insurance to you. It would be difficult to imagine the Immigration Department allowing people to satisfy a government insurance requirement with insurance from a foreign insurer that is technically not allowed to sell to you, especially with the OIC aware of the insurance requirement.

 

Almost all countries have similar regulations restricting cross-border insurance sales and Thai insurers are probably not permitted by your home country's regulator to sell you insurance while you are in your home country. That's why Thai insurers require a Thai address when taking out a policy. 

That's interesting information which I was not aware of.

However, those rules you mention seem only to apply when needing insurance for Immigration purposes when in Thailand (limited to Thai IO-approved TGIA-associated insurers only).

1 - When being abroad and wanting to re-enter Thailand, the Thai insurers are all too happy to sell you their Thai insurance (e.g. the mandatory insurance when wanting to re-enter on a Non Imm O-A Visa, STV or currently also the Non Imm O Visa for reason of retirement).  For the Non Imm O-A application you can make use of foreign/international insurance, but the requirement that such foreign/international insurance needs to be accompanied by the specific Foreign Insurance Certificate form filled-in/signed by your foreign insurer (and it referring to Thai legislation, which foreign insurers are not familiar with and therefore are reluctant to fill-in) drives applicants towards Thai insurance policies.  And the STV application in many countries ONLY accepts Thai insurance.

Note: And to meet the currently required 100.000 US $ covid-19 insurance, you have the option to subscribe to foreign/international insurance, but also to the TGIA covid-19 only Thai insurance.

>>> So it looks that the legislation you are mentioning is Thailand only rule to keep out 'foreign insurance competition' while Thai insurers can freely peddle their products/services abroad.

2 - I strongly doubt that if you do not need the insurance for Immigration purposes, that you would not be able to subscribe to foreign/international insurance EVEN when you are in Thailand.

I bought many times foreign travel-insurance 'on the fly' when being in Thailand, and I understand that some Thai insurance brokers also do provide foreign/international policies when they provide better value than their Thai counterparts (which by the way, is almost always the case).

 

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13 hours ago, Etaoin Shrdlu said:

Almost all countries have similar regulations restricting cross-border insurance sales and Thai insurers are probably not permitted by your home country's regulator to sell you insurance while you are in your home country. That's why Thai insurers require a Thai address when taking out a policy. 

 

Very good point but: 
As a registered foreigner I normally have access to all the insurances under the same conditions as the citizens of the country and usually in most countries no special prices are charged for foreigners in the state health facilities ....

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7 minutes ago, Etaoin Shrdlu said:

Thailand's insurance regulations are not much different than many other countries' regulations in that they restrict or prohibit the sale of insurance products by insurers not licensed by the local regulator in the country in which the purchaser resides.

 

Note that the Thai insurance regulations apply to insurance companies and not policyholders or individuals. This is common and it is because insurance regulators usually don't have the authority to prohibit what consumers may do, only insurance companies. 

 

I am aware of foreign insurers selling products into the Thai market without being licensed here. There does not seem to be much enforcement effort since it would be difficult, but technically it is not allowed and as a result it is unlikely that these insurance policies would be acceptable for statutory insurance requirements. I also think such sales are focused mostly on the expatriate community. It might be different if foreign insurers were selling to Thais in a meaningful way.

 

It seems that the Immigration Department and the OIC are presuming that foreign insurance purchased for the purpose of entering Thailand for the first time, or re-entering from abroad, was purchased by the foreigner while abroad and therefore the foreign insurer is not contravening Thai regulations. They are also probably assuming that the foreigner's home country has similar restrictions on cross-border insurance sales and are therefore not forcing foreigners to buy Thai insurance products in these instances. As you mention, they do require insurers to sign off on the document you mentioned, which will of course be a non-starter in many cases.

 

Thai insurers are probably not prohibited from selling across borders by the Thai regulator. Such prohibitions would come from the regulator in the other country. Whether a Thai insurer would be willing to do so would depend upon its own business considerations and risk tolerance. It could open up a Thai insurer to litigation in another country, including from a disgruntled policyholder, which is probably something it would wish to avoid.

 

Thai insurance tends to be expensive and not very broad in coverage compared with what is available elsewhere. This is due to the particular nature of the Thai insurance market and its relatively small size, especially given the large number of insurers active here. Insurance penetration, especially health insurance, is very low among the Thai populace, so none of them get any economies of scale or the benefit of the law of large numbers.

Thanks again for an insightful response.

It explains why Thai Immigration when you are already in country and have to meet the Thai insurance requirement re the 400K/40K health-insurance (when applying for the 1-year extension for reason of retirement based on your original Non Imm O-A Visa), ONLY allow Thai IO-approved insurance. 

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3 minutes ago, Etaoin Shrdlu said:

Yes, the need for Thai insurance for those already present in Thailand is primarily driven by regulatory issues and not some nefarious intent on the part of the Immigration Department or necessarily insurers themselves. In fact, I believe this scheme was pushed by the hospital industry due to the perception that resident foreigners were skipping off without paying.

 

I don't think the current scheme for retirees is a particularly big money spinner for insurers. It is not a particularly large demographic and it is not very desirable due to the age of most retirees. I suspect that the hospitals probably pushed for higher limits, particularly inpatient, but insurers pushed back and this is the result. 400k is not very meaningful for a major illness, so I think it is a compromise.

Yes, it resulted in a meaningless compromise, that

- didn't meet in any way the intent why it was introduced; and

- created a Big Headache for those on a Non Imm O-A based retirement extension.

>> Luckily LMG Insurance did introduce their Plan-1 insurance that reduces the cost of having to meet that mandatory insurance requirement (several times cheaper than the other Thai Non Imm O-A compliant policies), but of course that LMG Plan-1 policy is basically worthless and is only meant as a cheap and easy means to meet the 'paper' insurance requirement.

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Don't forget that Immigration offices -- at least as shown by Phuket -- can mitigate the OA insurance requirement by grandfathering those with extensions emanating from OA visas issued pre-2018:

 

Quote

– If the Non-OA visa from your home country is issued In or BEFORE 2017 then the health insurance is NOT required for your extension.
– If the Non-OA visa from your home country is issued in 2018 or later but the last entry date is before 1 October 2019 then the health insurance is NOT required for your extension.
– If the Non-OA visa from your home country is issued in 2018 or later but the last entry date is AFTER 1 October 2019 then the health insurance is IS required for your extension.

https://piv-phuket.com/long-stay-extensions/retirement/

I assume this is still in effect for Phuket extensions based on OA visas.... And why no other immigration office has done the same thing is maddening - is there some gravy splattering from TGIA over to Immigration?

And, if you happen to not be grandfathered, and are too old to get insurance, why, Phuket is your friend:

Quote

People who required the health insurance and who are not able to get the health insurance due to their age can discuss this with the officers in charge during their application in order to receive an exemption if necessary.

Really surprised we haven't seen more discussion on this....

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1 hour ago, sathornlover said:

 

Very good point but: 
As a registered foreigner I normally have access to all the insurances under the same conditions as the citizens of the country and usually in most countries no special prices are charged for foreigners in the state health facilities ....

I agree that the three-tiered pricing allowed by the government at state health facilities does not put the government in a good light and seems driven largely by xenophobia, especially as it also applies to foreigners working here and paying full social insurance premiums and taxes through their employer.

 

I don't have much knowledge of how countries with well-developed state-subsidized healthcare systems treat foreigners, so I can't offer much of a comment on that topic.

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2 hours ago, Etaoin Shrdlu said:

I agree that the three-tiered pricing allowed by the government at state health facilities does not put the government in a good light and seems driven largely by xenophobia, especially as it also applies to foreigners working here and paying full social insurance premiums and taxes through their employer.

I want to be fair, at least for this group of people this regulation does not apply as far as I know.

 

And, of course, it is not you who owes me a response to my comment on the alleged reasoning and arguments of the immigration authorities or those who are responsible for this regulation, which I believe are inconsistent.

 

I think your presentation of the country-specific and economic environment of the insurance companies is very plausible and I also think that this compulsory insurance is not the big deal.

 

But who benefits other than the insurers and visa service providers who offer to help people who find themselves in a predicament, such as the one described here?

 

For the common employee in the immigration office it means more work and for the applicant unnecessary costs in addition.

 

Or are these pragmatic throw-away insurance policies actually used to settle claims or could they even be used to reduce the alleged many outstanding hospital bills of foreigners?

 

As a reminder of how these assurances were justified:

 

 

1. Background:

1. The Department of Health Service Support has been operating the claim centre in to collect foreigners’ medical fee for public medical establishments with the objectives to manage and reduce the effect of bad debt in public medical establishments. The centre responds to coordinate with Royal Thai Embassy/Royal Thai Consulate in Thailand and the Immigration Bureau in the policy level. According to the data from public and private medical establishments, some of foreigners travelling to receive medical services in Thailand don’t have adequate money to pay for medical free; it leads to the bad debt problem. Therefore, to cover the foreigners, the department propose the health insurance policy. Initially, the policy applied to the appliance of non-immigrant visa (1 year) as the long stay applicants tend to have high health risk.

2. According to the meeting dated 6 June 2018 with the Ministry of Tourism and Sports and the Minister of Public Health as the chairpersons, The Board of Committee of Medical Hub Policy stated that health insurance purchasing could reduce the risk of bad debt. Therefore, the Department of Health Service Support was assigned to coordinate with the Immigration Bureau and related authorities for the operation on the next step …

 

 

 

4. The Amount of Bad Debt from Medical Fee Contribution to Foreigners .png

Edited by sathornlover
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5 hours ago, Etaoin Shrdlu said:

Thailand's insurance regulations are not much different than many other countries' regulations in that they restrict or prohibit the sale of insurance products by insurers not licensed by the local regulator in the country in which the purchaser resides.

 

Note that the Thai insurance regulations apply to insurance companies and not policyholders or individuals. This is common and it is because insurance regulators usually don't have the authority to prohibit what consumers may do, only insurance companies. 

 

I am aware of foreign insurers selling products into the Thai market without being licensed here. There does not seem to be much enforcement effort since it would be difficult, but technically it is not allowed and as a result it is unlikely that these insurance policies would be acceptable for statutory insurance requirements. I also think such sales are focused mostly on the expatriate community. It might be different if foreign insurers were selling to Thais in a meaningful way.

 

It seems that the Immigration Department and the OIC are presuming that foreign insurance purchased for the purpose of entering Thailand for the first time, or re-entering from abroad, was purchased by the foreigner while abroad and therefore the foreign insurer is not contravening Thai regulations. They are also probably assuming that the foreigner's home country has similar restrictions on cross-border insurance sales and are therefore not forcing foreigners to buy Thai insurance products in these instances. As you stated, they do require insurers to sign off on the document you mentioned, which will of course be a non-starter in many cases.

 

Thai insurers are probably not prohibited from selling across borders by the Thai regulator. Such prohibitions would come from the regulator in the other country. Whether a Thai insurer would be willing to do so would depend upon its own business considerations and risk tolerance. It could open up a Thai insurer to litigation in another country, including from a disgruntled policyholder, which is probably something it would wish to avoid.

 

Thai insurance tends to be expensive and not very broad in coverage compared with what is available elsewhere. This is due to the particular nature of the Thai insurance market and its relatively small size, especially given the large number of insurers active here. Insurance penetration, especially health insurance, is very low among the Thai populace, so none of them get any economies of scale or the benefit of the law of large numbers.

So in respect to a new application for an OA visa in a Home Country at an RTE. Is the RTE on thin ice by providing a "courtesy" link to insurance that is not authorised to be sold in the overseas country, combined with the form for an overseas insurer to sign, knowing that technically, they can't legally comply with (iaw with a Thai Cabinet resolution).....Whilst the RTE is saying the insurance is compulsory for the application! Then there is the issue of the Thai Policy T&Cs, which may have a clause that says the policy , shall not be appropriate unless you have resided in Thailand for 6 months out of 12.

 

Any way how does that help in anyway with the unpaid hospital bills, as it would appear they are individual policies, not a mutual medical fund pool.

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18 minutes ago, UKresonant said:

So in respect to a new application for an OA visa in a Home Country at an RTE. Is the RTE on thin ice by providing a "courtesy" link to insurance that is not authorised to be sold in the overseas country, combined with the form for an overseas insurer to sign, knowing that technically, they can't legally comply with (iaw with a Thai Cabinet resolution).....Whilst the RTE is saying the insurance is compulsory for the application! Then there is the issue of the Thai Policy T&Cs, which may have a clause that says the policy , shall not be appropriate unless you have resided in Thailand for 6 months out of 12.

 

Any way how does that help in anyway with the unpaid hospital bills, as it would appear they are individual policies, not a mutual medical fund pool.

Please don't mistake my attempt at describing certain insurance regulations as I understand them with a defense of this scheme and all issues arising from it and how the various parties interact with it. I have no particular insight into the motivations of those who put it together, nor do I wish to try to defend the pricing or coverage of the policies themselves. My comments were intended to be much narrower in scope.

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I am returning to Thailand shortly. I have a Medical Card which gives me full medical treatment , because I am married to a government teacher. Is that sufficient, or do I need to buy insurance also ?

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10 hours ago, Farangdanny said:

I am returning to Thailand shortly. I have a Medical Card which gives me full medical treatment , because I am married to a government teacher. Is that sufficient, or do I need to buy insurance also ?

You need to check with the embassy that will be issuing your certificate of entry (COE). You could apply for the COE and attach a copy of your Medical Card for of the covid 19 insurance proof.

If for the 40k/400k baht insurance is required that would would be another issue.

 

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On 3/2/2021 at 10:41 AM, Peter Denis said:

Thanks again for an insightful response.

It explains why Thai Immigration when you are already in country and have to meet the Thai insurance requirement re the 400K/40K health-insurance (when applying for the 1-year extension for reason of retirement based on your original Non Imm O-A Visa), ONLY allow Thai IO-approved insurance. 

But it completely overlook the possibility of foreigners continuing to buy a foreign based policy from their home country.

 

Many retirees make regular trips back to their home countries. Retiring here does not mean severing all ties.

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4 hours ago, Sheryl said:

But it completely overlook the possibility of foreigners continuing to buy a foreign based policy from their home country.

 

Many retirees make regular trips back to their home countries. Retiring here does not mean severing all ties.

That is certainly was the case for me in 2019, I asked one of the companies now involved in the TGIA / database system whether it was possible to have a Thai policy, which would also have my son added on. They certainly could insure my son, but as I was frequently back and forth to the  UK, and surely would not be in Thailand more than 270 days (in the UK tax year), so it would not be appropriate to issue a policy, as there was no certainty that I would be in Thailand more than 180 days in any 12 month period (one of the principle problems anyway).

Noting that I always had very good Travel Insurance, which allowed multi upto 92 day trips, and always paid outpatients directly.

So I had hoped that the OA-ME was a possible replacement for the non-O ME which was sunk with the introduction of the E-Visa system in June 2019, but that was sunk with the attachment of the insurance to the conditions of the OA in October 2019. 

 

There does not appear to be a way forward, for those that that have considerable commitments back home, it also most difficult if your country's system does not by default produce a need to have a private health insurance. 

 

There does not seem to be a middle ground, for those that are not wanting to burn their bridges from home country, but see there is no longer a way of being reasonably settled in Thailand over the long term, I think that settled feeling  is Historical now...then along came SARS Cov-2 (but vaccinated yesterday 🙂 ) !  

 

Edited by UKresonant
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1 hour ago, UKresonant said:

That is certainly was the case for me in 2019, I asked one of the companies now involved in the TGIA / database system whether it was possible to have a Thai policy, which would also have my son added on. They certainly could insure my son, but as I was frequently back and forth to the  UK, and surely would not be in Thailand more than 270 days (in the UK tax year), so it would not be appropriate to issue a policy, as there was no certainty that I would be in Thailand more than 180 days in any 12 month period (one of the principle problems anyway).

Noting that I always had very good Travel Insurance, which allowed multi upto 92 day trips, and always paid outpatients directly.

So I had hoped that the OA-ME was a possible replacement for the non-O ME which was sunk with the introduction of the E-Visa system in June 2019, but that was sunk with the attachment of the insurance to the conditions of the OA in October 2019. 

 

There does not appear to be a way forward, for those that that have considerable commitments back home, it also most difficult if your country's system does not by default produce a need to have a private health insurance. 

 

There does not seem to be a middle ground, for those that are not wanting to burn their bridges from home country, but see there is no longer a way of being reasonably settled in Thailand over the long term, I think that settled feeling  is Historical now...then along came SARS Cov-2 (but vaccinated yesterday 🙂 ) !  

 

 

Actually there is  way forward (at least in non-COVID times) which is not to get an OA visa but rather an O via and then do in-country extensions of stay. No insurance requirement (though you are strongly advised to get a meaningful policy, which need nto be fro ma Thai company, there are excellent expat policies issued by foreign companies).

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