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Health Insurance - what to watch out for


Sheryl

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3 hours ago, nchuckle said:

Thanks for highlighting this revealing issue. I've been here two years and although considering insurance really haven't grasped the nettle due to a lot of things like this. I'm not being complacent but although 64 I am in very good health,neither smoke nor drink,eat sensibly,not overweight,exercise and have no cancer or major health issues in the family . I feel that my premiums would effectively be subsidising those with a less healthy lifestyle and to an extent have the means to self insure. I am of course concerned that I am not of course immune,especially from an accident,and fear the unexpected big hit. I could of course limp back to the uk where I still have a uk address and am on the electoral roll but understand that certain events may even preclude that. I'm interested in hearing suggestions to suit my situation,including accident only cover and/or major medical only. That way I may end up paying premiums more reflective of my actual risk profile. Grateful for considered opinion.

 

You are pretty much in the same boat as me, however I am 8 years younger, but have a pre-existing condition, e.g. had a stent inserted into my left anterior descending artery at age 47, and the reason for that, is actually quite bashful as I decided to go it a 4th time in the one day, not a usual reoccurring occurrence for me, but someone must have spiked my muesli that morning ? 

 

Long of the short I had a severe chest pain and trouble breathing, suffice to say they went in and cleared the clot with a wire and inserted the stent.

 

I had private health cover in my early adulthood then dropped it, suffice to say Medicare back in the home country covered me as a tax payer (levy surcharge), however once you exit the country for 183 days and are deemed a foreign resident, your on your own.

 

I tried twice here in Thailand to get cover for my pre-existing condition, suffice to say I haven't had an issue since the event in June 2008, the old fella is back to his old self (21) thanks to the great blood flow, the stent being a new lease of life in that department, e.g. no more semi's, but the insurers won't cover me for my pre-existing condition, i.e. for having a single stent put in, they don't look at the fact that I am 56 and healthy, I asked the Cardiologist after the initial check up if he could put a time frame on my life, suffice to say I was concerned after having a heart attack at 47, he turned and smiled, said, you over exerted yourself, you are a healthy young man, you had a single stent inserted and we removed the clot, your arteries are as good as any 47 year old who is as fit as you and eats well, however avoid your stressful job, maybe a change, away from stress.

 

The insurance companies will insure me and take my $2,500 AUD but without covering my pre-existing medical "condition", suffice to say I have decided that the scale is unjust, and therefore have decided to self insure, I figure that at $2,500 AUD per annum I don't have an issue for 10 years, well I would be up $25,000 AUD which would cover a fair bit in Thailand, now I am not familiar with the other terminologies, but I refer to them as excess/differences/top up, so if you had to add to that to the already saved amount, it would pretty much work out the same as being insured, I figure, fortunately I am in a position to cover myself from events, being financial, but who wants to dip into their own, that's why we have insurance, I would accept a 2 year waiting period on pre-existing but as some have said, it doesn't matter, as soon as you have an incident they will increase the premium, dirty business, life insurance is a better area, because I called my insurer and said I had an event and they said carry on, because you took the policy out before it, therefore its not an issue.

 

I think if more people were in the position to turn around and stick their noses up to the insurance companies, they just might adjust their policies, I totally understand that there are some major pre-existing conditions that wouldn't be taken on, but to put us all in a single category is grossly wrong IMO. 

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When starting an underwritten policy where one submits a medical history, the insurer looks at how many years one might pay in before the odds go that there will be a major claim. When anyone starts to look at taking out insurance post age 60, the insurer will probably guess that number could be zero waiting period or not for some conditions.

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Actually those calculations are not made on a person by person basis, they are already reflected in the age specific premium.

 

What the underwriter will look for is pre-exisitng conditions. If any are identified they may decide to either not insure you, or insure you with exclusions.

 

nChuckle: you are putting way too much stock on your lifestyle and family history. They do not render you immune. Can't tell you how many people I've seen with healthy lifestyles, no family history of cancer, but nonetheless developed a life threatening condition. It happens. Thinking it won't happen to you is the biggest mistake you can make.

 

If you opt to self-insure, just remember that once you have tapped into that money, unlike insurance it is gone. So it's a better option for those who have a contingency plan for returning to a country where they'll be covered under a national health system than for those not.

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There certainly is an age specific premium: It's just a matter whether they decide to issue a policy or not and with what rider-type conditions.

 

I was more referencing above about underwriting criteria in general -- as in no new policies after age 60 -- not how they evaluate a specific applicant. But Insurers can deny an application for any reason and they don't as a matter of practice -- I found out -- tell you what their reason for denial was.

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57 minutes ago, 4MyEgo said:

 

The insurance companies will insure me and take my $2,500 AUD but without covering my pre-existing medical "condition", suffice to say I have decided that the scale is unjust, and therefore have decided to self insure, I figure that at $2,500 AUD per annum I don't have an issue for 10 years, well I would be up $25,000 AUD which would cover a fair bit in Thailand

 

Bt.660,000 might go a long way in a government hospital but in a private one that sum can be evaporated really  quickly

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54 minutes ago, Don Mega said:

Bt.660,000 might go a long way in a government hospital but in a private one that sum can be evaporated really  quickly

 

I suppose it could, but if their not prepared to cover my pre-existing, why should I be prepared to support their discriminatory policies, I say that regarding their 5 year slot increases on top of not covering pre-existing conditions, we all know with age we get older, but for insurers to increase policies every year or 5 years is really a joke, they should have a reward system like some car insurers have, whereby for those who don't make claims for long periods of time, don't get a policy increase, in some cases a reduction, but no, its all about profit, like everything else.

 

So, I could take out insurance without pre-existing and in 10 years they get $25,000 AUD without me making a claim, but because my past track record excluding the over exertion in 2008, has never landed me within kooeee of a hospital, and I don't expect to be visiting one in the 10 + years, regular exercise, healthy food, healthy lifestyle, fresh air, positive outlook on life, and lots of bonking, e.g. although no more than twice a day should keep me out of hospitals, unless I get hit by a car or go out with a big bang which is the preferred 555

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1 hour ago, Sheryl said:

Actually those calculations are not made on a person by person basis, they are already reflected in the age specific premium.

 

What the underwriter will look for is pre-exisitng conditions. If any are identified they may decide to either not insure you, or insure you with exclusions.

 

nChuckle: you are putting way too much stock on your lifestyle and family history. They do not render you immune. Can't tell you how many people I've seen with healthy lifestyles, no family history of cancer, but nonetheless developed a life threatening condition. It happens. Thinking it won't happen to you is the biggest mistake you can make.

 

If you opt to self-insure, just remember that once you have tapped into that money, unlike insurance it is gone. So it's a better option for those who have a contingency plan for returning to a country where they'll be covered under a national health system than for those not.

Thanks Sheryl,I did actually use the phrase that I do not consider myself immune. The scenario that I dislike and think may be likely  is the one you originally highlighted, they take my premiums for say 10/12 years which will be a quite substantial total given my starting age,then after that  point where I am much more likely to claim they effectively shut me out by ,as you say ,either directly or by raising premiums to a ridiculous level so you have to stop. I then am in a much more vulnerable position and without the reserve I would have had from those premiums (the worst of all worlds). To paraphrase you, in that context once the premiums have gone,they have gone . I admit I am from a business and finance background so look at it from that perspective and understand that insurers objectives are to have a surplus from the premiums they collect minus the claims they pay out. If I am a lower risk,for reasons I identified, I will be more into the sector of the contributors than the claimers. For that reason I have always had a philosophy of insuring only for those events (like my house or compulsory car insurance)from which a large event,even if low risk ,would be difficult to recover from. That is why my question of looking for only that type of cover was raised. The type of actions that Thai based insurers can get away with due to no or poorly enforced regulation is another disincentive. I am still uncomfortable,feeling somewhere between a rock and a hard place! Mainly intelligent points of view here ,especially yours is food for thought,thank you.

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Repatriation insurance could solve the problem of returning to home country for treatment of a serious illness/injury and if anyone has experience with this, I would be grateful for the information.

 

I did have extensive email correspondence with https://theairrescuecard.com/ several years ago and they assured me they would take me from a hospital in Thailand to a hospital of my choice in Australia if I held a current Air Rescue Card from them.

 

However, they are a USA based company and I was wary of the reliability of this claim, because it would seem rather out of the way for them to take a patient from Thailand to Australia. Also, I was concerned that they might consider appropriate treatment for the prevailing illness/injury is available in the Thai hospital, so no need to repatriate.

 

The annual premium is currently $US525.

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Yep....health insurance is a scam until the day you have a medical emergency and need to pay for the medical bills.
 
There have been plenty of news stories on TVF of farangs who were barred from leaving the country until they could collect enough funds to pay their medical costs.
 
 

Suggest it's a scam because insurance companies will do everything possible not to pay out. Find yourself in hospital and the fine print policy exceptions are revealed. All Policies have significant exceptions all to the benefit of the insurance company.
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3 hours ago, Don Mega said:

Bt.660,000 might go a long way in a government hospital but in a private one that sum can be evaporated really  quickly

 

Even in a government hospital, can easily run to more than that. And I'm interested to know by what magic 4MyEgo plans to be guaranteed no accideents, inbjuries or illnesses in the 10 years prior to racking up that sum in savings.

 

Some insurers will cover "acute exacerbations" of pre-exisiting conditions and, depending on what the  condition is, many will remove the exclusion if you go say 2 years without needing medical care for it. Doesn't help if your pre-exisitng is a chronic condition that you continue to suffer from, but will if it is just something that happened in the past. Worth shopping around  on this point.

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It was ACS (ALLIANZ) but note that I did not read any further so can't say re other terms/conditions.
 
http://www.acs-ami.com/en/expatriate-health-insurance/acs-asia-lifetime-docs
 
(they have 2 plans, one gives  lifetime cover and the other covers you only up to a certain age. the latter  would not make sense if one was planning ot staty permanently abroad).
 
Having niow waded through a number of international policies, I can tell you that there are a lto of differences among them and close reading of policy documents is essential.
 
For example, I found one that excludes coverage for all chronic diseases even if newly developed afterwards. That basically rules out all the illness to which an older person is subject...heart disease, cancer etc.
 
Another policy required a second opinion for all hospitalizations costing more than US 2,000 (i.e. most hospitalizations) and it looks like the doctor will be of their choosing, or possibly employed by them...
 
The above 2 things are not universal, in fact they were each found in only one policy examined. the point is, one has to read carefully and policies do differ, significantly.
 
 


Surely a health insurance policy that didn't provide cover for cancer or heart disease wouldn't be worth even considering. I find it difficult to believe that an international regulated insurance provider would hide such an exclusion.

Sent from my SM-A500F using Thaivisa Connect mobile app

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8 hours ago, jerojero said:


Suggest it's a scam because insurance companies will do everything possible not to pay out. Find yourself in hospital and the fine print policy exceptions are revealed. All Policies have significant exceptions all to the benefit of the insurance company.

Well as long as we're in suggesting mode I will suggest that one of the main causes that situations like the above occur is that the the insured persons did not reveal all details of their medical history when they applied for the policy and that became known to the insurance company only when the insured finds himself in the hospital with a big potential claim.

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2 hours ago, JLCrab said:

Well as long as we're in suggesting mode I will suggest that one of the main causes that situations like the above occur is that the the insured persons did not reveal all details of their medical history when they applied for the policy and that became known to the insurance company only when the insured finds himself in the hospital with a big potential claim.

You're both right and it's foolish to try to conceal any conditions or information. The egregious behaviour by the insurers is when they discover a minor and innocently forgotten fact which in itself had no bearing or relevance to the claim and use that as a technicality to deny the claim. This has happened in the uk but the insurance ombudsman has overruled the insurers in many cases to establish a principle. No such safety net exists in thailand.

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Whether innocently forgotten or not, one of the ways to avoid that situation is to have a long medical record with one of the insurer's network hospitals. A  lot of the questions on here are for persons wishing to start a policy after age 60. Better to have started at age 50 and then the hospital has 10+ years of medical records. Starting an insurance policy late in life when there has not been a number of claim-free years is kind of a statistical/actuarial oxymoron.

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On 11/13/2016 at 1:12 PM, Sheryl said:

From one of the international policies I looked at:

 

"Once accepted, (company)  commits not to cancel your policy due to above average medical expenses, nor to raise your fee beyond the general annual premium increase."

 

That is what one wants.

 

Unfortunately, even that's not iron clad.  There are many blogs about companies that raise the general rates based on their plan costs, then offer the healthy people slightly different plans at significantly lower rates.  Eventually, the original plan ends up with nothing but really sick people paying astronomical rates.  All with the blessing of the regulatory agencies because they're not picking on individuals, and only covering their higher, verifiable costs- as they're allowed to do.  Still sucks for people who end up stuck in such a plan.

 

I can't say I've seen that story specific to Thailand.  I ran across quite a few horror stories when I was living in China and considering repatriating to the USA with its outrageous health care costs.  In fact, it may be specific to US based insurers- and perhaps limited by states as well.  That's all I was looking into at the time.  But worth checking out.

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I feel cheated by BUPA. I was with the International cover for 20 years, then transferred to Thailand ten years . They refused to cover existing problem. This is dishonest !

Now I am wondering what will happen next year, after I now reached 70yrs. As I first joined over 30 years ago, they should continue to cover me. We will see.

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2 minutes ago, Farangdanny said:

I feel cheated by BUPA. I was with the International cover for 20 years, then transferred to Thailand ten years . They refused to cover existing problem. This is dishonest !

Now I am wondering what will happen next year, after I now reached 70yrs. As I first joined over 30 years ago, they should continue to cover me. We will see.

It's quite posible that BUPA International is a totally seperate company to BUPA Thailand, so you effectively stopped the old policy and started a new on with a new company, with all the hassle that that involves at our age....  My condolences, but not sure what you can do.  How long ago did you change?

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8 minutes ago, Farangdanny said:

I feel cheated by BUPA. I was with the International cover for 20 years, then transferred to Thailand ten years . They refused to cover existing problem. This is dishonest !

Now I am wondering what will happen next year, after I now reached 70yrs. As I first joined over 30 years ago, they should continue to cover me. We will see.

At a similar age to yourself -- here's what Cigna quoted me -- They might be worth your while exploring....

cignaglobal.com

 

Your Online Quote for International Health Insurance

Where you live:Thailand

Area of cover:WorldWide Excluding USA

Start date:27 Sep 2016

Dependants:$coveredDependants.size()

Payment period:Monthly

Your Core Quotes

Silver

Overall annual benefit - £650,000

30% cost share with a £3325 out of pocket maximum

Inpatient, daypatient & accommodation costs - Paid in full for semi-private room

Total cover for cancer

No maternity

No Travel Safety service

£100.15 per month 

APPLY & BUY

 

Your Optional Benefits

Outpatient
Additional and more extensive outpatient cover that protects you for any treatments that don’t require a hospital stay.

View benefits

Medical Evacuation
Peace of mind cover for transport and repatriation costs for you and a family member if you need treatment in another country.

View benefits

Health & Wellbeing
Allows you to manage your health in your own way with cover for screenings tests, examinations and other wellbeing activities.

View benefits

Vision & Dental
Cover for your vision and dental costs.

View benefits

 

 

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2 hours ago, Farangdanny said:

I feel cheated by BUPA. I was with the International cover for 20 years, then transferred to Thailand ten years . They refused to cover existing problem. This is dishonest !

Now I am wondering what will happen next year, after I now reached 70yrs. As I first joined over 30 years ago, they should continue to cover me. We will see.

This is the kind of scenario I alluded to in my earlier comment. You have paid 30 years premiums and now effectively can't get what you paid for. Just add up what you've paid them in total (+adjustment for inflation) consider what that amount would now be if invested in safe equities  over those years and ask yourself what side of the equation you'd be on if you subtracted the cost of your needed treatment from that sum........sorry I'm probably not making you feel any better about this! The lesson is that when it comes to insurers and banks loyalty is not valued,it signals to them that you are a mug ready to be taken.

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People can can come here on with all the horror stories they want. My personal experience with BUPA here in Thailand is that a major surgery claim was paid -- after authorization was requested and received by one of their network hospital surgeons -- early on in my policy history without any of the BS that you would think by reading on this forum is typical. The claim was roughly equal to my first 3 years total premiums paid. They did refuse to pay however for the 2 Coca Colas that I drank from the hospital room mini bar.

 

10 days in a private room -- in USA, if there were no complications, they would send you home at 6 pm the same day of your early morning surgery.

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Ignore JLCrab's advice as you so wish. 

 

As an aside, my wife and I travel on Bupa's comprehensive travel insurance on an annual basis.  Not expecting any problems with claims going forward.  We have already performed our due diligence of the sensible insurance providers.

 

You get what you pay for.  Just be honest.

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12 hours ago, JLCrab said:

People can can come here on with all the horror stories they want. My personal experience with BUPA here in Thailand is that a major surgery claim was paid -- after authorization was requested and received by one of their network hospital surgeons -- early on in my policy history without any of the BS that you would think by reading on this forum is typical. The claim was roughly equal to my first 3 years total premiums paid. They did refuse to pay however for the 2 Coca Colas that I drank from the hospital room mini bar.

 

10 days in a private room -- in USA, if there were no complications, they would send you home at 6 pm the same day of your early morning surgery.

Of course insurers are going to pay out mostly,especially where it is straightforward and where they really have no option or doubt under the terms of their policy ,which is I'm sure descriptive of your case. The acid test is in the slightly greyer areas,which often occur, which can technically be open to interpretation of the small print but where most would conclude that in a moral sense the claim should be met. This is where the company should be judged and there are many examples in the industry of where their behaviour has been egregious. I'm glad you had a good experience but don't think you are immune from a totally different experience should your circumstances not be quite so clear.it can be a bit of a lottery.

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While that surgery, as I mentioned, was early in my policy history, I now have a 10 year track record of no further claims and out-patient visits to that same network hospital where they monitored vital signs and other data. So whether my circumstances might be clear or not, they will not be the same as someone who takes out a new policy at an advanced age and then wants to go into claims mode shortly thereafter.

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The so-called Fine Print/small print people refer to is not in fact small or fine in the least. It is in clear, normally sized letters and clearly enough worded to boot, in the policy documents (sometimes called Plan Booklet or Members Guide). The problem is that people tend not to read these, neither before getting a policy (which is when they should, and take it into consideration in their choice) nor even afterwards.

 

Hence the surprise when something turns out not to be covered, or the company does something like drop the policy or jack up rates based on claim history. Read the documents.

 

Having now waded through some 10 such, I can assure you they are far from all the same. There are huge differences. And it is not necessarily the most expensive whop have the most inclusive coverage and safeguards.

 

Where you will indeed not find this information is in the marketing literature of the company, and this often includes the benefits tables shown on their website which may not be as detailed as what is in the actual policy documents. And you will surely not hear it from the sales agents. But it is right there, in black and white, in the policy documents.

 

Some insurers post these documents right on their website, but with most you have to request them. I haven't had any trouble getting them when I did so - maybe  one case where I had to ask twice, that's all.

 

The points to give special attention to:

 

  • Provisions regarding renewal, cancellation and calculation  of premiums. Any insurer  will increase  premiums as you age, and any will reserve the right to  increase premiums for all age bands based on inflation, but you want to be sure that the terms of the policy limit them to this and that they cannot single you out for a disproportionate increase because you have had claims or developed a chronic condition. (This will often be referred to as your "risk profile").  Any insurer will void a policy if you don't pay your premiums or have committed fraud, but short of that you want an assurrance of guaranteed lifetime renewal.
  • Exclusions in general, and regarding chronic diseases in particular. All insurers exclude things like cosmetic surgery and other purely elective things, most will exclude things that are the result of your being intoxicated. But make sure there aren't exclusions for things like chronic diseases or motorcycle accidents.  
  • Benefit limits - not just overall but for specific things. Chronic conditions (dialysis etc) are often targeted for ridiculously low caps.
  • Requirements for second opinion - not unusual for an insurer to require this for a few specific surgeries that have a track record of unnecessary procedures, but it should not  be required for all surgeries/treatments , and you should be able to select the doctor.
  • Requirements for pre-notificatiopn - most insurers have this for hospitalization but check that it is worded reasonably enough that you don't have your benefits reduced because it was an emergency and you were physically unable to call anyone

 

To give you an example of the sort of things I mean, one gem I found was a policy where all hospital stays/treatments expected to cost  more than $2,000 (i.e. virtually all hospitalizations) require a second opinion that they are necessary and that second opinion must come from a doctor employed by the insurance company....  Needless to say that went at once into the "out of the question" pile, but I'm willing to bet there are TV members with that policy and unaware of that clause.

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1 hour ago, Sheryl said:

The so-called Fine Print/small print people refer to is not in fact small or fine in the least. It is in clear, normally sized letters and clearly enough worded to boot, in the policy documents (sometimes called Plan Booklet or Members Guide). The problem is that people tend not to read these, neither before getting a policy (which is when they should, and take it into consideration in their choice) nor even afterwards.

 

Hence the surprise when something turns out not to be covered, or the company does something like drop the policy or jack up rates based on claim history. Read the documents.

 

Having now waded through some 10 such, I can assure you they are far from all the same. There are huge differences. And it is not necessarily the most expensive whop have the most inclusive coverage and safeguards.

 

Where you will indeed not find this information is in the marketing literature of the company, and this often includes the benefits tables shown on their website which may not be as detailed as what is in the actual policy documents. And you will surely not hear it from the sales agents. But it is right there, in black and white, in the policy documents.

 

Some insurers post these documents right on their website, but with most you have to request them. I haven't had any trouble getting them when I did so - maybe  one case where I had to ask twice, that's all.

 

The points to give special attention to:

 

  • Provisions regarding renewal, cancellation and calculation  of premiums. Any insurer  will increase  premiums as you age, and any will reserve the right to  increase premiums for all age bands based on inflation, but you want to be sure that the terms of the policy limit them to this and that they cannot single you out for a disproportionate increase because you have had claims or developed a chronic condition. (This will often be referred to as your "risk profile").  Any insurer will void a policy if you don't pay your premiums or have committed fraud, but short of that you want an assurrance of guaranteed lifetime renewal.
  • Exclusions in general, and regarding chronic diseases in particular. All insurers exclude things like cosmetic surgery and other purely elective things, most will exclude things that are the result of your being intoxicated. But make sure there aren't exclusions for things like chronic diseases or motorcycle accidents.  
  • Benefit limits - not just overall but for specific things. Chronic conditions (dialysis etc) are often targeted for ridiculously low caps.
  • Requirements for second opinion - not unusual for an insurer to require this for a few specific surgeries that have a track record of unnecessary procedures, but it should not  be required for all surgeries/treatments , and you should be able to select the doctor.
  • Requirements for pre-notificatiopn - most insurers have this for hospitalization but check that it is worded reasonably enough that you don't have your benefits reduced because it was an emergency and you were physically unable to call anyone

 

To give you an example of the sort of things I mean, one gem I found was a policy where all hospital stays/treatments expected to cost  more than $2,000 (i.e. virtually all hospitalizations) require a second opinion that they are necessary and that second opinion must come from a doctor employed by the insurance company....  Needless to say that went at once into the "out of the question" pile, but I'm willing to bet there are TV members with that policy and unaware of that clause.

Excellent points,well made,especially regarding having to request the policy document details. You are clearly doing a lot of valuable homework on this which certainly I and I'm sure many TV members ,would like to see the results of when finished. Could you please summarise the companies you would recommend as a result of this and probably a rogues gallery also would be helpful? 

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On 16/11/2016 at 5:31 PM, Sheryl said:

The so-called Fine Print/small print people refer to is not in fact small or fine in the least. It is in clear, normally sized letters and clearly enough worded to boot, in the policy documents (sometimes called Plan Booklet or Members Guide). The problem is that people tend not to read these, neither before getting a policy (which is when they should, and take it into consideration in their choice) nor even afterwards.

 

Hence the surprise when something turns out not to be covered, or the company does something like drop the policy or jack up rates based on claim history. Read the documents.

 

Having now waded through some 10 such, I can assure you they are far from all the same. There are huge differences. And it is not necessarily the most expensive whop have the most inclusive coverage and safeguards.

 

Where you will indeed not find this information is in the marketing literature of the company, and this often includes the benefits tables shown on their website which may not be as detailed as what is in the actual policy documents. And you will surely not hear it from the sales agents. But it is right there, in black and white, in the policy documents.

 

Some insurers post these documents right on their website, but with most you have to request them. I haven't had any trouble getting them when I did so - maybe  one case where I had to ask twice, that's all.

 

The points to give special attention to:

 

  • Provisions regarding renewal, cancellation and calculation  of premiums. Any insurer  will increase  premiums as you age, and any will reserve the right to  increase premiums for all age bands based on inflation, but you want to be sure that the terms of the policy limit them to this and that they cannot single you out for a disproportionate increase because you have had claims or developed a chronic condition. (This will often be referred to as your "risk profile").  Any insurer will void a policy if you don't pay your premiums or have committed fraud, but short of that you want an assurrance of guaranteed lifetime renewal.
  • Exclusions in general, and regarding chronic diseases in particular. All insurers exclude things like cosmetic surgery and other purely elective things, most will exclude things that are the result of your being intoxicated. But make sure there aren't exclusions for things like chronic diseases or motorcycle accidents.  
  • Benefit limits - not just overall but for specific things. Chronic conditions (dialysis etc) are often targeted for ridiculously low caps.
  • Requirements for second opinion - not unusual for an insurer to require this for a few specific surgeries that have a track record of unnecessary procedures, but it should not  be required for all surgeries/treatments , and you should be able to select the doctor.
  • Requirements for pre-notificatiopn - most insurers have this for hospitalization but check that it is worded reasonably enough that you don't have your benefits reduced because it was an emergency and you were physically unable to call anyone

 

To give you an example of the sort of things I mean, one gem I found was a policy where all hospital stays/treatments expected to cost  more than $2,000 (i.e. virtually all hospitalizations) require a second opinion that they are necessary and that second opinion must come from a doctor employed by the insurance company....  Needless to say that went at once into the "out of the question" pile, but I'm willing to bet there are TV members with that policy and unaware of that clause.

 

 

Did you already make a decision where you will sign up and if so, what is the cost ?

 

does anybody have experience with Ayudhya ? They r part of Allianz too but probably nothing really "international" on them, which means they can apply all those nasty local rules that will haunt you as you get older

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