Health Insurance in Thailand


This article was written a few years ago, and some details may have changed. However, the main conclusions are still relevant.

Before reviewing the health insurance possibilities in Thailand, we need to mention we come from one of the smaller European countries, where basically health care is socialized. As a result we are somewhat accustomed to the best health care in the world (for the average person) at a small price. Health insurance is obligatory and not for profit and covers basically the whole lot.
When moving abroad, this is one of the benefits one looses. Even when keeping the same insurance company as before, the rules change for expatriates. Things become more expensive and complicated, even when you move to a country where health services are cheaper (as in Thailand).
Recently we were advised about another rather steep increase in our health insurance premium, so we started looking around for coverage in Thailand.

Now, of course, health insurance in Thailand is for profit. Furthermore, there are not really a lot of insurance companies (catering to the needs of expatriates) around so competition between companies is hardly present. The important thing however is what they cover. Their prices may be considered high, but still less than what we would pay for our present health insurance.

We evaluated both BUPA Health Insurance (Thailand) and IAG Insurance (Thailand). The latter was until recently known as Royal and Sun Alliance Insurance (Thailand). Both do not actually directly compete with each other since their premiums are quite different.

There are many excellent health facilities in Thailand. But can you afford treatment, and does your health insurance cover all treatments? Picture : Entrance to Samitivej hospital

 

BUPA's offices are centrally located at Convent Road (off Silom Road).
As an example we quote their platinum plan that covers up to 2 million baht per disability for hospitalizations and Out Patient Benefits up to 50,000 baht total per year. The premium for this coverage is 50,202 baht in the age band of 41 to 45 years of age. If you want coverage for hospitalization only, the premium is much lower at 28,111 baht per year. There are different rates for hospitalization coverage per disability of 1 million and 5 million baht respectively.

Important remarks and exclusions :
- Coverage is worldwide, but in the United States BUPA will only cover medical expenses, which are the result of an accident
- Annual Check up (one visit per year) covered up to 700 baht
- Emergency Medical Assistance fully covered
- Overall maximum coverage of 2 million baht applies (per disability)
- Pre-existing conditions are NOT covered
- Not covered (this is not a complete list) : Birth control, treatment for infertility, hormone replacement therapy, congenital abnormalities, mental illness and stress related conditions, dental treatment, sexually transmitted diseases, alcoholism, drug abuse, transplant surgery, renal dialysis, treatment for injuries resulting from dangerous sports. Interestingly not more than 200,000 baht will be paid for injuries occurred while driving a motorcycle (or riding pillion). Bacterial infections after an accident are not covered.

Using a wheelchair in Bangkok is hard enough. And does your insurance company cover equipment like this? Check your policy!

 

The other health insurance provider we checked out is IAG Insurance, formerly known as Royal and Sun Alliance Insurance. Their offices are located on New Petchburi Road.
As an example we take their Comprehensive insurance package in the age band of 40 to 44 years. Premium is 59,589 baht per year. With increasing age, rates go up rather steeply (much more so than at BUPA). For example between the age of 60 and 64 you would pay 135,897 baht per year.
This package has a standard excess per medical condition applicable to out-patient claims of 1,800 baht. [You have to pay this yourself, before coverage starts]

Important remarks and exclusions :
-Overall maximum of coverage is 80 million baht
-Out-patient treatment is covered up to 340,000 baht (an excess as stated of 1,800 baht per condition)
- Dental treatment covered up to 34,000 baht (but insured person has to pay 25% of the costs incurred per claim)
- Medical check-up covered up to 10,200 baht
- Chronic medical conditions covered up to 34,000 baht per year
- Organ transplants covered up to 13,600,000 baht
- Nursing at home covered up to 170,000 baht
- Emergency evacuation and repatriation covered in full
- Emergency medical treatment outside are of cover up to 2,040,000 baht
- Exclusions (this is not a complete list):
Pre-existing medical conditions. After 2 years of continous insurance some pre-existing conditions may become eligible again
Chronic medical conditions.
Hormone replacement therapy, congenital abnormalities, kidney dialysis, injuries due to professional sports, sleep apnoea, sexually transmitted diseases (including HIV/AIDS)

Motorcycle taxis are popular in Bangkok. But do you know some insurance companies offer only limited coverage for you when involved in an accident with a motorcycle? Our advice : Never use them. Do walk down the sois, or use other public transport.

 

What to think of all this? It is clear that neither of the insurance companies mentioned, offers complete, comprehensive coverage. Admittedly, both follow accepted insurance industry standards.
Rather dubious is the exclusion for some diseases by both companies. Striking is the non-coverage of kidney dialysis and sexually transmitted diseases.
The most important issue in practice is the non-coverage of pre-existing medical conditions. If the insured is young, he may be covered for most events that occur to him/her afterwards. However, most middle aged and older persons will have a variety of minor and major chronic pre-existing conditions. In other words, their weak body parts have been revealed already.
Now, before we say anything more, we have to point out that both insurance companies ask you to fill out a form, and will then afterwards give you a personalized lists of things covered or not-covered. So to know exactly what will be insured in your particular case, you will have to wait for this evaluation first.
As an example of a pre-existing condition we may point out hypertension (high blood pressure). At age 45 about 30-35% of persons will have developed hypertension (statistics apply to U.S. citizens). If you duely fill out this on your forms, you are surely not covered for treatment of this condition and possibly all related diseases. Now, about 50% of all serious life-threatening diseases are somehow related to high blood pressure (like heart diseases, strokes). So, bad luck for you.
To make this even more striking. Neither insurance company asks for a medical check-up prior to admission to their insurance programmes. Now, about 30% of people that have high blood pressure, are not aware of it, and thus are actually covered. Bad luck if you faithfully have been looking after your health, and are aware of your problems!
Not to mention smoking, which probably is at least as lethal, but does not result in higher premiums or exclusion from insurance at all!

The message is clear. If you are young and have no important pre-existing conditions check out these insurance companies. Their premiums and coverage for hospitalization expenses are quite different, so make a choice depending on your financial status and personal preference. Both insurance companies have some variations on the insurance described above available.
However, if you have pre-existing conditions, check carefully what they are able to provide to you as health insurance for anything resulting from these conditions.
If you have a pre-existing health insurance, even though its premiums for expatriates are high, you may be better off for peace of mind, to stick with it as long as you financially are able to do so. [Most insurance companies will continue covering you for conditions that arise while you are in their health insurance programme]
People in most countries in Europe do not really realize how lucky they are to be able to benefit from not for profit health insurance in their countries.

Disclaimer : We certainly do not want to put the insurance companies mentioned into a bad light. The information provided, by necessity, is not complete. If you are looking for health insurance, we strongly advise you to contact the above mentioned companies yourself, and evaluate their health insurance benefits independently.