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I’ve been in Thailand since 2014. If you asked me back then if you should get health insurance for your family, I would’ve said “no” because the cost of healthcare is cheap enough to pay for most costs out of pocket.
But all these years later I’m starting to rethink my family’s need for health insurance.
I’ve spent a lot of money on unexpected healthcare costs. And to be honest, I don’t want to do it anymore.
To help out other families in Thailand who are looking for coverage, I’m going to invite you along as I break down four popular insurance plans for expat families in Thailand.
This guide shows you the benefits, requirements, coverage, and limits with health insurance for your family in Thailand.
- 1 Going Without Insurance
- 2 Benefits of Having Family Health Insurance
- 3 Requirements
- 4 Coverage
- 5 Common Exclusions
- 6 Limits
- 7 Plan Comparison
- 8 Now, on to You
- 9 Support Us
Going Without Insurance
You might think that going without insurance in Thailand won’t hurt your pockets. And maybe for some people that is the case.
After all, healthcare is much cheaper in Thailand than it is the West. But to be honest, healthcare costs are relative to where you live and how much you make.
If you’re earning Thai baht, or you’re on a fixed income, paying for healthcare out of pocket isn’t always your cheapest option.
Since moving to Thailand from America in 2014 I’ve spent hundreds of thousands of baht on medical treatment and emergencies.
Here are some of the various things I’ve paid for out of pocket since our family moved to Thailand:
|Endoscopy and Non-cancerous Tumor Removal||50,000 baht||Thainakarin (private)|
|Cesarean Birth||55,000 baht||Ramathibodi (premium clinic)|
|4-Day Admission for RSV||35,000 baht||Thainakarin (private)|
|4-Day Admission for RSV||93 baht||Bangkok Children’s Hospital (government)|
The expenses I mention above are only the ones I could remember as I sit here and type–although I’d love to someday forget them.
And there’s all the small things that have added up over the years:
- emergency room visits
- doctor fees
- dentist visits
- eye exams
With a family of four (mostly clumsy) people, the list continues.
Looking at the table above you might being asking yourself, “John, why not just go to a government hospital every time?” After all, my wife and I did save 34,907 baht on our daughter’s last admission for RSV.
But here’s the thing: you don’t want to make a habit out of going to government hospitals in Thailand.
First, the staff at government hospitals can’t always speak English. So it’s going to be hard to communicate unless you can speak Thai or have someone with you who could.
Third, since patients are admitted at different times, nurses come to check them at different hours of the night. This means while you should be resting, you’re disturbed every time a nurse enters the room and flicks on the lights.
On top of that, if you or your spouse aren’t Thai you won’t be entitled to the 30-baht card, which is how we paid only 93 baht.
Now, onto the benefits of having insurance.
Benefits of Having Family Health Insurance
The benefits of having insurance for your family outweigh the drawbacks.
There’s no such thing as “family health insurance” per se. The plans offered by insurance companies in this guide start off as individual plans.
But the more people you add to the plans, the greater the discount you get. It’s the same way group health insurance works.
Depending on the insurance company, you get between 5% and 20% discount on insurance when you get coverage for your family.
Another benefit to having health insurance for your family is the financial control you get. With health insurance, you pay a fixed amount every month and you won’t have to worry about unexpected hospital bills.
Peace of Mind
One of the major benefits that come with having health insurance is the peace of mind you get knowing you and your family are covered for sicknesses or injuries.
You never have to worry about expensive hospital bills because you don’t have insurance or enough money to pay for them.
Comprehensive for Illness and Accidents
You have quite a few plans to choose from. Depending on the plan that suits your needs and budget, you can get full coverage for illnesses and accidents.
Each insurer has standards and processes set in place to make sure you’re covered and reimbursed according to your plan. This way you never have to worry about claims or unpaid medical bills.
International Health Coverage
Depending on the plan you pick, you also get international coverage for you and your family. So when you travel in Thailand or abroad, or go back home, you never have to worry about medical bills.
Lifetime Renewal Guarantee
Most of the plans I cover in this guide come with lifetime renewal guarantees. This means no matter what happens while you’re covered, your insurer won’t penalize you by refusing to renew your insurance plan.
There are a few basic requirements you need to meet to qualify for family health insurance and the discount in Thailand. They are:
- number of people
You and your spouse must be between eighteen and seventy years old to get insurance. Some insurers let older people apply. But this is on a case-by-case basis.
Children must be 24 years or younger. If they are 18 years old or younger they must be unmarried. If they are between 18 and 24 years old they must be unmarried and in school.
Newborn children should be added to the plan as soon as possible.
To get insurance for your family, here are a few things to consider:
You and your partner must be legally married, in a civil partnership, or permanently living together.
Any children insured under your family plan must be your children by birth, legally-adopted children, foster-care children, or children who depend on you for care.
You and your family must live in Thailand at least 180 days out of the year. The amount of days may differ from insurer to insurer. But 180 days seems to be the standard number.
Your children must be no older than 25. But to get coverage for your son or daughter, at least one parent has to apply for coverage as well.
Number of People
To qualify for the discount on family health insurance you must have a minimum number of family members on your plan.
To qualify for family health insurance all your family members must be covered under the same plan. For example, if you’re covered under Luma Plan 2, your kids must be covered under Luma Plan 2 as well.
Coverage is exactly what it means: what you’re covered for if you or a family member gets sick or injured.
Coverage options depend on the type of plan you take out, which I get into later. But here are some general coverage options you should be aware of when shopping for insurance plans.
Coverage for inpatient treatment comes standard with even the lower-costing health insurance plans. Inpatient coverage covers you and your family for things like:
- hospital rooms
- operating rooms
- nurses fees
- doctor fees
- surgical fees
- and more
Outpatient treatment is usually covered on the more expensive health insurance plans. If you opt for outpatient coverage, you and your family will be covered for things like:
- doctor fees
- and more
Outpatient coverage comes in two forms. Premium plans offer full coverage within limit. Standard plans cover you only for a specific limit per hospital visit each year.
Having outpatient coverage increases your premium. So if you’d rather keep your premiums low and still get coverage for the items listed above (and more), there is a general workaround.
When you or a family member is sick, just ask the hospital to admit you or your family member to the hospital so the treatment falls under inpatient care.
Routine Health Checkups
To get coverage for routine health checkups you usually have to buy higher-costing health insurance. In this case you and your family are covered for full health screenings, PAP tests, prostate exams, and other early detection tests.
Unlike in the West, where dental is usually included in health insurance plans, in Thailand it’s an add on. You only get dental coverage for higher-costing insurance plans. With this, you and your family are covered for things like:
- general treatments
With some plans, you might have to wait anywhere from nine to twenty-four months before dental coverage kicks in for your family.
With coverage for vision, your family gets glasses, frames, contact lenses, and laser treatments at no cost to you.
But just like dental coverage, you have to wait between nine and twenty-four months before vision coverage kicks in.
With maternity coverage, you or your wife are covered when having a baby in Thailand: pregnancy costs, including delivery costs, complications, and newborn care.
With some plans, you might have to wait up to ten months before this coverage kicks in. So if you’re planning to have a baby, make sure you get maternity coverage before you or your wife gets pregnant.
With coverage for accidents, you and your family are covered in the event of a death; dismemberment; loss of sight, speech, or hearing; and disability.
Some plans may even cover you if you were riding or were a passenger on a motorcycle, which is a big plus in Thailand.
If you or one of your family members are injured or get sick in another country, your insurer covers the costs of getting you to a hospital for treatment, or for returning you to Thailand for treatment.
Now that you know about coverage options, let’s move on to common exclusions.
Exclusions are anything that your insurance company won’t cover you or a family member for. For an exact list of exclusions, reach out to the insurance company you’re interested in.
Here’s a list of common exclusions:
- alcohol-related accidents
- cosmetic surgery
- high-risk jobs
You won’t find an insurance company that covers you or a family member for alcohol-related accidents.
You won’t be covered for cosmetic surgery that is considered personal preference, not cosmetic surgery because of an accident. So if you or your spouse wants to remove varicose veins or get a tummy tuck you won’t be covered.
If you’re a politician, police officer, athlete, soldier, or you’re at risk for mental and physical illness or injury, it’s hard to find insurance. There are some insurance companies that cover you if you work a high-risk job, but expect to pay high premiums.
Since you and your spouse are expats in Thailand, it’s probably safe to say you’re working a low-risk job in Thailand.
If you have any questions on whether your job is high-risk, ask your insurance company. This is a good time to check if your son or daughter is covered for a sports injury picked up at school or on the team.
With most insurance plans you have annual limits and coverage limits on how much your family is entitled to each year or each visit.
The higher your premium, the higher your limits and the more coverage you get.
There are four types of limits to be mindful of when buying insurance for your family.
- annual limits
- maximum limits
- inpatient limits
- outpatient limits
Your annual limits cover you for mostly everything as long as it’s under the limit amount. For example, if you get surgery and it costs three million baht, and your annual limit is 32 million baht, you’re covered.
Luma and ACS are two insurers that offer health insurance plans with annual limits.
Other insurers offer maximum limits, which work a little different.
Your maximum limits cover you per treatment. With some insurers like Aetna and Pacific Cross, you get maximum limits for things like hospital rooms, nurses fees, and surgeries. Be sure to find out what your maximum limits cover you for.
When it comes to inpatient treatment, you also have different annual limits depending on which policy you take out. You can find the typical limits for inpatient care in the table in the Plan Comparison section on some popular insurance plans for expats in Thailand.
If you opt for outpatient coverage you and your family are limited to how much coverage you get every year. You can find the typical limits for outpatient care in the table in the Plan Comparison section on some popular insurance plans for expats in Thailand.
The four plans I cover in this comparison are:
- Luma Plan 2
- ACS Silver Plan
- Aetna Ultimate Plan
- Pacific Cross Standard Extra
I picked these plans for four reasons:
- the plans cover a variety of budgets
- the plans are specific to expat families in Thailand
- the insurance companies are reputable
- the plans will cover your family for most of your needs
Are these the best or only plans in Thailand available to expat families? Absolutely not. But they give you a general overview of the different plans available and the prices.
Some points to keep in mind:
- most insurers offer lower-end insurance plans and more expensive insurance plans
- lower-end insurance plans only cover you for inpatient treatment
- more expensive plans usually cover you for outpatient treatment
The rates at the bottom of the table are based on a family of four: Husband and wife in their late 30s and two kids, ages three and five.
Annual Limits Comparison
|Coverage/Insurance Limit||Luma Plan 2||ACS Silver Plan||Aetna Ultimate Plan||Pacific Cross Standard Extra|
|Annual Limit||32,000,000 baht||33,000,000 baht||-||-|
|Maximum Limit||-||-||5,000,000 baht||780,000 baht|
Inpatient Limits Comparison
|Inpatient Limits||Luma Plan 2||ACS Silver Plan||Aetna Ultimate Plan||Pacific Cross Standard Extra|
|ICU||Full Coverage||Full Coverage||24,000 baht, maximum 15 days||8,000 baht, maximum 15 days|
|Hospital Room||5,440 baht||Full Coverage||12,000 baht||4,000 baht|
|Parent Accommodation||1,280 baht, maximum 30 days||Full Coverage||-||-|
|Hospital Expense||Full Coverage||Full Coverage||200,000 baht||100,000 baht|
|Surgery||Full Coverage||Full Coverage||250,000 baht||100,000 baht|
|MR, MRI, and Other Scans||Full Coverage||Full Coverage||Within Hospital Expense limit||Within Hospital Expense limit|
Outpatient Limits Comparison
|Outpatient Limit||Luma Plan 2||ACS Silver Plan||Aetna Ultimate Plan||Pacific Cross Standard Extra|
|Outpatient Limit||32,000 baht per year||Full Coverage||2,500 baht per day, up to 30 visits per year||2,000 baht per day, upto 30 visits per year|
|Specialist Fees||8,000 baht per visit||Full Coverage||Within OPD Limit||Within OPD Limit|
|Therapy||1,600 baht per visits, maximum 10 visits per year||Full Coverage||Within OPD Limit||Within OPD Limit|
|Required Number for a Family Plan||4||3||3||3|
Now, on to You
After doing research for this guide on expat family health insurance in Thailand, I’ve decided Luma is the plan for me and my family. At 7,037.25 baht a month for a family of four, it’s the least-expensive plan with the most inpatient coverage I could find.
But you should get a variety of quotes from a few different insurers because each of us have different needs.
- Get a quote from Luma
- Get a quote from ACS
- Get a quote from Aetna
- Get a quote from Pacific Cross
- Compare insurers using Mister Prakan
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