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When I wrote about my cost of living in Bangkok, a common question I got by email was:
“Hey Karsten, what health insurance are you using?”
If that’s all you want to know, that’s easy. I use ACS. If you’ve never heard of them, don’t worry, neither had I until three days before I took out insurance with them.
Before ACS, I had insurance through a French company that I won’t name. They were pretty awesome–until they weren’t.
Two weeks before my insurance expired they sent me a message saying they’d raised their premiums by 30%—effective immediately.
I was tempted to reply to them stating I no longer needed their coverage using colloquial terms for body parts.
Given that I’m obsessive compulsive about insurance coverage, the fact that I only spent three full days researching, analyzing, and comparing insurance plans is a feat.
Saving myself—and you—some time for the next time an insurance company pulls a stunt like this, I’ve typed up this guide on the crucial points of health insurance in Thailand.
I hope this article answers your questions. If it doesn’t, feel free to send me an email and I’ll do my best to help you out.
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- 1 Before You Come to Thailand
- 2 Insurance Options
- 3 Insurance Plans Explained
- 3.1 Exclusions
- 3.2 Pre-existing Conditions
- 3.3 Cancellations or Non-Extensions
- 3.4 Area of Coverage
- 3.5 Coverage Limits
- 3.6 Age Restrictions
- 3.7 Premiums
- 3.8 Optional Coverage Choices
- 3.9 Other Terms and Conditions
- 4 Paperwork
- 5 Finding the Right Insurance Plan
- 6 My Insurance Plan
- 7 Now, on to You
Before You Come to Thailand
When I first came to Thailand, I had German travel insurance that covered everything under the tropical sun.
There were no upper limits and barely any exclusions or restrictions on pre-existing conditions.
The cost? I’m glad you asked. I paid 2,238.75 baht a month.
The reason I stopped using them? They would only cover me for the first three years I was abroad.
Germans aren’t the only ones who can take advantage of home-country health insurance.
A Swedish friend of mine got into a severe accident. His insurance chartered a Bangkok Airways plane to fly him from Koh Samui to a hospital in Bangkok that was capable of treating him.
But his insurance is only for Swedes.
So what do these two cases mean for you? If you could get health insurance from your home country before you move to Thailand then you’ll get the best deal, usually if you’re a younger expat.
But if you’ve already moved to Thailand, then you can’t get coverage like this. The kind of coverage I talked about in my case and my Swedish friend’s case above is only for people in certain countries.
If you’re German, I can suggest a travel insurance company that I’ve used before, plus others. But you’ll need to become a Patreon to get access to this info.
Now, on to everyone else.
Your main reason for getting health insurance is that you want to safeguard yourself against costly medical care.
I know that’s why I have it.
Back in 2016 I had nose surgery at Bumrungrad Hospital for a breathing problem. The surgery costed me just under 300,000 baht. But my insurer paid for it.
Aside from worry-free surgeries, having insurance will also let you go to the hospital without a thought.
Since this article is about health insurance in Thailand, I cover the five common ways to get insured in Thailand:
- local insurance
- offshore insurance
- travel insurance
- Social Security
- group insurance
Local insurance is a type of private insurance you’ll find in Thailand.
Agents and brokers offer local insurance and it’s what you’ll see advertised in local media.
Coverage can be limited in terms of:
- the amount covered when compared with other countries
- your age (meaning a few will kick you out when you’re seventy-five)
- exclusions (don’t get into a motorcycle accident)
But if you get local insurance, you won’t have to worry about going over your coverage limits.
Costs at hospitals in Thailand are within the coverage limits of most insurance plans you’ll find in Thailand.
Another big upside to having local insurance is that hospitals regularly deal with local insurers. You show you card when you register, and the hospital and insurance company take care of the rest.
You also won’t have to fill out and send in so much paperwork with local health insurance.
You will need to go to a hospital in a local insurance company’s network. But if you go to a hospital or clinic outside of the insurance network, you can file a claim later and get reimbursed.
Your insurer updates the list of hospitals in their network every year. You can find it on your insurance brochure or policy.
One company I often suggest is Luma Health. They’ve partnered with many top-tier hospitals including:
- Bangkok Hospital
With Luma insurance, you can show your insurance card and the hospital in their network will take care of payments and paperwork.
Their Asia Care Plus plan is one of the best value-for-money plans out there.
One of the most well-known insurance companies in the local market is Aetna, which used to be BUPA.
Aetna is widely-accepted and I use a basic group plan for my staff. They seem to be happy with the coverage they get through Aetna.
From what I gather, if you have Aetna you can pick which hospital you want to go to.
I also heard about a number of banks offering health insurance. But it’s more of an accident insurance or life insurance than a comprehensive package.
The easiest way to compare and buy local insurance is through Mister Prakan. You can compare Thailand health insurance plans side-by-side in English.
If you prefer to talk with an insurance broker who’s also an expat in Thailand, fill in the form on our health insurance page. I’ll put you in touch with an expert insurance broker.
With offshore insurance, you get much higher coverage limits. This means you can get healthcare at top-tier hospitals while staying under your limits.
Offshore insurance companies will also renew your insurance without age limits.
My own insurance, ACS, falls into this category.
Insurance brokers in Thailand do offer offshore insurance. But brokers who sell only local insurance complain that offshore insurance isn’t licensed in Thailand.
So offshore brokers offer services to expats and tend to keep a low profile.
I’m no lawyer, but I assume if you have a dispute with an offshore insurance company, you might not be able to pursue your claim in Thailand.
And disputes overseas would be a lot harder. Offshore insurers know that few people will have the funds and the will to fight a legal case in a foreign country.
As far as I know, you can dispute claims with local insurance companies with the Office of Insurance Commission without involving a lawyer.
As I said above, some insurance companies offer short-term coverage in the form of travel insurance.
Short-term coverage can range from a few weeks to a few years. You can get travel insurance if you apply from your home country, not while you’re in Thailand.
Their pricing is a lot more attractive than what you’d get for long-term coverage.
By taking out coverage under them, though, you’re facing two possible problems.
- Travel insurance companies don’t have to deal with expensive long-term care. If you need long-term care they could repatriate you and hand you off to the Social Security system in your home country.
- Travel insurance companies tend to offer emergency healthcare coverage. This means you’re covered for accidents or illnesses that need immediate care.
You should get travel insurance for short-term stays or vacations in Thailand.
Other than that, it makes sense to get long-term health insurance so you’re covered for severe medical problems.
If you work legally in Thailand, you’ll have insurance through Social Security.
Your employer will deduct 5% of your gross salary, but no more than 750 baht, for Social Security every month.
With Social Security, you can get medical care and medicine for free.
Starting in 2018, you no longer need your Social Security card to see a doctor. Instead, you can tell hospital staff your Social Security card number and show them your passport.
In practice, Social Security means free treatment. But the costs come in the form of long lines, limited medication, and rushed doctor visits.
And you might not be able to get some patented, more recent, drugs with Social Security.
It’s common for doctors at Social Security hospitals to see between eighty and one hundred patients during an eight-hour shift. This means they have a few minutes to spare for you.
You can’t pick a hospital, but you can pick three that you’d prefer. You have forty-three hospitals to choose from in Bangkok.
You’re assigned to a hospital for a year, too. You’ll need to choose a new hospital at the beginning of every year.
Most of the time you’ll get the same hospital unless it stops taking part in the Social Security System.
If you live in a small province, there might be only one hospital under Social Security.
Which hospital you get assigned to will affect the quality of care you’ll get. The difference between the hospitals can be significant.
You can get treatment at hospitals outside the one assigned to you but only in an emergency.
In this case, you’re covered for the first seventy-two hours of necessary care. But you’ll get coverage for lower than what basic local insurance covers.
And you’ll need to pay and get reimbursed later at the Social Security Office.
People tend to avoid some the smaller, for-profit clinics in Thailand. While they might be easy to get to or have shorter wait times, things might get hairy if you end up needing more costly healthcare.
This means you should pick a large hospital from the get go. If you pick a smaller hospital and your case is serious, a smaller hospital has to refer you to a larger hospital before you can get treated.
But referral processes can be awkward, making it much better to be with a large hospital like Lerdsin or General Police to begin with.
My Social Security hospital used to be Camillian Hospital in Thong Lor. It was one of the best Social Security hospitals for expats because of English-speaking doctors and the short waiting times.
But Camillian Hospital stopped taking part in the Social Security System. My insurer gave me a list of hospitals and I had to pick three.
My friend had surgery for a meniscus tear done there and it costed him 27,000 baht. He felt they handled the surgery well, but pointed out they didn’t speak a lot of English.
But at the time of writing this guide, every foreigner I know who moved to Bangkok got Kluaynamthai Hospital, no matter which hospital they picked when they signed up.
I’d link their website, but according to Google the site may have been hacked.
While I’ve never been there, their Google ratings will make you want to look for other health insurance choices if that’s your Social Security hospital.
I think in the future, foreigners will be able to register at other facilities for Social Security healthcare.
Because of this, I’ve put together a list of Bangkok hospitals that are available to Thais and recommended for their quality of care to me by friends in the medical field:
|Lerdsin||Silom||crowded, good for orthopedics (sports injuries)|
|General Police||Rama 1||one of the largest, lots of specialists on staff|
|Yanhee||Charan Sanitwong||social security allows you to use all their branches|
Please note that I’m not a medical specialist and can’t vouch for these hospitals.
You can get a discount on group insurance if you have a family of three or more people or run a company in Thailand.
For more info, read our group health insurance guide.
Insurance Plans Explained
You’ll find the price of health insurance and the rough description of what’s included are just the tip of the iceberg.
You’ll have to read the fine print to find out about:
- pre-existing conditions
- cancellations or non-extensions
- areas of coverage
- coverage limits
- age restrictions
- optional coverage choices
Let’s take a closer look at what’s excluded.
Here are some exclusions you’ll find in every insurance plan:
- disasters and terrorism
- motorcycle accidents
- sexually transmitted diseases
But one important exclusion varies from insurer to insurer:
- chronic diseases
You should take a good look at the fine print. Here’s what to watch out for:
Insurers exclude alcoholism under all plans. There are also selective exclusions if you get hurt under the influence of alcohol.
You’ll have to read the fine print to find out if this means no coverage for “drunken bar fights” or “for anything as long as a traceable amount of alcohol is in your blood.
I’ve heard of one insurance company who hired a private investigator to check if a patient who filed a big insurance claim was under the influence during the accident in question.
It turned out that he was. The insurance company refused to pay for medical care and the hospital kicked the patient out of the hospital.
You won’t see this limit often. Most of the time, insurance companies exclude pre-existing conditions. But they cover any new conditions in full.
Some insurance companies might limit your coverage of chronic diseases. You should worry about this.
With outpatient department coverage, or OPD, chronic diseases cause some of the most costly claims.
Disasters and Terrorism
Every insurance company excludes you from coverage if you take part in war or crime.
Some insurance companies might not offer coverage if you were a victim of a natural or man-made disaster.
Given the political protests and bombings that happen in Thailand every few years, make sure this isn’t the case with your plan.
Some plans don’t cover anything motorcycle-related. Not good. In Thailand you’re likely to be on a motorcycle at some point.
Other plans are more lenient and won’t cover you only if you were driving without a license.
Then there are the tricky plans that exclude accidents involving both jaw bones, regardless if you wore a helmet or not.
You should read the fine print of this exclusion on insurance plans.
Sexually Transmitted Diseases
Some insurers exclude coverage of sexually transmitted diseases, or STDs.
Others exclude it, unless you weren’t at fault. But the burden of proof may be on you.
Some insurance companies limit coverage costs for HIV treatment.
In any case, keep in mind that the majority of costs for the treatment of STDs are OPD. Unless you opt for OPD coverage, insurers won’t cover you for STDs.
You won’t find much coverage for taking part in professional sports, combat sports, and other high-risk activities such as paragliding.
If you compete or take part in a dangerous sport, check the exclusions for sports activities.
Some insurance companies exclude specific sports. Others describe the sports they exclude less clearly.
If you’re at risk for sports injuries, you’ll want your potential insurers to put into writing whether or not they’ll cover you.
Pre-existing conditions are the biggest problem with health insurance plans.
You’ll often hear that insurance companies will review pre-existing conditions on a case-by-case basis or offer insurance excluding pre-existing conditions.
In my experience, that’s true for things like:
- injuries that don’t affect other parts of the body
- one-time occurrences from accidents
Insurers may refuse you coverage for serious injuries or illnesses that can lead to problems in the future.
As a rule of thumb, if your illness is a major reason you’re seeking insurance, they won’t accept you.
Beware of insurers that accept you and don’t check this until you make a claim. They’ll give you a false sense of security.
Cancellations or Non-Extensions
Is the insurance company able to cancel the policy or refuse to renew it?
Avoid plans that allow insurance companies to cancel or refuse the renewal of your policy.
Because if you send in a lot of claims, get a chronic disease, or are sick when the renewal date comes around, expect insurance companies to do just that.
I had one reader email me who had that happen to him.
A broker sold him an affordable plan that seemed comprehensive. He found out it was an “annual plan” when the insurance company canceled it the moment he became too pricey for them.
The same thing also happened to my employee. A few years ago he had to get a cardiac Holter monitoring test.
Although the results showed that his heart was normal, the insurance company listed it as an exclusion and they didn’t cover costs related to cardiac arrhythmia for a year after that.
In other words, when my employee needed the insurance the most, the insurer walked away scot-free.
Area of Coverage
Are you covered when traveling to your home country and other destinations? If so, for how long? Not a big deal really, since travel insurance can be had for cheap: As long as you don’t forget signing up for it every time you go abroad.
You’ll find three types of limits in insurance contracts in Thailand:
- overall plan limits
- benefit limits
- procedure-specific limits
Limits are quoted per year.
But in-patient department, or IPD, benefit limits or procedure-specific limits are either per year, per illness, or for the entire length of the contract.
Overall Plan Limits
Coming from Germany, the fact that a Thai insurance company would only repay me a certain amount was new to me.
In Germany, you’re either covered in full or you have to make a co-payment—usually for dental work—and that’s it.
It doesn’t matter if you’re in a coma for ten years or more. What are they going to do? Stop treating you once you reach your limit?
Well, that’s what can happen to you in Thailand.
In Thailand, every private health insurance sold has a limit. If you’re new to the country, it’s a tough call to decide what amount of coverage is enough.
So what limit should you choose?
To get a good idea of how much health checkup cost in Thailand, check out Bumrungrad Hospital’s health checkup package comparison page.
The list might be on the high side. But they are one of the most reputable hospitals in Thailand and their prices match the quality of care and level of comfort they offer.
A few procedures cost more than 500,000 baht.
But the real heavy hitters for hospital costs are less-routine surgeries, along with the long-term stays in ICU due to a mishap or illness.
The most expensive case I’ve heard of involved heart surgery with a total hospital stay of six months. The cost for that came to 12 million baht.
He amassed that amount the first few weeks in the ICU, which clocked in at about 500,000 baht a day.
No broker I talked to knew of anyone who ran up more than 16.5 million baht in bills.
If I were to sign up for new insurance, I would aim for at least 15 million baht in coverage. For offshore plans that would mean $500,000 in coverage.
On the lower end you should keep in mind what the Thai government deems minimum coverage. Thailand’s Social Security System has a coverage limit of 2 million baht.
In other words, that’s the healthcare coverage every 7-Eleven employee gets.
You don’t want to go below that.
Many local insurance plans come with limits on IPD benefits on room and board, operating costs, ICU, surgical’s fee, and hospital bills related to IPD treatment.
Your plan may have a limit of 1 million baht but might have the surgical fee capped at 100,000 baht, hospital bills at 80,000 baht, and room and board at 8,000 baht per day.
As I said earlier, my biggest health bill came from having my nose operated on. I had endoscopic sinus surgery, septoplasty, and radio frequency turbinate redirection.
My insurance company paid for it.
The surgery was 2.5 hours long under general anesthesia followed by a single night stay.
The total cost for the operation and stay was 260,208 baht. This price didn’t include pre- and post-operative care and follow-ups.
Here’s a breakdown of costs:
- general anesthesia: 8,110 baht
- doctor: 95,000 baht
- lab – pathologist: 985 baht
- lab – pathology: 1,470 baht
- medical equipment: 26,925 baht
- medical supplies: 70,736 baht
- medicine: 24,022 baht
- nursing services: 2,710 baht
- operating room: 22,140 baht
- other medical service charges: 760 baht
- room: 7,710 baht
To put these expenses into insurance terms, it should be labeled as surgical cost at 95,000 baht, room at 7,710 baht, and hospital bills at 157,498 baht.
Even with the limit at 2 million baht, if my insurance plan limited the hospital expense coverage to 80,000 baht, I would have need to pay 77,498 baht out of my own pocket.
Insurance companies limit specific procedures. Here’s an overview of common procedures and how much you’re limited to:
Some insurers have limits on donor costs for organ transplants. Now Health International’s WorldCare Excel plan limits them to $50,000.
I assume if a liver is too costly, they’ll pass and wait for the next, cheaper one?
Most limits are about donor’s costs. I assume they want to avoid having the hospital bill them for ICU costs by the late donor.
In some cases, like with ACS, they refuse to pay for any donor costs.
This is a big topic in Southeast Asia. Lots of insurance companies leave it out if caught through sex. Some even exclude it outright.
Those that don’t limit treatment costs will put a limit on the maximum amount you can claim. With Luma’s Asia Care Plus plan you’d get 480,000 baht.
HIV treatment in Thailand isn’t too pricey because HIV medication is made here. But in the future you might not get coverage for more expensive treatments.
I haven’t spent too much time looking into this limit for obvious reasons.
But to my knowledge pregnancy is an add-on, often with coverage limits and a 10-month waiting period before coverage kicks in.
You can check out our post on having a baby in Thailand for more details and the costs involved.
I’m not sure at the reasoning for procedure-specific limits. It might be hospitals attempts to limit artificial cost inflation for pricey treatments.
In practice this may limit your hospital choices for those procedures, though the impact on quality of care you get is not that big.
The rule of thumb is that if you sign up before the age of sixty, you can find health insurance with lifetime coverage.
Once you turn sixty-five, it becomes harder to get comprehensive health insurance for people of retirement age.
One reason for the de-facto age limit is that, on average, people spend 80% of their healthcare costs in the last five years of their lives.
Of course acceptance is just one part of it–the other is the premium.
Above the age of sixty, you won’t be able to find cheap insurance coverage. Insurance plans in Thailand don’t subsidize older age groups with premiums from younger members.
This means coverage at an advanced age comes at a much higher price than you’d pay back home.
As already noted under the Conditions section, it’s important that your insurance can’t cancel or refuse to renew your coverage.
You also want to watch out for any specified maximum ages.
Lots of companies with lower costing, local insurance plans specify an age at which coverage ends.
It might not matter if you’re thirty-three, but at fifty-five you need to take this into account.
Of course that doesn’t protect you from rising premiums, but that may be a lot cheaper than finding yourself without coverage after falling ill.
One insurance company you can take a look at is Luma Health. Their plans comes with:
- a 32-million baht limit
- coverage for cancer treatment
- medical evacuation
- a lifetime guarantee
The plan doesn’t cover any pre-existing conditions. But this is normal for health insurance companies.
Although the maximum age you can sign up is seventy, you should get it before turning fifty-five.
The premium rate for fifty-five year old males starts at 70,000 baht a year.
The premium is the clearest part of an insurance policy. It’s the fine print that’s trickier to get. But even though the premiums are stated, you should keep these things mind:
- payment terms
- medical inflation
- age groups
A number of insurers, especially those offshore, have a significant surcharge for monthly payments.
Since your contract runs the full year anyway, you might as well pay in full.
Your premiums will be a lot lower if you agree to pay for the first thousand or two thousand dollars of healthcare each year yourself.
In practice, that means you won’t be able to claim anything but severe cases.
Make sure you keep receipts and file them by their deadlines. People forget about this because they don’t expect to have to pay for bills beyond their deductible—until they do.
An easier, more hassle-free choice that would get you the same results but much less paperwork would be to just opt out of OPD coverage.
What happens if you’re in an age group where cost for insurance shoots up? You can add a deductible to lower your premium to an affordable level while keeping coverage for serious cases.
Medical inflation in Thailand is high. Most insurance companies say they’ll raise yearly premiums by less than 10%.
From my experience I’d say that the increases are a lot lower than that.
But you should keep this in mind for future budgeting. Your health insurance will go up 5% each year along with the increases that occur when you get older.
Most insurance companies divide age ranges in groups of five years.
Every time you enter a new age group, your premiums will go up. In your twenties and thirties that doesn’t make much of a difference. But once you pass fifty, the increases can start to hurt.
You should compare current day rates and the rates your insurance is charging people who are five to ten years older than you.
Optional Coverage Choices
A few options are covered as add-ons. Skipping them lets you lower your premium as long as you’re okay with paying out of pocket.
Some of the optional coverage is:
- medical evacuation
I’ve logged my own OPD costs between 2015 and 2017. While not representative, my costs give you an idea of the cost of OPD treatment at top-tier international hospitals in Bangkok for men in their thirties.
I got all but one of my treatments at Bumrungrad. The other I got at Chulalongkorn Hospital.
|Year||Visits||Average Cost per Visit||Total Cost|
During these years I had two major health checkups. The most costly was a stomach checkup at Bumrungrad in 2015, which, including doctor and facility costs, came to 21,973 baht.
Most people I know don’t get OPD coverage because treatment isn’t that pricey here.
Going to a hospital in Bangkok costs anywhere from 700 baht to 3,000 baht, depending on the fanciness of the hospital and the doctor’s chosen medical field.
Medication is sold at a mark-up in the hospital itself. Mark-ups range from two to ten times the cost in a pharmacy.
If you buy medication at the hospital you could pay just as much as you pay to see the doctor.
As you can see in the above table, my costs are at the higher end of that spectrum.
Going to cheaper hospitals that don’t have free juice and a hotel lobby style waiting room would lower your OPD costs.
If you’re not living in Bangkok, the OPD facilities you’re going to use will be a lot cheaper.
A close second in why you might not want to bother with OPD insurance is the paperwork. A lot of people dread having to fill out forms, mail claims, and dispute rejections.
It’s frustrating to do that for a minor claim only to have it denied. You’re better off paying straight out of your own pocket.
Last but not least, the overall limit. Most OPD insurance coverage limits me to a few thousand dollars per year. My OPD insurance limits stops at 217,311 baht.
In most cases, the math doesn’t make sense. What you pay for insurance coverage far exceeds the amounts you’re likely to claim.
Things might be different if you’re looking at expensive long-term OPD care for diabetes or kidney failure.
You should also be aware of some insurance companies classifying certain procedures as OPD, even though you might spend a few days in the hospital.
This way they can refuse a claim unless you did opt for OPD coverage.
In the end, I opted for OPD coverage because I feel the amount I overpay is worth the fact that I’ll never put off a hospital visit due to cost.
Call it a psychological effect.
Coverage for dental varies a bit. Some insurance companies make you co-pay or cover one routine checkup a year.
In my experience though, they’ve covered 100% of my dental costs for the minor claims I filed.
From 2015 to 2017, I paid about 2,116.33 baht per year for dental care. This includes regular checkups every six months.
I go to Bangkok International Dental Center, or BIDC, for my dental work.
It’s not the cheapest dental center out there. Their prices are about 25% more costly than a high-quality, independent dentist.
But BIDC offers significant savings over other English-speaking dental clinics in Bangkok.
One major reason I go to them is that they are opposite of my office. Bangkok has a lot of both dentists and traffic jams, so location becomes a major factor.
Also, BIDC dentists don’t seem to drill often. It’s either that, or my dental hygiene improved around the same time I switched to them.
Being the cautious German that I am, I use my annual Christmas vacations back home to get a second opinion from my village dentist on the work I get done in Thailand.
I pay him in fruit and bakery baskets and he’s absolutely awesome. So far he hasn’t objected, so I guess the standard of care measures up to that of German dentists.
Most insurance plans you’ll find in Thailand include dental work. But since the cost of dental care is lower, you shouldn’t worry about it too much.
While international hospitals with English-speaking doctors and short wait times charge a significant premium, you’ll find their dentists are a bargain.
Some insurance companies offer medical evacuation as an add-on. The usefulness depends on where you live in Thailand.
Most competitive-priced plans won’t fly you to your home country, but to the next suitable hospital, which in most cases will be in Bangkok.
If you don’t leave Bangkok much or get travel insurance when you do, there’s little point in requiring medical evacuation.
The exception? If your limit is high, I imagine the insurance company might offer it themselves whether you picked it or not.
Flying you home might be cheaper for them than paying for an extended stay at a top-tier hospital in Thailand.
But don’t count on it.
Other Terms and Conditions
There may be other terms and conditions that can affect the viability of your insurance coverage.
Reading the conditions of your insurance contract is tedious. But think about how much you’ll be spending on this for the next five to ten years.
That should be worth setting aside an hour or two to go over the details of your plan.
International Citizens published a nice wrap-up on expat insurance terms and what they mean. You should check it out to get to know the language of insurance.
If in doubt, I suggest sending an email to your potential insurer, listing out what you’re concerned about, and trying to get some statement from your broker or insurance company that clarifies your question.
I’m not a lawyer or insurance expert and this isn’t legal advice, but I assume this should improve your position if it ever comes to a dispute.
When you take out insurance, you’ll have to think about the amount of paperwork involved. So let’s look at three common areas of insurance in which you’ll need to file paperwork:
- insurance applications
- prior authorizations
- denials of claims
Applying for insurance in Thailand is like applying in other countries. Each insurance company has its own survey.
Insurers will ask you questions about your past health and illnesses and if you lie about it, it might void your coverage.
Some companies ask if other companies have turned you down. If you think you’re at risk of getting turned down by some companies, apply for all of them at once.
This way they can’t deny you if you’re going to be turned down by another insurer.
In some cases, insurance companies require prior authorization before getting hospital care. This is standard for any non-urgent visits to a hospital.
Some insurance companies also require prior authorization for more expensive OPD procedures like MRIs.
That tends to result in a back and forth between hospital and insurer and you waiting a day or two until the insurance comes through.
I’ve never heard of insurers refusing authorization, but I assume it does happen. Otherwise, why have it?
In some odd cases, some insurance plans like the Southeast Asia Serene Plus plan by A Plus II even requires prior authorization for organ transplants.
That’s a bit weird. Is there really a danger of people getting unnecessary organ transplants?
Denials of Claims
What good is insurance coverage if your claim gets denied?
My current insurance company has declined two of my claims so far. Nothing major. Just claims they thought were pre-existing.
But pre-existing can be anything you have that they think is recurring. In my case they denied my claim for 635 baht for dyshidrosis.
That wasn’t surprising since dyshidrosis is chronic. The fact that they even bothered checking for that amount surprised me.
It’s hard to get good data on how often insurance companies deny claims.
If you happen to have some info and would like to share it with me, please email me.
Finding the Right Insurance Plan
When looking for insurance plans, don’t make the mistake of looking for the cheapest plan.
Instead, it’s better to look at:
- area of coverage
- coverage limits
- renewal guarantee
- company reputation
Area of Coverage
Does the plan cover you in Thailand or other countries as well? This is important for those who often move or travel to new countries.
How much is the plan’s coverage limits? And what are the limits of the benefits? Are they enough for your needs?
Are there exclusions that you should be aware of? Do you have a chronic disease or take part in activities that aren’t covered?
Are they going to let you go if you’re diagnosed with a chronic disease, make too many claims, or claim too much?
Is the insurance company easy to deal with? Do they raise premiums every year by a large percentage? How about people’s experiences with them?
The plan suitable for you might not be the cheapest, but it’s better than getting a plan that doesn’t give you enough coverage when you need it.
Reading the fine print, looking at reviews from customers and talking to a good broker will help.
You can research suitable insurance plans by checking out:
- comparison websites
Each of these methods have pros and cons.
Comparison websites let you search for insurance plans with filters and searches, rather than having to compare sales brochures and broker’s Excel sheets.
You can also fill out medical surveys and apply online for plans.
For expats, Mister Prakan offers the most comprehensive comparison of health insurance plans in Thailand.
The website covers major insurance companies and:
- sorts them by price
- allows you to filter them by coverage level
- gives details about coverage limitations
- displays editorial ratings of each company.
They also act as a broker and have English-speaking staff who can answer your questions.
In case you’d like to look into offshore insurance plans, you can give BrokerFish a try.
For international insurance plans, you can:
- compare plans
- filter results according to your needs
Sadly, they’re missing some of the more competitive offshore plans. And they don’t have any info about plans sold in Thailand, which may offer better coverage.
You shouldn’t have trouble finding a broker in Thailand. The rate you get when going through a broker is the same as when you go the insurance.
The main advantage of a broker is that they can offer you a wider range of plans than an insurance company.
If you don’t already know which plan you want, they can give you details on what best suits your needs.
In theory, brokers are neutral and act in your best interest. In practice, in Thailand that’ll be true for good brokers and not so true for others.
One thing to keep in mind is that sales commissions for brokers are recurring.
For every year you stay with them, they get between 15% and 18% of your premium.
If you go through an insurance company, the insurance keeps that sales commission.
This means brokers have an incentive to sell you an insurance plan and keep you as a client in the future.
This recurring commission payment means that the broker will have a financial interest to help you out when it comes to dealing with insurance.
But brokers only offer you limited help with claims or disputes.
Aside from the details of the claim and your individual case, it depends on their relationship with each insurer and of course on the insurance itself.
Whether or not your broker sends your insurance company a lot of business, and whether or not your insurance company cares can make a difference.
In case you’re not happy with the support of your broker, you should also know that you can change brokers without changing insurance plans.
In short, signing up for insurance through a broker means you have one more person you can talk to before signing, and one more person to complain to after signing.
On the other hand, a broker might not know every single detail about every insurance plan for sale.
If you’re looking for a broker, I suggest using Mister Prakan. They’ll allow you do to do the initial research yourself, making it easy to compare plan benefits and costs online at your own pace before talking to one of their agents.
If you’re looking for a locally licensed, Thai-baht insurance plan, they’re a one-stop shop.
For legal reasons they don’t offer any offshore insurance plans like ACS, the one I’m using.
But the Asia Care Plus plan by Luma Health may work for you.
Lastly, you can fill out our insurance form to get advice from a broker who is also an expat and has years of experience with both offshore and local insurance.
My Insurance Plan
As I said before, I’m insured with ACS. Below, I’ve listed the reasons why I chose them. Unless noted, conditions are from the time of signing up and based on my notes:
- HIV/AIDS treatment: included
- medical evacuation: included
OPD: $6,000 limit
- exclusions: common exclusions; donor costs in case of organ transplants
- overall limit: $500,000
- 2018 premium: $1,855.00 a year for a thirty-six year old male
The bullet points reflect my own grasp of their insurance plan and lists out attributes according to my priorities. It’s not meant to be an “official” or a comprehensive list.
After being with them for many years, I’d say I’m satisfied with their service.
ACS is easy to reach. They don’t work in a certain time zone. There are no cultural or language barriers.
The premiums tend to go up over time but stay in line with what other insurers charge.
There were a few minor claims they denied based on them being pre-existing conditions or outside the described coverage. But I wasn’t surprised and I’m pretty happy with the service I got from them so far.
But in the end I went with ACS. They offer the best value for money for the coverage I need.
Now, on to You
Are you left with questions about buying insurance in Thailand? Feel free to send me an email and I’ll help you out as best as I could.
Keep in mind I’m not a broker, lawyer, doctor, or professional proofreader, but when I wrote this article I did my best to research and fact-check.
I also can’t promise the info in this post is 100% true. Things always change with insurance. And although I do my best to keep this post up-to-date, you should check with a professional before buying insurance.