Should I self-insure for medical expenses when moving to Thailand with pre-existing conditions?

Dec 28, 2022
2 years ago
Linz ************
ORIGINAL POSTER
*EDIT*

Thank You All For Your Invaluable Advice, Decision Pretty Much Made, We will most likely Self Insure

Comments Now Turned Off

A few years ago I suffered from something called a spontaneous internal carotid artery dissection, I did not suffer a stroke and I have not had any medical intervention (no stents fitted etc) but as a result of my dissection, I now take multiple prescribed medication to try to control my blood pressure and it has left me with neurological issues (short term memory issues being one example)

Must say, to look at me, I look perfectly ‘normal’

Within the next 18 months we (myself and my wife) are planning on selling up (from the UK) and moving to Thailand to retire on a permanent basis, I will be 55 and my wife will be 61

Medical Insurance…

I have just read an article that insurance providers will not cover any pre-existing conditions, so with having high blood pressure, if I was to suffer from a stroke/ heart attack etc, I would not be covered as that could be linked to my blood pressure

I also appreciate, as we age, the premiums will increase substantially

So, based on the above, if I was to simply put a lump sum of money away and, in the event of a medical emergency, go to a public hospital and pay for any required treatment, would this be a viable option?

Has anyone got any experience on using the public hospitals?

As always, thank you in advance
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TLDR : Answer Summary
The discussion revolves around the decision of an expat planning to move to Thailand regarding medical insurance given pre-existing health conditions. The original poster expresses concerns about not being covered for pre-existing conditions, particularly high blood pressure. Community members provide insights on the quality of medical care in Thailand, differentiate between public and private hospitals, share personal experiences with healthcare costs, and discuss the viability of self-insuring versus obtaining health insurance. Many suggest that with proper cash reserves, self-insuring can be a feasible option, especially given the lower medical costs in Thailand compared to the UK.
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Twiggy ******
I have lived in Thailand for 19 years and always go to the local (not international) hospitals if I need to check or fix anything. The cost is very fair in both private and state run hospitals. But I don’t have serious health problems.
Barry **********
I have similar to you. Medication isn't too expensive and readily available without prescription. I have an annual scan of my carotids and its about 9000 baht including blood tests. No point in insurance for what I already have and that is being managed, so I've got a big wedge put aside should anything else pop up.
Dave **********
My Heart Attack & By Pass cost USD 60,000 in 2020 at Bangkok Hospital, Bangkok. First Class Medical Team and they saved my life.
Taz **********
Public hospitals are cheaper than private

You need to look at the cost of both
William *******
I agree. Self insure. With a history of an internal carotid artery dissection you are at very high risk for a stroke and especially if your hypertension is not under control. Your premiums will be very high if you are lucky to be insurable and you are correct regarding your history of hypertension. Cerebovascular and cardiovascular events in addition to chronic renal failure are definite risk factors of hypertension. Many of us self insure. I have for decades. Medical costs are low in Thailand and the care can be excellent. So don’t worry
David *******
If you have the cash then keeping a reserve amount for medical treatment instead of having insurance is fine. Hospitals will want to see proof you can pay so make sure you have that on you. Government hospitals are fine but will involve long waits. Plenty of hospitals around at various price levels. Most medications can be bought over the counter at any pharmacy.

When you make the move get the Non O visa for Retirement and not the Non O-A or you’ll be forced to buy useless insurance to qualify for your annual extensions.
John **********
Some of my Thai friends use the public hospitals but they all pay extra for private rooms and generally they have family with them
****
to provide food and generally help them out. The doctors are as good as the private hospitals but it's all the ancillary stuff that's the issue.
Mitchell *******
You COULD PUT $$$ away instead of insurance. There are people who do that. But keep in mind that the older you get, the harder it is to get truely comprehensive insurance if you decide to change your mind.

From my experience, If you have an emergency, you will want to be taken to a private hospital. Nothing wrong with the public Thai hospitals, but the private ones, as you would expect, may have the more cutting edge tech in Thailand, and have more resources. If you are awake, they will ask you "Thai, or Private/foreign hospital". 2nd Question "insurance??". If you say no, they will ask you how you will pay. You would want to have that card on you. Your ability to show you can make the payment has a direct impact on where the ambulance will take you.
William *******
@Mitchell ******
Regarding having “a card on you” all you need is a credit card. I charge medical visits and hospitalizations with my American Express Card.
David **********
Plenty of guys here have called me insane. However sir that’s exactly what I do. I am financially independent and have substantial cash reserves. I have found the cost of medical issues here are pennies on the dollar compared to other places of course in the UK your medical is free. Lots of guys will argue that cancer or heart disease would be hundreds of thousands pounds cost. I’ve checked with my Thailand doctors here and if you have plenty of credit on your credit card or you put a substantial amount say US$100,000 aside you’re gonna be fine. When you add up the cost ofHealth insurance premiums over the long haul it’s pay me now or pay me later. Those of us with cash reserves are not insane.

Oh BTW I have a great cardiologist that spends well over an hour with me when I go see her. The cost to visit a specialist is $15 here. At the hospital. I don’t go to Chiang Mai ram which is very popular with the expats they don’t seem to like to leave the old city 🙂 I go to the center for medical excellence which is affiliated with Chiang Mai University medical school Sriapht Hospital. I had a heart attack nine years ago. I’ve changed my diet manage my blood pressure with medication and see my doctor regularly. Private message me if you need further information I’d be glad to share the great medical care you can get here In Chiang Mai. I’ve been here six years
Craig ********
This is something you need to discuss in depth with your insurance provider and then READ ALL THE DOCUMENTATION THAT COMES WITH YOUR PLAN. You need to make totally sure the details before you sign or pay for anything. Take this seriously, do your own research, and do not believe what people on facebook might say about this.

Facebook is a reasonable place to get advice about where to find good coffee or what bar shows the football game.... but life and death decisions about how your medical insurance works is way beyond the scope of what you should trust to facebook.
Linz ************
ORIGINAL POSTER
@Craig *******
thank you and yes, very valid points,

In fairness, my original question was based on peoples experience on using the public/ government hospitals 👍🏼
Nigel ********
Many insurance companies do cover you for a stroke. Disclose the pre existing conditions and pay an extra premium. Ps. public hospitals in Thailand are not the same as public hospitals in England and Australia. They're free but private hospitals are a far better option for a farang.
Bernard *****
@Nigel *******
No they are not free ! And not always free for thai people also, if they are not in their district.
Nigel ********
@Bernard ****
, I was generalising to give the OP some ideas. My Thai friends and relatives have never been asked to pay for public hospital treatment (Chon Buri and Isaan) even when not in their province.
Bernard *****
@Nigel *******
Niece had to pay if she wanted another treatment from another public hospital where she thought it was better for her than the public hospital of her district.
David ********
@Nigel *******
Don't believe that public hospitals are free to anyone who is not a Thai. Thailand government often complains about foreigners not paying their medical bills.
Linz ************
ORIGINAL POSTER
@Nigel *******
thank you, please tell me more
Nigel ********
@Linz ***********
, about what?
Linz ************
ORIGINAL POSTER
@Nigel *******
about the public/ government hospitals
Nigel ********
@Linz ***********
, I suggest you visit one next time you're in Thailand. Just my opinion, insurance is a must.
Kool *******
The public university hospitals are world class.
Bernard *****
@Kool ******
Is there a list to know where they are?
Kool *******
@Bernard ****
Google maps is widely used in Bangkok
Bernard *****
@Kool ******
Yes I know Google maps 😊 but I thought about other places and about a simple list
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