What qualifies as a 'pre-existing condition' for medical insurance in Thailand?

I have an OA Visa so I needed health insurance. I think it's a good idea especially if you're in a car accident or something like that but I think it's better to just get an O visa and I'm not sure if it's even worth getting insurance because it seems like these companies try to get out of paying anything.

That’s actually a very good question, Vincent 😊

Many people only discover the difference between “health-related products” and real medically underwritten health insurance once they start looking deeper into the subject.

In general, a pre-existing condition can be anything that existed before the policy start date — whether ongoing, treated, healed, or simply documented in your medical history. But how this is assessed depends very much on the insurer and on how professionally the underwriting is done.

And that’s exactly where huge differences exist in Thailand. Not every company evaluates medical risks the same way, and not every “insurance product” is built around genuine health insurance principles.

If anyone here is currently reviewing coverage and wants honest guidance, clear explanations, and someone who actually takes the time to explain things properly instead of just selling a policy, feel free to reach out anytime 😊

The best policy you can get is the one you write yourself. Do everything possible and get your health in order before you arrive. Lose weight and get rid of your diabetes and HBP, sleep apnea if at all possible. Less to worry about and less out of pocket while you’re there.

Reading these comments makes me think I won’t be able to get insurance… I have high BP, cholesterol, and diabetic! All controlled with meds… I will be using FMP and Tricare, but don’t I have to have local insurance as well?

Ive asthma, and a flare up aint covered if i need hospital treatment,as pre existing

For the correct information it is best to consult your medical practitioner rather social media.

A pre-existing disease (PED) or condition in health insurance is any ailment, illness, or injury whose signs or symptoms existed within the six months prior to purchasing or upgrading a policy, regardless of whether it was formally diagnosed. Insurers usually impose a 12-month waiting period before covering these conditions.

Key Aspects of Pre-existing Diseases:Definition & Timeframe: It is a condition where a insurer-appointed medical practitioner determines that signs/symptoms existed within the 6 months before you joined or upgraded your cover.Diagnosed vs. Undiagnosed: A condition can be considered pre-existing even if a doctor has not formally diagnosed it, provided symptoms were present.Waiting Periods: Generally, a 12-month waiting period applies for hospital treatment related to these conditions.Exceptions: Mental health conditions, rehabilitation, or palliative care may have shorter waiting periods (e.g., 2 months).

Examples: Common examples include diabetes, high blood pressure, heart disease, arthritis, cancer, back/neck issues, and mental health conditions.Synonyms/Related Terms: Common synonyms and related terms include "pre-existing conditions" (PEC), "underlying conditions," or "chronic conditions".Impact on Coverage: If deemed pre-existing, treatment costs for that condition will likely not be covered during the initial 12-month period.

I am looking to retire to Thailand and will be looking for insurance (I will be 68). Should I be looking to get medical records before leaving UK or do insurance companies require a medical to be undertaken in Thailand. I have no pre-existing conditions (that I know about!) and do not take any medication.

I applied and was rejected by an insurer when I did the required PSA test which came out high. Hadn't had it done in ages because my previous insurer didn't consider it trustworthy, so it wasn't covered. But the result was reason enough to deny coverage without a biopsy report.

I believe one has to tell insurers everything.

I have a very good friend whose girlfriend was an underwriter for insurance here in Thailand. He told me that she said to him insurance companies here hire people to do nothing but scan claims looking for any loophole even the smallest one that could get them out of payment. Unfortunately if you have pre-existing conditions doesn't matter for what or when they'll try to tie it into your ongoing claim when you put one in. It's unfortunate but that's just how it is.

Had a hole in the heart plugged 15 years ago.

I have had numerous medicals that say my heart is in excellent condition. I swim a mile a day and yet the insurance companies still class it as a pre-existing condition and as a result I cannot get any medical insurance, I am 70 this month

Yep!!! Declare everything and the company will come back with more exclusions than coverage. Us old folks are screwed. Simple as that.

Mention ALL not hide one .. in case you need a hospital… because of the preexisting they kick you out … like in our countries

Tricky area all ok until you try a claim. My advice would be tell them if on regular medication, obviously if you have had major operations

I had high Cholesterol (supposedly)so they re-wrote the policy to exclude all organs. I told them to poke it where the sun doesn't shine.

I took my hospital report to a local clinic and they said my cholesterol was fine.

I now dont trust insurance companies

Thank you, helpful to me also.

I think, pre-existing condition and pre-existing injury are different things.

Depends on insurance . I had shoulder surgery 20 years ago , had a letter from a doctor stating 100% recovered. One insurance company loaded 30% and excluded all cardiovascular , went to another insurance company and they did not care at all.

Also what you may find interesting is when applying for a policy , questions are pretty general such as have you had a surgery in past 5-10 years . But once you make a claim , they deny saying surgery 20 years ago was a pre existing ( Just example )

It will depend on the insurance company and underwriter I think. something like a broken bone that was long time ago is not really a pre-existing condition. something like an elevated PSH is. elevated blood pressure even if it was under control with medication is. since almost everything can be connected with blood pressure through your heart and vascular system, what's them to stop paying for a heart attack since that could be part of your high blood pressure problem?

think of insurance as something you choose to pay but don't ever expect it really to pay out.

and if you want the monthly payment to be manageable then you have to go with a high deductible.

make sure you have the deductible in the bank.

I broke my ankle years bebore and declared it for my insurance, they said that if I broke it again I was covered but if I had problems with the metal implant I wasn't. If I didn't declare it I expect they wouldn't cover anything if I broke it again. Insurance companies will use anything to get out of paying so don't give them a chance, declare things before taking out the insurance and if they refuse cover then try a different company

High blood pressure they can tie to many other medical conditions in the future like heart attack, stroke, etc, etc, etc and deny a claim

Normally the Insurance form will have a set of definitions somewhere, which will include what they mean by this.

I've had a hip replacement and it didn't affect the policy but they wanted to know about it.

EVERYTHING OR IF THEY FIND OUT YOU GET NOTHING.

Any Thai insurer will be strict regarding pre conditions. Pacific Cross, Luma. AIA, AXA , Zurich. Any medication you may be prescribed. Broken bones, knee + Hip replacements are part of what is the underwriting process. In essence you declare everything. Because remember in the event of a claim your insurer can and WILL be all over your medical records like a rash..!

Generally anything like that triggers an “exclusion”. Or a “waiting period” For instance a simple thing like a 20mg Statin tends to trigger an exclusion of anything related to Hyperlipidemia - heart attack, stroke.

Which can make your policy fairly worthless. I do recommend

A comprehensive medical. The hopefully decent results can be highly effective in convincing the underwriter you are worth insuring without exclusion. What you do need is an experienced and reputable broker in your corner. Expect the process to take quite some time. Specialist expat Insurers, a lot less fussy regarding pre- conditions. But double the price. Cigna for instance, who I have used and can in no way reccomend.

No. It's stuff that might take you to hospital and cost them a lot of money. If you had a broken leg 20 years ago and is fully healed, then its not what they're looking for. If your doctor has given you any diagnosis that ended with a solemn "so let's monitor this", that's probably on the list.

Normally things like cancer and similar are what they are looking for.

You typically will get a questionaire, you answer the questions.. If it mentions have you ever had a broken let.. And you have you say yes...

Usually stuff like a broken bone etc isn't an issue, until it is. If you don't declare it and they find out you will be on the hook, and they will look. But if you declare it and they say no problem then you are pretty much good to go.

Yes