Would throwing away 40k baht on a completely unnecessary Thai insurance policy "kill me"? No, of course not. But why would I want to throw away money when I am already insured? A Thai policy certainly wouldn't give me any additional "peace of mind", because my US policy fully covers me in Thailand, with all providers considered to be "in network". That's not just in theory - my policy has covered all of my medical expenses here, including multiple surgeries, for decades.
As I wrote to Todd above, people who already have close ties to Thailand and want a way to stay here will buy that unnecessary extra policy as a cost of doing business. The ones with no Thai associations, though - the ones BoI really wants to attract in large numbers - will be less forgiving, and may just choose a different country instead. Just my opinion.
We can certainly assume that, but that doesn't make it true 😂 So yes, if you happen to have had 100k in the bank for a year anyway - as was true in my case - then the insurance is irrelevant. But if you don't have that much in cash, and they don't accept either your perfectly valid insurance or your investment accounts instead, that is very frustrating, and would be enough to put off many people.
The great majority of current applicants seem to be people who already live in Thailand or regularly travel here, and just want a more convenient visa. The folks the government really wants to attract, though, are those who would not have thought of living in Thailand otherwise, but are attracted by the LTR. That group will be much less willing to jump through hoops than current Thai residents like me.
I think there may be a few issues. One, there usually isn't a policy number, just a member number. Two, there usually isn't a number listed for coverage - mine just said "no dollar limit". Three, there's no start or end date specified, as the policy just continues until you either die, change to another provider, or drop out of the program (which almost no one does, since being uninsured in the US is setting yourself up for bankruptcy).
What they are expecting, and are very comfortable with, is an individual, one year policy with a specific coverage limit and ending date. That fact that such a policy is usually grossly inferior to the government or corporate sponsored group polices doesn't matter at all.
They could easily assign someone to research this kind of coverage by reading online and talking to the US embassy - I spent most of my career as a visa officer, and that's what we would have done in a similar situation - but for whatever reason it seems they prefer just to reject it out of hand, even though doing so may alienate tens or hundreds of thousands of potential applicants.
Even the WP category suffers from the "requirements not matching...desired target group realities" problem, though to a much lesser extent. The issue that I and many other US applicants faced is that we had comprehensive health insurance as part of our retirement, but it's in the form of group insurance - the norm in the US - that BoI either doesn't understand or is somehow barred from accepting.
They never explain what they don't like about it, but instead just keep sending the "please provide medical insurance" boilerplate again and again, even after all the insurance details have been provided. This type of insurance typically has unlimited coverage and is valid for life, and yet they just won't allow it. With that kind of restriction, many US retirees won't even bother applying.
That depends on your definition of "long term", but yeah, it's not permanent, which it really should be for a retirement visa (who wants to move again at age 75 or 80?). It's also not even renewable every five years; at this point, you get five years to start, and then can activate the second half of the "ten year" visa at the end of that time. What happens after that? We won't really know until 2032...