Farang insurance dilemmas building up

[Joachim]

GB,
You definitely have a point and my "plan" does not cover all eventualities. But making risk/reward assessment one should take into account that insurance companies are for profit organizations which calculate their premiums based on sophisticated actuarial math (and believe me they know their math). That is especially true when they deal with individuals (who have no bargaining power) on global markets. Besides, keeping money on your own bank account is not exactly tying them up. Dealing with insurance companies under described circumstances is akin to gambling in casino (where mathematical odds are definitely not in your favor).

[fountainhall]

If you are seriously ill or in need of surgery, and flying back to the USA is not an option due to a need to do - now - whatever is necessary to save your life, $60,000 could easily be only a fraction of what you'll actually need..

Whilst I agree in principle with Joachim's views on insurance companies, I too would be concerned at self-insuring on the basis or Bt. 2 million. I expect the costliest treatments are likely to be open heart surgery, major transplants, stroke and on-going cancer treatment. I recall reading not so long ago that the total cost of a quadruple bypass here would be around Bt. 1 - Bt. 1.2 million. How accurate that is, I really do not know. The real problem with self-insurance surely is not so much the cost of one major urgent procedure. It is the need then to top up the balance - or worse, requiring a couple of procedures within months. That could be $60,000 gone and the need to find another $60,000 for the future.

Even if you are basically healthy, the costs of being treated for involvement in a serious accident with a car or van whose driver did not have much 3rd party insurance could also eat up that reserve.

I had one friend who had had an excellent job in Hong Kong but then went through hard times. He found lesser paying work and was able to keep going but had decided not to bother with medical insurance. One of the last occasions I saw him he was coming out of a gym. This was his insurance, he told me! Two years later he collapsed, the result of a malignant brain tumour. Friends rallied round and helped with the initial operation. Thereafter he was confined to a wheelchair and died la few months later. He was 65. I could not face that possibility with no insurance.

[thaiworthy]

jiminbkk...
Thanks for sharing this helpful information.

May I ask...

Is your Medicare coverage a "Medicare Advantage" policy

Or the traditional Medicare plus a "Medicare Supplement" policy?

Thanks again...
Tj

Good question.

Personally, I have a Medicare Advantage plan, but I will warn you, qualification for this is tricky. By that I mean this specific advantage plan I have can end your coverage if you are away from the US for more than 6 months. So I come twice yearly, visit doctors, pick up medicine, pickup mail, etc. Then I pick up two 90-day prescriptions when I am there. I get a relative to stockpile the other two 90-day prescriptions for me by going to the pharmacy the other 2 times a year. You can send me a PM if you want specific details. Medicare alone is relatively little by itself. The cost for the Advantage plan is $0 a year and covers so much more.

I could not have figured out all this without the help of TravelerJim. While we are different politically, he holds a wealth of information and I am totally grateful for his help.

While in Thailand I have AXA PPP which costs me 2277€ a year (paid annually) with a 2550€ deductible. Any annual increases are community-based. There are exclusions for pre-existing conditions. It covers dental up to a maximum of 402€ with a 50% co-pay. At the time, the agent told me to purchase the policy in Euros because the prices were much more competitive than the same policy in dollars.

The annual limit is 950,000€, with a private room, intensive care, no outpatient, OP Oncology, OP Advanced Imagery, CT/MRI/PET, no annual health check, covers acute chronic conditions, lifetime renewability, direct billing and a 5% discount if paid annually.

Initially, I took Puan and Gaybutton's advice and called Cigna in Scotland. The accent was so thick I couldn't understand a word he said. Then he asked who referred me to them. I said two members of a forum. I did not mention the name of the board or member names. But he thought it was funny. He started laughing when I couldn't give actual names. He couldn't stop laughing. He thought it was hysterical. So that was that.

Then I contacted PacificPrime.com from an ad on Facebook, which has an office in Hong Kong and we got along just great. The gentleman's name is Walter van der Wal, Business Development Manager, Southeast Asia - Pacific Prime. He followed up on emails and took me far more seriously. He doesn't represent just one insurance company, he gave me quotes for 8 of them. Graphic below. In fact, they rushed my membership card and policy the day before I was to leave for my first US trip of the year. Amazing, incredible service.

[Joachim]

Whilst I agree in principle with Joachim's views on insurance companies, I too would be concerned at self-insuring on the basis or Bt. 2 million.

Note I do not recommend self-insurance with 2 mln baht. I recommend combination of medicare with 2mln in Thai bank account. In case of brain tumor, I would definitely fly back to US. Having separate health insurance in Thailand and medicare as described in Thaiworthy post below is incredibly expensive and really not worthy. Would never do that.

[Dodger]

In case of brain tumor, I would definitely fly back to US.

Not me. I'm too much of a chicken. I would probably pass out in the hallway after receiving this news and they'd have to perform the surgery before I woke up.

I can just see it now: Stewardess...stewardess...can you please ask the pilot to fly at a lower altitude because of my brain tumor"...

[thaiworthy]

In case of brain tumor, I would definitely fly back to US. Having separate health insurance in Thailand and medicare as described in Thaiworthy post below is incredibly expensive and really not worthy. Would never do that.

I can just see it now: Stewardess...stewardess...can you please ask the pilot to fly at a lower altitude because of my brain tumor"...

It's really not that funny if you've ever been in this situation, no matter how you perceive it to be. In January 2016, I flew back to the US for a serious, but non-life-threatening condition that required various procedures and tests that would have been expensive here. Under Medicare, it was basically free. When I boarded the aircraft I notified the purser about it and she replied "Do you really think you should be flying in your condition?" I was fine to fly, just nervous. I replied, "I have no choice."

I pay $127 for Medicare and Medicare Advantage, and $204 with AXA PPP (equivalent in Euros at the time of payment) which equals $3972 a year for health care. I have a pre-existing condition that could only be cheaply administered by a health plan in the US for my medicine, which would cost me over $3000 a year if I bought it in Thailand. Living in Thailand only would cost $5400 with no coverage for pre-existing conditions which includes paying for my own medicine, not including doctors. The trips to the US twice a year is approx. $2400. That brings my current strategy to a cost of almost a $1000 more ($6400). Add to that, the benefits of visiting with family, driving a free car and living rent-free while I am there makes it all the more "worthy." I also bring back a ton of stuff I can't get in Thailand, about 3 suitcases at 50 lbs. each.

The cost of the travel should really not be factored in, since I would make this trip anyway. What is expensive? How anyone else determines that when they don't know all the factors is ludicrous. How much is your health worth? Is it worth an extra thousand bucks? The older you get, the more value there is to that money, AND I probably will require more medicine than less as time goes by. None of us are getting any younger.

I might add accessing both Medicare and your Medicare Advantage plan from Thailand will require a VPN routed through a server in the US.
Also, Medicare, your Medicare Advantage plan and Social Security all now require you to change your password at least every 2 months.

The world gets smaller every day. Whether you're here or there makes little difference to me. Yes it's 24 hours+ door to door, but then again, that's part of the price you pay. I paid my taxes all these years. The way I see it, I am on a 5-month vacation, twice a year. I have a Skype number for making/receiving calls to the US, and it shows up as a US number to callers from anywhere in the world.

I am enormously happy living in Thailand. I have no regrets and would do it all again. What price tag shall we put on happiness, hmmm . . . ?

Expensive or not expensive, just depends on your own point-of-view. Everyone's situation is different and it makes no sense to make some comparisons. You cannot predict what is going to happen to you. You call the shots the best you can, and if you can't then you shouldn't be living in Thailand. There are going to be advantages and disadvantages to every scenario, but it all boils down to one thing for most of us. If you want to live in Thailand for most of the year, AND get benefits from the US, this is what it takes.

[fountainhall]

I'm sure we've all heard near-disaster stories from friends. One is of the former owner of another Board, a sick man with chronic conditions who decided to fly back to the US. He died on the plane, I understand.

I know of one expat here in Thailand who had a fall. Apart from some bruising he felt fine. About three weeks later he was due to return to the US but had started suffering from headaches. So he thought he should see a doctor before he left. The doctor did some tests. Then told him in no uncertain terms: if he took any fight he'd die. He had swelling on the brain and required an immediate operation.

Thaiworthy is right. Our situations are all different and we just have to make our own choices to fit them. The important thing is to know all the facts and do all the necessary research. Don't trust what others say. It's your life.

[fountainhall]

I see. Well, whatever you were drinking, send a case of it to me, willya . . . ?

I have a bottle of Glenfiddich Cask Collection Single Malt waiting for you when you are next in Bangkok. Mind you, it's only a 20cl duty free bottle but a very pleasant drink or two . . . or three! And I'll add a case of mixers

[Gaybutton]

I have a bottle of Glenfiddich Cask Collection Single Malt waiting for you when you are next in Bangkok.

Sounds REAL good to me.

"You have an educated taste in whiskey."
- Christopher Plummer (Rudyard Kipling), 'The Man Who Would Be King'

[Joachim]

I'm sure we've all heard near-disaster stories from friends. One is of the former owner of another Board, a sick man with chronic conditions who decided to fly back to the US. He died on the plane, I understand.

I know of one expat here in Thailand who had a fall. Apart from some bruising he felt fine. About three weeks later he was due to return to the US but had started suffering from headaches. So he thought he should see a doctor before he left. The doctor did some tests. Then told him in no uncertain terms: if he took any fight he'd die. He had swelling on the brain and required an immediate operation.

Thaiworthy is right. Our situations are all different and we just have to make our own choices to fit them. The important thing is to know all the facts and do all the necessary research. Don't trust what others say. It's your life.

You are talking about Neal. He was at least 10 years on dialysis and flew to America basically to die. What I find interesting is that you touting UK healthcare system do not trust it yourself (so did LMTU). Well, I trust "the worst" American system. I am trying to say very simple things: Americans on medicare do not need second international insurance. It is much cheaper to keep an emergency fund in local currency. This, Thaiworthy and others waist their money paying for the international insurance. By the way, diabetic medications are much cheaper in Thailand than in US. I would not fly to US just to get free diabetic medications through medicare.