Farang insurance dilemmas building up

[Gaybutton]

Farang insurance dilemmas building up

July 20, 2017

The news that all foreign tourists to Thailand will soon need to obtain travel insurance to enter the country is causing the usual confusion from leaked sources.

Thai public sector hospitals have complained for many years that they are having to fund the medical costs of foreigners who need treatment and can produce neither the cash nor a valid insurance letter. Estimates of the true costs vary but the total is probably in the region of three billion baht annually.

It seems that, from an unknown starting date, all tourists (likely defined as those able to stay between 15 days and three months before being required to leave) will need to show on arrival a valid travel insurance document which has either been bought in advance or obtained at the airport or border post from a dispensing machine. Travel insurance is not the same as full medical insurance and normally covers only matters such as delayed travel, loss of luggage and emergency treatment for accidents. It does not cover pre-existing medical conditions.

Critics of the move point to a number of potential problems. Does the new rule apply to every tourist including infants under one year and the elderly in their 80s and 90s as travel insurance often contains a cut-off age date? Will the responsibility to enforce the regulation lie with the airline which will need to check the documentation? Will there be long queues at immigration or custom counters as officers struggle to examine travel insurance papers which may not be written in Thai? Will the proposals actually work in practice as many medical emergencies are not caused by accidents? What about use of credit cards which often include the benefit of limited travel insurance as a perk for purchasing the air ticket on-line?

Travel sources say that the imponderables mean that any compulsory policy, if endorsed by the Thai Cabinet, will likely be delayed until next year. Government officials will be concerned lest a hasty start produces a deluge of bad publicity which will handicap the government’s stated aim of receiving 40 million foreign tourists annually in the next decade. Several years ago, the Shinawatra government introduced an optional, private-sector insurance scheme for tourists which had only limited success, partly because of poor marketing and weak support by hospitals.

Expats and holders of multiple non-immigrant visas are not covered by the recent announcement because travel insurance in this context obviously means visitors to Thailand and not those residing here as a base for long periods. Holders of one year extensions – retirees and those married to Thais in particular – are concerned that they may be required to hold full medical insurance at application or renewal time. Last year, the government announced the possibility of introducing such a regulation – requiring an insurance claim payment of at least US20,000 – for in-patient care. However, that prediction was linked to the possibility of a 10-year retirement visa which might (or might not) replace the current one year extension of stay. Nothing further has yet been heard of these particular proposals.

One problem area in requiring retirees to produce full medical insurance is that older people find it very expensive to fund ongoing cover, or even impossible if they have serious health issues. Some expats prefer to keep a sum of money here specifically to cover hospitalization. In any case, private sector hospitals these days will not perform surgery without clear evidence of repayment by cash or by agreement of the insurer, if any. One solution to this dilemma might be to insist on a larger cash deposit or proof of income at the application or the renewal stage of a one year extension. It should also be noted that, in the past, existing retirees were not required to abide by new financial regulations. This discretion has been known as “grandfathering”.

The whole subject of visitors to Thailand and their insurance is now likely to loom large in immigration publicity for the foreseeable future. But it is important to stress that there have yet not been any formal government announcements of policy changes.

http://pattayaone.news/en/farang-insura ... -building/

[Dodger]

I can see it now...SAWATDEECARE.

I doubt they will institute a policy like this any time in the near future due to the huge investment Thailand is making in its EEC Project (Eastern Economic Corridor) which involves ten's of billions of baht and a lot of very high level reputations supporting EEC.

The EEC charter involves the expansion of Utapao Airport (which is already underway), new high speed rail system, and new highways to service the area. This huge investment is intended to boost tourism along Thailand's eastern seaboard from Na Jomtien to Rayong. I doubt that they would change any policies having a negative impact on tourism at this juncture. What I would expect to see is the tightening of private hospital policies where very limited services would be provided to uninsured farang unless they had the cash-in-hand.

[fountainhall]

When I have travelled I always purchased travel insurance with sufficient cover for almost all medical eventualities. I actually object to those who make the decision to travel to other countries, who could easily take out a similar insurance policy but elect to save money by not doing so. As an expat living in Thailand, I pay for my own insurance. On the few occasions I have to visit a hospital in Bangkok, I notice that prices increase virtually every year. Some of that will be due to the usual medical inflation being higher than normal inflation. But some may well be a small part of my costs having to subsidise someone who had failed to take out insurance.

It seems that, from an unknown starting date, all tourists (likely defined as those able to stay between 15 days and three months before being required to leave) will need to show on arrival a valid travel insurance document which has either been bought in advance or obtained at the airport or border post from a dispensing machine. Travel insurance is not the same as full medical insurance and normally covers only matters such as delayed travel, loss of luggage and emergency treatment for accidents. It does not cover pre-existing medical conditions.

Are there not two types of travel insurance? One is usually purchased at the departure airport and covers not much more that flight delays and personal accident. The other which is far more common and which I always purchased also covers medical and hospitalisation costs (other than pre-existing conditions) at quite a high level, and repatriation.

Will the responsibility to enforce the regulation lie with the airline which will need to check the documentation? Will there be long queues at immigration or custom counters as officers struggle to examine travel insurance papers which may not be written in Thai?

I foresee this as a very big problem. My annual travel policy is only in English and covers six pages of very small writing. The one-page policy document that goes with it has nothing about the amount covered. Imagine Immigration officers having to go through a series of such documents, all different, and many in a variety of languages. It is frankly unworkable.

Making an airline responsible is hardly the answer. What if I fly into Thailand on Aeroflot from Moscow or China Eastern from Chengdu? Expecting the check-in clerks to take responsibility is cloud cuckoo land!

One problem area in requiring retirees to produce full medical insurance is that older people find it very expensive to fund ongoing cover, or even impossible if they have serious health issues

This could well be a problem for those already living here. But those in the process of considering a move can surely obtain a basic policy - even if it has various exclusions. I frankly find it extraordinary that anyone would consider retiring anywhere without sufficient medical and accident insurance. It is such a risk.

[Gaybutton]

I frankly find it extraordinary that anyone would consider retiring anywhere without sufficient medical and accident insurance. It is such a risk.

And yet many people do. For Americans, in a way that is the fault of the US embassy or maybe it's standard State Department policy, that Americans are not required to substantiate, with even one iota of evidence, that they're being truthful about their monthly income when obtaining their proof-of-income statement in order to get the retirement visa.

As a result there are many Americans living in Thailand who easily can get the proof-of-income statement, but the reality is they don't even come close to Thailand's minimum monthly income requirement.

These people cannot possibly pay for an insurance policy when they barely have enough money to even exist. What happens if they need to be hospitalized? Who pays? To the best of my knowledge, even for people who have no money at all, hospitals are required to at least try to stabilize an emergency patient, but are not required to do anything else. If they are able to stabilize such patients, if they have no money then that's it. The hospital will discharge the patient, but at least tell them goodbye and good luck.

If a virtually indigent farang living in Thailand on a falsely obtained retirement visa suffers a debilitating stroke, but the hospital is able to stabilize him, I have no idea what becomes of him next. I, for sure, wouldn't want to be a person who has to find out the hard way.

Meanwhile the hospital is stuck with the cost of treating foreign patients who have no insurance, cannot pay, and are living in Thailand under false pretenses if they lied or fabricated evidence to get the retirement visa.

It's not just travelers causing these problems.

[Daniel]

I know of many tourists and expats who have no insurance cover. Some can’t afford it and others take the gamble that they won’t need it. In the UK, there are no qualifications to access accident and emergency services, or treatment for most infectious diseases, including STIs; the UK taxpayer picks up the bill. Thailand could do the same; it makes enough money out of tourism. If other treatment is required and the foreigner doesn’t have the means to pay for it, then don’t treat them. I don’t see the need for insurance legislation for tourists or expats. I make no judgement about those who have no insurance.

[Jun]

What cover for Thai people without medical insurance get ? I thought it was naff all. In which case, why do they worry about tourists ? No insurance or no means to pay should just mean adios.

[Gaybutton]

What cover for Thai people without medical insurance get ?

They are sent to public hospitals, such as Pattaya's Banglamung Hospital, and placed in wards. They do get medical care, but it is not the quality of care most readers of this board would probably want.

[fountainhall]

What cover for Thai people without medical insurance get ? I thought it was naff all. In which case, why do they worry about tourists ? No insurance or no means to pay should just mean adios.

I'm not sure if you mean Thais in Thailand or Thais as tourists. If the former, about 50 million Thais are covered under Thaksin's Universal Healthcare scheme. I'm not sure if the Bt. 30 cost for a doctor's visit or a hospital procedure has gone up since its introduction, but it's budget has mushroomed from Bt. 55 billion to Bt. 165 billion – and this only covers the government's subsidies. This has already resulted in many hospitals facing liquidity crises. Perhaps another reason for ensuring foreign visitors are not a further drain on the system.

If you mean Thais going overseas, if they go abroad on tour groups I expect the tour company has to have some form of master cover since it would be the responsible party in the country/countries visited. Wealthier Thais will be savvy enough to realise the need for insurance. But there are solo Thai tourists who never dream of taking out travel cover. I have one Thai friend I have known for 21 years. He travels extensively, a lot for his tiny business and a lot for sightseeing. He has never bothered with insurance. When I tackle him about it, he just says "I'Il be OK!"

[Joachim]

The article mentions the cost of treatment of foreign tourists in about 3 billion baht. This is 100 million USD. Taking 30 million visitors to Thailand every year, one can simply add 3 dollars to airport (or other entry) tax. Some may recall airport departure tax 500 baht which is now included in the price of tickets. That would resolve the problem. I see much bigger danger for the expats in Thailand. I would not be surprised at all (taking into account how migrant workers were treated recently), if annual extensions will be SUBSTITUTED by 10 year retirement visa. That will spell a lot of trouble for expats in Thailand taking into account known conditions for obtaining such a visa.

[fountainhall]

Taking 30 million visitors to Thailand every year, one can simply add 3 dollars to airport (or other entry) tax. Some may recall airport departure tax 500 baht which is now included in the price of tickets. That would resolve the problem.

In principle I agree (although the tax is now Bt. 700 and the AOT is seeking an increase to Bt. 800). An extra few dollars on a ticket will not mean much to premium passengers and those departing on long haul flights. But I have no doubt it will have the low cost carriers using BKK screaming. In itself, that's somewhat ironic as it may well be that a good percentage of their passengers may not have insurance! Worse for them, the DMK tax was doubled from Bt. 50 to 100 and the AOT is requesting a 15% increase in DMK landing fee charges.

I see much bigger danger for the expats in Thailand. I would not be surprised at all (taking into account how migrant workers were treated recently), if annual extensions will be SUBSTITUTED by 10 year retirement visa. That will spell a lot of trouble for expats in Thailand taking into account known conditions for obtaining such a visa.

I cannot see the present one-year retirement visa being changed retroactively - at least for those who are already here. That would provoke a firestorm of international criticism. What the government might do, though, is add a requirement for a medical insurance policy amongst the documents that have to be submitted each year - just as they added the requirement for confirmation of apartment ownership last year.