Expat Health Insurance Concerns

[Dodger]

For us expats only those with O-A Non-Immigrant visas are required to have health insurance. As a result, some of the retired expats have insurance - and some don't. Risky business, but that's none of my business.

I've known numerous farang over the years who have had life-threatening medical concerns who didn't have insurance or enough money to cover the hospital charges. Most died, either in their rooms or after having received minimal care in a government hospital, as the private hospitals won't provide services to a foreigner unless he's financially covered.

My old friend Monty fell in this category. If it wasn't for a very thoughtful and generous farang friend who helped with the finances he wouldn't have even received the care he did before his passing. That friend I refer to happens to be a member of this forum.

Here's another Brit who's facing the same problem:
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Latest unfortunate case of Brit unable to pay his medical bills

By Barry Kenyon

October 1, 2025

Alexander Parker, a 73-yearold Scot, lies immobile in a Thai provincial government hospital with suspected blood cancers or lymphoma. Neither he nor his UK-based family apparently have the funds for full-scale treatment and surgery in a top-notch Thai private hospital such as Bangkok Hospital Chanthaburi. Even the bills in the current government facility are mounting at around 21,000 baht or 500 pounds a day, with family members seemingly encouraged to learn about feeding tubes and changing dressings.

Mr Parker’s daughter Jayne Simpson said the only answer was to move father by air ambulance to a UK hospital with an anticipated cost of about 30,000 pounds. However, Sky Care International was quoted as estimating the typical cost would likely be at least 85,000 pounds for a full-scale medical evacuation. Mr Parker is too ill to take the far less expensive option of a scheduled flight with one or two medical personnel in attendance.

Like all distressed families, members have approached the British embassy in Bangkok for assistance. But the diplomatic post cannot pay medical bills and their contact with hospital authorities has not so far led to the patient being moved to a better public facility in the Chanthaburi region, a four hour drive from Bangkok. Thai hospitals are very reluctant to move patients to more expensive premises unless the extra cash is obviously available.

Mr Parker was medically uninsured. He is a former Royal Fleet Auxiliary serviceman with substantial experience in foreign fields, but the Royal British Legion has stated that they are unable to pay medical bills from their grants, but can assist with ancillary services and detailed advice. A GoFundMe appeal has been launched in the UK and has, so far, raised just over 8,000 pounds. This is a typical amount for hospitalized Brits.

Most foreigners in Thailand are not required to have medical insurance even for longstay permits such as the five year Destination Thailand Visa or the Privilege Card for 5-20 years, both of which do require a cash bond on application. In recent years, private hospitals have refused to treat foreign patients without insurance or sizeable cash funds, whilst the cheaper public hospitals are not always able to provide the same quality of care in serious cases.

So far in 2025, according to AI assisted research, 26 ill Brits have sought crowd funding to pay medical bills with average donations totalling under 10,000 pounds per case. Thai governments have resisted requiring medical insurance for all visitors unless neighbors competing for tourists – Cambodia, the Philippines and Vietnam – do the same. Meanwhile, foreigners feel relaxed about the statistics that fewer than one percent of travellers require inpatient treatment whilst in a foreign country. They are assuming that serious illness abroad affects only other people. Sadly, not always true.

https://www.pattayamail.com/latestnews/ ... lls-520901

[Gaybutton]

Thai governments have resisted requiring medical insurance for all visitors unless neighbors competing for tourists – Cambodia, the Philippines and Vietnam – do the same.

We have discussed this many times over the years. In my opinion anyone who travels to a foreign country, especially if planning to stay for an extended length of time, without adequate medical insurance whether such insurance is required or not, is my idea of a damned fool.

Hospitals, especially private hospitals, are not going to treat seriously ill patients for free. The Thai government is not going to cover the cost of medical treatment. The home government is not going to cover the foreign cost and is not going to cover the cost of repatriating the patient.

In short, if anyone who gambles with their health like this, but ends up unfortunate enough to become seriously ill in Thailand and cannot come up with the money to pay the bills - that person is doomed and is going to die. It's just as simple as that.

If you don't have adequate medical insurance that will cover you in Thailand, then I suggest you don't go to Thailand.

[Jun]

Alexander Parker, a 73-yearold Scot, lies immobile in a Thai provincial government hospital with suspected blood cancers or lymphoma. Neither he nor his UK-based family apparently have the funds for full-scale treatment and surgery in a top-notch Thai private hospital such as Bangkok Hospital Chanthaburi. Even the bills in the current government facility are mounting at around 21,000 baht or 500 pounds a day

I completely buy into the concept of medical insurance for travel and for full time expats.

However, how does medical insurance work for people who get some condition which may need expensive and prolonged treatment ?
In this case at about THB 7.5 million (£182,500) per year.
Potentially lasting for years.

Once the insurer finds you have this, what happens at policy renewal time ?
Can they refuse to reinsure, or increase the premium to THB 8 million per year ?

[Dodger]

......However, how does medical insurance work for people who get some condition which may need expensive and prolonged treatment ?
In this case at about THB 7.5 million (£182,500) per year.
Potentially lasting for years.

Once the insurer finds you have this, what happens at policy renewal time ?
Can they refuse to reinsure, or increase the premium to THB 8 million per year ?

All valid questions:

These were some of the main concerns I had when selecting an insurance provider and the type of policy I felt I needed.

I selected a provider with an excellent reputation, and one who also offered a guaranteed lifetime renewable policy. I then selected a policy which should cover anything from a sliver in my finger to open-heart surgery - with a policy limit that renews annually per medical incident including long-term care.

Regardless of how much the cost of my insurance increases as I age it's something that just has to be done. I would never put my daughter in a position like the unfortunate gentlemen in that article did.

[Jun]

I selected a provider with an excellent reputation, and one who also offered a guaranteed lifetime renewable policy. I then selected a policy which should cover anything from a sliver in my finger to open-heart surgery - with a policy limit that renews annually per medical incident including long-term care.

Thank you.

1 What does guaranteed lifetime renewable policy mean ? If you get something that requires over $200,000 per year of medical expenses (as in the opening post), possibly for several years, do they guarantee to renew the policy without adjusting the premium ?

2 What is the policy limit & policy limit per medical item ?

I'm asking, because if anyone gets this wrong, presumably they're going to be requiring a 1 hour appointment at the local crematorium when the money runs out.

I fully understand that the premium should go up with age (see link). I'm just concerned about what happens when your risk profile changes.
https://ukhsa.blog.gov.uk/wp-content/up ... 68x422.jpg

[Gaybutton]

1 What does guaranteed lifetime renewable policy mean ? If you get something that requires over $200,000 per year of medical expenses (as in the opening post), possibly for several years, do they guarantee to renew the policy without adjusting the premium ?

2 What is the policy limit & policy limit per medical item ?

My insurance policy renews annually for life as long as I pay the premiums. The annual premium cost does go up with age, but not an unaffordable amount. I am covered for US $ 1-million per year.

You can adjust the deductible if you need to, to reduce the cost of the premiums.

I doubt I can do any better than that.

[Dodger]

What does guaranteed lifetime renewable policy mean ? If you get something that requires over $200,000 per year of medical expenses (as in the opening post), possibly for several years, do they guarantee to renew the policy without adjusting the premium ?

That means the insurance company won't cancel your policy because of age, or medical claim history.

Most insurance companies, including mine, reserve the right to increase the cost of premiums based on the amount of medical expenses incurred during a given period if those claims exceed 80% of the premium coverage. It's also common to have the premium cost reduced again after a period of no claims. I receive an annual discount for having no claims.

Policy limit and limit per medical incident per year are one in the same.

Also, most major insurance company's servicing Thailand do not provide coverage in Thai State Hospitals, although these hospitals can provide a good option for foreigners who have minor, or non-life threatening medical concerns, where they can just pay out-of-pocket.

State Hospitals want cash up-front from foreigners (tourists and expats) - which is where the farang in the story linked to this post got into trouble. Having no insurance is bad enough, but not having money to cover your ass is even worse.