Why Health Insurance in Thailand Can Be Difficult for Expats

Just to give you a little bit of background, I was in the UK. I’m moving out here. I’m basically here full time. I’m going back in a week or so to finalize my house, but I’m basically here. I’ve got an apartment, long term visa, and a Thai driving licence. I am, for all purposes, a resident here rather than in the UK.

This started about a year ago. I started thinking about health insurance in Thailand. I started looking at various companies, and the one company I’m going to talk about is the company I’ve spent a lot of time researching through online meetings, phone calls, and emails. I really dug deep into this company.

What impressed me about them was that they do have Western people here. They’re not a broker; they are an actual insurance company. I’m not really keen on going with a broker. They are an insurance company, as I say, and they have Western speaking staff, so they were able to talk to me. I understood them fully.

When I was in the UK, I wrote them a few emails, and some of the things they didn’t understand, so I gave them my WhatsApp number. Surprisingly, they did call me, and I had conversations with one of these guys for up to an hour sometimes, a couple of times in a week. I really dug deep and asked questions.

He said to me, “Well, we’ve never had questions like this.”

The Smoker Question

I’ll give you an example of one question I asked. I used to be a heavy smoker from the age of 15 right up until about 10 years ago. I did a bit of vaping and then knocked that on the head because of the laws in Thailand, where you can go to prison.

One of the questions I asked them was, “Look, I don’t want to lie on your form.” One question was, “Are you a smoker?” And I said, “No, I’m not a smoker.” But my question to him was this: if I get throat cancer and I go into hospital, because the application is basically a yes or no answer, and I put no, saying I’m not a smoker, then I go into hospital with throat cancer, God forbid, in a few years’ time, and they discover that I was a smoker, am I covered?

The answer to that was yes, but there might be a waiting period for the insurance to kick in, maybe a year or something like that.

So those were the sort of questions I was asking. I didn’t take a cavalier attitude. I took it very, very seriously. I had a couple of online meetings with them. I must have had 20 to 30 emails back and forth, answering all my questions. I was very, very happy with them.

Meeting an Insurance Representative at Terminal 21

I had a meeting with the representative I’d been dealing with in Terminal 21. I met him in the basement there. We had a coffee, sat for about an hour, and finalized everything.

He went through the packages, and I picked a mid package, not the cheapest one and not their most expensive one, but it would have come to about nearly 40,000 baht a year, which is about £1,000 or $1,200 US dollars.

I managed to get that down a little bit by having no outpatients and also agreeing to pay the first 40,000 baht of any serious injury. That brought it down quite a bit. I think I got it down to about 33,000 baht, but the original policy was 40,000 baht. So I was always happy with it.

Advice to Be Totally Honest

One thing the representative told me, and I agree with this, was, “Whatever you do, whatever medicine you’re on, whatever treatment you’ve had, put it on the form.”

I said to him, “Insurance companies have got quite a bad reputation as far as turning people down for claims who have been paying for years and years and years. There’s actually movies been made about it.” I wanted to make sure that I did the right thing. I wanted to be Mr. Good Guy. I wasn’t going to pull any wool over anybody’s eyes or anything like that.

So I went through it step by step, ABCs and 1 2 3s, right from the very beginning. He said to me, “Look, just make sure you put everything down on our questionnaire. It doesn’t matter if you’re on aspirins or whatever it is, you put it.”

So I did. I got the application form through.

The Hospital Check Up That Hurt Me

When I was in Pattaya a couple of months ago, Bangkok Hospital in Pattaya was doing a promotion for 5,500 baht where you could go in and get your heart, kidneys, and lungs tested. There was nothing wrong with me; I did it for peace of mind. They did a stress test on your heart.

Everything was normal. The only thing was that I had something slightly high in my blood. I think they call it triglycerol, which isn’t really serious, but it was slightly high. There were one or two other bits as well.

But the cover letter to this report, which was voluntary on my part because I wasn’t sent for it by the insurance company, said something like: “Healthy heart no sign of heart disease found. Heart is normal size. Rhythm is normal. BP is normal.” So basically, I’m normal.

Within my blood, they found a few minor things that could potentially be problems later. To be fair, I think it’s down to drinking a bit too much. I’ve been going through a lot of stress with my marriage over the last year, although I’m finally getting over that now. I’ve been drinking a bit too much, and I have put some weight on because food when you’re stressed out is a bit of a comfort thing, isn’t it?

I’m going to do something about it. I’m going to get the weight off, and I’m going to stop drinking for a few months. So that’s where we are at the moment.

The Application Process Being Transparent

I’ve had the meetings. I’ve been honest with them. I’ve told them everything I know. I’ve told them what medicines I’m on. He’s checked it all out. He’s gone to the underwriters. It all seems good to go. I’ve got the price of the package now. It’s going to be under 40,000 baht, about £1,000 a year.

I arranged to pay it in quarterly payments. I think it worked out to about 8,500 baht a quarter, which is about £200, maybe $240 US dollars. Not bad; that’s every quarter, not every month. So I was happy with that. I thought, “I’ll be well covered. It’s not a bad price. It was worth all the research and everything.”

The form came from them. It was quite a long form, but to be fair to them, it was quite a simple form. The problem is that it’s all boxes. They ask you a question, yes or no, and that’s it. You can, on some of the questions, add notes. But I found it impossible to be honest and answer the form.

I’ll tell you what I actually did. I’ve got some paperwork. It’s just my experience with them. I went over the form, and I’ve got all the history with the insurance company and everything. So in my eyes, I’m good to go. Everything’s good.

When I got the form, I checked it over. It’s not bad; it’s quite long, but it’s not complicated. They’re yes or no answers. They’re boxes. You can add notes to some of the questions. But to be honest with you, when I read it I thought, “Well, I can’t answer this honestly” because it’s so tempting to just put “no, no, no” and send it in. But of course, they’re going to find out, aren’t they? And then they’re going to reject your claim.

I could have been paying close to 33,000 baht a year for five years, and then they’d turn me down because of some wrong answer. I’ll give you an example of somebody who got turned down. I asked him what sort of things they turn down. There was a couple who went to Cambodia. They caught COVID and had all the treatment over there. But when they got back to Thailand, they had one more visit to a clinic. The insurance company found out they had COVID in Cambodia because they had one more treatment check here in Thailand, in the north of Thailand. They rejected the claim for both people. Now, I didn’t want that happening to me.

The Impossible Health History Question

As I was going through this form, I thought, “I can’t answer these. These are really difficult answers.” So I thought, “What’s the best way to handle this to show the insurance company that I am being totally, totally honest?” As far as my health goes, I’ll tell you what treatments I take and what I wrote on the form.

I have a scalp condition. Every few months I get a very itchy head, and I have to use this lotion, which is a hormone, and then I don’t get it again for another three months. I take a reflux acid reflux tablet because I get acid coming up from my stomach. I’ve been taking it for 25 years, and it’s not got any worse since the first day I had it. I also take a statin before I sleep every night because my cholesterol, when I first went back to the UK from Thailand 20 years ago, was something like 7.5%, which is dangerous. The doctor put me on statins. It came down to about 4.5 or 4.6, and it’s been below 5 ever since. I’m very happy with them.

So I told them about the head problem, the reflux, and the statins. Other than that, A1, no problems as far as I know. I also mentioned that I went to the Bangkok Hospital in Pattaya and explained everything to them. After I’d submitted the application, they came back and said, “Well, we want the report from the hospital, the full report.” No problem. I scanned it in and took pictures, probably about eight pages. I sent it off, waited about a week, and then they didn’t ask me anything about it.

In the meantime, I filled out the forms. When I looked at the form, I thought the easiest way to explain this to them was just to put it in my own words to show them I’m being honest. For diabetes, I had diabetes too because I was overweight, then I lost the weight and it went away. I probably got it back, I don’t know. Approximately six years ago I was diagnosed with type 2 diabetes. No medication was prescribed or taken because I had to lose weight, and that’s what I did. For gastro reflux disease, I explained what I’ve just explained to you. Gout is another one. I used to get gout. I haven’t had it for 10 years, but I thought I’d better mention it. I’ve got standby medicine, but I don’t get it anymore. For other skin disorders, I told them about my scalp lotion.

This was the one I found very difficult to answer. They said, bearing in mind I’m 63, have you ever been to a clinic or a hospital as either an inpatient or an outpatient at any time in your life? I’m 63; I’ve been around the world. If yes, name the dates, the hospitals, and what it was for. I mean, how can you answer that honestly? So this is what I wrote on the form: “This question is actually impossible to answer with exact dates, so I will try and explain as best as I can. I’ve only been in hospital once in my life, which was to remove my tonsils when I was seven years old in 1967 in the UK. I’ve never broken any bones in my body. I’m completely healthy. Therefore, I have never been admitted into a hospital for sickness or accident not even once, apart from 1967. Over the past 62 years of my life, I have visited hospitals and clinics all over the world as an outpatient, but for nothing serious. As said, I cannot remember how many times or for what against serious illness.”

The good news is they accepted that. They looked at that and thought, “Well, the guy’s been honest. He can’t remember all the dates.” Then they asked, “Have you ever been advised to have medical tests, health and physical checkups, or procedures to investigate other than as noted above including annual checkups?” So I put, being honest again: “I visited Pattaya in December 2022. Bangkok Hospital in Pattaya were doing a promotion for checking the heart and other organs with a stress test of the heart. The cost was 5,500 baht. I went and had the test just as a precautionary checkup. I did attend the hospital because I did not have any symptoms. This was purely to check for my own peace of mind. The results came back normal with no problems with anything apart from the slightly high bits and pieces I’ve told you about before.”

Then I ended it with a statement. I wanted them to look at this and think, “Well, this guy’s been honest.” I ended with: “I have completed the application form to the best of my ability and knowledge. I have been truthful and honest, and any relative relevant additional information is described above.” I’ve been totally transparent with them. I couldn’t put a yes or no answer. I’ve given them those notes, and they seemed to be happy with them. A week went by.

Acceptance with Crippling Exclusions

They’ve written back to me and said, “Dear Mr. Hopkins, with reference to your application, we would like to confirm our acceptance resulting from the completed application that you have submitted. The conditions being applied for as follows:”

Happy days! I’ve done it. A year of lots and lots of research. I’ve been honest with them. They see that I’ve been honest. They’re going to insure me. But there are some things they won’t insure. These are the exclusions, and some of the words I can’t even say, but I’ll have a go.

Investigation and treatment of gastro reflux disease (GERD) and their causes. So basically, because I take a reflux tablet, they’re saying anything related to that they don’t want to know. Okay, fine; I can live with that. The next one is investigation and treatment of something to do with my head, my scalp lotion. I can handle that.

Investigation and treatment of dermatitis and their complications. Okay, I can live with that. Fine. Investigation and treatment of diabetes and complications, including all kindling diseases, some other bits and pieces, and leg infections. Well, I’ve never had any problems with my legs, but I suppose it’s all linked in, isn’t it?

Then we’re coming to the nail in the coffin. Investigation and treatment of symptoms and disorders related to gout, gouty arthritis, and all infections to the leg. Here’s the goal scorer, where the nail in the coffin is the one that I told them about afterwards: investigation and treatment of heart disease and disorders and vascular diseases and disorders and their causes and complications.

What is the main reason why I wanted to take out insurance? Because of my age, there’s quite a high possibility that I could have a heart attack at some point, which is why I want the insurance. So I rang up the insurance agent and told him straight, “Look, I’m not angry with you because I know you’re just selling the insurance; it’s your underwriters. I said, but this is absolutely ridiculous if they think I’m going to pay close to 40,000 baht a year, approximately £1,000, for an insurance policy that doesn’t cover anything.”

I said to him, “What are they going to cover?” They’ve basically struck everything off. On top of that, they’re saying something to do with cancer that it wouldn’t kick in for two years, even though I’m paying for the insurance policy. Two years would go by before they’d actually pay for any treatment, because I suppose some people insure themselves and a month later they get cancer and they already knew about it. I said to him, “Look, would you buy a car without an engine?” And he said, “No, that’s going to be useless, wouldn’t it?” I said, “Do they honestly sit behind their tables in their office wherever they are and think I’m going to pay for this non insurance?” He understood what I meant. He said, “I’ll go back to the underwriters. I’ll have another chat with them and I’ll get back to you.” He came back to me and said, “Yeah, no, they’ve said that’s it.” They wanted to know what I said, and we were having another meeting tomorrow. He said he’d call me after that meeting. That was yesterday. I never heard from him. He didn’t even ring me back.

Why I Was Pissed Off and Disappointed

With all that in mind, I’ll be honest with you: I’m pretty well pissed off about it because I’ve wasted so much time. I tried to be a good guy. I tried to do the right thing. I did all that research. I had all the meetings and all the emails. It took a lot of time. I didn’t enjoy it, but I thought it had to be done.

At the end of the day, the people who just put “yes, no, yes, no” don’t even think about it. I thought I wasn’t going to be one of those irresponsible people. But you’ve seen the outcome now.

I thought to myself, “What should I do now? What are my options now? Should I go and look for another insurance company?” I thought it was pointless. It’s absolutely pointless because that test that I did in Pattaya has actually hurt me.

This company that I’m talking about, unless you’re over 65, will send you for a medical and pay for it, but you have to get accepted. With myself, I could have just gone along, and I said this to the guy. He said, “Well, the thing is, you did have the test, which is right.” So it’s actually hurt me. I went in there just to self-test, just to make sure that there was nothing wrong with me.

Because it’s on a computer system now, even if I lost the weight and in six months’ time went to another insurance company, or back to them, and said, “Look, I’m going to do another test. Everything’s normal,” they can use the first test as an excuse not to pay up. This insurance company, as I said at the beginning, if you’re perfectly healthy, is still quite a good insurance company. They’re just not the insurance company for me.

Choosing Self Insurance

So what are my other options? I’m going to self insure. I’m going to take 300,000 baht. It’s not for everybody because it’s quite a lot of money to tie up. I’m going to take 300,000 baht, which is about £7,500, close to $8,000 US dollars, or $15,000 Australian dollars.

What I’m going to do is stick that in a bank account. I’m going to ask my friend Simon, whom I trust and who trusts me, that if anything ever happens to me, I want to be able to give his number to the hospital. He’ll call them up: “Here’s my debit card, credit card, whatever.” He’ll cover everything, and I’ll immediately transfer the money back to him.

We’ve known each other for 30 years. He knows I wouldn’t stiff him, and I know he’ll cover me if anything happens.

The Bad Points of Self Insurance

There’s a couple of good points and a couple of bad points about doing that.

The bad point is that I have to make sure that I’m not rich; I’m not even nearly wealthy. I’m okay, but I haven’t got shedloads of money, as it were. So that money’s got to be tied up permanently, basically about 300,000 baht. I can’t touch it because if I have a heart attack and they rush me into the hospital, that’ll hopefully cover most of it. If there’s a little bit more, I’m sure I can find it, but I won’t need to find a big pot, as it were.

So that’s the only bad point as I see it: I have to tie up the money.

The Good Points of Self Insurance

Let’s talk about the good points. Because thinking about it overnight, when I turned them down, actually when I said, “No, get stuffed,” I was thinking about it. The first thing that hit me was, “I’m going to have to tie up all this money. I don’t like it, but what else can I do?” I tried to put a lot of different solutions through my mind, but nothing worked.

Then I was making dinner. I was feeling a bit gloomy with myself, a bit depressed, and I was thinking about it. I thought, “Hey, you know what? There’s some really good things to come out of this.”

Firstly, if you’re with an insurance company, there’s no guarantee that they’re going to pay out. I’m not here to put down all insurance companies and slate all insurance companies and say all insurance companies are bad. I’m not saying that. But there are many documented cases of people who’ve been paying health insurance for years, who get sick, go into hospital, and, for whatever reason, the insurance company doesn’t pay out and they’re left in a lot of trouble.

One of the good points about self insurance is that if the money’s there, I know whatever happens to me, it’s not a gamble whether it’s going to get paid out. That money is mine, and I’ll pay it to make myself healthy again. That’s the first thing.

The second thing is the premium. Think about it: if I’m paying 33,000 baht a year in premiums, after three years that’s already 100,000 of that money in the bank, isn’t it? So it’s going to take me nine years, which is a long time, to cover what’s in the bank. But let’s just say I get to 75, no issues. I’m getting really old now, but I’m still okay. That money’s sitting in a bank, so I’m still insured.

I don’t have to worry about “Oh, we don’t insure you after 65, you have to go for a medical exam.” “Oh, that wasn’t covered in the insurance because you didn’t tell us about it.” “Or we don’t cover that one.” “Or there’s a history of that one.” There’s none of that. It’s my money, sitting in the bank. After nine years, that 300,000 will have gone on premiums, but it’s still sitting in my bank account. Eventually I will pop my clogs. I will visit that big man in the sky, or the other one. What will happen? That 300,000 will go to a beneficiary of mine, whether it’s my daughters or whoever. Somebody will benefit from that money.