tonyd

I have done extensive research on this problem, Phil, and have tried to touch all bases by coming up with four of the lowest cost options available, depending on a person’s age and situation.

1. In the case of the teacher who was dropped from the group plan for being too old, I would recommend that she have her employer contact E-InsureThailand to bid on replacing the present group insurer.

THI, for example, provides very good group insurance coverage for a reasonably low price. Employees can continue to be insured up to age 70. The cost per insured is determined by the number of people in the group. The age of those covered in the group, as a rule, has no effect on the cost of the group coverage.

2. If #1 is not an option, and the person is under age 65, the best choice would be to purchase a personal health insurance policy through THI. Their coverage is good, their prices are reasonably low and they provide coverage up to age 70.

3. If the person is still teaching, and #2 is not an option because that person is over age 65, I would recommend contacting E-InsureThailand and asking them about their low cost international health insurance coverage for teachers. This plan provides coverage up to age 74.

4. If the person is over age 65, and not a teacher, I would recommend that the person purchase an international health insurance plan called “Senior Health Insurance Plan for over age 60” available through, coincidentally, E-InsureThailand. With this plan the insurance company guarantees to continue the coverage for as long as the premiums are paid. But, they require the applicant to take an insurance physical at his or her own expense, first.

There are many other outstanding international health insurance plans available to people over 65, but they are more costly. The two recommended above are the cheapest I’ve found and they provide more than adequate coverage for Thailand.

UPDATE: Starting in July, E-InsureThailand be offering a Thai-based health insurance plan that provides coverage up to age 75.

Bangkok Phil

Tony, I have some questions about group insurance coverage for teachers. I'm sure you are aware that I'm covered by THI group insurance. I have found that the coverage is quite good and the premiums are reasonably low when compared to similar type coverage offered by other insurance companies. Many teachers haven't been so fortunate, though. Some teachers complain that their employer provided group coverage is quite small and inadequate. Others complain that their employer refuses to provide them with any medical coverage whatsoever. What options do these teachers have, other than going out and purchasing their own personal medical coverage? Is there any way that E-InsureThailand can help them get good group insurance coverage?

__________________
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mrsquirrel

Tony

Thanks for the advice on the missus I am not sure what her plans are yet. She has only been paying into her AIA for five years so it's only about 150k that she has paid in so far.

For me though my BUPA runs out in July and I need to start thinking now about what I am need.

I have to pay for Thai social insurance every month as I have said before. I also have the second best BUPA package which I have never had toi use (fortunately)

What is the best option for covering me bearing in mind that I have this social insurance covering me at my local private hospital (not the best but better than the public one down the street).

What sort of cover do I need?

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tonyd

Basically, your wife has 4 options with her policy. 1) She can keep paying and continue to build up cash in her policy until it matures and pays her the cash build up. 2) She can cancel the policy and request AIA to give her the cash build up that she has already accumulated in the policy. 3) She can just stop paying and let the cash build up in the policy continue the death benefit as term insurance for a few years. 4) She can ask AIA to convert the policy to reduced paid up life insurance.

The result of choosing any of these options at anytime throughout the life of the policy should be included with her policy. She can look at that to help her make her decision. If she would like me to help her, she can fax or email me a copy of that schedule. I would be happy to assist her.

Posted after 3 hours 25 minutes 4 seconds:

Thank you your question, mrsquirrel. Your timing is perfect. I have known for quite sometime the kind of supplemental coverage I would like to be able to offer people covered under the Social Insurance scheme; but, unfortunately, it has only been available as an attachment to a life insurance policy. Now, a local stand-alone version has finally become available and is being offered through E-InsureThailand.

In terms of coverage, the most obvious weakness in your SI Inpatient coverage is the Daily Room and Board and (possibly) nursing care benefit. It also doesn't pay for medicine that needs to be imported from overseas. Using BUPA or Thai Health health insurance coverage to support these weaknesses, though, would be kind of overkill. As a rule, health insurance policies have built-in protection to prevent insureds from making a profit from being hospitalized. Therefore, the insurance companies will only pay for covered charges that your primary insurer (SI) doesn't pay for.

The best supplemental solution for you, and any one else covered under SI, is a plan that pays you a guaranteed fixed daily income for every day you are in the hospital, no matter what your hospital costs are or how much other hospital insurance you may have. Theoretically, this coverage would let you make a profit from being in the hospital. In reality, though, it would most likely help provide you with a financial override in dealing with any other weaknesses that show up in your SI coverage.

The plan available through E-InsureThailand offers 4 choices of Daily Hospital Income benefit, 500 baht, 1,000 baht, 2,000 baht and 3,000 baht. The plan doubles the income benefit if the insured is in ICU, hospitalized overseas or hospitalized for a critical illness. It also pays a lump sum benefit for accidental death or permanent disability. In addition, it even covers treatment for accidental injury to teeth.
--------------------------------------------- -------SALES PROMOTION!!---------------:chug:-------------------
The insurance company is offering a SPECIAL 20% DISCOUNT off the annual premium to anyone who purchases this plan before 30 June. :twogirls:

Mrsquirrel, please feel free to call or e-mail me if you have any more questions about this or your wife's insurance.

Posted after 5 hours 52 minutes 53 seconds:

Phil, E-InsureThailand currently represents 3 well respected local insurers who offer group medical insurance coverage. We also have a close working relationship with a large international insurance broker (intermediary) located in Hong Kong that gives us access to about 25 or more of the top international insurance companies who also offer group insurance. That fact, coupled with the fact that I really, really hate having to give an insurance buyer an excuse for turning to someone else for their insurance needs, means that in terms of price, product, flexibility and service, we should be able to compete quite well in satisfying the group insurance needs of any employer.

So what can employees do to get their employer to provide better group coverage?
1. They can ask their employer for permission to invite E-InsureThailand in to bid on the group insurance needs of the company or school. If the employer agrees to meet with me, the employee can then call or e-mail me and fill me in on anything I need to know before contacting the employer.
2. If the employees are not comfortable approaching the employer about group coverage, they can just contact me and give me all of the information I need to know to approach the employer.

If the employer is willing to listen, but unwilling to pay more to upgrade the coverage, which will most likely be the case, we will work out ways to improve the coverage without increasing the employer’s cost.

If the employer refuses to upgrade the group coverage, then employees can supplement that coverage with a low cost Major Medical policy available from E-InsureThailand. This coverage would take over when the basic benefits were used up and would pay 90% of the additional costs up to a maximum of 1,500,000 baht.

What can the employees do if the employer just absolutely refuses to provide any type of group medical insurance coverage? They can provide it themselves, and not get the employer involved. But, there must be at least 5 or more employees willing to participate. And, one of the group members must be willing to assume the role of “Administrator”, with assistance from E-InsureThailand. The only disadvantage to this is that they would have to pay for their coverage themselves, without employer assistance, and their premium would have to be paid annually.

The advantage would be that group coverage would still be cheaper than personal coverage. Since the premium is determined by group size, the bigger the group the lower the cost. Family members can be included in the group to increase the size and lower the cost per group member. And, since the group has no ties with any employer, group members can change jobs and still keep their coverage, as long they keep paying the annual premium.

We can also provide coverage like this for established clubs and associations. Information on this can be found on our website. www.e-insurethailand.com

mrsquirrel

Thanks again Tony I will be in touch

I understand that the BUPA coverage I have is overkill however I also know that it covers me out of my province where as the SI insurance is a bit more of a pest to use once away from my designated hospitals

Is there a good mix and match to offer me coverage when I am away on holiday around THailand?

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tonyd

Yes, SSI is a bit of a pest to use away from your designated hospital, but they will cover you.

That said, if you would prefer have a low cost private plan to cover you when are traveling around Thailand, here are couple of good options for you:

1) Purchase a low room benefit THI "Wealthy Healthy" plan (WH800). The benefits aren't great, but they should be adequate if you also have the AXA Daily Hospital Income plan I recommended earlier. The important thing, though, is that the WH800 plan will pay for sending you back home to your designated hospital, if needed.

2) Purchase a low cost AXA Personal Accident plan. It will not cover you for illness, but the premiums are very cheap and the accident coverage is good. Traveling roads frequented by 10 wheeled vehicles with fast running-away drivers makes this coverage worth considering.

Both plans issue you a card that allows you to be admitted and receive covered treatment at a member hospital for free. These plans, of course, are available through E-InsureThailand.

what the hell

Hi Tony

I've got Thai Health Insurance with dental. It's only 3000 baht a year, but it's still covered.

tonyd

Thank you for pointing that out "what the hell". Now tell me that the coverage isn't group insurance and that you don't work for a company with more than 50 employees. If you work for a company that has more than 50 employees insured with Thai Health group insurance, THI will allow the employer to include special benefits not normally available in personal coverage or smaller group coverage. Dental and maternity care are among the more traditional benefits that can be included. In fact, the material I send out to employers interested in THI group insurance mentions that dental can be added. In my answer above I was talking about personal insurance. I guess that I should have clarified that.

what the hell

Yes, I do work for a company with more than 50 employees.

Bangkok Phil

Tony, will insurance companies cover treatment for existing medical problems? Are there any common health problems that could cause someone to be rejected completely for medical insurance?

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tonyd

Thanks, "what the hell".

Posted after 1 hour 42 minutes 44 seconds:

No, Phil. Private insurance companies are in business to provide a necessary service, but, they are also in business to make a profit. Medical claims eat profits, so obviously they want to keep medical claims down.

They normally have three opportunities to do that: 1) when they create an insurance plan, determine what it will and won’t cover and figure out what the potential claims risk (premium) should be for each age group; 2) when they screen applicants during the application approval process; and, 3) within the first one or two years (depending on the contract) that the policy is in force. (If you seek treatment during that time for a condition that the doctors determine you had before you applied for the policy, the insurance company can refuse to pay for that treatment, and may even cancel the coverage if they have reason to believe that you lied on your application).

In most cases, the insurance company will insure someone who is receiving treatment for a pre-existing condition, but they will exclude treatment for that condition and will, also, often exclude conditions that are related to that pre-existing condition. But, unfortunately, little, if any, clarification is provided as to what "related" conditions might be excluded.

E-InsureThailand is currently gathering information to deal with that problem. We can provide it now for "diabetes and related complications".

Some insurance companies now refuse to issue insurance policies to applicants with Diabetes. I have “inherited” type-2 diabetes, myself, and have coverage through one of the companies that now refuses to issue a policy to diabetics. They explained that this change in policy came about because of too many problems with diabetics who didn't understand what the the diabetes exclusion entailed when they went into the hospital for treatment. I checked with another health insurer and they told me that they had had the same problem also. Frankly, I didn't understand how broad the exclusion was either. I thought that I was covered for strokes and heart disease, at least.

After researching the matter, I now understand why insurance companies are having this problem. Diabetes is a disease of the blood. Everywhere the blood flows is a candidate for exclusion from coverage for treatment.

People with diabetes are at greater risk for problems that involve damage to small blood vessels and nerves due to high levels of glucose in the blood. They are also at a greater risk of developing hardening of large arteries (atherosclerosis) that can result in a heart attack, stroke, and poor blood flow to the legs. Damage to small blood vessels can affect the eyes, kidneys, and nerves. Damage to eyes, specifically the retina, is called diabetic retinopathy and is the leading cause of blindness. Damage to the kidneys can lead to kidney failure and the need for dialysis and is called diabetic nephropathy. Damage to the nerves that supply the legs and arms and gastrointestinal tract is called neuropathy. Some people with diabetes that develop peripheral neuropathy (damage to the nerves in the legs) and have poor blood flow to the legs will eventually need an amputation. Impotence and depression can also result from diabetes. (Now, I am depressed).

The good news for type 2 diabetics is that these problems can be avoided by proper diet and exercise. But, many sufferers lack the proper determination and commitment to do that. And there is no way for insurance companies to know which of us have it and which of us don’t, without regular testing and follow up. To try to distinguish on a regular basis between those that do and those that don’t would require constant monitoring by the insurance company. Which would cost them money for use of time and resources. That cost would then be passed to policy holders in terms of higher premiums.

Instead, insurance companies opt for the easy way out either by accepting the applicant's money and excluding the condition, or, by rejecting the applicant altogether and thus avoiding conflict in the future.

Bangkok Phil

Tony, what can expats living in neighboring countries, such as Lao or Cambodia, do about health insurance? Is international health or travel insurance the only option for them?

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tonyd

That is a problem that we have been trying hard to find a solution for. As a rule, Phil, local health insurance companies can't sell health insurance outside the boarders of Thailand. So they can't sell health insurance to expats in the neighboring countries, in spite of the fact that these expats would be receiving their medical treatment in Thailand. Our first thought was to just have them find an address in Thailand to claim as their residence. They would probably get away with that. But, if caught, it could put their coverage in jeopardy and the insurance company would most likely refuse to pay any medical claims.

BUPA and THI both said no, they couldn't cross borders to sell health insurance. But, to our surprise, AXA said yes. But, they couldn't cover medical evacuation. Being covered for medical evacuation is a very important requirement for people living in these areas. So we gave up on local insurance and went looking for the best deals we could find in international insurance. The lowest rates we could find, though, were still quite high.

No, it isn't. We contacted SOS International and are now able to offer individual medical evacuation and 24-hour medical hotline assistance coverage to our clients. We bundle the SOS International coverage with local AXA coverage so expats living in remote areas of Thailand's neighboring countries can have coverage somewhat similar to that packaged by Thai Health. Unfortunately, though, it costs considerably more (I never realized before what a good deal Thai Health bundled with SOS Inter. really is). That said, our local bundle is still much cheaper than the cheapest international coverage we found.

pauleddy

I recently took out a THI Insurance through Tony Dabbs.

I have never met Tony, although I can recommend his service to anybody considering PHI. As an ex-Health Professional who was for many years involved in clinical and managerial areas, Tony answered my (many) questions patiently and clearly. I also gained the impression that he was 100% honest, and "on my side", rather than in the pay of any insurance company. He also answered my questions about podiatry, which is not included under the package, when I needed to locate a podiatrist.

I chose the 4000 package, which is not the top end one, although it seems fine for my needs. It seems to offer a slightly enhanced range of benefits compared to the BUPA equivalent.

In fact, during the month that I have had the insurance, I have attended my local hospital with an ear infection, and also another minor complaint. I did not pay a penny, and everything was processed by the hospital cashier within five minutes. It is somewhat more expensive (although still good value) to include out-patient/non-emergency visits in the package, although I wanted the peace of mind that this entailed. Many people choose emergency cover only, which is fine, as a doctor visit here is not too expensive.

I have seen some very expensive packages advertised (200,000 baht a year, for example). The cover levels are extremely high. If you are very wealthy, by all means consider one, but you may not need that level of cover.

Thanks again, Tony, for your patience with a difficult customer!

:smile: