Health Insurance in Thailand: What You Need to Know as an Expat

A girl wearing an oxygen mask with the title: Health Insurance in Thailand: What You Need to Know as an Expat

When I wrote about my cost of living in Bangkok, a common question I got by email was:

“Hey Karsten, what health insurance are you using?”

If that’s all you want to know, that’s easy. I use ACS. If you’ve never heard of them, don’t worry, neither had I until three days before I took out insurance with them.

Before ACS, I had insurance through a French company that I won’t name. They were pretty awesome–until they weren’t.

Two weeks before my insurance expired they sent me a message saying they’d raised their premiums by 30%—effective immediately.

I was tempted to reply to them stating I no longer needed their coverage using colloquial terms for body parts.

Given that I’m obsessive compulsive about insurance coverage, the fact that I only spent three full days researching, analyzing, and comparing insurance plans is a feat.

Saving myself—and you—some time for the next time an insurance company pulls a stunt like this, I’ve typed up this guide on the crucial points of health insurance in Thailand.

I hope this article answers your questions. If it doesn’t, feel free to send me an email and I’ll do my best to help you out.

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Before You Come to Thailand

When I first came to Thailand, I had German travel insurance that covered everything under the tropical sun.

There were no upper limits and barely any exclusions or restrictions on pre-existing conditions.

The cost? I’m glad you asked. I paid 2,238.75 baht a month.

The reason I stopped using them? They would only cover me for the first three years I was abroad.

Germans aren’t the only ones who can take advantage of home-country health insurance.

A Swedish friend of mine got into a severe accident. His insurance chartered a Bangkok Airways plane to fly him from Koh Samui to a hospital in Bangkok that was capable of treating him.

But his insurance is only for Swedes.

So what do these two cases mean for you? If you could get health insurance from your home country before you move to Thailand then you’ll get the best deal, usually if you’re a younger expat.

But if you’ve already moved to Thailand, then you can’t get coverage like this. The kind of coverage I talked about in my case and my Swedish friend’s case above is only for people in certain countries.

If you’re German, I can suggest a travel insurance company that I’ve used before, plus others. But you’ll need to become a Patreon to get access to this info.

Now, on to everyone else.

Insurance Options

Your main reason for getting health insurance is that you want to safeguard yourself against costly medical care.

I know that’s why I have it.

Back in 2016 I had nose surgery at Bumrungrad Hospital for a breathing problem. The surgery costed me just under 300,000 baht. But my insurer paid for it.

Aside from worry-free surgeries, having insurance will also let you go to the hospital without a thought.

Since this article is about health insurance in Thailand, I cover the five common ways to get insured in Thailand:

  • offshore insurance
  • local insurance
  • travel insurance
  • Social Security
  • group insurance

Offshore Insurance

With offshore insurance, you get much higher coverage limits than local insurance. This means you can get healthcare at top-tier hospitals while staying under your limits.

Offshore insurance companies will also renew your insurance without age limits.

My own insurance, ACS, falls into this category.

Insurance brokers in Thailand do offer offshore insurance. But brokers who sell only local insurance complain that offshore insurance isn’t licensed in Thailand.

So offshore brokers offer services to expats and tend to keep a low profile. But I can put you in touch with them.

I’m no lawyer, but I assume if you have a dispute with an offshore insurance company, you might not be able to pursue your claim in Thailand.

And disputes overseas would be a lot harder. Offshore insurers know that few people will have the funds and the will to fight a legal case in a foreign country.

As far as I know, you can dispute claims with local insurance companies with the Office of Insurance Commission without involving a lawyer.

Local Insurance

Local insurance is a type of private insurance you’ll find in Thailand.

Agents and brokers offer local insurance and it’s what you’ll see advertised in local media.

Coverage can be limited in terms of:

  • the amount covered when compared with other countries
  • your age (meaning a few will kick you out when you’re seventy-five)
  • exclusions (don’t get into a motorcycle accident)

But if you get local insurance, you won’t have to worry about going over your coverage limits.

Costs at hospitals in Thailand are within the coverage limits of most insurance plans you’ll find in Thailand.

Another big upside to having local insurance is that hospitals regularly deal with local insurers. You show you card when you register, and the hospital and insurance company take care of the rest.

You also won’t have to fill out and send in so much paperwork with local health insurance.

You will need to go to a hospital in a local insurance company’s network. But if you go to a hospital or clinic outside of the insurance network, you can file a claim later and get reimbursed.

Your insurer updates the list of hospitals in their network every year. You can find it on your insurance brochure or policy.

One company I often suggest is Luma Health. They’ve partnered with many top-tier hospitals including:

  • Bumrungrad
  • Bangkok Hospital
  • Samitivej

With Luma insurance, you can show your insurance card and the hospital in their network will take care of payments and paperwork.

Their Asia Care Plus plan is one of the best value-for-money plans out there.

One of the most well-known insurance companies in the local market is Aetna, which used to be BUPA.

Aetna is widely-accepted and I use a basic group plan for my staff. They seem to be happy with the coverage they get through Aetna.

From what I gather, if you have Aetna you can pick which hospital you want to go to.

Other major players in the local insurance market include AXA, AIA, and LMG.

I also heard about a number of banks offering health insurance. But it’s more of an accident insurance or life insurance than a comprehensive package.

The easiest way to compare and buy local insurance is through Mister Prakan. You can compare Thailand health insurance plans side-by-side in English

Travel Insurance

As I said above, some insurance companies offer short-term coverage in the form of travel insurance.

Short-term coverage can range from a few weeks to a few years. You can get travel insurance if you apply from your home country, not while you’re in Thailand.

Their pricing is a lot more attractive than what you’d get for long-term coverage.

By taking out coverage under them, though, you’re facing two possible problems.

  1. Travel insurance companies don’t have to deal with expensive long-term care. If you need long-term care they could repatriate you and hand you off to the Social Security system in your home country.
  2. Travel insurance companies tend to offer emergency healthcare coverage. This means you’re covered for accidents or illnesses that need immediate care.

You should get travel insurance for short-term stays or vacations in Thailand.

Other than that, it makes sense to get long-term health insurance so you’re covered for severe medical problems.

Social Security

If you work legally in Thailand, you’ll have insurance through Social Security.

Your employer will deduct 5% of your gross salary, but no more than 750 baht, for Social Security every month.

With Social Security, you can get medical care and medicine for free.

Starting in 2018, you no longer need your Social Security card to see a doctor. Instead, you can tell hospital staff your Social Security card number and show them your passport.

In practice, Social Security means free treatment. But the costs come in the form of long lines, limited medication, and rushed doctor visits.

And you might not be able to get some patented, more recent, drugs with Social Security.

It’s common for doctors at Social Security hospitals to see between eighty and one hundred patients during an eight-hour shift. This means they have a few minutes to spare for you.

You can’t pick a hospital, but you can pick three that you’d prefer. You have forty-three hospitals to choose from in Bangkok.

You’re assigned to a hospital for a year, too. You’ll need to choose a new hospital at the beginning of every year.

Most of the time you’ll get the same hospital unless it stops taking part in the Social Security System.

The top government hospitals in Bangkok like Chulalongkorn and Siriraj offer great quality care. But due to their popularity you’re rarely able to pick them.

If you live in a small province, there might be only one hospital under Social Security.

Which hospital you get assigned to will affect the quality of care you’ll get. The difference between the hospitals can be significant.

You can get treatment at hospitals outside the one assigned to you but only in an emergency.

In this case, you’re covered for the first seventy-two hours of necessary care. But you’ll get coverage for lower than what basic local insurance covers.

And you’ll need to pay and get reimbursed later at the Social Security Office.

People tend to avoid some the smaller, for-profit clinics in Thailand. While they might be easy to get to or have shorter wait times, things might get hairy if you end up needing more costly healthcare.

This means you should pick a large hospital from the get go. If you pick a smaller hospital and your case is serious, a smaller hospital has to refer you to a larger hospital before you can get treated.

But referral processes can be awkward, making it much better to be with a large hospital like Lerdsin or General Police to begin with.

My Social Security hospital used to be Camillian Hospital in Thong Lor. It was one of the best Social Security hospitals for expats because of English-speaking doctors and the short waiting times.

But Camillian Hospital stopped taking part in the Social Security System. My insurer gave me a list of hospitals and I had to pick three.

One of them was the Police General Hospital on Rama 1, across from Central World. It was easy to reach.

My friend had surgery for a meniscus tear done there and it costed him 27,000 baht. He felt they handled the surgery well, but pointed out they didn’t speak a lot of English.

But at the time of writing this guide, every foreigner I know who moved to Bangkok got Kluaynamthai Hospital, no matter which hospital they picked when they signed up.

I’d link their website, but according to Google the site may have been hacked.

While I’ve never been there, their Google ratings will make you want to look for other health insurance choices if that’s your Social Security hospital.

I think in the future, foreigners will be able to register at other facilities for Social Security healthcare.

Because of this, I’ve put together a list of Bangkok hospitals that are available to Thais and recommended for their quality of care to me by friends in the medical field:

HospitalLocationComment
LerdsinSilomcrowded, good for orthopedics (sports injuries)
General PoliceRama 1one of the largest, lots of specialists on staff
YanheeCharan Sanitwongsocial security allows you to use all their branches

Please note that I’m not a medical specialist and can’t vouch for these hospitals.

Group Insurance

You can get a discount on group insurance if you have a family of three or more people or run a company in Thailand.

For more info, read our group health insurance guide.

Retirement Visa

As of 2019, you officially need to have health insurance if you want to retire in Thailand with a retirement visa though reports of when this rule will actually be fully enforced seem to vary. This said, you’ll probably find that getting your health insurance in place before you actually need it may be a good investment (especially since serious issues may not only crop up without prior warning but also then prevent you from being able to obtain coverage in the future due to a pre-existing condition or the high likelihood of this reoccurring).

If you get insurance for the purpose of a retirement visa, it can be either offshore insurance or local insurance as long as it has at least 400,000 baht IPD and 40,000 baht OPD coverage.

MisterPrakan is a good way to find local insurance. You can find and compare all local insurance plans from their website at once. 

You can also fill out this form if you just want to find health insurance to pass this new requirement.

It’s cheaper than many insurance plans and has the exact 400,000 baht IPD coverage and 40,000 baht OPD coverage.  

However, note that most plans still only accept those who are younger than 75 years old.

Insurance Plans Explained

You’ll find the price of health insurance and the rough description of what’s included are just the tip of the iceberg.

You’ll have to read the fine print to find out about:

  • exclusions
  • pre-existing conditions
  • cancellations or non-extensions
  • areas of coverage
  • coverage limits
  • age restrictions
  • premiums
  • optional coverage choices

Let’s take a closer look at what’s excluded.

Exclusions

Here are some exclusions you’ll find in every insurance plan:

  • alcoholism
  • disasters and terrorism
  • motorcycle accidents
  • sexually transmitted diseases
  • sports

But one important exclusion varies from insurer to insurer:

  • chronic diseases

You should take a good look at the fine print. Here’s what to watch out for:

Alcoholism

Insurers exclude alcoholism under all plans. There are also selective exclusions if you get hurt under the influence of alcohol.

You’ll have to read the fine print to find out if this means no coverage for “drunken bar fights” or “for anything as long as a traceable amount of alcohol is in your blood.

I’ve heard of one insurance company who hired a private investigator to check if a patient who filed a big insurance claim was under the influence during the accident in question.

It turned out that he was. The insurance company refused to pay for medical care and the hospital kicked the patient out of the hospital.

Chronic Diseases

You won’t see this limit often. Most of the time, insurance companies exclude pre-existing conditions. But they cover any new conditions in full.

Some insurance companies might limit your coverage of chronic diseases. You should worry about this.

With outpatient department coverage, or OPD, chronic diseases cause some of the most costly claims.

Disasters and Terrorism

Every insurance company excludes you from coverage if you take part in war or crime.

Some insurance companies might not offer coverage if you were a victim of a natural or man-made disaster.

Given the political protests and bombings that happen in Thailand every few years, make sure this isn’t the case with your plan.

Motorcycle Accidents

Some plans don’t cover anything motorcycle-related. Not good.

Buying health insurance in Vietnam is similar to Thailand in this regard. You’re likely to be on a motorcycle at some point.

Other plans are more lenient and won’t cover you only if you were driving without a license.

Then there are the tricky plans that exclude accidents involving both jaw bones, regardless if you wore a helmet or not.

You should read the fine print of this exclusion on insurance plans.

Sexually Transmitted Diseases

Some insurers exclude coverage of sexually transmitted diseases, or STDs.

Others exclude it, unless you weren’t at fault. But the burden of proof may be on you.

Some insurance companies limit coverage costs for HIV treatment.

In any case, keep in mind that the majority of costs for the treatment of STDs are OPD. Unless you opt for OPD coverage, insurers won’t cover you for STDs.

Sports

You won’t find much coverage for taking part in professional sports, combat sports, and other high-risk activities such as paragliding.

If you compete or take part in a dangerous sport, check the exclusions for sports activities.

Some insurance companies exclude specific sports. Others describe the sports they exclude less clearly.

If you’re at risk for sports injuries, you’ll want your potential insurers to put into writing whether or not they’ll cover you.

Pre-existing Conditions

Pre-existing conditions are the biggest problem with health insurance plans.

You’ll often hear that insurance companies will review pre-existing conditions on a case-by-case basis or offer insurance excluding pre-existing conditions.

In my experience, that’s true for things like:

  • rashes
  • allergies
  • injuries that don’t affect other parts of the body
  • one-time occurrences from accidents

Insurers may refuse you coverage for serious injuries or illnesses that can lead to problems in the future.

As a rule of thumb, if your illness is a major reason you’re seeking insurance, they won’t accept you.

Beware of insurers that accept you and don’t check this until you make a claim. They’ll give you a false sense of security.

Cancellations or Non-Extensions

Is the insurance company able to cancel the policy or refuse to renew it?

Avoid plans that allow insurance companies to cancel or refuse the renewal of your policy.

Because if you send in a lot of claims, get a chronic disease, or are sick when the renewal date comes around, expect insurance companies to do just that.

I had one reader email me who had that happen to him.

A broker sold him an affordable plan that seemed comprehensive. He found out it was an “annual plan” when the insurance company canceled it the moment he became too pricey for them.

The same thing also happened to my employee. A few years ago he had to get a cardiac Holter monitoring test.

Although the results showed that his heart was normal, the insurance company listed it as an exclusion and they didn’t cover costs related to cardiac arrhythmia for a year after that.

In other words, when my employee needed the insurance the most, the insurer walked away scot-free.

Area of Coverage

Are you covered when traveling to your home country and other destinations? If so, for how long? Not a big deal really, since travel insurance can be had for cheap: As long as you don’t forget signing up for it every time you go abroad.

Coverage Limits

You’ll find three types of limits in insurance contracts in Thailand:

  • overall plan limits
  • benefit limits
  • procedure-specific limits

Limits are quoted per year.

But in-patient department, or IPD, benefit limits or procedure-specific limits are either per year, per illness, or for the entire length of the contract.

Overall Plan Limits

Coming from Germany, the fact that a Thai insurance company would only repay me a certain amount was new to me.

In Germany, you’re either covered in full or you have to make a co-payment—usually for dental work—and that’s it.

It doesn’t matter if you’re in a coma for ten years or more. What are they going to do? Stop treating you once you reach your limit?

Well, that’s what can happen to you in Thailand.

In Thailand, every private health insurance sold has a limit. If you’re new to the country, it’s a tough call to decide what amount of coverage is enough.

So what limit should you choose?

To get a good idea of how much surgeries cost in Thailand, check out Bumrungrad Hospital’s list of surgery costs.

The list might be on the high side. But they are one of the most reputable hospitals in Thailand and their prices match the quality of care and level of comfort they offer.

A few procedures cost more than 500,000 baht.

But the real heavy hitters for hospital costs are less-routine surgeries, along with the long-term stays in ICU due to a mishap or illness.

The most expensive case I’ve heard of involved heart surgery with a total hospital stay of six months. The cost for that came to 12 million baht.

He amassed that amount the first few weeks in the ICU, which clocked in at about 500,000 baht a day.

No broker I talked to knew of anyone who ran up more than 16.5 million baht in bills.

If I were to sign up for new insurance, I would aim for at least 15 million baht in coverage. For offshore plans that would mean $500,000 in coverage.

On the lower end you should keep in mind what the Thai government deems minimum coverage. Thailand’s Social Security System has a coverage limit of 2 million baht.

In other words, that’s the healthcare coverage every 7-Eleven employee gets.

You don’t want to go below that.

Benefits Limits

Many local insurance plans come with limits on IPD benefits on room and board, operating costs, ICU, surgical’s fee, and hospital bills related to IPD treatment.

Your plan may have a limit of 1 million baht but might have the surgical fee capped at 100,000 baht, hospital bills at 80,000 baht, and room and board at 8,000 baht per day.

As I said earlier, my biggest health bill came from having my nose operated on. I had endoscopic sinus surgery, septoplasty, and radio frequency turbinate redirection.

My insurance company paid for it.

The surgery was 2.5 hours long under general anesthesia followed by a single night stay.

The total cost for the operation and stay was 260,208 baht. This price didn’t include pre- and post-operative care and follow-ups.

Here’s a breakdown of costs:

  • general anesthesia: 8,110 baht
  • doctor: 95,000 baht
  • lab – pathologist: 985 baht
  • lab – pathology: 1,470 baht
  • medical equipment: 26,925 baht
  • medical supplies: 70,736 baht
  • medicine: 24,022 baht
  • nursing services: 2,710 baht
  • operating room: 22,140 baht
  • other medical service charges: 760 baht
  • room: 7,710 baht
The receipt of my nose surgery.

To put these expenses into insurance terms, it should be labeled as surgical cost at 95,000 baht, room at 7,710 baht, and hospital bills at 157,498 baht.

Even with the limit at 2 million baht, if my insurance plan limited the hospital expense coverage to 80,000 baht, I would have need to pay 77,498 baht out of my own pocket.

Procedure-Specific Limits

Insurance companies limit specific procedures. Here’s an overview of common procedures and how much you’re limited to:

Organ Transplants

Some insurers have limits on donor costs for organ transplants. Now Health International’s WorldCare Excel plan limits them to $50,000.

I assume if a liver is too costly, they’ll pass and wait for the next, cheaper one?

Most limits are about donor’s costs. I assume they want to avoid having the hospital bill them for ICU costs by the late donor.

In some cases, like with ACS, they refuse to pay for any donor costs.

HIV Treatment

This is a big topic in Southeast Asia. Lots of insurance companies leave it out if caught through sex. Some even exclude it outright.

Those that don’t limit treatment costs will put a limit on the maximum amount you can claim. With Luma’s Asia Care Plus plan you’d get 480,000 baht.

HIV treatment in Thailand isn’t too pricey because HIV medication is made here. But in the future you might not get coverage for more expensive treatments.

Pregnancy

I haven’t spent too much time looking into this limit for obvious reasons.

But to my knowledge pregnancy is an add-on, often with coverage limits and a 10-month waiting period before coverage kicks in.

You can check out our post on having a baby in Thailand for more details and the costs involved.

I’m not sure at the reasoning for procedure-specific limits. It might be hospitals attempts to limit artificial cost inflation for pricey treatments.

In practice this may limit your hospital choices for those procedures, though the impact on quality of care you get is not that big.

Age Restrictions

The rule of thumb is that if you sign up before the age of sixty, you can find health insurance with lifetime coverage.

Once you turn sixty-five, it becomes harder to get comprehensive health insurance for people of retirement age.

One reason for the de-facto age limit is that, on average, people spend 80% of their healthcare costs in the last five years of their lives.

Of course acceptance is just one part of it–the other is the premium.

Above the age of sixty, you won’t be able to find cheap insurance coverage. Insurance plans in Thailand don’t subsidize older age groups with premiums from younger members.

This means coverage at an advanced age comes at a much higher price than you’d pay back home.

As already noted under the Conditions section, it’s important that your insurance can’t cancel or refuse to renew your coverage.

You also want to watch out for any specified maximum ages.

Lots of companies with lower costing, local insurance plans specify an age at which coverage ends.

It might not matter if you’re thirty-three, but at fifty-five you need to take this into account.

Of course that doesn’t protect you from rising premiums, but that may be a lot cheaper than finding yourself without coverage after falling ill.

One insurance company you can take a look at is Luma Health. Their plans comes with:

  • a 32-million baht limit
  • coverage for cancer treatment
  • medical evacuation
  • a lifetime guarantee

The plan doesn’t cover any pre-existing conditions. But this is normal for health insurance companies.

Although the maximum age you can sign up is seventy, you should get it before turning fifty-five.

The premium rate for fifty-five year old males starts at 70,000 baht a year.

Premiums

The premium is the clearest part of an insurance policy. It’s the fine print that’s trickier to get. But even though the premiums are stated, you should keep these things mind:

  • payment terms
  • deductibles
  • medical inflation
  • age groups

Payment Terms

A number of insurers, especially those offshore, have a significant surcharge for monthly payments.

Since your contract runs the full year anyway, you might as well pay in full.

Deductibles

Your premiums will be a lot lower if you agree to pay for the first thousand or two thousand dollars of healthcare each year yourself.

In practice, that means you won’t be able to claim anything but severe cases.

Make sure you keep receipts and file them by their deadlines. People forget about this because they don’t expect to have to pay for bills beyond their deductible—until they do.

An easier, more hassle-free choice that would get you the same results but much less paperwork would be to just opt out of OPD coverage.

What happens if you’re in an age group where cost for insurance shoots up? You can add a deductible to lower your premium to an affordable level while keeping coverage for serious cases.

Medical Inflation

Medical inflation in Thailand is high. Most insurance companies say they’ll raise yearly premiums by less than 10%.

From my experience I’d say that the increases are a lot lower than that.

But you should keep this in mind for future budgeting. Your health insurance will go up 5% each year along with the increases that occur when you get older.

Age Groups

Most insurance companies divide age ranges in groups of five years.

Every time you enter a new age group, your premiums will go up. In your twenties and thirties that doesn’t make much of a difference. But once you pass fifty, the increases can start to hurt.

You should compare current day rates and the rates your insurance is charging people who are five to ten years older than you.

Optional Coverage Choices

A few options are covered as add-ons. Skipping them lets you lower your premium as long as you’re okay with paying out of pocket.

Some of the optional coverage is:

  • OPD
  • dental
  • medical evacuation

OPD

I’ve logged my own OPD costs between 2015 and 2017. While not representative, my costs give you an idea of the cost of OPD treatment at top-tier international hospitals in Bangkok for men in their thirties.

I got all but one of my treatments at Bumrungrad. The other I got at Chulalongkorn Hospital.

YearVisitsAverage Cost per VisitTotal Cost
20157฿3,385.14฿23,696.00
20168฿3,007.08฿24,056.64
20179฿2,621.86฿23,596.70
Total24฿2,972.89฿71,349.34

During these years I had two major health checkups. The most costly was a stomach checkup at Bumrungrad in 2015, which, including doctor and facility costs, came to 21,973 baht.

Most people I know don’t get OPD coverage because treatment isn’t that pricey here.

Going to a hospital in Bangkok costs anywhere from 700 baht to 3,000 baht, depending on the fanciness of the hospital and the doctor’s chosen medical field.

Medication is sold at a mark-up in the hospital itself. Mark-ups range from two to ten times the cost in a pharmacy.

If you buy medication at the hospital you could pay just as much as you pay to see the doctor.

As you can see in the above table, my costs are at the higher end of that spectrum.

Going to cheaper hospitals that don’t have free juice and a hotel lobby style waiting room would lower your OPD costs.

If you’re not living in Bangkok, the OPD facilities you’re going to use will be a lot cheaper.

A close second in why you might not want to bother with OPD insurance is the paperwork. A lot of people dread having to fill out forms, mail claims, and dispute rejections.

It’s frustrating to do that for a minor claim only to have it denied. You’re better off paying straight out of your own pocket.

Last but not least, the overall limit. Most OPD insurance coverage limits me to a few thousand dollars per year. My OPD insurance limits stops at 217,311 baht.

In most cases, the math doesn’t make sense. What you pay for insurance coverage far exceeds the amounts you’re likely to claim.

Things might be different if you’re looking at expensive long-term OPD care for diabetes or kidney failure.

You should also be aware of some insurance companies classifying certain procedures as OPD, even though you might spend a few days in the hospital.

This way they can refuse a claim unless you did opt for OPD coverage.

In the end, I opted for OPD coverage because I feel the amount I overpay is worth the fact that I’ll never put off a hospital visit due to cost.

Call it a psychological effect.

Dental

Coverage for dental varies a bit. Some insurance companies make you co-pay or cover one routine checkup a year.

In my experience though, they’ve covered 100% of my dental costs for the minor claims I filed.

From 2015 to 2017, I paid about 2,116.33 baht per year for dental care. This includes regular checkups every six months.

BIDC

I go to Bangkok International Dental Center, or BIDC, for my dental work.

It’s not the cheapest dental center out there. Their prices are about 25% more costly than a high-quality, independent dentist.

But BIDC offers significant savings over other English-speaking dental clinics in Bangkok.

One major reason I go to them is that they are opposite of my office. Bangkok has a lot of both dentists and traffic jams, so location becomes a major factor.

Also, BIDC dentists don’t seem to drill often. It’s either that, or my dental hygiene improved around the same time I switched to them.

Being the cautious German that I am, I use my annual Christmas vacations back home to get a second opinion from my village dentist on the work I get done in Thailand.

I pay him in fruit and bakery baskets and he’s absolutely awesome. So far he hasn’t objected, so I guess the standard of care measures up to that of German dentists.

Most insurance plans you’ll find in Thailand include dental work. But since the cost of dental care is lower, you shouldn’t worry about it too much.

While international hospitals with English-speaking doctors and short wait times charge a significant premium, you’ll find their dentists are a bargain.

Medical Evacuation

Some insurance companies offer medical evacuation as an add-on. The usefulness depends on where you live in Thailand.

Most competitive-priced plans won’t fly you to your home country, but to the next suitable hospital, which in most cases will be in Bangkok.

If you don’t leave Bangkok much or get travel insurance when you do, there’s little point in requiring medical evacuation.

The exception? If your limit is high, I imagine the insurance company might offer it themselves whether you picked it or not.

Flying you home might be cheaper for them than paying for an extended stay at a top-tier hospital in Thailand.

But don’t count on it.

Other Terms and Conditions

There may be other terms and conditions that can affect the viability of your insurance coverage.

Reading the conditions of your insurance contract is tedious. But think about how much you’ll be spending on this for the next five to ten years.

That should be worth setting aside an hour or two to go over the details of your plan.

International Citizens published a nice wrap-up on expat insurance terms and what they mean. You should check it out to get to know the language of insurance.

If in doubt, I suggest sending an email to your potential insurer, listing out what you’re concerned about, and trying to get some statement from your broker or insurance company that clarifies your question.

I’m not a lawyer or insurance expert and this isn’t legal advice, but I assume this should improve your position if it ever comes to a dispute.

Paperwork

When you take out insurance, you’ll have to think about the amount of paperwork involved. So let’s look at three common areas of insurance in which you’ll need to file paperwork:

  • insurance applications
  • prior authorizations
  • denials of claims

Insurance Applications

Applying for insurance in Thailand is like applying in other countries. Each insurance company has its own survey.

Insurers will ask you questions about your past health and illnesses and if you lie about it, it might void your coverage.

Some companies ask if other companies have turned you down. If you think you’re at risk of getting turned down by some companies, apply for all of them at once.

This way they can’t deny you if you’re going to be turned down by another insurer.

Prior Authorizations

In some cases, insurance companies require prior authorization before getting hospital care. This is standard for any non-urgent visits to a hospital.

Some insurance companies also require prior authorization for more expensive OPD procedures like MRIs.

That tends to result in a back and forth between hospital and insurer and you waiting a day or two until the insurance comes through.

I’ve never heard of insurers refusing authorization, but I assume it does happen. Otherwise, why have it?

In some odd cases, some insurance plans like the Southeast Asia Serene Plus plan by A Plus II even requires prior authorization for organ transplants.

That’s a bit weird. Is there really a danger of people getting unnecessary organ transplants?

Denials of Claims

What good is insurance coverage if your claim gets denied?

My current insurance company has declined two of my claims so far. Nothing major. Just claims they thought were pre-existing.

But pre-existing can be anything you have that they think is recurring. In my case they denied my claim for 635 baht for dyshidrosis.

That wasn’t surprising since dyshidrosis is chronic. The fact that they even bothered checking for that amount surprised me.

It’s hard to get good data on how often insurance companies deny claims.

If you happen to have some info and would like to share it with me, please email me.

Finding the Right Insurance Plan

When looking for insurance plans, don’t make the mistake of looking for the cheapest plan.

Instead, it’s better to look at:

  • area of coverage
  • coverage limits
  • exclusions
  • renewal guarantee
  • company reputation

Area of Coverage

Does the plan cover you in Thailand or other countries as well? This is important for those who often move or travel to new countries.

Coverage Limits

How much is the plan’s coverage limits? And what are the limits of the benefits? Are they enough for your needs?

Exclusions

Are there exclusions that you should be aware of? Do you have a chronic disease or take part in activities that aren’t covered?

Renewal Guarantee

Are they going to let you go if you’re diagnosed with a chronic disease, make too many claims, or claim too much?

Company Reputation

Is the insurance company easy to deal with? Do they raise premiums every year by a large percentage? How about people’s experiences with them?

The plan suitable for you might not be the cheapest, but it’s better than getting a plan that doesn’t give you enough coverage when you need it.

Reading the fine print, looking at reviews from customers and talking to a good broker will help.

You can research suitable insurance plans by checking out:

  • comparison websites
  • brokers

Each of these methods have pros and cons.

Comparison Websites

Comparison websites let you search for insurance plans with filters and searches, rather than having to compare sales brochures and broker’s Excel sheets.

You can also fill out medical surveys and apply online for plans.

For expats, Mister Prakan offers the most comprehensive comparison of health insurance plans in Thailand.

The website covers major insurance companies and:

  • sorts them by price
  • allows you to filter them by coverage level
  • gives details about coverage limitations
  • displays editorial ratings of each company.

They also act as a broker and have English-speaking staff who can answer your questions.

In case you’d like to look into offshore insurance plans, you can give BrokerFish a try.

For international insurance plans, you can:

  • compare plans
  • filter results according to your needs

Sadly, they’re missing some of the more competitive offshore plans. And they don’t have any info about plans sold in Thailand, which may offer better coverage.

Brokers

You shouldn’t have trouble finding a broker in Thailand. The rate you get when going through a broker is the same as when you go the insurance.

The main advantage of a broker is that they can offer you a wider range of plans than an insurance company.

If you don’t already know which plan you want, they can give you details on what best suits your needs.

In theory, brokers are neutral and act in your best interest. In practice, in Thailand that’ll be true for good brokers and not so true for others.

One thing to keep in mind is that sales commissions for brokers are recurring.

For every year you stay with them, they get between 10% and 15% of your premium.

If you go through an insurance company, the insurance keeps that sales commission.

This means brokers have an incentive to sell you an insurance plan and keep you as a client in the future.

This recurring commission payment means that the broker will have a financial interest to help you out when it comes to dealing with insurance.

But brokers only offer you limited help with claims or disputes.

Aside from the details of the claim and your individual case, it depends on their relationship with each insurer and of course on the insurance itself.

Whether or not your broker sends your insurance company a lot of business, and whether or not your insurance company cares can make a difference.

In case you’re not happy with the support of your broker, you should also know that you can change brokers without changing insurance plans.

In short, signing up for insurance through a broker means you have one more person you can talk to before signing, and one more person to complain to after signing.

On the other hand, a broker might not know every single detail about every insurance plan for sale.

If you’re looking for a broker, I suggest using Mister Prakan. They’ll allow you do to do the initial research yourself, making it easy to compare plan benefits and costs online at your own pace before talking to one of their agents.

If you’re looking for a locally licensed, Thai-baht insurance plan, they’re a one-stop shop.

For legal reasons they don’t offer any offshore insurance plans like ACS, the one I’m using.

But the Asia Care Plus plan by Luma Health may work for you.

Lastly, you can fill out our insurance form to get advice from a broker who is also an expat and has years of experience with both offshore and local insurance.

My Insurance Plan

As I said before, I’m insured with ACS. Below, I’ve listed the reasons why I chose them. Unless noted, conditions are from the time of signing up and based on my notes:

  • HIV/AIDS treatment: included
  • medical evacuation: included
    OPD: $6,000 limit
  • exclusions: common exclusions; donor costs in case of organ transplants
  • overall limit: $500,000
  • 2018 premium: $1,855.00 a year for a thirty-six year old male

The bullet points reflect my own grasp of their insurance plan and lists out attributes according to my priorities. It’s not meant to be an “official” or a comprehensive list.

After being with them for many years, I’d say I’m satisfied with their service.

ACS is easy to reach. They don’t work in a certain time zone. There are no cultural or language barriers.

The premiums tend to go up over time but stay in line with what other insurers charge.

There were a few minor claims they denied based on them being pre-existing conditions or outside the described coverage. But I wasn’t surprised and I’m pretty happy with the service I got from them so far.

I thought about buying insurance plans from Luma Health and A Plus II when I was shopping around.

But in the end I went with ACS. They offer the best value for money for the coverage I need.

Insurance Guide in Other Countries

We also have our health insurance guide in other countries including:

Now, on to You

Are you left with questions about buying insurance in Thailand? Feel free to send me an email and I’ll help you out as best as I could.

Keep in mind I’m not a broker, lawyer, doctor, or professional proofreader, but when I wrote this article I did my best to research and fact-check.

I also can’t promise the info in this post is 100% true. Things always change with insurance. And although I do my best to keep this post up-to-date, you should check with a professional before buying insurance.

57 comments
  1. Karsten, Et Al;

    Much Ado About Nothing.

    For a clarification of what appears to be a (deliberate?) misrepresentation / misunderstanding with regard to a “mandatory health insurance requirement” for a “retirement visa”, please see the following web site: https://forum.thaivisa.com/topic/1115587-health-check-phuket-immigration-confirms-mandatory-health-insurance-for-o-a-%E2%80%98retirement%E2%80%99-visas-not-in-force/#comments

    Regards.
    R. Gibbs

    1. Thanks for the input. I’ve edited the article to clarify that this doesn’t seem to be uniformly enforced. This said, it’s important to keep in mind that ‘hospitals having to admit everyone to the emergency room regardless of insurance status’ is also not uniformly enforced.

      Getting health insurance before you need to make use of it is a good idea. That’s also the only time you can actually get it. I can’t count the number of e-mails I receive that start with ‘I always used to be healthy…’ before going into the details of a recent health issue that essentially made the person uninsurable.

  2. Hi thanks for the detailed information Karsten.
    I have a kidney transplant and have always been hesitant to travel, or live in another country because of it. I feel if I did decide to stay in another country for an extended period of time figuring out how to manage my whole medical dilemma I have would be tricky.
    I’m 42 years old really but very healthy minus my transplant and I feel like I don’t have much time left. I don’t want to die having never left Phoenix, AZ. I feel trapped because right now I’m on accchs insurance which is exclusive to AZ.
    In 2009 I was Infected with West Nile virus which led to severe encephalitis. I probably should have died but here I am.
    I’m going to re-read your article now and try to figure out my best options. In your experience what would you say my best options are based on my position?

    Again thanks for the great details.

    1. Sounds like you have a bitter sweet history with health – both in terms of things you had to suffer through and situations you were lucky to survive. I’m not sure how things work in the US, but coming from Germany I know that there sometimes are health coverage options by your home / national insurance for temporary travel abroad. For temporary travel you might also be able to arrange for travel insurance, depeneding on what their individual exclusions are (see also here: https://www.expatden.com/thailand/thailand-travel-insurance/)

  3. Just want to say thank you for doing this work.
    This was very kind of you, and useful.

  4. So I checked with several companies for a short visit, with one month coverage. All of the companies I looked at are pre=pay and then submit for reimbursement, which would be the same as my Blue Cross, Except in the instance where you are admitted and then contact the insurance company they will do a guaranteed payment. Is there nothing like presenting your insurance card if you get sick or injured and do not require admittance?

    1. Not for short term visits as far as I know. There would probably be way too many issues with fraud to make it worthwhile dealing with from an insurance point of view.

  5. Hi Karsten,

    I was wondering why you decided to go with an International plan? I understand that Thailand has a highly regulated market, providing consumer protecting, which I believe you do not have with ACS. Can you please comment on this point, as I have also narrowed down to ACS, but reluctant only because of this point.

    1. Good question. When I looked at the plan for myself, I figured that an international insurance plan regulated by a European insurance agency was on par with a Thai plan regulated by a Thai agency: It might be harder to escalate a claim, but I figure the language barrier, available documentation and outcome of potential disputes would be more transparent and predictable.

      Since then I talked to a number of people in the industry. From what I gather, the insurance companies and brokers have a great deal of respect for the OIC in Thailand (which is good). However, this also seems to be the case for international insurance companies. I assume the OIC can create a lot of problems for them as well, even if it’s not formally their jurisdiction – they still have to carry out some activities here (e.g. reimbursements, hospital cooperations, claims processing). So it seems in that regard it’s not much of a drawback to go with an international plan.

      Another concern I had was that maybe an international plan would be less restricted in hiking their premiums. And indeed, the OIC limits the premium increases of local insurance companies from what I understand. However, that limit is something like 50% every three years … I’m sorry, but limiting premium increases to 50% every three years isn’t exactly a limit. So this doesn’t seem to add much.

      All said and done, the issue is fairly technical and the practical impact is hard to judge. It’s a fairly new market with a limited number of disputes and it’s hard to tell what in the end is the best solution. While I also see benefits in having a local plan, I’ve personally opted for an international one, figuring the potential downsides to not be of much relevance in my case.

  6. Hi Karsten,

    I retired last year and still have health insurance from the Blue Cross. Is it accepted in Thailand or will I still need to buy local insurance?

  7. Hi Karsten,
    Very useful info. Thanks for sharing.

    I read discussions at the Thaivisa forum that most of the local insurance policies give the companies the right to raise premium at ridiculous rates at renewal when they found out that you have a long term illness, like cancer. Would you know if this is true? Thanks.

    1. I’ve seen people warn against that possibility (and point out that the plans they advocate don’t do it), but all policies I looked at when signing mine had a disclaimer that prices would not be raised on an individual basis. However, I do hear about friends who have their premiums increase (and then decrease when they renegotiate), which certainly sounds like that could be the case.

      I recommend checking the fine print and ask your broker about it. Feel free to get in touch in case you’d like me to share the contact details of one.

      Of course if you already have it at signing and didn’t mention it, they’ll probably just cancel your coverage entirely and potentially ask back for payments already made on your behalf.

      1. Thanks for your reply. It would be great if you can share the contact of your broker with me. Thanks again.

  8. Well, we are not in the same leage. We don’t even have to compare insurances. You are paying 77 000 bath/year. I am 63 years old and I pay 17 000 bath/year…!

    1. Obviously there are different price ranges depending on the coverage required.
      Can you share more details about your insurance (e.g. company, plan, limitations)? Would make it helpful for other people reading this.

  9. Hi there Karsten!
    You’re terrific for being so kind to put this all together for us – thank you heaps for your wonderful efforts. My question is rather open and I fully realize it truly depends on the individual’s preference, current health, and budget. But overall in general Karsten, what would be a comfortable amount to have as a maximum coverage to feel secure?

    I see max coverages amount to 500,000 and 750,000 and of course anything over 1mill baht. I’m very healthy and rarely need a doctor, but I’m worried about some unforeseen accident/surgery that could result in numerous days in the hospital.

    Anyway, I’d love to hear what ‘you’ yourself would think is a comfortable max coverage to have, where it doesn’t break the bank. Thanks so much indeed Pal, I’m very grateful!

    1. I’m comfortable with USD 500,000. It means that short of an extraordinary catastrophic coincidence, treatment at any and all facilities in the country (including the ICU at Bumrungrad) would be covered.

      The government social security service tends to consider it possible that patients can accumulate THB 2m per treatment at a government hospital and recently raised their internal billing limit to that amount. I’d thus consider that a minimum if you were to get private insurance.

  10. I understand your frustrations, though changing at this point would come at a very, very steep price (if it’s possible at all). I’d strongly advise trying to see if you can resolve this without changing providers.

    1. Hi Karsten, please forgive me should I be hassling you with my concerns. But I really do not know what to do and your advice is so greatly appreciated!
      I’m sorry to ask for clarification of your recent comments…
      For what reason are you advising that insuring myself with another company would be much more expensive than what I currently pay? Is it just a case of starting with another company at my age? OR because there is a chance that BUPA will decide that they’ll ignore what happened 30 odd years ago and reverse the decision, thus covering my hospital costs of a couple months ago and allowing me to continue being fully covered without extra charge? (Even if they did the later, I am sure that any future incident would not be considered as a one-off incident but as a preexisting condition that they will not cover.). OR is it something that I haven’t even realized?
      Let’s face it, because the doctor wrote to the insurance company and used the word “seizure”, if it were to happen again, even if it be caused by a completely different reason, the word “seizure” would be enough for them to say “No”, don’t you think?
      Again, I really appreciate your suggestion because even when I asked a Professional, (the broker), I got nowhere and now I don’t know where to turn. (Plus it is soooo busy each day at work that I cannot afford to take a 10minute break all day let alone shop around all the insurance companies out there!).
      Thanks again!

      1. If you were to switch now, all pre-existing conditions are definitely excluded at your next insurer (pretty much everything that you field a claim for and has any likelihood of recurring). So your coverage would definitely get worse.

        Challenging on BUPA is not about asking them kindly to change their mind on a courtesy basis. It would be to look at the fine print and your originally provided information to see if something that happened more than 10 years before you signed up would indeed be classified as ‘pre-existing’ condition. It’s hard to say without seeing the actual contract. However, if this wasn’t specified as an exclusion and you didn’t provide false details when you applied, there is a chance you can legally challenge them on this. I recommend consulting the Office of Insurance commission or talking to a lawyer to see if that’s possible. If the regulatory body or a court orders them to pay, it could be a ruling along the lines ‘this is not a pre-existing condition’ and all subsequent treatments may be covered as well.

        I’m not an insurance specialist or lawyer, so take this with a grain of salt. My recommendation is to talk to a lawyer or independent insurance body to get advice on this case before you cancel or switch your current coverage.

        1. Thank you very much. I won’t trouble you again with my case and do greatly appreciate your time and advice.

  11. Thanks very much, Karsten! A good read! Unfortunately, it didn’t really tell me what I am online looking for.
    I’ve had top hospital coverage with Blue Cross/BUPA since moving to Thailand 17years ago (although not OPD which, as you said, is not worth it!). I’ve had three stints in the very comfortable BNH Hospital during that time which insurance saw were nearly fully covered and have always enjoyed the peace-of-mind that insurance provides. However, recently I had a seizure (which unfortunately I told BUPA I had one of 30 years ago!). One night in ICU cost me 90,000-baht and BUPA refused to pay one baht of it! I am trying, with little success, to find health insurance which will cover a preexisting condition. BUPA won’t allow me to pay an additional premium on top of the already sizeable amount I’m paying to cover a preexisting condition. I’m stressed as I feel uninsured. Stress leads to seizures, they say. So that’s more stress. The broker I saw was useless, (he was only interested in what the company I work for pays each year because that’d be big commission!!). I guess I need to be pointed toward an insurance company that will provide a 50 year old with health cover and allow me to pay an additional amount for a preexisting condition. Any advice would be extremely appreciated!

    1. Sorry to hear about the seizures and the insurance issue with it.

      You can actually change your broker if you feel unhappy with their service (without having to change insurance companies). Shopping around for a more supportive provider can be helpful and your commission (which is recurring – so every year you stay with that broker, they keep getting it) can go to a more helpful one.

      Are you sure the insurance was right to deny the claim? I’d double-check that – it’s possible that if the last incidence was several years before you signed up, this may not count as a pre-existing condition (depends on the wording of the insurance and their sign-up questionnaire). You can consider challenging them on that claim, either by going to the office of insurance commission (ask a Thai friend to help) or to a lawyer who specializes in it. While the disputed amount might not make that worth it, ongoing coverage might very well do.

      Finding a provider with a serious pre-existing condition is probably not possible.

      Since you went to BNH though, you can consider going to Chulalongkorn Hospital next time (which is nearby). Their treatment quality is pretty good and it’s a lot more affordable. While not as good as full insurance coverage, it does provide an option to secure affordable medical care.

  12. Thanks Karsten,

    This was really useful when I was compiling quotes! Any comments on cover for preventive screening tests such as colonoscopies, mammograms, prostate tests etc?

    Best Regards

    Michael

    1. Some insurance companies specifically preventive screening, others have a budget for health checkups (e.g. my plan at ACS allows USD 300 of health checkups every 3 years). I don’t have the details for other companies off the top of my head, but in general that’s something you’ll find in a number of plans.

  13. Thanks Karsten.

    I was already recommended ACS by a friend. I have been researching for a few weeks. I have even met with some agents (locally).

    I have decided on ACS as well due to:
    1. The friend who recommended – had a friend who had no issues in claiming a motorcycle accident that he had in Chiang Mai. It was quite a large sum.

    2. Cost and benefits that ACS provides.

    3. Your recommendation

    Let us know if anything should change in your opinion or if you find something that is better.

    Thanks for the recommendation and yes i follow your blog (although, i have not read everything and this is my first post to you)

    Michael

  14. There’s a British doctor called Dr Donna who provides an incredible kind of General practice/ family medicine services. Her clinic is based in sukumvit soi 49 and is called Medconsult. Would thoroughly recommend as Dr Donna has been the main doctor in Bangkok for myself and my family since we moved here and Dr Donna is just a world-class, very skilled doctor.

    Another plus is that I don’t pay as they bill it all straight to my insurance which is hassle-free and great for us!

  15. Not taking out insurance is a fool’s errand. Not only is it not true anymore that treatment is cheap, but some hospitals charge way more than what you might be used to paying at home (and this is comparing the actual cost of treatment in your country not taking into account whether your home country social security such as Medicare or private health insurance takes care of it or not) and some hospitals are even known to charge foreigners extra compared to locals.
    Just because some insurance broker claims foreigners’ choice of hospitals and lifestyles increase their premiums, doesn’t make that an excuse not to take out a policy. Unless you’re an out of work foreigner or one who works a low end English teaching job without a proper work visa, you have no excuse not to take out some sort of health insurance policy – the best ones being as you mentioned in your first few paragraphs travel insurance policies taken out before you leave. If you work for a Thai based employer, more than likely they’ll sign you up to some sort of Thai or expat insurance policy.

  16. Very useful information for long term stays abroad.

    As you, I started out using travel insurance from Germany, which seems to be a very good choice for the first 5 years. I actually just did a comparison of 50+ available options to Germans, Austrians and Swiss Travelers:
    http://www.flocutus.de/auslandskrankenversicherung/

    After 5 years you have to look for Expatriate insurance like the ones you mentioned.

  17. Hi Karsten,

    Thank you for your article on health insurance! Since I will be moving to Thailand next month your insight is extremely relevant and useful. Cheers!

    Like you did when you moved to Thailand I´ve bought a travel health insurance which covers all emergency treatments for the first 18 months of my stay in Asia. I think they offer to extend it by another 18 months should I wish to do so at the end of the first period, so theoretically, that should give me 3 years of the most important health cover. Nonetheless, being German like yourself, I am a bit paranoid and obsesses with insurance, lol. And that´s why I wonder if cover for emergency care is enough.

    The reason is that I wonder what will happen in worst case scenarios, i.e. long-term chronic diseases, cancer etc. As you write yourself, the company behind my current travel insurance might pay for the flight to Germany but that´s it, they would not pay for any necessary treatments for the long-term illnesses. Did you, when you arrived in Thailand, think about “topping up” your travel insurance with another local health insurance so that in a worst case scenario you could stay in Thailand rather than going back to Germany? Do you happen to know if there are any insurance companies that offer such “top up” health policies that only cover such long-term illnesses, so that I could use the travel insurance for emergencies (at least for the first 18/36 month) whilst having the “proper” local health insurance for other illnesses that travel insurers don´t cover?

    Or am I just too paranoid here? 🙂

    Cheers
    Achim

    1. I think my initial insurance was limited to 3 years. I didn’t get a local insurance on top as the ‘temporary health insurance’ covered pretty much everything (not just accidents). Accident only insurance is very thin coverage and if illnesses aren’t covered, you might want to look into getting something that covers that.

      The main question is if you get sick/in an accident, does the insurance get extended until you are recovered. Easiest way to handle it is to ask your broker/insurance by e-mail ‘what happens if…’ – this way you have something ‘written’ in case there’s an issue.

    2. Travel medical plans will cover you for up to the 3 year period but then terminate. Typically they will have additional benefit period to continue covering you after the policy expires for illnesses that occur during the policy period – but that might be as few as 30-60 days.

      A Global Medical Insurance Plan, or Expat Health insurance, would be available that would cover you long term for all medical conditions. If you chose a high deductible, the premiums would be less and you would be able to access it to cover large medical bills long term.

  18. Hi Karsten, Well done for helping others via this post. I am trying to find 3 montsh cover whilst in Thailand for medical/health and its proving very hard to find.
    I tried AA Insurance but their minimum was 6 months with bupa. Do you happen to know of any company who will help with a shorter policy? Ive e mailed your other recommendations as well as some have replied and said the same i.e. only an annual policy or 6 months only…
    thanks
    Jon

    1. I’d say for three months, the best option is to check in your country of residence for a travel insurance. It’ll end up being cheaper and more comprehensive than locally available options. Important point would be to sign up before you embark on your trip.

      1. I am in Thailand now.Thats my dilemma. Its very expensive to go back just to sign up for travel insurance. I have tried all the people on your list and no one can help. Seems hard to believe no one will insure individuals because they are here already.There must be a lot of expats whose policies from their own countries expire but they don’t want to buy a 12 month local deal if they need shorter cover

        1. Tricky. You could try for an international travel insurance (e.g. World Nomads) to see if they cover you. Otherwise signing a six months contract but only using 3 of them might be your cheapest option, the alternative being to carry a credit card on you at all times and hoping for the best.

          1. yes thanks Karsten.Been doing the credit card thing a couple of months but don’t want to tempt fate too long! Six month thing might be the only alternative.Many thanks again

      2. Karsten. Great site. Very impressed. I am working on retiring to Chiang Mai in next year and am a huge planner so this is helping get going. I am in the US. I read your note:

        “When I first came to Thailand, I had German travel insurance that covered everything under the tropical sun.”

        Have you heard of anything like this from people in the US. All I can find is typical travel insurance that covers for emergencies, not Drs visits/dental/vision, etc.? If not no big deal as the Luma and ACS are still very affordable.

        I am also guessing it is hard to find a policy that covers you for anything more than emergencies when returning to visit home country (US). I am just paranoid to give up my US insurance until I get a year under my belt in Thailand to make sure it is a good fit for me. I could always keep my current health insurance and pay both premiums, but US insurance is expensive and would rather not.

        Thanks again for all the information

        Darren

  19. Hi, I’m an expat currently living in Costa Rica – when we moved medical was number 1 on our list (in order of importance) we got all the right answers but forgot to ask some pretty important questions we took for granted – never again – how difficult is it getting prescriptions for narcotics and are they expensive. I suffer from severe back pain and spend $700 a month for my pain meds!!!!! Time to go!! LOL. But certain countries just don’t have certain drugs – can anyone enlighten me about the way Thailand doctors and pharmacies view narcotics? Thanks for anyone’s time and response – PURA VIDA!

    1. From what I gather, narcotics won’t be very expensive, but getting a doctor to prescribe them might be difficult:

      Codeine for example is a ‘class II controlled narcotic drug’ in Thailand, putting it on similar footing with morphine, cocaine, and ketamine. If a doctor at a Thai hospital prescribes it, the hospital pharmacy will be able to provide it to you in small quantities. However, due to abuse, doctors are usually reluctant to do so.

      Diazepam (Valium) is a ‘class IV controlled narcotic drug’ and thus potentially easier to receive a prescription for. Still, a similar problem might apply.

      Keep in mind I’m not a pharmacist or a lawyer, so take this with a grain of salt. Best check with a local health provider, your embassy or an insurance company or broker (if you like, I can put you in touch with someone).

      1. As I just had a bout with kidney stones, I can tell you that they don’t really have the narcotics you probably are used to ( I assume). The well qualified and competent doctors at a mid-tier hospital did not know what hydrocodone (vicoden), oxycodone (many names) or percocet were. There were only two options… OTC Tramadol (not strong and kinda nasty) and straight up morphine pills (not a good way to take morphine). It may be due to the potential abuse or other, but the hospitals (possibly the country?) do not have the opiods that are generally used for daily pain management or severe acute pain (my situation). They are missing that middle road (though dangerously addictive) of opiods. Overall it seems you either get a IV of morphine or nothing. The treatment I had is generally done either with heavy sedation or a general in the U.S., but they just gave me a NSAID (weak anti-inflammatory) and told me I could handle it lol. I did, but would much rather have had a real narcotic as they were shocking me for an hour haha. Opiods are pretty much taboo here outside of Morphine in the ER or admitted section.

        Also, thanks Karsten for this article and the many other well researched articles. You helped me find a gym I really like (Design Your Body) and helped with banking issues. I really appreciate it!

        1. Glad to be of help. Thanks for sharing your experience, What route did you (or the doctors) eventually choose for pain management? Hope you’re feeling much better!

        2. Sean, I talked to a Thai anesthesiologist about the case you described and received the following input. It might help shed some additional light on the situation:

          “It seems the patient was going through ESWL (http://www.m.webmd.com/a-to-z-guides/extracorporeal-shock-wave-lithotripsy-eswl-for-kidney-stones).

          According to the NIH,
          despite reports of various studies comparing different analgesic techniques during ESWL,[7,9,10] guidelines for pain management during the procedure are not established. General anesthesia may be preferred in following conditions – children, extremely anxious individuals, when a lengthy treatment is anticipated.

          The patient’s description is correct in that Thailand lacks intermediate opioids. I actually think it’s a good thing considering how the US for example is facing a lot of problems with opioid addiction in form of these not so strong and less restricted opioids.

          If you actually had ESWL however, it is internationally common to use strong opioids, like the IV morphine you mentioned (or of the same family). NSAIDs are usually used as adjunct, sometimes with opioids, sometimes with numbing agents.”

          Hope this helps!

  20. Great info. I’m staggered that you’ve needed medical care 24 times in 3 years.
    I guess everyone is different, but in 7 years living in Bangkok I’ve only been to see a doctor once (and that was a small clinic not a hospital) when I scraped my shin getting out of the pool and developed a slight infection. The cost for that was 200 baht for the consultation and drugs.
    I’m 48 and starting to think that I should get some insurance, so this was a really useful article.

    1. Yes, I also meet a doctor every 10 years but maybe the future can be different ?

  21. I found your blog via reddit – thank god! Lots of extremly useful stuff.

    I am living in UK and working with many Thai people which come here for training. Thanks to this experience I am planning to move to Thailand (BK) in 2-3 years and start my business.

  22. Lots of good information. As an American used to high medical costs, I was surprised at how affordable private medical care is. Personally, I pay out of pocket to avoid the hassle and because I assume over the long run (as long as medical treatment in Thailand isn’t going to bankrupt me), it will give me more choices and I will save the “insurance” premium. I would guess that the non-government insurance premiums offered by Thai and Offshore insurance companies have a pretty significant profit margin.

    I want to add a few things. The cheapest pharmacy I found is Chula Paysut (on Rama IV, across from Chamchuri square, west from Crown Plaza). I buy my blood pressure and cholesterol medicine there, and it saves a bunch.

    I also find that many private thai hospitals often try to “admit” you for relatively minor reasons, like “for observation”. Of course this drives up the hospital bill. I’m not sure if the motive is always for the patience best interest

    1. Not sure what the profit margin is, but I assume it’s about 10-20%. Add the 15% that goes to the broker. Statistically speaking, that means on average you’ll pay 50% more when going the insurance route. That’s the price for peace of mind.

      Thanks for chiming in on the pharmacy. I can see how that can save some people quite a bit of money!

      1. Even 20% is ridiculously low compared to the truth. Nobody works for this margin.

  23. With that many OPD visits, I guess you are not popular with ur insurance company 😛

  24. This article, at least for me, is pure gold and very useful. Many thanks for taking the time and making that effort!

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