#  >  > Living And Legal Affairs In Thailand >  >  > Thai Visas and Visa Runs >  >  Phuket Retirees 'Must Have Health Insurance'

## Mid

*Phuket Retirees 'Must Have Health Insurance'*
Alan Morison and Chutima Sidasathian    
Sunday, December 19, 2010

EXPAT retirees should be made to take out health insurance before  being allowed to stay on Phuket, says the Chief Executive of the Phuket  Provincial Administrative Organisation, Paiboon Upatising.

He called this week for compulsory health insurance as part of a general  reform to tighten the issuing of retirement visas to expats. 

''Some retirees are allowed to stay, but they do not have health insurance,'' he told _Phuketwan_. ''When they fall sick, they take beds in public hospitals, but they cannot pay.''

Khun Paiboon said there were about 40 cases in the past 12 months where  expat retirees were admitted and treated at Phuket's public hospitals,  although they did not have the money to pay for treatment. 

''Retirees who qualify are allowed to stay, but some do not have health  insurance,'' he said. ''When they fall sick, they take beds in public  hospitals, although they have no money.

''Right now, Vachira Hospital and Patong Hospital have some _farang_ [expats] who live in Phuket but they cannot pay for the medical treatment.''

Khun Paiboon also said there were expat retirees who borrowed money to  meet the provision of the retirement visa, which requires 800,000 baht  in the bank.  

''They borrow the money, put it into the bank for three months, but don't keep it in the bank all the time,'' he said. 

Thailand's visa regulations would need to change to make Khun Paiboon's suggestion a nationwide law. 

Phuket has three public hospitals and all are under growing pressure for  bed space because of the increasing number of residents on Phuket,  including an estimated 200,000 Burmese. 

At times, the beds at Vachira Hospital spill from wards into elevator foyers and corridors. 

Khun Paiboon intends to raise the suggestion of compulsory health  insurance and reforms to retirement visas first at a meeting with the  Governor of Phuket, Tri Augkaradacha, then at the Phuket ''Parliament''  with honorary consuls and embassy representatives in February. 

The move is likely to win the support of the envoys and be suggested to the national government as a necessary reform. 

Compulsory insurance for visiting tourists has also been suggested by  honorary consuls but is unlikely to win approval because it would make  Thailand less competitive in comparison to other destinations in Asia. 

Uninsured visitors who suffer serious injury in a motorcycle fall or  some other mishap quickly build up large hospital bills in Thailand and  can find other aspects of their lives are severely affected.

phuketwan.com

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## Stinky

Who would retire to Thailand without health insurance anyway? seems like a given to me.

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## Davis Knowlton

Not unreasonable. And they should have it anyway, for their own protection.

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## dirtydog

What if they are too old for insurance or have pre existing conditions?

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## Davis Knowlton

Stay at home. Let their own country pay for it. If I was a Thai, I wouldn't like it anymore than I like paying for illegal aliens who have bankrupted the medical system in the US, especially in states which border Mexico.

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## Stinky

> What if they are too old for insurance or have pre existing conditions?


Well they're knackered then, have to stay home, take their chances or just put up with short term holidays

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## koman

> Who would retire to Thailand without health insurance anyway? seems like a given to me.


A hell of a lot.  Many of the farangs I know don't have it because they can't get it.
It's becomes more and more  difficult over age 60 and the coverage is crap in many cases (full of exclusions and of course any pre-existing condition is excluded)  The cost becomes very prohibitive as you get older even if you do buy it when you are young enough.

If they made it compulsory, they would pretty much have to set up an insurance market that could make it available at prices that people could actually pay. No problem if you are young and healthy, but a pretty big portion of the ex-pat community don't fit that description.

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## SEA Traveler

> If I was a Thai, I wouldn't like it anymore than I like paying for illegal aliens who have bankrupted the medical system in the US, especially in states which border Mexico.


agreed!  We all need to be paying our own way.

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## Davis Knowlton

^^Understood. But note that this plan only extends to those on retiree visas. I am not sure about Thailand, but I do know that very few foreigners here are on retiree visas. I have full medical insurance for myself and my family as part of my pension package, but am not here on a retirement visa as it is just more paperwork and I don't really need it. I have a lot of friends in Thailand, on a variety of visas, but can only think of one or two who are on retirement visas. It is indeed a drag that older folks can't get decent insurance, however that doesn't make it right for them to further stress out an already stretched thin health care system in a country not their own.

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## Norton

> Many of the farangs I know don't have it because they can't get it.


Can't get it in Thailand but most all have medical coverage in their home country. If one is retired, either they have the money to pay for hospital service in Thailand or they have to go home for treatment. Why should Thailand foot the bill?

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## superman

> I wouldn't like it anymore than I like paying for illegal aliens who have bankrupted the medical system in the US, especially in states which border Mexico.


I also think like you DK, and tried to prove that illegal aliens bleed the system. I actually couldn't find a site supporting that theory. All I could find was that they contribute more than they're given.



> Illegal immigrants also don’t qualify for Medicaid, except in certain emergency conditions, and that amounts to relatively little


Social Security for Immigrants and Refugees | FactCheck.org

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## superman

If you have the Yellow Tambien Baan Book then a farang is entitled to free treatment in a Thai government hospital.

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## Davis Knowlton

^^Superman: Google 'Can American hospital emergency rooms turn away illegal aliens?"

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## terry57

> What if they are too old for insurance or have pre existing conditions?



Fokers should stay at home would be a good guess.

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## superman

May be they can't DK, I haven't looked yet. I don't want to get into a 'who's right' argument. Let's leave it there.

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## koman

> Originally Posted by koman
> 
>  Many of the farangs I know don't have it because they can't get it.
> 
> 
> Can't get it in Thailand but most all have medical coverage in their home country. If one is retired, either they have the money to pay for hospital service in Thailand or they have to go home for treatment. Why should Thailand foot the bill?


That's partly true, but many national insurance plans stop coverage after you have been out of your country for a period of time (varies by country) and there is a waiting period to get back on the plan if you return.  UK I believe is 6 months, Canada 90 days...etc etc.   I suppose there are ways to get around it by "beating the system" but not a very comfortable solution. 

I agree it should not be Thailand's problem. I assume that's why they are proposing to make medical coverage a part of getting a retirement visa.
I also think that if it became compulsory for a retirement visa it would be extended in due course to any other visa that allowed extended stays in the country. Ie Marriage visa,  Business etc. Time will tell.

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## Davis Knowlton

^^Not looking for an argument. I don't think we disagree. Fresh out of Kryptonite in any case, so wouldn't stand a chance.

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## Stinky

> Originally Posted by Sdigit
> 
> 
> Who would retire to Thailand without health insurance anyway? seems like a given to me.
> 
> 
> A hell of a lot.  Many of the farangs I know don't have it because they can't get it.
> It's becomes more and more  difficult over age 60 and the coverage is crap in many cases (full of exclusions and of course any pre-existing condition is excluded)  The cost becomes very prohibitive as you get older even if you do buy it when you are young enough.
> 
> If they made it compulsory, they would pretty much have to set up an insurance market that could make it available at prices that people could actually pay. No problem if you are young and healthy, but a pretty big portion of the ex-pat community don't fit that description.


In that case it's tough titties for the old retiree, I wouldn't expect Thailand to pick up my medical bills if I've just turned up at 60 and paid nothing I to the Thai economy all of my life, thats half the reason the National Health is so shafted in England now.    
I had Buppa international until recently and at just over a grand sterling a year I find that kind of money is easy doable, if it were to become so expensive that I couldn't afford it I'd have to seriously concider moving on, especially if I had health problems.

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## baby maker

> It's becomes more and more difficult over age 60 and the coverage is crap in many cases (*full* *of* *exclusions* *and* *of* *course* *any* *pre*-*existing* *condition* *is* *excluded*) The cost becomes very prohibitive as you get older even if you do buy it when you are young enough.


 
*So what's new about this idea...TIT....paying for something you don't get...*
*from the hookers to the noodles....what's different...*

*rots of ruck............*

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## koman

> If you have the Yellow Tambien Baan Book then a farang is entitled to free treatment in a Thai government hospital.


I've heard that before on other forums but have never been able to substantiate it.
I think it might be pretty limited service???  Would be good to find out for sure...

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## Stinky

Marry a Thai medical profecional that works for a government hospital and it free care for life, thai standard of course but that's fast becoming better than UK standards anyway so happy happy  :Yup:

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## Thetyim

I just looked up health insurance at Thai Life 
Rates seem quite reasonable
Thai Health Insurance...Intensive Care

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## Thetyim

> I've heard that before on other forums but have never been able to substantiate it.


Yes, it is true
I have used it.

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## Chairman Mao

Perfectly reasonable.

Hope it comes to fruition as a nationwide visa requirement.

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## Chairman Mao

> I just looked up health insurance at Thai Life 
> Rates seem quite reasonable
> Thai Health Insurance...Intensive Care


Extremely reasonable.

Go Thailand!

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## Chairman Mao

> Marry a Thai medical profecional that works for a government hospital and it free care for life, thai standard of course but that's fast becoming better than UK standards anyway so happy happy


Or one in the international standard hospitals - better and cheaper than the West. Hence why there's so much medical tourism from Western countries to take advantage of the superior Thai package.

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## superman

Sorry I cocked up.

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## Norton

> I also think that if it became compulsory for a retirement visa it would be extended in due course to any other visa that allowed extended stays in the country. Ie Marriage visa, Business etc. Time will tell.


May well happen. Others correct me if I'm wrong but a Thai applying for a visa of any type in UK or US must show they have medical coverage.

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## Marmite the Dog

Sounds reasonable when they get round to charging the same for foreigners as they do Thais.

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## Thetyim

> Others correct me if I'm wrong but a Thai applying for a visa of any type in UK or US must show they have medical coverage.


Wasn't true when I lived in the UK.
Any thai with a settlement visa was entitled to free medical care

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## dirtydog

Quite a few scandi countries they got to have medical insurance.

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## FarangRed

if you had 800,000 in a bank account here in Thailand you have got enough to pay your medical bills, how much more fuking money do they want you to bring here.

Have you seen the cost of medical insurance for over 60? I think a lot would leave the country if that was the case, compulsory cover.

Normal tourist landing here should have insurance, on a tourist visa that was normal when you booked a holiday in England to include travel insurance

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## dirtydog

> if you had 800,000 in a bank account here in Thailand you have got enough to pay your medical bills,


Ahh, but the Thai guy reckons they are borrowing the 800,000baht for 3 months to get the visas, of course if someone is willing to lend someone 800,000baht just to get a visa I'm pretty sure they may help out in a medical emergency.

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## Loy Toy

In most western countries you cannot gain admission to any Private hospital unless you can proove you can pay for the service either by having cash up front or certified qualified health insurance cover.

In fact I believe you cannot gain admission to Bangkok Pattaya without firstly proving without doubt you can pay for the services provided.

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## FarangRed

> Sounds reasonable when they get round to charging the same for foreigners as they do Thais.


Thats about right charge the same price and maybe the insurance cost would come down, I'd love to know I had to go Phuket International the other day it cost me 2050 baht but I'm sitting there looking at all the Thais how can they afford to come here or like you say they get it cheaper.

But also a know fact here in Phuket if you do use insurance is a higher price than if you pay cash.

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## chitown

> Originally Posted by Davis Knowlton
> 
> 
>  If I was a Thai, I wouldn't like it anymore than I like paying for illegal aliens who have bankrupted the medical system in the US, especially in states which border Mexico.
> 
> 
> agreed!  We all need to be paying our own way.



Maybe look at it as a return on our investment in this place?

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## FarangRed

> Originally Posted by FarangRed
> 
> if you had 800,000 in a bank account here in Thailand you have got enough to pay your medical bills,
> 
> 
> Ahh, but the Thai guy reckons they are borrowing the 800,000baht for 3 months to get the visas, of course if someone is willing to lend someone 800,000baht just to get a visa I'm pretty sure they may help out in a medical emergency.


He never mentioned about all the doggy retirement visa people are on here, you dont need to borrow the 800,000 to get one, best we dont talk about that one

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## superman

> In fact I believe you cannot gain admission to Bangkok Pattaya without firstly proving without doubt you can pay for the services provided


This is the case at the Bangkok Hospital in Korat. They phone the insurance company up before they admit you.

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## corvettelover

so how many falungs get treatment for free in thailand at any hospital be real front page of paper if you dont pay

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## dirtydog

> Khun Paiboon said there were about *40 cases in the past 12 months* where expat retirees were admitted and treated at Phuket's public hospitals, although they did not have the money to pay for treatment.


Now we can guess he rounded that figure up, so because of 3 farangs a month he wants the countries laws changed, he will go far.

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## Thetyim

^ ^
I get free hospital treatment
I also get free phone calls

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## Chairman Mao

> so how many falungs get treatment for free in thailand at any hospital be real front page of paper if you dont pay


It sure would, given that Thais don't even get hospital treatment for free, without insurance.

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## BobR

Always some xenophobic twat wanting to make things more difficult for foreigners.  Just get me stable and I would fly home for anything serious anyway.  I do not trust the "for profit" hospitals here.

Besides, expats pay taxes here, and probably more than most Thais. So what, they have to treat a few of them.

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## Thormaturge

If someone enjoys good health, views insurance premia as a waste of money, and has resources to fund medical expenses, they should not be forced to pay if they have sufficient funds to meet any likely medical costs.

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## FarangRed

Always some one trying to make a name for themselves, like the one about not being able to display cigarettes in the shops not to encouage people to smoke.

It would be interesting to see some kind of results after a couple of years now in operation

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## Thormaturge

Khun Paiboon Upatising has probably bought shares in a few Thai health insurance companies recently.

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## BobR

> Always some one trying to make a name for themselves, like the one about not being able to display cigarettes in the shops not to encouage people to smoke.
> 
> It would be interesting to see some kind of results after a couple of years now in operation


Then there's the 1000's who have been saved from a lifetime of alcoholism now that booze can no longer be in holiday baskets.  Still, when it comes to silly, worthless and harassing laws, Thailand has a long way to go to catch up with the West.

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## farmerfloyd

I thought that it was impossable to get insurance for a male over 70 yrs of age?
 What would it cost for somebody who is healthy,  them motorcycles are dangerous but sure enjoy them 110  cc Honda. 5 years no crash yet, fingers crossed. but do have money for care.

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## Krumble

The foreign retirement population has mushroomed since the one year retirement extensions came into being around 30 years ago.  I sense that some people in authority may be starting to feel that these easy regulations may have outlived their usefulness and there is now a need to review them.  Thais are forced to get medical insurance for European Schengen visas, so they might feel this would be a no brainer for retirees.  Unskilled labourers from neighbouring countries are also required to pay into a deportation fund and this may also be considered. I am not sure how many retirees borrow the B800k.  The three month seasoning rule makes this more difficult.  However, many people keep that B800k sancrosanct for their renewals which means it is not available for anything else, if they intend to stay in Thailand indefinitely. 

Malaysia requires medical insurance and the deposit of a bond from foreign retirees but in return gives them much greater rights in the form of a long term visa, the right to own a plot of land, the right to work part time with permission and the right to import a car duty free.  The numbers there are much smaller and the financial hurdles much higher than in Thailand but both the retirees and the authorities seem happy with the arrangement.

I thought medical insurance was available for senior citizens at a price.  My 86 year mother has insurance with AXA in the UK and she has claimed for several major operations over the years without being cut off.  Are posters saying that medical insurance is not available for over 60s or over 70s because they live in Thailand?

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## BobR

Seems like a non-existent or exaggerated problem anyway.  You already need 65000 baht a month income to qualify for a retirement visa, and anyone with that lind of money could afford to pay for their emergency care.

I have American health insurance and all the British all have their national plan, so all the Thais would have to do is patch me up enough to fly home.

I did have my hernioplasty last year  in a Thai public hospital. I paid for it and my American insurance paid me back.  The operation, 3 days in the hospital, anesthesia, everything including a private room was $700 usd, so you do not even need insurance to pay peanuts like that.

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## Davis Knowlton

^Exactly what I do here. I pay for it, then submit the bills to my American insurance company, which pays me back. 80% of everything, unless I stay overnight (or longer) in a hospital, and then they pay 100% of the bill. Same for wife and kids.

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## Javabear

> Originally Posted by koman
> 
> I also think that if it became compulsory for a retirement visa it would be extended in due course to any other visa that allowed extended stays in the country. Ie Marriage visa, Business etc. Time will tell.
> 
> 
> May well happen. Others correct me if I'm wrong but a Thai applying for a visa of any type in UK or US must show they have medical coverage.


I'm working the US visa process for my wife right now and no one has asked about medical insurance yet.

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## Norton

> I'm working the US visa process for my wife right now and no one has asked about medical insurance yet.


I was corrected. Turns out it's European Schengen visas that require insurance. You will have to claim financial responsibility for the wife so her medical expenses, if needed, will be your responsibility.

Good luck getting your visa.

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## Davis Knowlton

My formerly Filipina wife has been a US citizen for ten years. She had tourist visas for about ten years before we finally got married, and she got her citizenship. I think during the process I filled out enough forms to denude a rain forest, but I don't recall ever being asked about medical insurance anytime during the process.

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## Chairman Mao

> Besides, expats pay taxes here, and probably more than most Thais. So what, they have to treat a few of them.


Not if they're on a retirement visa. 

Besides of course the average sales tax when they buy their viagra, denture cream, adult nappies etc.

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## Krumble

> Originally Posted by Norton
> 
> 
> 
> 
> 
> 
> 
>  Originally Posted by koman
> ...


I only know of a medical insurance requirement for European visas.  My wife has never been asked for it for the UK, US or Oz.  I started getting it for her anyway for those countries as it doesn't cost much for a short trip.  

I can't see medical insurance coming in for people on transit or tourist visas, given the competitive concerns mentioned.  But for retirement and marriage visas it makes sense as the holders of those are usually not working in Thailand and many are at the age where they start needing more medical attention.  The authorities seem to have been in denial about the foreign retirement community.  It has been a convenient source of income, since the days when they had very few tourists, and they have been happy to pretend that they are only temporary residents because they have only short term visas and are considered as tourists.  Now they may have to start accepting that there is a substantial community that needs to be recognized in terms both of aspirations for more rights as well as potential costs.

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## superman

> However, many people keep that B800k sancrosanct for their renewals which means it is not available for anything else, if they intend to stay in Thailand indefinitely.


That I believe that is against the rules in that movement has to be seen within the account. Might be just the office I use ?

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## aznyron

:sexy: 


> Originally Posted by koman
> 
>  Many of the farangs I know don't have it because they can't get it.
> 
> 
> Can't get it in Thailand but most all have medical coverage in their home country. If one is retired, either they have the money to pay for hospital service in Thailand or they have to go home for treatment. Why should Thailand foot the bill?


I am one of those expats to old to get insurance & yes I have used both pvt & Government hospitals & they got paid & in both cases if it was to happen in the states I could have sued & won since both were no fault of my own. I welcome the idea of forced insurance for expats in all honesty I am fed up with the B/S of immigration rules this way it will make it easier for me to obtain a visa for my wife I suspect & return home this is not the thailand I came to 6 years a go things have changed & not for the better of Thailand

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## koman

> I thought medical insurance was available for senior citizens at a price. My 86 year mother has insurance with AXA in the UK and she has claimed for several major operations over the years without being cut off. Are posters saying that medical insurance is not available for over 60s or over 70s because they live in Thailand?


You can buy medical insurance in Thailand from about 15 or 16 different companies up to age 65.  The problem is cost once you reach 60+   Many of the plans are renewable for life provided you keep paying the increasing premiums.  I know because I have done it myself.  I get a  discount for each year I remain claim free and the policy has a guaranteed renewal for life clause.  I currently pay 42,000Thb a year for a 5 million per claim limit with a 25 million aggregate limit.  The policy has a 40,000Thb deductible.

 I only carry it for the big stuff.  I know a guy who ended up with close to 2 million Thb in medical expenses a few years back, and he thought he was bullet proof until he ended up int the cardiac unit.   Don't underestimate the potential costs of life saving medical care in Thailand.  It can get bloody expensive depending on what happens and the level of medical expertise you need to keep you alive.  Not everybody gets away with a few days in a government hospital.  Try 2 months in a Bankok private hospital with major surgery and post operative care.  You will be seriously unimpressed with the bill. A top flight cardiologist or neuro surgeon will charge 2-3K every time they enter your room.  Another guy I know had 3 "stints" inserted in Bkk... cost 700K without any hospital stay.   For those without insurance or lots of cash.....well you can die fairly cheaply here and  I think cremation is free.

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## Marmite the Dog

> I did have my hernioplasty last year in a Thai public hospital. I paid for it and my American insurance paid me back. The operation, 3 days in the hospital, anesthesia, everything including a private room was $700 usd, so you do not even need insurance to pay peanuts like that.


But the UK's NHS won't reimburse a Thai hospital for any treatment.

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## Davis Knowlton

^ MtD: But will they reimburse you for treatment which you had in a Thai hospital, and for which you paid cash, and then submitted the bill to them for reimbursement to YOU? That's what BobR and I are talking about.

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## pascharay

reading the replies to this story I'm reminded how hard-hearted most farangs are to both their own kind and thais as well. mean-hearted bastards to the most part. to be avoided and seen avoiding.

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## dirtydog

> ^ MtD: But will they reimburse you for treatment which you had in a Thai hospital, and for which you paid cash,


Nope, NHS doesn't play that game.

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## Tomesarn

> Originally Posted by Krumble
> 
> I thought medical insurance was available for senior citizens at a price. My 86 year mother has insurance with AXA in the UK and she has claimed for several major operations over the years without being cut off. Are posters saying that medical insurance is not available for over 60s or over 70s because they live in Thailand?
> 
> 
> You can buy medical insurance in Thailand from about 15 or 16 different companies up to age 65.  The problem is cost once you reach 60+   Many of the plans are renewable for life provided you keep paying the increasing premiums.  I know because I have done it myself.  I get a  discount for each year I remain claim free and the policy has a guaranteed renewal for life clause.  I currently pay 42,000Thb a year for a 5 million per claim limit with a 25 million aggregate limit.  The policy has a 40,000Thb deductible.
> 
>  I only carry it for the big stuff.  I know a guy who ended up with close to 2 million Thb in medical expenses a few years back, and he thought he was bullet proof until he ended up int the cardiac unit.   Don't underestimate the potential costs of life saving medical care in Thailand.  It can get bloody expensive depending on what happens and the level of medical expertise you need to keep you alive.  Not everybody gets away with a few days in a government hospital.  Try 2 months in a Bankok private hospital with major surgery and post operative care.  You will be seriously unimpressed with the bill. A top flight cardiologist or neuro surgeon will charge 2-3K every time they enter your room.  Another guy I know had 3 "stints" inserted in Bkk... cost 700K without any hospital stay.   For those without insurance or lots of cash.....well you can die fairly cheaply here and  I think cremation is free.


Mind if I ask what company you are insured with?
thanks in advance...

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## Krumble

> If you have the Yellow Tambien Baan Book then a farang is entitled to free treatment in a Thai government hospital.


Interesting point.  Can anyone reference the regulations for this?  I know there is some legislation providing unskilled alien workers and stateless people with alien ID cards access to government health care and I think registered unskilled alien workers are now part of the Social Security Fund.  However, I can't find any legislation that says any foreigner on a tabien baan is entitled to universal health care. The 2002 National Health Security Act doesn't specify who is eligible but in the preamble it refers to Thai people (only).  Regulations do require registration on a tabien baan to receive a Gold Card but they also require presentation of a national ID card along with the Gold Card when claiming free health care.  

I wonder if some people have confused the fact that anyone can register with a government hospital and receive cheap health care with actually getting a Gold Card.  I am on a blue tabien baan and was once sent an application form to apply for a Gold Card which I assumed was a mistake.  Should I pursue this as a fallback, even though I would prefer not to have use it?

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## superman

The German guy who lives near me got his Yellow book by paying tea money. He then received a piece of paper that covered him for one month Thai medical insurance. After that month was up he received the card and has actually used it at the local government hospital.
I have now got the local Ampur to agree to issue a yellow book. My wife tried to pay team money to save on the pissing about, but they've refused, and will only do it according to their book.

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## Lorenzo

> ''Some retirees are allowed to stay, but they do not have health insurance,'' he told Phuketwan. ''When they fall sick, they take beds in public hospitals, *but they cannot pay*.''


*they cannot pay ..... * and this is the only reason we want the here in the first place

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## Thetyim

> I wonder if some people have confused the fact that anyone can register with a government hospital and receive cheap health care with actually getting a Gold Card.


I was issued with a Yellow Tapien Baan house book and later on I received a Gold Card without even asking for it.
I have used the gold card to get free medical care and free prescriptions without a national ID card.

If I go private then I will get the same doctor treating me.

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## The Master Cool

> Originally Posted by Mid
> 
> ''Some retirees are allowed to stay, but they do not have health insurance,'' he told Phuketwan. ''When they fall sick, they take beds in public hospitals, *but they cannot pay*.''
> 
> 
> *they cannot pay ..... * and this is the only reason we want the here in the first place


Why would any country want foreign retirees (not paying tax on earnings) to reside in their country?

Especially without medical insurance and the ability to pay for any medical expenses the incur.

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## superman

> Why would any country want foreign retirees (not paying tax on earnings) to reside in their country? Especially without medical insurance and the ability to pay for any medical expenses the incur.


From what I've been reading of late, I'd say thev UK.

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## koman

> Originally Posted by Krumble
> 
> I wonder if some people have confused the fact that anyone can register with a government hospital and receive cheap health care with actually getting a Gold Card.
> 
> 
> I was issued with a Yellow Tapien Baan house book and later on I received a Gold Card without even asking for it.
> I have used the gold card to get free medical care and free prescriptions without a national ID card.
> 
> If I go private then I will get the same doctor treating me.


How long ago did this happen?  I believe the "gold card" was for access to the Thaksin 30 baht medical  care deal for Thai nationals  I've also been told that this program has been pretty much gutted under the present government.  (probably because Thaksin was behind it.. :Smile: ) 

It's a bit of a mystery because just yesterday I happen to meet a Thai who works in the admin department of a pretty big government hospital and she said "falangs can not get 30 baht health care"  

Also, private medical insurance in a booming business in Thailand...amongst the Thai's that is. Why would so many Thai's be buying "expensive" insurance if the government program was any good??  Be nice to get to the bottom of it......

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## Krumble

> The German guy who lives near me got his Yellow book by paying tea money. He then received a piece of paper that covered him for one month Thai medical insurance. After that month was up he received the card and has actually used it at the local government hospital.
> I have now got the local Ampur to agree to issue a yellow book. My wife tried to pay team money to save on the pissing about, but they've refused, and will only do it according to their book.


Interesting.  I think I will try to apply for a Gold Card and see what happens.  My missus has also never bothered to apply for one.  So we can go together.  Do you apply at the district office or do you have to go to the Miinistry of Public Health?

Many district offices try to create a mystique about issuing tabien baans for foreigners, either because they don't know the law or just don't like it.  The fact is that district offices are obliged under the 2008 Registration of Persons Act to register everyone who lives in their district on a tabien baan.  The law specifies that this includes foreigners who are not permanent residents and that they should receive a yellow book (TR13).   In fact the district officers are guilty of dereliction of duty by not registering every one who applies (except those on tourist or transit visas).  Retirees and those on marriage extensions certainly qualify for yellow books, the only difficulty being persuading landlords for those in rental accommodation.

Maybe this is the solution to the problem, even if not necessarily the one that K Paiboon was hoping for!  LOL

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## Thetyim

> I believe the "gold card" was for access to the Thaksin 30 baht medical care deal for Thai nationals I've also been told that this program has been pretty much gutted under the present government.


Abhisit removed the 30 baht fee and made it free

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## Norton

> Many district offices try to create a mystique about issuing tabien baans for foreigners, either because they don't know the law or just don't like it.


I was the first to ever get one in my district so the "clerks" had no idea how to do it. Was told cannot get one. Called a friend in the provincial government office. Had one in an hour.

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## superman

> Abhisit removed the 30 baht fee and made it free


Correct. The one thing I miss from Mr Thaksin's days is that in government offices, IE immigration for one, cover must be maintained during lunch time. They've all reverted back to their old ways, and now stop en bloc again.

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## koman

> Originally Posted by koman
> 
> I believe the "gold card" was for access to the Thaksin 30 baht medical care deal for Thai nationals I've also been told that this program has been pretty much gutted under the present government.
> 
> 
> Abhisit removed the 30 baht fee and made it free


I don't know if that is correct about the 30 baht,  but even if its true, it does not mean the program itself has not been compromised.  I am being assured by a couple of Thai's who work in the system that it has.   Anyhow you did not provide any information about when you accessed this free health care and what was involved...that's the issue...not the 30 baht. 

There are totally conflicting stories about this situation on several forums and nobody seems to be able to authenticate any of it.   If this is supposed to be an information exchange, one liners won't really accomplish much I'm afraid.

Again, if its all free and wonderful, why are the Thai's who can afford it climbing over each other to buy medical insurance??

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## Thetyim

> Anyhow you did not provide any information about when you accessed this free health care and what was involved.


Last month.
I showed the card, I got free treatment (examination & drugs)

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## superman

> Again, if its all free and wonderful, why are the Thai's who can afford it climbing over each other to buy medical insurance??


May be it's because having insurance gets you fast tracked. Under the government system if they feel there's no hope for you they send you home to die. Why waste money trying to keep someone alive when it's futile. Whereas having insurance gets you the better system.

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## Norton

> Under the government system if they feel there's no hope for you they  send you home to die. Why waste money trying to keep someone alive when  it's futile. Whereas having insurance gets you the better system.


If there is indeed no hope, perhaps the government system is the most humane for the patient and their families.

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## navynine

So if your married to a thai you would need no insurance other than free BULLSHIT. As a retired person living in LOS I pay at a higher rate to start with and the hospital's here have tried in no way to accept out of country insurance plan's I went as far as getting all the information and forms for BGH to fill out and return which would only mean a phone call from the hospital to the insurance provider and was told it was too expensive to call on each farang to get approval. Once again Bullshit take your proposed plan and your visa and put it where the sun does not shine. Now that the rant in over ;  enough is enough and beware if at first the retired then what or who is next.

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## superman

> If there is indeed no hope, perhaps the government system is the most humane for the patient and their families.


I beg to differ on that.

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## pascharay

i'm always surprised at how cheap farangs are with their own kind until I realized how kee-neo they are with thais

farang kee-nok

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## superman

> farang kee-nok


These days I have to admit I am. Due to raising 3 kids and thinking of their education, choice isn't necessary an option.

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## Lorenzo

> Why would any country want foreign retirees (not paying tax on earnings) to reside in their country?


They spend money which originates outside Thailand, net effect is the same as exporting manufactured goods.

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## Krumble

> So if your married to a thai you would need no insurance other than free BULLSHIT. As a retired person living in LOS I pay at a higher rate to start with and the hospital's here have tried in no way to accept out of country insurance plan's I went as far as getting all the information and forms for BGH to fill out and return which would only mean a phone call from the hospital to the insurance provider and was told it was too expensive to call on each farang to get approval. Once again Bullshit take your proposed plan and your visa and put it where the sun does not shine. Now that the rant in over ;  enough is enough and beware if at first the retired then what or who is next.


I had a different experience with BNH in Bangkok which is owned by BGH.  I went in for a minor op with an overnight stay - cost B70,000.  I gave the hospital a claim form from AXA PPP in the UK and BNH billed them direct.  The billing must have gone smoothly as I never heard anything more about it.

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## Krumble

> Originally Posted by The Master Cool
> 
> Why would any country want foreign retirees (not paying tax on earnings) to reside in their country?
> 
> 
> They spend money which originates outside Thailand, net effect is the same as exporting manufactured goods.


Correct.  The income from retirees' expenditures should go into the tourism account which is exports of services.  Unlike manufactures which usually have a significant imported input component that offsets the export income, tourism dollars don't have this, TAT's overseas staff and advertising aside.   However, there is a cost in terms of the domestic infrastructure consumed by retirees and tourists, e.g. their wear on roads, use of airports, immigration officers, police, prisons & etc.  This is not normally a huge cost relative to the income but foreign retirees getting into the news by refusing to pay bills at government hospitals creates an emotional cost out of proportion to the size of the unpaid bills.  

Now that the foreign retiree population has grown quite large with minimal regulation, it is inevitable that the government will step in sooner or later to regulate it more closely and medical insurance is probably a no brainer on that front.  A time when tourism has recovered nicely, like now, could be a good time to start.  Any type of clamp down on foreigners is usually a good vote getter at election time.  Doing something about farangs is a good way to distract attention from the fact that the government has no coherent policy to handle the 2 million Burmese, Khmers and Laotians they are now dependent on for sweated labour without human rights.

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## Thetyim

> e.g. their wear on roads, use of airports, immigration officers,


We pay annual car registration tax
We pay airport taxes
We pay for extensions of stay

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## Thetyim

> The income from retirees' expenditures should go into the tourism account


Should being the correct word but I have yet to see any evidence that it is.

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## Krumble

> Originally Posted by Krumble
> 
> e.g. their wear on roads, use of airports, immigration officers,
> 
> 
> We pay annual car registration tax
> We pay airport taxes
> We pay for extensions of stay


The individual examples don't need to be taken too seriously.  I am just trying to make the point that there is some sort of cost involved that is hard to quantify and isn't generally that high.  A lot, if not all, of this is also offset by VAT payments which even on expenditures of say B30,000 a month is higher than the average Thai citizen.  However, it is easy to focus attention on one item that occurs infrequently, i.e. unpaid medical bills or foreign criminals requiring incarceration, and make out that the overall cost is much higher than it really is. 




> Originally Posted by Krumble
> 
> The income from retirees' expenditures should go into the tourism account
> 
> 
> Should being the correct word but I have yet to see any evidence that it is.


The Bank of Thailand can get an accurate handle on this by assuming all retail forex transactions into baht are due to tourism.  It is impossible to separate out the retirees' expenditures from general tourists but, since the number of retirement visa extensions should be known, it is possible to estimate this.  A similar estimate can be made for those on marriage extensions.  Even though it is possible for them to work legally, most are probably retired, since most people on work permits get non-imm B visas that are generally easier.  

I have no idea how many retirement and marriage extensions there are but I guess their contribution to tourism revenues is reasonably significant.  Whether those in authority appreciate this and will continue to appreciate it or not is hard to say but allowing foreign retirees to stay indefinitely on temporary visas is not something that happens in more developed countries.  Most only allow long term settlement with significant barriers to entry or tourist visas for up to 6 months a year.  Inevitably Thailand will go that route too but it might take another generation.

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## dirtydog

> or foreign criminals requiring incarceration


To keep 1 Thai criminal in jail in the UK probably costs the same as keeping 100 farang criminals in jail in Thailand.

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## superman

Anyone wishing to do time in the BKK Hilton should know their rights. There aren't any. Sorry to go off topic
STEVE'S LIFE IN BANGKWANG PRISON THAILAN - A Bravenet.com Hosted Site

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## Krumble

After reading about farangs getting gold cards here I contacted my district office to see if I was eligible for one.  They asked for my ID number from my tabien baan and after looking it up in the computer told me that a gold card had been issued automatically in my name when the scheme first started under Thaksin and sent to my house.  I remember receiving a notification about the gold card at the time, which I thought had been sent to me by mistake, as I thought it was only for Thai nationals, but I didn't receive the card.  So my next question was, "Can I have a replacement card issued?", to which the answer was "no" as gold cards can no longer be issued to foreigners, following a recent change in the rules.  However, the officer told me that my coverage was still good without the actual card.  I can get free treatment at a government hospital if I take along my tabien baan and other ID documents.  They will verify my membership in the computer. 

I guess that they noticed that a large number of foreigners have been getting on tabien baans since the 2008 Civil Registration Act made it compulsory for district offices to register all foreigners living in their district on any type of visa except tourist or transit visas.  Hence the rule change.  As far as I know foreigners who got into the scheme before the rules changed are currently allowed to stay in it indefinitely.  Thanks to the posters here for pointing out my entitlement.

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## Seekingasylum

Not sure if it has already been highlighted but adequate full health insurance for  someone in their late 50s or early 60s residing in Thailand would be provided by the major players in the UK at an annual premium of between £3 - 5,000. 

Given this quite challenging indemnity it would occur to most folk that to wing it might be the best financial solution. 

Now, accident insurance is another matter and should be compulsory.

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## Mid

*Hospitals count cost of foreigners' bills*
20/01/2011

*Elderly patients often can't pay for treatment * 

*PHUKET* : State hospitals in the southern  province are shouldering a heavy burden for treating elderly foreigners  who cannot afford to pay their medical bills.

 Many retired foreigners who came to Thailand with the hope of  settling down here are now struggling after spending their pensions  wastefully and marrying Thai women, some of whom left them after their  money ran out.

 Lots of foreigners have fallen ill and been admitted to local  hospitals. Their relatives back home refuse to pay for their treatment  on being contacted by the embassy, Vachira Phuket Hospital's public  relations centre said.

 The embassies regard the matter as personal. They will provide help to their nationals only in cases of emergency or disaster.

 "So we've treated these patients based on professional ethics until  the last moments of their lives. Funeral rites and merit-making  ceremonies are held for them," a source at the centre said.

 The state-run Vachira Phuket Hospital admitted a record 377 foreign patients, mostly Britons, in the 12 months to Sept 30, 2010.

 There were also cases of foreigners who died outside of hospital but  were brought in for autopsies. They died of causes ranging from road  accidents to drowning and suicide.

 The hospital last year spent 1.3 million baht treating 17 penniless  foreigners. It was the third consecutive year that the hospital had  logged unpaid bills.

 The hospital bore costs of more than 1.2 million baht in 2009 for 22  foreign patients, a 50% rise from the 800,000 baht in costs to treat 17  patients in 2008, the centre said.

 "These patients are mostly European men," the source said. "They  didn't take out health insurance. They renew their visas every year and  have no savings."

 Some of them produced fake financial statements to have their visas  renewed. Each foreign national seeking the renewal of his or her  retirement visa must have at least 800,000 baht in their bank account or  show they have earnings of at least 65,000 baht a month.

 The source said foreigners' savings often were quickly used up on entertainment and women.

 Some who wanted to build families in Phuket married Thai women who later took off with their money.

 In a lot of cases, the patients require long-term treatment for  chronic illnesses such as alcoholism and liver and heart diseases.

 The source said the government should review its policy and focus on quality tourism.

 Stricter screening of visa applications was needed. Foreign residents must be required to have health insurance.

 The government should even set up a fund to help foreign patients with some of their financial costs, the source said.

bangkokpost.com

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## dirtydog

> The source said foreigners' savings often were quickly used up on entertainment and women.


Bit of a sweeping statement that, I assume they mean Thai women?

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## genghis61

> struggling after spending their pensions  wastefully and marrying Thai women, some of whom left them after their  money ran out.


not limited to Phuket I'd imagine.
we have a friend in Phuket who will fall into this category, has a 4m 'asset' he can't touch as it is all in the name of the local woman he fell for here who has since found another farang to live off; he came to Thailand at a time when his UK pension (his only income) traded at 70+ baht - what is it now, high 40s? 
His family 'back home' have wiped him he has nowhere to go but his self-built prison, at 76 no medical cover. 
What to do?

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## taxexile

> The source said the government should review its policy and focus on quality tourism.


.... and tourists should focus more on quality women.

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## dirtydog

The Phuket expats club has just submitted their demands to TAT, they want a better class of hookers in Phuket, no more of the Pattaya cast offs should be allowed on Phuket island, sign their petition at Phuketexpats.com/better-class-of-whores-wanted/

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