Differences between Thai health insurances and overseas health insurances

International Health Insurances:

1. Most companies have no traveling restrictions except for the USA. You are covered for everything, anywhere in the world including Medical Evacuation costs.

2. All International companies adjust their premiums annually to compensate for continually changing medical costs and worldwide inflation. For well managed health insurance companies, this adjustment can range anywhere from Zero to 10%. For poorly managed companies, the increase can be higher.

3. The cheapest plan from any International company will pay for a normal private room in any hospital in the world. There are usually no limits for the room rates, just as long as the room rate is comparable to other hospitals in the same area.

4. International Health Insurance plans will normally pay ALL In-Patient expenses as long as they have been sent an invoice beforehand. It is important that you contact the insurance company before being admitted to the hospital and to make sure the hospital sends invoices to the insurance company to avoid unnecessary delays.

5. As long as you continue to pay the premiums before the due date, you are guaranteed renewal of your annual policy, Certain Insurance companies have limits on the maximum renewal age; others have no limits.

Local Health Insurances:

1. Competitive premiums with corresponding coverage limits. Health cover benefits are proportional compared to premiums charged.

2. Cheaper plans include sub-limits to costs of treatment, such as Surgeons Fees, Hospital General Expenses, Room and Board, Ambulance….etc.

3. Premium rates do not always reflect the real cost of insuring persons at each age group because premium rates are not adjusted annually to compensate for ever-increasing medical costs and inflation.

4. Renewal Premium rates are not guaranteed. If you are a healthy person with no claims, you can expect to pay the same premiums as other persons in your age group. If you are sick and have claims that have cost the insurance company money, your renewal premiums will be loaded by a percentage based on the size of the claims incurred by the Insurance Company. These loadings can range anywhere from 10% to 25% and are applied each year as a factor to the basic premium you pay. In later years, these loadings are compounded for each significant claim paid by the Insurance Co.

5. Renewal of your Local Health Insurance is not automatic. The policy is year by year. If the Insurance Company decides not to renew your policy, they have the right to refuse renewal if there is proof that you have misled the insurance company. This is allowed by the Office of Insurance Commission.

6. Local Health Insurance companies normally include a 30 day waiting period at the start of the policy for illness claims. There is no waiting period for Accident claims. Some companies also include a 6 month waiting period for a few medical conditions, see list below.

      1. Benign or malignant tumor, cancer, polyps or cysts.
      2. Hemorrhoids.
      3. Hernias.
      4. Pterygium, pinguecula or cataract.
      5. Tonsilectomy or adenoidectomy
      6. Stones
      7. Endormetriosis.
      8. Varicose veins.
      9. Hallux valgus.
      10. Ganglion.

7. Local Health Insurances have time limits on travel outside of Thailand; some companies limit you to as little as 90 days travel each year and 30 days per overseas trip.

8. Even the cheapest local health insurance policy offers worldwide cover. There are no Thai health insurance policies that only offer cover in Thailand. Unfortunately, the limits might be too low for certain countries where health costs are much higher than Thailand.

Features common to both International and Local Health Insurances:

1. You must be perfectly honest and disclose everything required in the insurance application. Hiding medical information is not to your benefit. If the insurance company finds out, they can either cancel your policy or deny paying claims.

2. All Insurance Companies abide by the same rules regarding Pre-Existing Conditions. Any claim as a result of a Pre-Existing Condition will not be covered. This applies even if you did not know about the Pre-Existing Condition and have never received treatment for this Pre-Existing Condition. Some insurance companies allow a 2 year grace period for pre-existing conditions. If in the first 2 years of the policy, you do not have a claim, take medication or need to see a doctor for that condition, you can ask the insurance company to cover it.

3. Other than Accidents, claims that occur in the first year of Insurance are always suspect. All Health Insurance companies are very cautious in paying for claims that occur in the first year because of the risk of being related to a Pre-Existing Condition. Therefore, it is in your best interests to have a Full Medical Checkup at a reputable hospital just before starting your health insurance policy. This Medical Checkup provides you with documented proof of your medical condition at the start of the Insurance Policy. It is the most important document that will help you dispute an insurance company’s decision to deny paying a claim because it is related to a Pre-Existing Condition. Don’t be surprised if you are asked to pay medical claims in the first year and wait for the insurance company to refund you after they have investigated the claim and received all supporting documents.

4. You must inform the insurance company anytime you change your address or change your job description.