Health Insurance Required for Older Expats in Thailand

Making Sure Only Financially Secure Expats Retire in Thailand?

In a recent news paper article, Thai officials announced new rules governing health insurance for expats staying for extended periods of time, including retirees.

Health insurance has been made mandatory for foreigners aged 50 years and above seeking long-term stay in Thailand. The insurance policy must offer up to Bt40,000 coverage for outpatient treatment and up to Bt400,000 for inpatient treatment. 

This is one of the measures the government has introduced to ease the financial burden placed on state hospitals by foreigners, many of whom have not paid for treatment. 

“The Cabinet has already approved the new rule,” Health Service Support Department director-general Nattawuth Prasert-siripong revealed yesterday.  

According to Nattawuth, the new rule applies to both new applicants for the non-immigrant visa (O-A), which offers a stay of up to one year, and those wishing to renew their visa. Each renewal is valid for one year.

Overseas policies okay too.  “Such health insurance is good for foreigners too,” Nattawuth said.  Foreigners can buy valid health insurance from longstay.tgia.org or if they wish to use health insurance that they bought overseas, they must ensure that the coverage amount is no less than what is required by the rule. “We are going to discuss with relevant authorities on to how to check the validity of health insurance bought from overseas,” Nattawuth said.

Asked about foreigners who cannot buy health insurance because their health risks are considered too high, Nattawuth said relevant authorities might consider requiring them to have higher deposits in bank accounts so as to make sure that they have enough to live in Thailand.

This change comes on the heels of rules requiring proof of adequate resources to live in Thailand, either through an ongoing $25,000 balance in a Thai bank or proof of monthly income from abroad of about $3,000. 

What About Medicare?

I am planning to retire to Thailand in the summer of 2020.  One part of my project planning is finding health care coverage.  I have learned that Medicare does not apply abroad. Even so, enrollment penalties encourage people over 65 to enroll and pay the monthly premium of about $500.  

Even if I can't use Medicare abroad to obtain treatment, I could do "reverse" medical tourism and return to the US regularly for preventative care and other needed treatment. I say "reverse" medical tourism because Thailand is known for offering high-quality medical care to tourists.  

Medical Tourism in Thailand

I had a wonderful experience at Bumrungrad International Hospital in Bangkok in 2016 when they did a top to toe physical exam.  Best exam I have ever had!  Senior package cost $750 and included abdominal ultrasound, mammogram, blood test, stool test, eye exam, and other tests.  They completed all the tests in the morning through a very efficient assembling line process.  All the doctors and assistants were grateful, humble, helpful, and fluent in English. I got an ovarian cancer test, while I waited, for $30 when the ultrasound revealed some ovarian cysts.  

In 2017, I returned to have cataract surgery.  The head of the ophthalmology department did the surgery over a two week period on the latest medical equipment.  Post-operative care was excellent.  I am very happy with the results.  My surgeon looked a lot like the fellow in this photo.  I thanked him with jazz CDs, expensive bottles of scotch, and chocolates.  In the Thai way, he did not open the gifts in front of me, but waited until later. 

Finding Senior Expat Insurance in Thailand

I've been talking with an insurance agent in Thailand to see what options exist. Thai policies exclude existing conditions and rarely insure anyone over 70 years old. Policies for folks above 60 have been described as "expensive" on the expat FB pages, but what most folks consider expensive is not what I consider expensive given my experience with US health care costs.

But, these new rules, with a captive market, may either increase or decrease insurance prices.  They could decrease insurance prices if more healthier seniors must get insurance.  But, more likely, they will increase prices as seniors -- who will likely need expensive care -- become part of the insurance company's book of business.  It could even make available insurance more scarce.

The new rule may allow retirees with uninsurable health risks to keep a bunch of money in a Thai bank account for self-insurance.  Many expats on the FB forums talk about "paying as they go."  In other words, they are self-insuring for the regular care they need.   In the end, self-insuring for even large medical events may be cheaper than paying for available policies.  I say that only because Thai medical care is so very affordable. 

High-Deductible Policy

I hope to find a Thai policy that will cover a major hospitalization by offering to pay a very high deductible, say $5,000 or $10,000 dollars.  The high deductible is a form of self-insurance.  So, if I get in a traffic accident with serious injuries, I'd get good care.

I am also considering an 5-year Elite Visa that costs $16,000. It may grandfather me in as Thailand seems to be tightening retirement visa requirements.  It may also provide some leeway on the health insurance requirement.  We will see.

Update with an additional resource: TGIA website.

More information:  Requirement may not apply to all folks older than 50.  See here, too.