FAQ – TIGON CONSULTANCY
What is Health / Medical Insurance?
A Health /Medical Insurance policy can protect you from bearing the full expense of regular health care, be it the costs of medical and surgical procedures. In exchange for paying a premium, your insurance company will cover the costs of your healthcare and certain medical procedures when you experience an unexpected illness and injuries.
Should you have a Health plan via your employer, you can also have the option of purchasing your healthcare coverage privately to boost the amount of medical cover, providing you peace of mind for any major medical scenario.
Why do I need Health /Medical Insurance?
Health Insurance will provide for you for those unexpected illnesses, injuries and accidents that may occur. Having a Health Insurance policy can protect you from both financial, mental and emotional stress.
Should you have no Health Insurance cover or you are with limited funds, you could end up in a very difficult situation to pay your hospital bills because of unforeseen circumstances.
Having an adequate health insurance policy helps you to be control of your health. With routine testing / annual check-ups, this can help with early detection of conditions and diseases, such as diabetes, heart conditions, thyroid problems and cancers, which can require much more extensive and costly care if they go untreated if not dire endings
How much does Health Insurance Cost in Thailand?
Your Health Insurance policy and premium is based on the following :
- Which Insurance company you select
- Your age
- your plan selection
- area of coverage and,
- whether you opt to have either a co-payment and, or a deductible ( Excess) .
Should you wish to reduce the Health Insurance premium, pending upon the Insurance Company and the level of cover selected, you can opt for one of the following:
- Deductible / Excess: This is the elected amount of money that you agree to pay for your medical treatment before the Insurance company settles the medical Bill. This can be either applied as per claim or per year basis, depending on the selected Insurance company. Eg You have a bill of B150,000 and an excess of B40,000 on your policy. You would pay first B40,000 of this cost and the Insurance company would cover the remaining B110,000.
- Co-payments: With a co-payment, the insurance company agrees to pay for a service but you must cover a pre-set cost, eg 500 Bht. This cost applies every time you schedule a service that has an assigned co-pay. Co-pays can be lower or higher depending on the plan or according to the service provided.
Speaking with one of our staff, we will work with you to find the best solution to your needs
How do I pay my premium?
Premiums are payable annually in advance, by bank transfer or credit card.
Some Insurance companies will, for an additional charge, allow for either bi- annual or quarterly premium payments.
There are not many companies in Thailand that provide monthly premium payments
How much Health / medical insurance cover do I need in Thailand?
This varies from person to person, your age, health condition and of course your budget. Should you wish to cover for emergency cases only, we would suggest the minimum basic cover of eg 1 Million Bht.
Lower levels of cover are available, although in good practice, this is frowned upon.
Hospitals have different charges and this could be insufficient depending upon the treatment that you require.
Some people would like to have “all the bells and whistles”.
Should it be dependent on your budget, speak to one of our staff to assist you further
It is always easier to downgrade your level of cover than what it is to upgrade.
Are there any age limits to take out a Health /medical insurance Policy in Thailand?
For individuals the minimum entry age is 2 weeks of age ( new borns) and pending upon with which Insurance company you select, the average maximum entry age is 65 yrs.
Who is eligible to apply for Health / medical Insurance cover?
Almost anyone can purchase a Medical / Health Insurance policy.
Some of the insurance companies that we work with, provide cover for local nationals
What geographical coverage is provided in your Health Insurance plans?
Most of the plans we offer fall into three categories of geographical coverage:
- Worldwide Including the USA, Canada and the Caribbean,
- Worldwide excluding the USA ,Canada and the Caribbean .
- Local or Regionalised plans eg SE Asia ( Thailand, Cambodia, Laos, Philippines, Vietnam, & Myannmar)
The Worldwide plans tend to around 50% more expensive than the excluding USA plans, and this is because of the expensive costs for treatments and medicines in the USA and neighboring areas.
Most clients opt for the Worldwide excluding North America (USA and Canada) areas of coverage.
There some companies whom provide more regionalized / localized plans eg SE Asia only, which exclude worldwide coverage.
To find out which plan is best suited to your needs, speak to one of our advisors
Do I need to provide details of my medical history?
All insurance companies require you to complete a medical questionnaire.
Providing detailed information about an existing or past medical condition will help the Insurance company to evaluate treatment you may require in the future. This will help to ensure that you do not find yourself with unnecessary restrictions.
Should have any confusion when completing the application form do not hesitate to contact us.
Do I need to have a medical examination to obtain a new Medical / Health Insurance Policy?
Depending upon your entry age and the Insurance Company chosen, you may require to have a medical examination. This is normally applied to the more senior applicants of 60 yrs and older.
In most cases, you only need to complete a medical questionnaire.
It is not to your benefit by hiding any medical information as it can can cause you more harm than good. Should the insurance company find this out, they can either cancel your policy outright or deny paying any claims.
What are pre-existing conditions?
A pre-existing condition means any disease, illness or injury for which have had received medication, advice or treatment, you are still currently taking medication, or which you have experienced symptoms, whether the condition has been diagnosed or not, at any time before the date on which your medical Insurance policy starts
It is the discretion of the Insurance company, whether your pre-existing Medical Conditions will be accepted or not, which had been declared on your new application form.
Should you switch insurers, it is most likely that new insurance company may exclude any conditions you have had treated whilst with the previous insurer.
On occasions, the Underwriters of the various Insurance companies may issue either a partial (Moratorium) exclusion/s, total exclusion/s or, propose an additional premium to waive exclusion/s.
NB: All new applications need to declare their pre-existing conditions.
Do all family members have to have the same level of cover for a Health Insurance Policy
All members of the family, yourself and your dependents will be covered on the same plan with the same chosen excess and co-pay. An age-rated premium applies for each insured member
Are Dental and Vision treatment offered on your Health Insurance plans?
Most Insurance companies have this as an optional extra, and it varies from company to company and the plan level selected .
Can I change my level of Health Insurance cover?
Changing one level of cover can only be done at the renewal date of the policy, whether this be to downgrade, upgrading plan or have other options. In the most cases of upgrading, a new medical questionnaire may need to be completed.
Will I be covered for chronic conditions on my new Health Insurance policy?
This depends on the plan level you choose from the selected Insurance company.
Speak to one of our staff for assistance.
What is the difference between ‘Out-patient’ & ‘In-patient’?
Outpatient is treatment you receive when you go to hospital, see the doctor, obtain medicine etc and then return home.
Inpatient is when you are admitted to hospital for a period of time.
Will I be able to renew my Health Insurance policy until I die?
Insurance companies usually have an age restriction, they will only cover you until you’re 80 or 90. This varies from company to company.
Ask your broker / agent until what age you are able to renew your health insurance.
Can I choose which hospital I want to have my treatment at in Thailand?
You are free to choose any medical provider you are comfortable with. Most insurance company’s have a network list.
Should you go to a hospital or clinic that is not on their list you could end up having to pay first and then get reimbursed.
Will the Insurance company settle my bills directly with the hospital?
For in-patient treatment, most Insurance companies operate a direct-billing facility to any of their contracted hospitals. Costs for treatment at hospitals with which they do not have a billing agreement will require a letter of guarantee which they will provide for any hospital worldwide and will be dealt with on a case-by-case basis.
For Out-patient medical costs, you may need to pay first and then submit a claim.
Claims tend to be processed in an average of two weeks, but this may vary from company to company.
Why should I use A Health Insurance Broker?
Using a Health insurance broker does not cost you anything extra.
Whether you go direct to the Insurance company or you go through a broker, you pay the same rates.
Your broker is there to work with you, guide you and for you.
You have more choices ( Insurance companies and plan options ) available and someone to hold your hand when you have complications / queries.
The broker is not beholden any one company.
Why do my Health Insurance premiums increase every year
Health Insurance premiums increase every year due to the following :
Global cost of medical treatments increase annually
Hospitals increase their medical costs each year.
The price of medications go up each year.
You pose a higher risk to the insurance company as you get older, in addition, the cost of treating you will rise considerably if you have to have treatment at a hospital.
All health insurance companies charge premiums according to the customer age / age band and these premiums are normally split into 5-year age groups.
As you get older, you will move to a higher age group and you will notice a higher jump in the premium increase when you move.
Each year, health insurance companies have to revise their premiums based on the previous year’s claims expenses.
If all the customers had a higher incidence of claims, the premiums have a higher annual-incremental increase.
When hospitals increase their medical charges, the premiums have to go up.
Most Health insurance companies try to keep their premiums as reasonable as possible in light of helping their clients, and as well as making some profit.
There is nothing that the insurance companies can do to control the hospital medical charges; all hospitals try their best to charge as much as possible for their services.
Cheaper options are available but work with your Health Insurance Broker, so that you do not place yourself in a disadvantaged position.
Can I get a Group Health Insurance Plan for my company in SE Asia?
Company or group health insurance policies are available for any small businesses to large companies in Thailand and neighboring countries.
Our insurance advisors can discuss with you your company’s needs and provide you with a range of medical benefits as well as different levels of coverage options.
We will then obtain proposals from a number of leading and reputable companies that are on our list.
We can offer comprehensive group health insurance options to companies worldwide. Company health insurance plans which we work with are perfect for groups of more than 3 employees, and can often be tailored to meet the specific needs of your organization.