The Ultimate Guide to Health Insurance in Thailand

1. Who are we and why are we writing this?

Tenzing Pacific Services is an insurance and financial services agency with offices in Bangkok and Pattaya, Thailand. We put together this guide to help people understand how health insurance is marketed and managed here, based on 50+ years experience in the region. Unless you’ve been kicking around Southeast Asia for a good while, you’re likely to find some surprising information here.

We believe that educated consumers are in the best position to benefit from our broad expertise and offerings. Tenzing works with more than 40 health insurance providers, both international and local, so we can provide the widest possible range of benefits and coverage options. We charge no fees for our services, which include year-round customer support to find and book local health facilities, set up cashless billing, assist with claims issues and documents, help with premium payments, and more. You can talk to an expat advisor who lives here – they will give you a quote that compares policy features on an apples-to-apples basis, based on your situation and needs.

So, please read on. We hope this is useful.

2. What kinds of health insurance are available in Thailand??

There are several types of health insurance options available to meet the specific needs of expats and locals alike.

• Employer-sponsored health insurance: Many expats working in Thailand can receive health insurance coverage as part of their employment benefits. The quality of these policies varies widely – some are excellent, while others don’t meet even basic needs. These plans are usually the only kind that will cover pre-existing conditions.
• Government health insurance: The Thai government provides health insurance options for specific groups of expats, such as those working in government agencies or participating in social security programs. These government-sponsored health insurance schemes vary in terms of coverage and eligibility criteria.
• Travel health insurance: For short-term visitors or expats who frequently travel outside of Thailand, travel health insurance plans can be an option. These plans offer temporary coverage during trips outside your residence country and typically include some emergency medical treatment, evacuation and repatriation benefits.
• Local Thai health insurance: Local health insurance plans in Thailand typically provide coverage only within Thailand and may have a network of partnered hospitals and healthcare facilities with direct billing. Note that benefit levels are generally not sufficient to cover medical cost at an expat hospital.
• International health insurance: International health insurance plans can provide comprehensive coverage in Thailand and when traveling outside the country. Many of these plans offer a wide network of healthcare providers, including access to private hospitals and clinics in Thailand and Southeast Asia. Most long-term expats find their way to a good international health insurance plan.

Here are some pros and cons of each group:

3. How much will this cost?

The cost of an international health insurance policy, called a premium, is generally based on a combination of these factors:

• Age. Our bodies break down as we get older, so it costs more to insure them as we age.
• Benefits selected. Like any consumer product, if you want more or better product, you have to pay for it.?Adding dental or maternity coverage to a policy will increase the cost.
• Coverage area. The larger the area where you’re covered, the higher the premium. And you’ll pay more for coverage in countries where medical costs are relatively higher.
• Number of people covered.
• Insurance company. Expect to pay more if you choose a high-end provider with global name recognition.
• Deductible, co-pay. You can lower the premium on some policies by paying part of the medical expenses yourself.
• Health. If you are in poor health, you may pay a higher premium.

This table will give an idea of what to expect to pay for a good policy in Thailand.?These prices are an average of some of the Regional and International providers in the chart above for an inpatient (hospitalization-only) policy with coverage in Southeast Asia.?Adding outpatient coverage will generally double your premium.

There are literally hundreds of additional choices on both the lower and upper ends of these price ranges.?A 15 minute call with either a Tenzing expat or local advisor can narrow your options to a manageable handful.

4. Who can be covered?

You can find coverage for a single person, a couple, a family or a group, and many providers offer discounts for policies larger than one. The applicable definitions of couple, family and group vary widely, depending on the provider. Don’t assume that someone can or cannot be covered under your policy until you understand how the provider defines the relationships.

• Individual health insurance.?Individual health insurance plans are designed to provide coverage for a single person. These plans are suitable for those who are self-employed, don’t have access to employer-sponsored health insurance, or prefer to have their own independent coverage. Individual plans offer personalized benefits and allow individuals to choose the level of coverage that aligns with their specific healthcare needs.
• Couple health insurance.?For couples residing in Thailand, couple health insurance plans can provide coverage for both individuals under a single policy. These plans offer the convenience of joint coverage, ensuring that both partners have access to necessary healthcare services and treatments.
• Family health insurance.?Family health insurance plans are designed to provide comprehensive coverage for the entire family, including spouses and dependent children. These plans offer peace of mind by ensuring that every family member has access to necessary medical care and treatments.
• Group health insurance.?Group health insurance plans are typically provided by employers or organizations to offer coverage to a defined group of individuals. These plans can vary in terms of coverage and benefits, depending on the employer’s offerings and the size of the group.

5. Where are you covered?

All health insurance policies define a geographic coverage area. With a few exceptions, the health insurance policies offered in Thailand provide four choices:

• Thailand only
• Southeast Asia excluding Singapore
• Worldwide excluding USA
• Worldwide including USA

The insurance providers choose which areas to offer coverage and most don’t offer all of these choices.?

In addition to full coverage inside your coverage area, most health insurance policies include some emergency coverage, which pays for accidents and illnesses that happen when you’re traveling on a temporary trip outside of your coverage area.

6. What medical expenses are covered??

You can choose to cover a range of medical expenses, from basic to comprehensive.

• Inpatient. Also called hospitalization, inpatient benefits are mandatory in that all policies include them. They cover treatment which typically requires you to be admitted to a hospital, usually overnight in a bed. This is for more severe illnesses, injuries and diseases. Inpatient benefits also usually include some outpatient coverage that is related to a hospital stay.
• Outpatient. As the name implies, outpatient covers you for minor injuries, illnesses and treatments done at a clinic or hospital where you get the treatment and then go home, rather than staying in a bed. This for your more routine and minor medical conditions. This is an optional benefit that you cannot choose without an inpatient plan. Read more at Inpatient vs Outpatient Health Insurance Benefits
• Maternity. Following a waiting period, usually 10 or 12 months, maternity covers a woman for the routine costs of a pregnancy, usually including prenatal visits, delivery, and complications. Most maternity policies are offered as an add-on benefit with additional premiums. A few inpatient policies cover complications without requiring the maternity add-on. Read more at Guide to maternity insurance
• Dental. Another add-on benefit, dental typically covers both minor and major dental benefits. Minor dental can be used right away and is for checkups, cleaning, polishing, scraping, sealants and some other less significant treatments. Major dental covers surgeries and sometimes orthodontia and is usually available only after a waiting period, typically 9 or 10 months.?
• Evacuation. Evacuation involves transportation in a significant medical situation to the nearest facility where appropriate treatment is available. A significant percentage of expats in Southeast Asia who need evacuation end up in Thailand. Evacuation is an extremely expensive service and health insurance providers know this, so it’s not easy to qualify for.

A note on travel insurance, travel health insurance and annual health insurance

International travel health insurance bridges the gap between basic travel insurance and international health insurance. Basic travel insurance from your credit card or bank might give you some limited medical coverage and lost baggage protection. Travel health insurance can give you more coverage – higher spending limits, larger geographic areas, more types of medical care, broader choices of doctors, etc. The benefits provided are usually less robust than an annual international health insurance policy — low annual benefits limits, lots of exclusions, no coverage for pre-existing medical conditions, mandatory deductibles, no direct billing. But for healthy people with a high risk tolerance, travel health insurance for a vacation or longer may be a good choice, providing access to basic health care to allow travelers to continue their trip or to return home.

7. What about pre-existing medical conditions?

Another factor that can affect the price of a policy is your health. Private health insurance is a for-profit business. Providing coverage for medical conditions that already exist when you enroll (Pre-X) would seriously lower profits, so insurers are very careful about taking on this risk. The reality is that finding coverage for a Pre-X is either difficult, expensive or effectively impossible, except under a group policy.

With that said, some insurers will cover some Pre-X, particularly those that are less serious. You’ll need to declare them during the application process and wait for a decision. Depending on the provider, the condition, how serious it is, the cost of related treatments, etc., the provider will take one of the following actions:

• Cover the Pre-X at normal terms and conditions
• Cover them with an additional fee (“loading”)
• Exclude that condition and anything related to it from your coverage
• Reject your application if the Pre-X is quite serious

Your health insurance broker can help you point towards the providers who are more likely to accept your pre-existing conditions. Typically, you’ll need to submit relevant medical reports and/or questionnaires, depending on the condition.

8. How would I pay my premiums??

Although high quality health insurance is priced on an annual basis, in some instances it’s possible to pay on a periodic basis:?monthly, quarterly or semi-annually.?There is usually an additional cost involved, typically a percentage of the annual premium.

Policies are issued in a single currency – your premiums and benefits are presented in a widely used currency, usually the USD.?Some providers use other currencies and some offer a choice.?Exchange rates from local currencies are set by the provider and may change annually or more often.

Premium payments are made in the policy’s currency.?Any exchange fees charged by the issuing or receiving bank are your responsibility.?Many providers allow use of a credit or debit card to avoid bank fees.?

9. Do I need to submit claims?

Want to make your health insurance experience in Thailand more smooth and easy? Get a policy that offers cashless direct billing services. This allows you to show your insurance card at the hospital and clinic and then not have to go through the normal pay and claim process. The better insurance providers will have a large network of doctors, clinics, hospitals and other healthcare providers.

Direct billing in Thailand is not a perfect system; the most common problem is delays in the medical provider getting confirmation of your coverage from the insurance company. Here are some other common issues:

• Direct billing is not available for every type of treatment; many insurers don’t offer direct billing for outpatient services, for example
• Some providers are much better at direct billing than others
• A hospital may require that you leave a credit card on file with them even if you’re using direct billing
• Make sure your preferred hospital or clinic is in the direct billing network of a prospective insurance provider

10. Where can I buy?

Generally, you can purchase health insurance directly from the provider, or you can use an intermediary that works with a number of providers. A provider can offer you only its slate of policy options, whereas a high quality agent will have access to hundreds or even thousands of choices and will know the relative pros and cons of each. Tenzing is an intermediary agent, so of course we recommend this option.

Tenzing offers the further benefit of a customer support team that can help you find a doctor or hospital, fix your direct billing problems, work with a doctor and the insurer to find and submit claims documents, help with payments, etc.

These benefits come with no additional cost – you pay the same premium using Tenzing as you would paying a provider directly.

11. What are the next steps to get covered??

Getting health insurance coverage isn’t exactly simple, but it’s not rocket science either.?The process is fairly logical and straightforward:

These articles are intended to give you enough information to make informed decisions, but health insurance is complicated. Whether you still have questions on this topic or feel ready to take the first steps toward getting a policy, our advisors can help.

Ask a question. Get a quote. Talk, chat, email – your choice.