Long before COVID, expats caught without health insurance were trapped in nightmare scenarios, some of which have become island legend. Bruce Stanely recounts some of those tales of doom here and explores how to fix the problem.
It was one of those familiar phone calls that make me sad. âCan you help us? We found our friend Jonathan unconscious in his room and we don’t know what to do.
“Where are you now?” I ask them.
âWe put him in our truck and took him to the government hospital in Vachira. But when he regained consciousness, he told us he had medical insurance and had to take him to an international hospital.
I learned then that no one knew where Jonathan had put his health insurance card, ATM card or passport. Fortunately, one of the international hospitals accepted him but requested a deposit of 50,000 B for his first aid. His friends all gave enough to get it admitted.
In no time, a CT scan revealed he had growth on his liver and other complications that would require extensive intervention. The hospital contacted its overseas health insurance company to say it would not cover what it felt was a pre-existing condition. Jonathan’s friends were asked to cover his medical bills which would eventually amount to several hundred thousand baht. In the absence of a guarantee of payment, the patient is transferred to the public hospital.
This disturbing story is not unusual. There are thousands of expats around the world who stay both short and long term in Phuket with insufficient or no health insurance. Most say they will pay themselves if they have a problem. This may have been feasible 20 or 30 years ago, when the costs of medical care were more affordable, but due to the rapid rise in hospital costs, only a fraction of visitors and residents of Phuket can afford their costs. medical bill.
When I arrived in Phuket almost 30 years ago to work at the newly developed Prince of Songkla University campus in Phuket, I was given the job of working with the Tourism Authority of Thailand to help foreigners from all countries in distress. Much of my job consisted of often delicate negotiations between foreigners and the local police in the event of an accident. The other part was helping to find medical care for an injured visitor. At that time, there were no international hospitals on the island. The choice then fell on Vachira or Mission hospitals and a few much smaller clinics, and neither of them had a lot of medical technology. I remember a Swiss who got hit on his motorcycle by a 10-wheeled truck and broke his leg in several places. He was advised to take a bus to a Bangkok hospital if he wanted to save his limb.
We have come a long way since then and the island can now boast of an international standard of care, but with that comes additional costs that the sick and injured are expected to pay and that means an adequate insurance policy. .
âIn an international hospital, the patient must have a direct relationship with his insurer. We can help organize and settle a claim, but the patient needs to make sure they have adequate coverage to pay for their injury, âa very experienced claims manager told me.
When the insurance company is based overseas, there may be issues with the insurer not knowing the costs and medical procedures of an injury in Thailand. This is why the Thai government recommends using an insurance company based in Thailand, as hospitals can more easily help the injured and the afflicted with their bills.
In Phuket, Eric Dohlon, Managing Director of Bangkok Insurance Brokers (BIB), has been offering health and accident insurance for 20 years. He is an advocate for expats especially the older ones who need an affordable policy that covers their medical care. He keeps abreast of the condition of his clients in hospitals and attends their social gatherings and funerals. He works in the best interests of his clients who can easily meet with him to discuss their medical insurance needs.
âThere is a big variation in the prices of what hospitals charge. Many are motivated by profit and steadily raise their prices when they think an insurance company will pay. These higher fees then push up insurance premiums beyond what customers can afford, âEric explains.
âI always advise my clients to shop in Thailand for non-essential medical care, as the savings can be significant. They should also speak with their insurance company to determine exactly what they will cover. Otherwise, the customer will be responsible for any shortfall. It is also wise to negotiate the final bill after a medical procedure, as the hospital has flexibility, especially for patients without adequate medical coverage.
There are often medical emergencies in Phuket like Richard who was living happily in retired Patong Beach when he fell ill. Normally, a high dose of paracetamol took care of his discomfort. But inevitably this was not the case and he was taken to Vachira hospital to learn that his kidneys had stopped working. He was put on dialysis and quickly had a big bill. When he advised the hospital to withdraw funds from their bank, he discovered that his resident girlfriend had emptied her retirement savings account and was missing. Without dialysis he would die. He had no family in his native England, but was able to muster enough money for a one-way ticket to London. He returned to Heathrow Airport in a wheelchair and taken care of by the National Health Service (NHS).
âHealth insurance is important, but an inexpensive accident insurance policy will also allow easy admission to hospital in the event of a vehicle, motorcycle or other unexpected injuries. Eric explains.
I remember an expatriate musician on the island who fell in his shower, hit his head and totally lost his memory and eventually had to be repatriated to his home country. And the young woman who had a tragic fall on the stairs of a club in Patong whose brain was severely damaged. While both had accident insurance, they unfortunately did not have repatriation coverage to their home country.
Not so lucky, Greg, a semi-professional cyclist who was run over by a high-speed truck in Rawai and left for dead on the side of the road before being rescued by a passing Thai family. They drove to several hospitals who asked to see proof of medical insurance before accepting it.
Thailand is the second most dangerous country in the world just behind South Africa for road accidents. It is no secret that many locals as well as expatriates drive untrained or under the influence of a staggering variety of mind-altering substances. Many tourists think that Phuket is the perfect place to learn to ride a motorcycle without a license or swim in the warm sea ignoring the red flags blowing in the wind. It’s quite a perfect disaster setting for those who aren’t careful.
Jonathan’s condition improved after two weeks in a virtual coma. He was eventually released from the international hospital with a medical bill of B1 million. He plans to pay it off monthly and hopefully find medical insurance that will cover any future relapses.
To consult Eric Dohlon at Bangkok Insurance Brokers (BIB), visit Insurance-in-Thailand.com or call 076-612722 or 089-6493012.