Private Medical Insurance for Expats Living in Thailand

Thailand is one of the strongest countries among the emerging economies and its medical services have improved massively over the last 20 years, although there is more to be done. An indication of this can be gained from its annual spending on healthcare, which amounts to 4.1% of its GDP (data.worldbank.org, 2014). That works out at about half the proportion of spending on healthcare in Western Europe and about a third of what North America spends.

GP shortages in health care

Healthcare is handicapped by a shortage of general practitioners, as most doctors are specialists. This can be an issue due to them tending to diagnose and treat within the parameters of their speciality. The clichéd view of a surgeon whisking patients into theatre in disregard of other possible treatments has an element of truth to it as the patient may be suffering from other medical conditions, which may or may not be linked with the primary health problem. This would not be the case if they were assessed by a general physician. The shortage of good primary care is due to a lack of funding and this forces people into having treatment at highly-priced hospitals, which can be a burden on the patient and the taxpayer.

The majority of hospitals in Thailand still have general physicians or family doctors, which are worth seeking out. If insured, you should contact your medical insurer and good providers tend to have a 24-hour helpline and may be able to suggest a suitable hospital in your area. Policyholders are required to notify their insurer before setting up an appointment, except in emergencies.

Dealing with Emergencies  

Medical insurer Allianz recommends that visitors who think they may need medical attention should base themselves near a hospital of appropriate standard. They also suggest keeping cash handy and to have medical insurance documents always with you.

In the case of hospital admissions, expats will be required to pay upfront for the treatments. In most European countries, these problems are normally avoided due to the patients having mandatory medical insurance and hospitals can be confident about getting paid.

Private Health insurance in Thailand

Thailand’s population is currently 68.8 million with 10% having private medical cover. This is only slightly less than in the UK and this strong market is evident in both the individual and company-paid sectors. The Thai population accounts for a much bigger part of medical insurance sales than the country’s large international Expat community.

Expat tax Incentives for private health insurance purchase

Tax incentives have fuelled private sector medicine, which has taken some of the stress off the state scheme and helps generate cash through health tourism. If expats buy insurance from a registered health insurance company, as an add-on, it escapes tax at the point of sale. As well as this, the purchaser would be entitled to claim relief on their premiums against his or her income tax. If you buy health cover from a non-life insurer, the purchase is subject to VAT.

Hospital provisions

Patients in Thailand are, more than likely, going to use one of 450 private hospitals in the country. In Bangkok, there are several hospitals that have good reputations and these are generally where most expats will go. These hospitals include: Bangkok General Group, Bumrungrad, Bangkok International and Bangkok Nursing home. Observers say this group has developed a reputation for top-end treatment, with a pricing structure to match. The concentration of foreign patients in these hospitals is very high and overall, the private sector has four times the number of beds per potential patient than the state sector, with much shorter waiting times.

Hospitalisation Fees

Hospital fees are structured well and patients should not feel that they are victims of dishonest charging. An MRI scan should come in at around £200, which is about a third of the UK price. Nursing care is inexpensive, both in terms of professional attention and room hire.

Outpatient fees are not usually paid in advance, unlike inpatient fees. Consultants’ fees can be as low as approximately £20 per appointment but there is normally an additional charge for use of facilities.

According to BUPA International, prices can fluctuate between hospitals and despite increasing prosperity, fees in the best hospitals are generally beyond the reach of most Thais.

Private hospitals offer a broader range of facilities and are better placed to deal with more important emergencies. Having cover from an insurance provider who is linked to a top-flight assistance company, will pay dividends, as assistance companies know where to find the appropriate medical skills.

Medi-vac cover

In Thailand, the standards of private care are good enough for the expatriate community to possibly dispense with medical evacuation in their policies. The standard of treatment used in Thailand and Bangkok is considered adequate by western standards. Thailand has a credible medical tourism proposition, with lower costs than many other destinations and some good locations for recuperation.

The Foreign & Commonwealth Office endorses the view that a lot of hospitals in Bangkok are up to western standards, however they give a warning that they can be expensive. They have stated that ordinary hospitals and clinics in Thailand are not always up to UK standards, particularly in the coastal islands and many mainland districts outside Bangkok. In these areas, hospitals and clinics are not equipped to deal with major incidents and treatments.

Health Hazards in Thailand

The FCP have recognised that there have been several thousand cases, in the previous years, of mosquito-transmitted dengue. This is an acute disease with high fever, headaches, aches in joints and muscles and enlarged nymph nodes. The second stage of this is fever and skin rash leaving the patient to feel unwell for weeks. Unfortunately, there are no vaccinations against dengue, although there may be one in the near future. The guide lines to avoid mosquito-bites are to wear leggings and sleeves and at nightfall to sleep under a mosquito net. This advice applies for malaria prevention, which should be supplemented by anti-malarial tablets and expats should consult their doctor before travelling. A fever comparable to dengue is the Chikungunya virus, also mosquito-borne. It exists in some 50 of Thailand’s provinces, including the tourist destination of Phuket.

Bird flu

The risk of avian flu varies but this is generally a very small risk; nevertheless, the consequences can be fatal. The major worry is that the flu virus could mutate into an easily transmissible organism within the human population, triggering a deadly disease. The advice from the government is to avoid visiting live animal markets and poultry farms.

HIV/Aids

It was reported that in 2008 around 600,000 people aged 15 or over in Thailand were carrying HIV. This virus then led to Aids. A World Health Organisation report put the HIV prevalence rate at 1.4 per cent of the adult population. This compares to the prevalence rate in adults in the UK of around 0.2 per cent.