Expat Health Insurance versus “Self-Insuring”

With health insurance now mandatory for some types of visa to Thailand, for many, gone are the days when self-insuring was the preferred option. The cost of health insurance has risen exponentially in recent years with medical advances. Although prices in Thailand are often far less than they may be in the west, most international hospitals’ cost is certainly not what would be described as “cheap” should you be admitted.

Ensuring that you not only have some health insurance but have the right level of cover is essential and could save your life. As an expat, would you want to be treated in a local hospital where little English is spoken, and the equipment is from a different era, or would you want to be treated in a state-of-the-art medical facility? The answer is the latter for most people, but this may not be an option without sufficient insurance.  

What is self-insuring?

Self-insuring is the practice of deliberately saving the money you would have paid in insurance premiums should you ever require medical assistance. Those who do this in a structured manner would put the money into a separate bank account, often earning a higher rate of interest. Unfortunately, many don’t save the money they would have spent on premiums, which leaves them in a desperate situation financially.

As healthcare costs have risen, it is unlikely those individuals would save enough money for any major treatment such as for cancer or if they are involved in an accident. It puts them in the unenviable position of either declining treatment or asking friends and family for financial assistance. In the past, many had suggested that they would “return home” in such an eventuality. However, this is rarely a feasible option either because of the urgency that treatment is required or the rules in their homeland.

Why would you self-insure?

The primary reason why people choose to self-insure is to save money. Insurance is one of the few things that we ever purchase, hoping that we never use it, and indeed some resent this. People often believe that healthcare costs are mistakenly less than the reality, while others adopt the “it won’t happen to me” attitude. Needless to say, this is a very dangerous practice, with the risks associated with such a gamble being higher than many would imagine.

Someone may self-insure because they have several pre-existing medical conditions, meaning that getting insurance is either impossible or the loaded premiums are beyond their means. In these circumstances, it is vital to make a reasoned decision regarding where you wish to live and where would be most appropriate for your long-term health interests. While the idea of retiring in a warm climate is undoubtedly appealing, it may significantly compromise your health.

The dangers of self-insuring

There are multiple dangers associated with self-insuring, not least that it unlikely that you will save enough money to get the treatment you require. Very few people are financially in a position to be able to get their hands on tens of thousands of dollars quickly, which can put incredible strain on others. In a country such as Thailand, the Hippocratic Oath doesn’t appear to apply, and if you haven’t got the means to pay for treatment, you won’t get it.

Not getting the treatment you require could make your condition significantly worse or worse still mean that you die from something perfectly treatable. While this may not concern you when you are fit and healthy, you should think about it in later life and the problems that it could cause for your family. There are certainly those that self-insuring is at best irresponsible, and at worst selfish.   

What is expat health insurance?

Expat health insurance is insurance designed purposely for expatriates meeting their needs in terms of cover and granting them access to the best hospitals. It is often slightly more expensive than local cover, but the coverage is infinitely better. Almost all policies will pay for your treatment, meaning that you don’t need to find vast sums of money, and as expatriates design them, they know that you may need to travel to different countries, and the cover remains the same.

Expat insurance will typically cover all family members, so you have the peace of mind that everyone will be covered, and you will have access to the best hospitals in the world. Transfers to better hospitals and repatriation are usually included in the package.

Different types of cover

There are various types of health insurance, but the most common are “Inpatient Only” and “Comprehensive”. Inpatient only cover will only come into effect if you are admitted to hospital, which makes it considerably cheaper, but could leave you with some hefty medical bills. Comprehensive cover, as the name would suggest, covers everything so you are safe in the knowledge that you will get the treatment you need without needing to pay yourself.

Premiums can be reduced by agreeing to pay an “excess” or “deductible” whereby you agree to pay the first part of any claim, typically $250 or $1000. Co-pay options are also and is agreed amount that you pay, typically after the deductible and are more common on US policies.  

Benefits of health insurance

The benefits of health insurance are undeniable, and for just a few hundred or thousand dollars a year, you can be confident that your healthcare needs are taken care of, regardless of where you are in the world. It will mean that you get access to the best possible treatment, and your recovery time will almost certainly be reduced. You will never have to balance paying the bills against getting the treatment that you need. The primary benefit of health insurance is undoubtedly the peace of mind that it gives you.

Need cover?

At Expat Health Insurance, we provide you with all the information that you need to make an informed choice about your medical needs. You will find our prices are competitively priced without compromising on cover.