Sink into the insurance swamp
With a disturbance in your heart rhythm, coupled with shortness of breath, you go to the cardiologist at his clinic in Hua Hin. After a few tests, he believes that further examination in the hospital is necessary and possibly even angioplasty. I have VGZ's Universal Complete Policy, which covers almost everything for expats admitted by VGZ. He writes a referral letter to the Bangkok Hospital in Hua Hin,
It later turns out to be his own fault, because the man is affiliated with this hospital as a cardiologist. The next morning I have to go to Be Well for a normal check-up. There the doctor says that she usually refers my type of patients to the Hua Hin Hospital, a government hospital. It's just as good and a lot cheaper. Although I am well insured, I always keep an eye out for the little things for VGZ in the hope that my good deeds will be reflected in the monthly policy costs (710 euros in 2023).
The HH hospital appears not to do business with foreign insurance companies, can do me within a few days, but does demand a deposit of 200.000 baht. Now I'm not poor, but I don't have such an amount in the nail box so quickly, with the risk that VGZ will not pay me anything back.
I then contact VGZ by telephone, which can be done via a number for urgent cases (VGZ emergency center) or a number for less urgent cases. That doesn't take up during office hours either and via the urgent cases I eventually end up with the less urgent ones. There a conversation develops between me and the lady on duty about the feasibility of angioplasty. This concerns the question of whether I need permission from VGZ for the procedure. Yes, this can be planned, but if I don't do it, I run the risk of a heart attack, for example. And that, in turn, is urgent and cannot be planned. The lady simply advises me to return to the Netherlands. I object that I have been deregistered for many years and live in Thailand. That is why I have a Universal Complete Policy. After some thought she has to agree with me, but I don't get a clear answer about the permission.
The next day I go to the heart center of Bangkok Hospital in Hua Hin. They seem to be only interested in the insurance papers. I'll get a call when they know more. I do have to sign two papers, one for the procedure with contrast fluid (55.000 baht) and one for angioplasty, possibly with placement of a stent (260.000 baht). This includes two nights in intensive care (!).
If I don't hear from the Bangkok Hospital, the heart center tells me that it takes time to collect all the data (I had supplied everything myself) and that the permission from VGZ can take up to a week. It is not clear who is responsible in case something happens to me in the meantime.
Then I called the VGZ emergency center again to ask for clarification. In practice, this turns out to be the ANWB emergency center, but all that happens is the assignment of a file number. Two days later, still no contact. The hospital refers to VGZ, who states that the ANWB emergency center is handling the case. Case of cabinet and wall, but that doesn't get me anywhere.
After another phone call, it turns out after two days that the referral from the cardiologist is on the paper from his clinic. And VGZ wants that on paper from the Bangkok Hospital. Notaben from the same cardiologist. That's on Friday afternoon. I hope. Unfortunately, the cardiologist is in Bangkok all weekend… In the evening, while eating, the emergency center rings. I can finally go under the knife.
It is unbelievable Hans, it would almost give you a heart attack, with a premium of € 710 per month for the Universal Complete Policy from VGZ you can expect a completely different service.
I wonder if there isn't an affordable alternative insurance policy for you?
Hans, get well soon! It may all work out and you will soon be back to normal. And the red tape, oh. when it comes to money, every hospital has a special interest in your papers. And only then for the knife….
Hans vanMourik says on March 4, 2023 at 13,00 NT
Since 2007 I have had an insurance with VGZ Universeel complete with Thailand as the country of residence and I have not had your problems
1) In 2009 I got Colon Cancer.
2) in 2013 Colon cancer
At point 2 with the necessary aftercare, including 12 chemo, CT scans, CT pet scans
Immediately helped and repaired in the Changmai Ram Hostpitaal
He arranged everything for me with my insurance
In 2018 I had a brain stroke in the Netherlands and was helped in Leeuwarden MCL
spent 5 days there
After 1.1/2 month back to Thailand and went to the Neurologist in the same hospital
In 2020 my eyes were bothering me and I went to the ophthalmologist I had 5 injections and then I said stop but see no improvement
Have also written all these things in the Thailandblog
Since 30-06-2022 I live in the Netherlands again in the KTOMM Bronbeek but come here every year for 6 months
I intend to write a piece about this in the Thailand blog.
Sometimes you have to use your mind over your feelings
My mind is the Netherlands, but my feeling is Thailand
Hans van Mourik
correction to my previous comment.
At point 1) must be 2009 prostate cancer
Hans van Mourik
I don't understand this whole story at all. Also have VGZ and they really arrange everything within a few hours at the most. Photo of my policy (VGZ app) and everything is arranged. Condition operation was necessary, within 1 hour all warranty was received and approved.
I assume you mean cataract surgery. I understand that it went quickly, because these are relatively simple and cheap outpatient procedures
Great insurance with a monthly premium of 710 Euros, and then being sent from pillar to post when you actually have something.
Where are the expats' experiences, who continue to insist that health insurance does not have to be expensive, and that a farang almost has priority in the Thai hospitals.
Yesterday happened to read a story of a Dutchman, whose name I do not want to mention, who is abandoned for a heart procedure by his insurance, for which people are now calling for help on Facebook, so that he can pay for his intervention of 250.000 Baht at all.
I wish for Hans as well as the latter that everything will be all right, and that both will be completely healthy again as soon as possible.
Health insurance in Thailand does not have to be all that expensive. It's just what choice you make. The writer of the article, who has lived in Thailand for many years, chooses to keep his NL insurance at a high premium. If he wants it that way and he can apparently afford it, fine. But Euro 710 per month x 12 is still Euro 8.520 on an annual basis. Lots of money. For some, the annual net AOW amount. Article writer, on the other hand, has medical expenses of ThB 315.000. Calculate for yourself how much euro that is, and then calculate how much euro/baht has been paid in premiums in recent years alone, and to what capital "invested" premiums can amount. If you have to be treated for serious ailments every year, the 8/4 method is a much better option at the usual monthly premiums. And if you think or fear that you occasionally need to be treated for a major ailment, consult AAinsure.net and the Health Insurance in Thailand file: click on the relevant item on the left.
Bye Grumpy.
You're not completely honest.
Well if you compare this with just this angioplasty treatment. But don't forget that older people more often (especially after this heart procedure) have to take medication for the rest of their lives. And many foreign insurance policies require you to insure the medication separately. Not the medication for the first 14 days, for example.
But all this chronically needed medication must be insured separately.
And that's the bottleneck. The medication itself is also expensive, so the insurance is accordingly.
And yes, if you only compare the hospital expenses against the premium, then it is cheaper. But it is not for nothing that some doctors insist on admission for research. Then these costs will be reimbursed and medication (if necessary) will be provided for 14 days.
And if you think you can take out a medication insurance AFTER an angioplasty treatment, this medication and all heart medication will be excluded from the insurance.
greetings Janderk
Hi Janderk, I don't see the unfairness when I say that a premium of eur 8520 per year should give you reason to think about other options. Especially if medication also needs to be insured separately. Won't the final premium be less, right? Anyway- I mentioned 2 options: the 8/4 method, and consulting https://www.aainsure.net/. I myself use a third option: every month I put 10K thb aside in a separate bank savings account, being a higher savings interest at 48 months. If there should be something going on I have that jar. If I fall short because the jar is not yet full enough, I am fortunate to have always been a frugal person and still, especially when I started my emigration preparations at the time. If nothing is ever going on, my wife will have an extra bank book in due course. See also Wim van Beveren at 03.11
I forgot to include the most important part of my comment. Because why would you take out expensive health insurance if, as @janderk says: "if you think you can take out medication insurance AFTER an angioplasty treatment, this medication and all heart medication will be excluded from the insurance." Surely you are not going to pay high premiums annually to companies that sell health insurance policies while excluding subsequent illnesses and/or ailments and pre-existing conditions? You don't have to fund their corporate profits anyway!
Dear Grumpy.
First say that a Dutch expat health insurance has nothing to do with the Dutch authorities nor with the Dutch tax payer. I'm not saying you suggested that. But an expat insurance is an insurance that exists separately from the healthcare authority. It is ordinary health insurance. The only connection one has is often a uniform policy and policy condition (eg a maximum of 365 euros deductible). The calculation of the premium is different for every health insurer. You have no options for reimbursement from Dutch taxes (care allowance).
And take it from me that an insurance company in the Netherlands will not sell or maintain a loss-making insurance policy.
Having said that I must say you are a poor reader.
I myself was on the point of stopping my insurance in the Netherlands.
Including suggested by one or more blog entries
There I ran into the problem of exclusion and medication. And as you know, the drugs are often the cost. All insurers, all over the world, know this.
You can of course also insure your medicines and you can of course separately insure hospitalization, the examination costs and separately the doctor's costs.
But the Dutch expat insurances (whether from one or the other insurer) cover the costs of the hospital, the doctors, the examinations and also the medication (including oncology). The only non-insured costs are extraordinary medical expenses such as admission to a nursing home.
And of course you can save money if you, as a Dutch Calvinist, put economy first
And jars will build for any costs that may come. And believe me, most expats of age can tell you that these extra costs will come.
So I say that once you are of age and you have a Dutch expat health insurance policy, you will not switch so quickly and start building up a jar for contingencies. Before you have started the jar, the jar is probably already empty.
For the premium I pay of over 600 euros per month, I now have physiotherapy at least twice a week, and the transport costs to the physiotherapy. I have not yet come across that in all the offers that I regularly receive from all kinds of international expat insurance companies (Cigna, IAI, etc etc). And I have plenty of time to go through them.
And that's apart from the medicines that I just get reimbursed as a heart patient.
And then returning to the start remark of Hans (Bos). Of course, plannable care is subject to prior approval (this is also the case in the Netherlands, but this often happens out of sight of the patient by the hospital and the health insurer). Unfortunately, we have to do that ourselves here. The fact that the health insurer in the Netherlands does not always respond adequately by employees who are not familiar with expat insurance is just bad luck. But as Hans also indicated, it turned out just fine. But if a cardiologist in Thailand had found it necessary to do angioplasty immediately, it would have been done within two hours from an insurance point of view. The angioplasty treatment could probably have taken place within 24 hours (experience). And that is precisely why I say not to take an intermediate step from a specialist who has a practice outside the hospital.
Greetings Janderk
Dear Grumpy, I admit that insurance of 8520 Euros per year is certainly not affordable for everyone, and is even expensive.
Nevertheless, I am convinced that the article writer has compared this insurance policy with other insurance policies for himself, and has come to the conclusion that this is the right choice for him.
There will certainly be clever calculators who will calculate this premium in 10 to 15 years to show others how much they actually earned afterwards, to take out another or even no insurance.
Hindsight means if you were very lucky never to have had a condition, accident, or major surgery.
If, at the age of 76, I were to add up all the insurance policies that I had actually paid unnecessarily in my life afterwards, then, assuming I had saved all this, I might not need any insurance at all.
Had I been unlucky 15 or more years ago, I would have been very happy with an admittedly much more expensive insurance, at least not having to worry about the financial.
While without, or a much cheaper insurance, with many exclusions I might have been a poor sotemieter now.
When I occasionally hear stories from expats who are full of praise for their insurance, it is often concealed that they have a premium, with their own risk and eventually have to count on all possible exclusions.
I do not know the health and treatment history of the article writer, but I would imagine that he wanted to prevent these exclusions of previously treated conditions, etc. by means of this more expensive insurance for the past now, and also in the future.
An older person with an admittedly cheap insurance who may have more exclusions due to bad luck, can, despite his low premium, be very unsure if he is actually insured.
Maybe the article writer can write something in a while, why he chose this insurance.
Very recognizable and emerging problems in Insuranceland and Hospitals. A lot of work is done side by side and one does not know what the other is doing. years in the same hospital with the same insurance. Both parties often week past each other and one doesn't know what the other is doing. I also have Dutch health insurance with a well-known health insurance company and this also happens a lot there. I pay 1 euros per month, which is a considerable part of my income. But you have no other choice or option, and certainly not if you are ailing a lot .When admitted to hospital, people often lie for a number of days when little or nothing is done. Until the guarantee payment has been received from the insurance. Then people actually know in the morning that you can go home, but you are still waiting until the evening to go home. By the way, Geert, you can only find cheaper and good insurance if you have a decent financial budget yourself. You can forget about cheaper Thai insurance, because these people with many disorders only take it if they are excluded..
I pay 432 THB per month for 100% reimbursement through Social Security of the employer
I used to be at Sikarin hospital Bangkok and now at Rajthanee in Ayutthaya because the insurance has been private in recent years and no longer through the employer
Both private hospitals taking on SS..
So John, they do exist and I'm not the only one
It does not make much sense to state a premium of your Thai insurance via the employer here, because this low premium also includes a lower salary, on average 20% of the Dutch salary, and in addition, you do not accrue AOW rights if you do not stays in the Netherlands, per year about 50 EURO / 2000 baht per month, which you miss out on and receive less from your state pension age, and then I don't even mention a company pension accrual.
Ger, I work in a management position at a multinational. That is why I no longer worry about the AOW that I miss, about 42%. And then there is the pension provision, just like in NL via the employer
If you pay Social Security via the employer, your personal contribution will be 750.- per month. (With a wage of Baht 15,000.- or higher). If you only pay 432.- baht per month, that means that you fall under art. 39 of the Social Security Act, and are no longer employed by an employer.
This insurance is fine in itself, but also quite limited in terms of maximum reimbursements in the event of serious ailments. Many Thais therefore have private insurance in addition to the “mandatory” social security.
Peter I took over the SS when I went on a sabbatical for a year in 2015, then I went back to work and let the SS go through privately. So my employer doesn't pay and I miss the benefits for a death and old age pension, but they are so minimal that I don't really care against the convenience of the SS in my name and the easy transfer to any hospital, if connected of course
Covers 100%, colleague had heart surgery, costs 750.000 thb, was 100% reimbursed
health insurance. All kinds of amounts and opinions are given about it. Is of little use. The price for health insurance is highly dependent on age and previous ailments. Mentioning a price and giving an opinion on it is simply pointless without it.
Thankfully, finally someone who understands. It's not a carton of milk with a fixed price. The price varies and depends on so many factors. Just put the policy conditions side by side and you will soon understand why one is more expensive than the other.
Dear Martin, Your reaction with which you want to convince me that there are also much cheaper insurance policies, of course, goes a long way.
The insurance you mentioned is linked to a social system, where most expats who take out private insurance, including the article writer, simply fall outside.
You could also mention the Thai 30 Baht system, which many Thais rely on, this is almost the same comparison.555
Hi John
Of course you are right in your first statement, but you yourself stated that you asked for responses from expats with cheap insurance, so.
And my insurance is for life as long as I keep paying the premium
Your comparison with the 30 thb insurance does not apply because it is 99% exclusive for Thai nationals, but you will know that yourself
Perhaps this is a little off the immediate cause but some remarks on the choice of a hospital. I recently underwent a routine surgical procedure that ended up costing around 120 Baht.
I made a diagnosis in the Pattaya hospital which is used by most farangs because it catches many customers through word of mouth and its "international" in the name. Apart from making a mess of the reports I sent to the treating doctor, an attempt to sell me a useless GP visit before I could get to the specialist, the estimate of the price was also 50% higher than the hospitals in Bangkok.
After decades here and a few treatments further, I have come to the conclusion that a group has bought most of the farang hospitals outside of Bangkok and thus spread their safety net. I myself was in need in one of those hospitals on USA and I don't want to know anything more about it. Their price was 2 times the cheapest.
Mind you I completely agree that finding a good doctor is the most important thing in Thailand, not the infrastructure that hangs around. Most doctors treat in a government hospital - where you make a "donation" if it's urgent - and also a commercial hospital for the money.
Finally, I arrived at the Chao Phya Hospital in Thonburi via the internet.
https://chaophrayahospital.com/
This is a smaller hospital, formerly visited mainly by ethnic Chinese, but with a few helpful people in an international office. Surprisingly good English and without nonsense or attempts to foist a useless service here and there. I had to wait a day because of an emergency that had priority and stayed in a small hotel on Klong Bangkok Noi (cheap too) where dozens of cars were parked in the parking lot from all kinds of provinces up to 600 km inland. That's how you know you're in the right place...
In the lobby were some commercial placards for knee and hip replacements with the price I found very moderate from experience with my mother's troubles.
About insurance: in Thailand it is almost impossible to take out hospital insurance once you reach the age of 70. Only in the temples will they do something for you!
When I read this I am glad that I am not insured, so save a lot and if I have something I go to a hospital nearby or to a Pharmacist (who often knows more than a doctor), then pay something of 5-10 euros for research and medicines.
Dottering is a cause of later heart failure (newly invented) thought they wouldn't do that so easily anymore. So I suffered heart failure due to previous angioplasty.
Not doing angioplasty with a blocked heart artery seems to me to be a recipe for heart failure........
Just a note about health insurance. If you have something wrong with your knees or have had an embolism, etc., this is usually excluded or you are of an advanced age, then the costs will skyrocket if you take out insurance when you go to live abroad.
This means that you are almost forced to continue living in the Netherlands because the medical costs are unaffordable. Even if you just want to continue paying taxes in the Netherlands
about your income, then this is not possible. Due to the 8/4 arrangement. So you can only go abroad
live if your core is healthy and not older than 65 (then the insurance will fall
costs abroad).
I believe this is a pure form of discrimination against
Disabled people and seniors from the Dutch state. I find it strange that no one has heard about this. People in the Netherlands talk about all kinds of discrimination. But you don't hear about this.
I still have a good income and when I retire soon too. The taxes also include or healthcare costs outside the compulsory health insurance. Please note that according to the new scheme with tax in Thailand, you will continue to pay the health care costs (now already) over your state pension because it is deferred wages. You therefore contribute to the healthcare costs in the Netherlands, even though you live abroad, but you cannot use it. I think that's what you're going to do about your pension. I'm no expert on this, but if I'm wrong, please let me know.
Have already written a letter about this to the national ombudsman who agreed with me. The problem was that they can't do anything with this because there is another organization for that from the health insurance companies. However, there you have to expose all your data, which in turn goes to your own insurance. They must respond. The only option is directly with the 2nd room
to communicate. The chance that something will be done is very small because you react as an individual.
Perhaps someone else has some ideas on how to overcome this discrimination
Forgot, I previously had an April/Avril zkv via AA, 400 USD per month, everything was covered…also existing problems
Dear,
Usually I don't respond to items. I am a reader and may be selfish, take advantage of the articles.
But now I have to say something. I was very shocked by the premium of € 710 per month.
I have insurance with a French company through AA insurance. You can take out this in euros or USD. I did that in dollars with a deductible of $500 per person per year.
We are a family of ; man. 69, wife 46 and child 13. We pay $5.200 a year, noting that I pay the highest premium because of my age. Actually, if you want to play it safe, you have to add 5200 x 3 to that $500, but then you end up with around $6.700. Always much cheaper than this person. And… The question is whether you spend the $ 500 every year. spend at your own risk. Must be a coincidence.
I therefore advise you to ask AA insurance in Hua Hin for advice, of course without obligation. They may come up with a good and affordable solution for you. You are free to ask and it is your money, so you decide what to do.
To be clear, I have no interest in AA insurance. Just run a policy
If this is seen as advertising, the moderator may refuse to publish it. My intention, however, is only to think along with the fellow countrymen.
Apparently many forget that the care in the Netherlands can definitely not be covered by the premium paid, but by the Dutch taxpayer. If you are deregistered in the Netherlands and start living in a country outside the EU, you must face the consequences and weigh up the pros and cons.
There's a lot of bullshit being sold here. I must remain insured in the Netherlands, given the other (expensive) condition I have that has nothing to do with the story. So there is no choice.
All those references to AA Insurance. Do the readers really think that after 17 years in Thailand and 11 years in Hua Hin I don't know Matthieu Heiligenberg from AA?
Incidentally, Joseph is right that the care in NL cannot be covered from that silly premium. You also pay on your gross income, so that you average 500 euros per month. You just don't see that… Then the difference with 710 from VGZ for deregistered Dutch citizens is suddenly not that big anymore.
Dear Hans,
We have roughly comparable insurance (not the same). We have both been in our current father (mother) country for a long time.
I now live in Bangkok. But actually I've been in the same hospital in Bangkok since 2006. For all.
Even for what we in the Netherlands simple doctor visits (general practitioner). So if I have something that I don't understand as a simple flu or simple food poisoning I go to the hospital (an international hospital called Thainakarin Heartcentre)
If one of the doctors there says I have to be hospitalized for any reason, there are two things.
Because I've had an angioplasty twice and my cardiologist is in the same hospital, I'm sent to him. He and the attending physician (eg urologist) determine the severity and urgency (mortality will also be discussed with you).
In case of emergency, I call the emergency center (SOS). At least first my insurance, but it switches to the emergency center at night and during the day you are transferred by telephone to the alarm center. Then the permission is there within an hour. Most of it takes place beyond my hearing and sight.
If it concerns plannable surgery care (eg scraping of a prostate) then I submit a request to the insurance company with the advice of the doctor at my insurance company and then there is usually permission within 10 working days. Other care (eg physiotherapy) must be tested and that may take longer.
In short, the extra step to a specialist who may live locally and have a practice only increases costs in this case.
So to anyone who has a "Dutch health insurance" I would recommend that if you have a medical problem in Thailand, immediately look up an international hospital and not take the step of a local specialist (whether that is a cardiologist or a dermatologist). This doctor in question probably refers you to the hospital where he (she) works and thus receives money twice.
By the way, you don't have to be frightened or afraid for the angioplasty treatment. You can often watch and it is very interesting how this specialist sends the catheter through your vein to the heart and can go into the various vessels in your heart. You will not feel anything from the placement of a stent. And if you understand Thai and English you can also hear what he gives to the assistant (usually one) for one
Get well soon and greetings
Janderk