Talk about medical cover for foreigners here isn’t new. In 1992 the government considered the idea as part of the requirements for the first version of the retirement visa which required a “six figure sum” in a Thai bank – at least 100,000 baht – and a minimum age of 60. However, it was decided to settle for a letter from a Thai hospital certifying that the applicant was free of serious disease. But the whole idea was dropped when an unfortunate Brit collapsed with a heart attack on the hospital steps and expired as he clutched his all-clear certificate. Accidents do happen.
In July 2019 it was reported that Thailand was set to introduce a travel premium on all visitors to Thailand to offset the costs of unpaid hospital bills by foreigners. According to press reports at the time, the cost would be as low as 20 baht per person for emergency medical cover of 30 days, to be paid for at special ticket machines located at airports and border posts. The idea so far has not been implemented and skeptics pondered what kind of cover 20p would actually provide. Not to mention two long queues for everyone – one to pay your 20p and another to show your passport to immigration. Being a tourist isn’t all fun.
In October 2019, it was announced that all retiree expats over 50 would be required to have comprehensive medical insurance of at least 400,000 baht (inpatient) and 40,000 baht (outpatient) annual cover. After a flurry, it turned out that only about five percent of retirees were included in the net, those who had obtained an initial “O/A” visa at a Thai embassy abroad. The vast majority, who obtained an initial “O” visa either at an embassy or at a Thai immigration office could rest easy. And that remains the position today.
Speculation continues as to whether the health insurance rule will be extended to all retiree expats. Many argue that it would be a good thing: bankrupt foreigners draining Thai medical resources or relying on crowd-funding as they lie dying. On the other hand, 400,000 baht won’t cover many significant medical procedures these days, notably in the private medical sector. Powerful exclusion clauses exist in any policy too. And what about the wealthy elderly with pots of money who are too old and/or infirm to be eligible? Best be careful not to throw out the baby with the bath water. Those guys have plenty of cash up front.
But in early 2020 Covid-19 appeared here and provoked a ban on all foreigners from entering the country. This blanket ruling has now been lifted slightly for a few special categories, but they must all obtain a certificate of entry from their local Thai embassy before being allowed to board a plane. One of the many documents required is a comprehensive medical insurance policy worth at least US$100,000. These are indeed available from several Thai-based insurance companies with the cost on a sliding scale relative to age. If you are in the 70-75 age range, expect to pay around 135,000 baht. If you are 76 years or over, sorry no deal. In effect, the advanced elderly are automatically banned from entry.
It’s worth noting in that context that some kinds of health insurance are available in Thailand for the advanced elderly. Several companies offer coronavirus cover of up to one million baht (death) and 100,000 baht (hospital treatment) for anyone aged 0-99 years. And that is likely to include you as long as you have resided in Thailand for at least six months. Of course, you must read the small print because glossy brochures can be seductive. Another opportunity is provided by the Thai banks which sometimes offer accident insurance of up to 600,000 baht cover for around 8,000 baht for seniors up to 99 years. Again the small print is what matters. Fail to read it at your peril.
So the situation in Thailand as regards state-required health insurance is complicated. The pesky virus has thrown the whole of the international insurance world into introspection, so no easy answers. Yet Thailand has a huge stake in the tourist dollar and the authorities need to start considering the frontline questions. Do they really intend to exclude anyone over 75 from entering Thailand forever? Is there a way of allowing people – young and old – who self-insure to secure long-term visas? Can significant cover of any kind, even for a 30 days tourist, be feasible for a paltry sum like 20 baht or is this a fund raising exercise? Once the emergency created by coronavirus subsides, maybe next year, such questions will need answers. One lives in hope.