Can you use your foreign health insurance policy to cover you in Thailand? If so, how do you go about it? These were the questions answered at the Pattaya City Expats Club meeting on Sunday, October 16. Master of Ceremonies Richard Silverberg introduced the Club’s guest speaker, Danny Quaeyhaegens, director, International Insurance Department, from Bangkok Hospital Pattaya (BHP).
Danny first gave some background information on BHP. Since it was founded in 1990 it has grown to become a JCI-accredited 400 bed facility. He noted that within BHP, there is an International Service Division. One department provides translation services and assists their international patients. The other provides assistance in arranging for BHP to direct bill your international insurance companies for inpatient care.
PCEC’s guest speaker for October 16th was Danny Quaeyhaegens, director of the International Insurance Department at Bangkok Hospital Pattaya (BHP).
His department will help you by contacting your international health insurance company, provide medical reports, and send them all documents necessary to arrange for direct billing by the hospital. If the patient chooses to pay the bill and file a claim (or the patient’s insurance will not provide for direct billing), they will assist the patient in obtaining all documents needed to file a claim. Danny emphasized that his topic was for international health insurance coverage and was not related to Thailand health insurance companies. Danny pointed out that BHP’s International Department provides this health insurance assistance free of charge.
The first thing to remember he said is that the contract of insurance is between you and your insurance company. BHP only works to help you obtain coverage for treatment at BHP from your insurance company. Thus, the type of coverage, if any, the treatment authorized, and the documents that are needed will be dictated by your insurance company. In many cases, they will want a copy of your passport with visa stamp and maybe copies of your flight ticket coupon. This is because some foreign insurance companies provide international coverage if you are traveling for short periods on holiday; not if your are residing or working in another country. They will also need a copy of your insurance identity card.
Bangkok Hospital Pattaya also provided free blood pressure checks for PCECs more health conscious members.
Also, in order to provide a Guarantee of Payment (GoP) to BHP, your insurance company will want a price estimate and a medical report for the condition you are seeking treatment. BHP will send these documents by mail or fax to your insurance company’s alarm center to request a GoP. Once your insurance company or an assistance company they use receive this information, they will check many things: (1) medical issues such as appropriate treatment, urgent treatment needed, etc.; (2) financial issues such as reasonable price for the treatment needed; and (3) personal issues such as it involves a paid up policy valid for your travel period and/or purpose of travel, etc. If they determine that they can provide coverage, they will usually send a GoP to BHP, but Danny emphasized that a GoP is not a blank check. It will usually be limited in time, valid for certain diagnoses and/or treatment, and limited to a certain amount.
But, as Danny pointed out, obtaining a GoP from your insurance is the first step and does not always equal a happy ending. This is because there are additional documents and determinations to be made by your insurance company before they approve a final GoP. On the day of discharge, the doctor may tell you that you can be discharged and prescribe home medication to be delivered to your room by the pharmacy; but there is paperwork that will need to be done before you can leave. The ward nurse will send the “chart” to the cashier’s department where they will prepare a final invoice and detail record of charges to be sent to your insurance company. Your insurance company will check the final medical details and final invoice. If it meets their requirements, they will send a final GoP.
PCEC member Sig (aka Harry Sigworth) provides members with an update of health news from the ‘net, both mainstream and alternative.
Danny said that there are some insurance companies they deal with, where they are allowed to do the assessment of coverage which speeds up the process, but they still have to check the ID, insurance card, travel dates, diagnosis, etc.; but they don’t have to send it to the insurance provider for confirmation. Also, although you may have health insurance coverage, BHP may choose not to deal with your company. This is usually because of past experience involving problems or very slow claims handling. In those cases, your option is to pay the bill and file the claim yourself. BHP will help by providing the documents you need. Other options are for your insurance or their assistance company to pay a deposit up front or they can arrange to have the GoP sent via a local Thai assistance company.
Danny concluded by noting that in most cases, they only process GoP cases for inpatient care. They do have some exceptions to this policy, e.g., a specific contract with the insurance/assistance company, the insurance/assistance company has a local office in Thailand, it is for follow-up after an in-patient episode, or the investigation/treatment involves costly outpatient procedures, e.g. being greater than 15,000 baht.
He then advised that their division is open M-F from 7 a.m. to 9 p.m. and on weekends from 7 a.m. to 6 p.m. They can be contacted by email at BPHintserv @bph.co.th or by telephone at 038-256-999. Danny then answered several questions from the audience and a few members that had used their services provided favorable comments.
Richard Silverberg then called on David Meador to conduct the always informative and sometime humorous Open Forum where questions are asked and answered about expat living in Thailand, recommendations for restaurants and movies are made, an and perhaps a joke or two are told.