The utter minefield of health insurance.

Ong Tay · Post by **Ong Tay** » Fri Apr 28, 2023 3:42 pm

I have "global" coverage through CIGNA, which should cover me anywhere in the world, except for the US (specifically excluded). It also has an evacuation rider, which would allow me to be medevac'd out of Vietnam to Singapore or Thailand.

One issue to consider is pre-existing conditions. When I applied for this insurance 2+ years ago, I had to complete a questionnaire about previous illnesses/conditions (but did not have to undertake a medical exam). That resulted in the insurer excluding such conditions from coverage; fortunately they were relatively minor conditions and I was comfortable with them not be covered, though slightly annoyed.

This policy is not cheap, but I have no co-pay or deductible. In theory, at least, it offers some degree of assurance that I will be covered should I be run over by a motorbike, stricken with cancer, or some other serious malady.

I would look for a plan that provides for inpatient hospitalization (and all of the costs associated with that - doctor's fees, diagnostics, procedures, food, etc) and medical evacuation.

As another poster said earlier, leave out the outpatient services and you should be able to save some money.

ego bibere nimis · Post by **ego bibere nimis** » Fri Apr 28, 2023 3:47 pm

Tootsfriend wrote: ↑Fri Apr 28, 2023 1:47 pm
xandreu wrote: ↑Fri Apr 28, 2023 1:24 pm I've lived in Cambodia for several years now and I have never had health insurance. - Go on, do your worst... "How irresponsible of you.... Were you hoping to rely on Go Fund Me...? You deserved all you get if you fall ill..."

The honest reason why I have never got health insurance is because I neither understand it nor, to some degree, trust it. Every now and again, such as at the moment, I feel that I really should get it sorted.

I have spent the last few days trying to find something that I think fits my requirements, but this is made even more difficult given the fact that I don't even know what my requirements are. How does anyone know what they need to be covered for? How can anyone know what's ailments they are going to succumb to? So many policies seem to cover this, but don't cover that, or that covers this but only if that has been fulfilled and that has to have been within this requirement if you want to claim, but you can only claim for that if this has been met. Good God!

A lot of the time, I can't even see what certain policies cover and what they don't. I always have this feeling in the back of my mind that a policy may say they cover cancer for example, but if you ever get cancer, they'll turn around and say "oh yes, we do cover cancer but unfortunately not that kind of cancer. Sorry about that".

I have been in touch with an insurance broker recently who has recommended a policy to me. I asked him if I were to have a serious illness, I would be looking to get treatment in a neighbouring country, as Cambodian healthcare is not of a particularly high standard. He replied yes - if you're in a hospital that can't treat you, you will be repatriated to a hospital that can. This doesn't fill me with much confidence. Of course a hospital is going to say they can treat you - they want the fees. Whether they can treat you with any decent standard though is open to interpretation. And who's to say they won't just transfer you to another Cambodian hospital? - They aren't exactly in the business of spending money needlessly.

Most of us westerners, except the Americans I guess, come from countries with free health care and don't have to think about or deal with this sort of thing. When we do, or at least when I do, I really don't know what I'm doing. But I know that I do need to be covered.

Are there any members here who know a thing or two about this and can guide me in the right direction? I just want something that will cover me for emergencies and any long term serious illness, with the option to go to Thailand or Vietnam should the need arise.

If anyone can recommend any insurance companies or give me some advice, I'd be really grateful.
I went through all that when I first came to Cambodia 19 years ago and decided that I would put the equivalent of a health insurance fee into a special account and not touch it. Presently stands around A $12k. Not a lot, but at least I know I''m not paying for all the expenses of sales agent fees, holidays, profits, and all those costs that make Insurance so high. Besides , what insurance company wants to insure old age pensioners when they turn 76 years of age.
Spoiler:
yep, it's my birthday today, and its so so exciting cause I've never been 76 before.

A broken arm requiring surgery (with pins) will cost 15k - happened t a mate a year ago. Look after yourself and have a great birthday!

ego bibere nimis · Post by **ego bibere nimis** » Fri Apr 28, 2023 3:49 pm

Ong Tay wrote: ↑Fri Apr 28, 2023 3:42 pm I have "global" coverage through CIGNA, which should cover me anywhere in the world, except for the US (specifically excluded). It also has an evacuation rider, which would allow me to be medevac'd out of Vietnam to Singapore or Thailand.

One issue to consider is pre-existing conditions. When I applied for this insurance 2+ years ago, I had to complete a questionnaire about previous illnesses/conditions (but did not have to undertake a medical exam). That resulted in the insurer excluding such conditions from coverage; fortunately they were relatively minor conditions and I was comfortable with them not be covered, though slightly annoyed.

This policy is not cheap, but I have no co-pay or deductible. In theory, at least, it offers some degree of assurance that I will be covered should I be run over by a motorbike, stricken with cancer, or some other serious malady.

I would look for a plan that provides for inpatient hospitalization (and all of the costs associated with that - doctor's fees, diagnostics, procedures, food, etc) and medical evacuation.

As another poster said earlier, leave out the outpatient services and you should be able to save some money.

These guys are OK. Made a couple of claims, paid up no fuss. https://www.william-russell.com/expat-h ... -thailand/

Premiums are reasonable (just like Doc, no US coverage otherwise premiums skyrocket).

xandreu · Post by **xandreu** » Fri Apr 28, 2023 9:48 pm

ego bibere nimis wrote: ↑Fri Apr 28, 2023 3:49 pm
Ong Tay wrote: ↑Fri Apr 28, 2023 3:42 pm I have "global" coverage through CIGNA, which should cover me anywhere in the world, except for the US (specifically excluded). It also has an evacuation rider, which would allow me to be medevac'd out of Vietnam to Singapore or Thailand.

One issue to consider is pre-existing conditions. When I applied for this insurance 2+ years ago, I had to complete a questionnaire about previous illnesses/conditions (but did not have to undertake a medical exam). That resulted in the insurer excluding such conditions from coverage; fortunately they were relatively minor conditions and I was comfortable with them not be covered, though slightly annoyed.

This policy is not cheap, but I have no co-pay or deductible. In theory, at least, it offers some degree of assurance that I will be covered should I be run over by a motorbike, stricken with cancer, or some other serious malady.

I would look for a plan that provides for inpatient hospitalization (and all of the costs associated with that - doctor's fees, diagnostics, procedures, food, etc) and medical evacuation.

As another poster said earlier, leave out the outpatient services and you should be able to save some money.
These guys are OK. Made a couple of claims, paid up no fuss. https://www.william-russell.com/expat-h ... -thailand/

Premiums are reasonable (just like Doc, no US coverage otherwise premiums skyrocket).

Thanks. I've just bought a policy from these guys. Still not entirely sure what I've bought but I guess one never knows how good an insurance company is until it's too late.

Thanks for the help

BklynBoy · Post by **BklynBoy** » Fri Apr 28, 2023 11:10 pm

Ong Tay wrote: ↑Fri Apr 28, 2023 3:42 pm I have "global" coverage through CIGNA, which should cover me anywhere in the world, except for the US (specifically excluded). It also has an evacuation rider, which would allow me to be medevac'd out of Vietnam to Singapore or Thailand.

One issue to consider is pre-existing conditions. When I applied for this insurance 2+ years ago, I had to complete a questionnaire about previous illnesses/conditions (but did not have to undertake a medical exam). That resulted in the insurer excluding such conditions from coverage; fortunately they were relatively minor conditions and I was comfortable with them not be covered, though slightly annoyed.

This policy is not cheap, but I have no co-pay or deductible. In theory, at least, it offers some degree of assurance that I will be covered should I be run over by a motorbike, stricken with cancer, or some other serious malady.

I would look for a plan that provides for inpatient hospitalization (and all of the costs associated with that - doctor's fees, diagnostics, procedures, food, etc) and medical evacuation.

As another poster said earlier, leave out the outpatient services and you should be able to save some money.

I used CIgna Global in 2020 to cover the health insurance part of my trip to Cambodia for that summer. I forget the cost. Maybe 150 per month? I used it to get in and then canceled it after a few weeks. ( i was in cambodia apprx 2 months)

question-- you said it's not cheap. Approx how much per month do you pay for Cigna?

truffledog · Post by **truffledog** » Fri Apr 28, 2023 11:47 pm

BklynBoy wrote: ↑Fri Apr 28, 2023 11:10 pm
Ong Tay wrote: ↑Fri Apr 28, 2023 3:42 pm I have "global" coverage through CIGNA, which should cover me anywhere in the world, except for the US (specifically excluded). It also has an evacuation rider, which would allow me to be medevac'd out of Vietnam to Singapore or Thailand.

One issue to consider is pre-existing conditions. When I applied for this insurance 2+ years ago, I had to complete a questionnaire about previous illnesses/conditions (but did not have to undertake a medical exam). That resulted in the insurer excluding such conditions from coverage; fortunately they were relatively minor conditions and I was comfortable with them not be covered, though slightly annoyed.

This policy is not cheap, but I have no co-pay or deductible. In theory, at least, it offers some degree of assurance that I will be covered should I be run over by a motorbike, stricken with cancer, or some other serious malady.

I would look for a plan that provides for inpatient hospitalization (and all of the costs associated with that - doctor's fees, diagnostics, procedures, food, etc) and medical evacuation.

As another poster said earlier, leave out the outpatient services and you should be able to save some money.
I used CIgna Global in 2020 to cover the health insurance part of my trip to Cambodia for that summer. I forget the cost. Maybe 150 per month? I used it to get in and then canceled it after a few weeks. ( i was in cambodia apprx 2 months)

question-- you said it's not cheap. Approx how much per month do you pay for Cigna?

I was CIGNA insured while beeing a working expat in China. Cost 6000 US$ per year. Had some minor incidents in 2 years and all costs were fully paid by insurance.

xandreu · Post by **xandreu** » Sat Apr 29, 2023 3:09 pm

simon43 wrote: ↑Fri Apr 28, 2023 3:18 pm
You misunderstand the UK situation. Expats can receive free treatment under the NHS as soon as they step foot on UK soil and state that it is their intention to return permanently to the UK (whether or not this is indeed the case).

After my French insurer refused to cover the costs to diagnose my prostate cancer/no prostate cancer, I returned to the UK and registered with a GP in a couple of days, then explained to him my situation and that I had returned to the UK for NHS treatment after 21 years living in south-east Asia. He immediately referred me to the local hospital for cancer diagnosis investigation and I had my first consultation a week later, with my doctor fully aware of my expat situation. After about 2 months of various tests, I was given the all-clear for prostate cancer (the problem is actually prostatitis/prostate stones, which gives similar symptoms to prostate cancer - raised PSA and shadows on the MRI scan).

At no time was my expat situation ever questioned by my GP or the hospital. Had it actually been prostate cancer, then my plan was indeed to remain in the UK. Since it was actually something of no great concern, I returned to Thailand

Thanks for the advice. I think you may have got lucky there. According to the government website, in order to qualify for free NHS treatment after living abroad, you have to show evidence that you have moved back to the UK on a permanent basis, such as a rental agreement for your address and domestic bills in your name with a UK address.

https://www.gov.uk/guidance/using-the-n ... -in-the-uk

phuketrichard · Post by **phuketrichard** » Sat Apr 29, 2023 3:36 pm

ego bibere nimis wrote: ↑Fri Apr 28, 2023 3:49 pm
Ong Tay wrote: ↑Fri Apr 28, 2023 3:42 pm I have "global" coverage through CIGNA, which should cover me anywhere in the world, except for the US (specifically excluded). It also has an evacuation rider, which would allow me to be medevac'd out of Vietnam to Singapore or Thailand.

One issue to consider is pre-existing conditions. When I applied for this insurance 2+ years ago, I had to complete a questionnaire about previous illnesses/conditions (but did not have to undertake a medical exam). That resulted in the insurer excluding such conditions from coverage; fortunately they were relatively minor conditions and I was comfortable with them not be covered, though slightly annoyed.

This policy is not cheap, but I have no co-pay or deductible. In theory, at least, it offers some degree of assurance that I will be covered should I be run over by a motorbike, stricken with cancer, or some other serious malady.

I would look for a plan that provides for inpatient hospitalization (and all of the costs associated with that - doctor's fees, diagnostics, procedures, food, etc) and medical evacuation.

As another poster said earlier, leave out the outpatient services and you should be able to save some money.
These guys are OK. Made a couple of claims, paid up no fuss. https://www.william-russell.com/expat-h ... -thailand/

Premiums are reasonable (just like Doc, no US coverage otherwise premiums skyrocket).

I've self insured since i've been in SE Asia and before < not saying others should or shouldn't
in the past 40 years , ive spent less than $2,500 for Hospital treatments
figure i have saved over $150,000

As a lark visited the site<
basic Bronze plan at my age it is $1,027/MONTH ( if i had started 13 years ago $507)
most expensive $2, 714

ali baba · Post by **ali baba** » Sat Apr 29, 2023 6:02 pm

Insurance doesn't offer me any peace of mind because there's no guarantee they'll step up and take care of you when you need them, if they do take care their focus is on their bottom line and not your health and even if everything goes smoothly you're still expected to have a small fortune on hand to pay the bills up front and then wait around for the insurance to reimburse you. Even if that moves quickly you're still expected to pay 15% of the bill due to deductibles and co-pays.

The best case scenario isn't good enough and the likelihood of it happening isn't high enough for me.

truffledog · Post by **truffledog** » Sat Apr 29, 2023 6:50 pm

ali baba wrote: ↑Sat Apr 29, 2023 6:02 pm Insurance doesn't offer me any peace of mind because there's no guarantee they'll step up and take care of you when you need them, if they do take care their focus is on their bottom line and not your health and even if everything goes smoothly you're still expected to have a small fortune on hand to pay the bills up front and then wait around for the insurance to reimburse you. Even if that moves quickly you're still expected to pay 15% of the bill due to deductibles and co-pays.

The best case scenario isn't good enough and the likelihood of it happening isn't high enough for me.

There are plenty of cases that tell a different story. Insurance is a difficult matter but it sure has help a tonne of people in tragic circumstances. Expectation are sometimes too high and the insurance companies will cut them in the fineprint. A policy that would cover fuck all would probably cost a fortune.

The utter minefield of health insurance.

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