Frequently Asked Questions
If the company is required to translate the supporting documentation for a claim, the cost of the translations will be deducted from the claimable amount.
If you do not get treated at a network hospital or clinic, your expenses will be reimbursed on receipt of complete documents from you. In this instance you must “pay first, then claim back” the claim costs incurred.
For most expatriates in the past there was often the option to return to their home country for treatment in the event of serious illness. However, many governments have made alterations to their legislation which means that this option may no longer be available.
In addition, in some countries international health insurance allows you to gain access to the top hospitals in a foreign country and avoid the local hospital network. It may also allow you to be repatriated to your home country to receive treatment and to be near family or friends. It should also cover accidents, which you can never predict.
Health insurance is a must for peace of mind.
This also applies to one-off prescriptions. You can also take a doctor’s prescription to the pharmacy to obtain your drugs. To reimburse these costs from the insurer you will need the original doctor’s prescription, medical certificate and an original receipt from the pharmacist.
◦ Down’s Syndrome
◦ Cleft lip/palate
◦ Hearing impairment
▪ North America
▪ Hong Kong
▪ EU Countries
However, you are still covered for accident and emergency treatment in all countries worldwide 7 days per week 24 hours per day.
▪ Heart Disease
▪ An illness that recurs or is likely to recur
▪ An illness that requires monitoring, consultations, check-ups, examinations or tests
Note: This list is only intended to provide a guide to the interpretation of a chronic condition.
Where there is no maternity benefit applying to your policy the “free cover” for new born children continues to apply (Group Plans excluded). Age Band premiums for children of all ages will apply at the policy renewal date. This does not prevent a parent for applying for coverage of the child under their policy plan or as a standalone policy, however for new born children of less than 15 days no cover is available.
The application for the child can be completed by either parent.
If what the surgeon charges you (or your doctor) is higher than what we consider ‘normal and customary’ for the covered service, then we may not allow the full amount to be claimed.
However, the impact of health insurance costs can be reduced by finding a provider that will allow you to spread the cost of payments throughout the year, or who offer an optional deductible or excess on the plan that you have chosen. In addition, opting to take a reasonable deductible/excess can often reduce your annual premium by 20% or more. Choosing the right health insurance policy for what you need and getting the right advice through a healthcare insurance broker could also reduce the premium costs.
Coverage for dental, routine health checks, routine visits to the doctor for common ailments all add significantly to the premium. And frankly, these are still relatively affordable in Thailand. However, make sure any plan you choose covers fully any treatment that is serious enough to require a stay in hospital or prolonged treatment on a day-care basis.
Buying an off-shore product does not offer such protection – the old adage of “buyer beware” applies.
If the cover offered by an employer really isn’t sufficient, it is worth using what cover there is for routine medical treatment and as the deductible/excess amount for a more comprehensive medical insurance plan. In addition to this it allows you to get accepted by a medical insurer before your membership in your company’s Group Medical Plan terminates. By using the benefit level of your company scheme as the deductible for your own policy, premium discounts of up to 50% can be achieve for a more comprehensive medical insurance plan.
It is important to note that memberships of Group or Employer Medical Plans terminate at age 65 years.
If you were to seek to change insurers after a large claim, you are morally obligated to advise the new insurer the details of your previous insurer and your claim. They in turn would seek information regarding your prior claims history and apply a premium rate commensurate with the health risk that you present. However in saying this, insurers generally vary in their attitude towards someone who has high claims and a careful check would be made before offering coverage by that replacement insurer. In some instances you may be declined cover.
Health insurance will not cover loss of earnings. Other insurances are available to compensate for loss of earnings in the event of serious accident/illness.
Not all policies provide Personal Accident cover so you must check out this aspect of the policy that you purchase. Our company provides a built in level of Personal Accident cover.
Treatment relating to alcohol or drug abuse
Treatment for addictive or compulsive disorders
Sexually Transmitted Diseases (STD’s)
This is by no means an exhaustive list. In addition, insurers will generally not cover pre-existing conditions but terms and conditions do vary from insurer to insurer so it does pay to check carefully. Take the example where a person is taking medication for high blood pressure. One insurer may exclude treatment for this and all related conditions, including heart attack and stroke. On the other hand, if the medication maintains that person’s blood pressure within acceptable limits, another insurer may exclude the routine treatment of high blood pressure but provide coverage in the event of a heart attack or stroke. It does pay to check.
The other area that insurers tend to put caps on things, if they offer cover at all, is the routine treatment of chronic conditions because treatment costs can be high and continue for many years. Common chronic conditions include the following: