Health insurance Buyer beware,read the small print.

Dear All,

I was not going to mention this but I think my experience will be helpful to save any of you falling into the same trap.

At Christmas/New Year 2005/2006 I was very under the weather with a sore throat that would not go away.I have always ensured that I was adequately covered on Health Insurance throughout my time living in Thailand with an International company covering worldwide. I had the emerald policy as I had been told that would cover me well and truly for any emergency in Thailand.

I went to a reputable Pattaya Hospital as an out patient and was prescribed Anti Bio tics for Laryngitis.I followed Doctors advice to the letter, however, I returned two weeks later, with the same condition. I was again prescribed Anti Bio tics, but a different brand and a longer course.

This still did not work. I sought a second opinion and went to A Bangkok Hospital. I told them the symptoms and showed them the medicines I had been prescribed. They organized a X-Ray, and it came back, they told me it was perfectly normal, and maybe it was anxiety as to why my problem was persisting.

Feeling no better, and by now, people around me could no longer understand my speech correctly, I was in company , by accident, with Dr Peter Morley, Medical Director of the famous Bumrungrad, who advised me to visit him and he would get to the bottom of it, once and for all.

By this time, We are moving into February, I was immediately sent to a specialist in Their ENT division at Bumrungrad. He, within, five minutes after examining me informed I had a 'vocal mass' on the Left vocal chord and advised an immediate Biopsy. I told him the previous Hospital had told me the X-Ray was normal. He told me ' Cancer does not show up on the type of X-Ray given of the Head!'

The Biopsy was done the following day and the result the day after.

BAD NEWS. I was told I had cancer of the vocal chord and it was malignant.

The next two months, I travelled daily from Pattaya to Bangkok for Radiation treatment whilst continuing my role in Throb/Splash and the Hotel business. A daily round trip of five/six hours for two months!

A period of time was allowed to elapse after completion of the Radiation Treatment as the swelling was immense due to Radiation and they had to wait again.My Insurance company was covering the costs as I expected under my policy.

In August 2006, I was informed all efforts to save the Larynx had failed, My body had not responded to the Radiation treatment and by this time, the cancer was blocking my windpipe.

A triple operation was required immediately under 'emergency procedure' I was also informed that the surgeon was so worried, he did not wish to put me under General Anaesthetic until the Stoma/Hole in my throat, enabling an alternative source of breathing, was made, whilst I was awake, as they feared I may die.

So guys, We have the time lost/wasted by misdiagnosis from two Hospitals and if that was not enough, I was having my voice box removed, to then be informed by my insurance company that I had reached the limit of 500,000 baht and would now have to pay all further expenses myself!!

I was shocked. These procedures were very substantially more than this, and I, like many people who take out Health Insurance had not read the small print and just accepted as fact, the advice given.

The small print had fees covered per schedule.

So, sometimes when you are seeing millions of bahts worth of cover, they are giving you the total cover for all different types of ailments and operations!!

The key is 'Amount per schedule' that is the amount covered for your operation/condition at that time.

Also, once you have reached this schedule level no funds now or in the future can be drawn for that condition. I am no longer covered for this cancer, but never mind, roll on a Heart attack and I am covered again!!!

BUYER BEWARE.Check and scrutinise your policy!!

What would have happened if you didn't have enough private funds to cover this?? I think you all know the answer.

Finally, My deep respect and appreciation to all the Doctors and Nursing staff of Bumrungrad Hospital, without whose help, I would not be writing this today.

K, thanks for sharing. Sorry that you have had to find out about the small print this way. Prayers that you never have opportunity to exercise the heart attack provisions or any of the other coverages.

[puckered_penguin]

Thanks for that kquill. I will look at hiking my Emerald into a Diamond maybe.

So are u still insured with BUPA?

I am surprised they did not pick that up straight away by examining your throat, but you don't need me to tell you that, and more importantly I assume you did smoke and due to that - I'm surprised they never examined further. I'm not sure what happens in the period of 2 months, whether it is slow growing or what. The good news is that from now on you will be examined regularly for other things going wrong (not that they will), but you are in a better position in that respect, if that makes you feel any better.

The lesson to be learned in this respect is - we put our lives in the hands of doctors and trust them but it is always wise to get 2nd, 3rd and even 4th opinions.

My mum was diagnosed with final stage ovarian cancer about 6 years ago, if anyone knows about "ovarian", at this stage it is basically "lights out" - to cut a long story short, she was, 2 years later, also diagnosed with non-Hodginsons - which is curable - anyway, as I said to cut the story short - that is what it was all along, non-Hodginsons and NOT ovarian. She has been through the mill, but is still around today and doing fine.

Guys,

Yes, I was a smoker, My God, if I knew then what I know now! I have not touched one since nor had the desire.

Answering further questions, I am still with BUPA as I have been with them 15 years and so is Tam and members of his family. The problem is, if I changed now, I would have to declare all previous ailments, to which, they immediately will refuse cover.

It is now a basically, no win situation, so I'll have to stay where I am.

Regards Whitedesire, I'm sorry to hear the unnecessary strain put on you and your family again through misdiagnosis. It is true, to check and double check, even if they think you're a pain in the ass!

It is better to be a nuisance than go through Whitedesire's mothers or indeed my own woes!

I did go back and inform the Hospital in Pattaya and got a blank look and a comment of How lucky I was to have double checked!

I will shortly arrive at my first year since operation and have had three clear scans, with glands and lungs also clear!

They say the danger period is the first two years and to monitor it for five before you are at the same risk as everyone else.

I leave the spirits alone now, don't smoke, I need to start more exercise, but removing myself from Pattaya will assist that objective,for sure!

Best,


Kevin.

[catawampuscat]

It is difficult to share such personal and traumatic events in ones life with strangers and you have earned our respect
by enlightening us from your harrowing experience.
I am sure some of us are checking our insurance policies today or calling an insurance agent with queries.

You may have saved someone from much suffering or worse and desire our appreciation. It is also apparent you
are lucky to have established a successful relationship with a Thai and even his family and love your life and truly appreciate
every day.
Even your post advising the cancellation of your dinner was evidence that you don't waste your
energy and spirit with the small things and displayed no anger or bitterness at what I assumed was a disagreement
with a petty farang over financial matters.
Of course, I am assuming things here, but at the moment your postings seem heroic to me, especially after the petty,
bitter, nasty and plain mean postings of some other posters, including catawampuscat.
Many of us , my self included, avoid hospitals, checkups, and lead unhealthy lives smoking tobacco excessively,
indulging in spirits daily, and the only exercise is to walk to the motorbike to get to the bar or buy another
bottle of gin and cigarettes.

A good friend pushed me to take advantage of the annual King's Birthday 1/2 price medical physical at the
Bangkok Pattaya International Hospital and literally took me for my examination. I hadn't had an HIV test in 10
years nor had my blood pressure taken, and all the rest.
It was a great relief when all went well except for a warning about too much protein which could lead to gout and
some excess weight. I appreciated my friends efforts and gave myself a New Year's present taking care of my life.

Kudos Kquill and I for one am very interesting in how your life story continues in the village/town where you are planning
on living and only regret that I never got to meet you or know you in Pattaya as I get the strong impression you are a
farang well worth knowing. chok dee

[Boxer]

I too have had Cancer problems and recommend Bumrungrad Hospital Horizan Centre in Bangkok most heartily.
I had 'confusing' at best, advice from two Pattaya Hospitals before moving to Bangkok specialists for tests, diagnosis and start treatment in three days on a fast growing Cancer.

A year later we have the beast under control. BUPA also would not cover me for Cancer as I had a previous known condition under test.
The personal cost this year has been just over 1.6 million baht and expensive medication costs continue!

Despite this I have gone to Platinum Plan to get an increase in the Scheduled Limit problem and would recommend yearly check ups to all as my condition was found from that, or I could be dead by now.

One key standard provision of all the Thai medical insurance plans I investigated is that they will not cover pre-existing conditions. Because of that, after a period of time, it becomes difficult to switch to another insurer, since as time goes by, you have more pre-existing conditions which won't be covered. I'm talking in particular to older farangs living in Thailand. If you are a healthy young stud who's never seen a doctor, you might be okay with pre-existing conditions.

Especially in his case, Kevin would lose a whole bunch of coverage if he changes insurance carriers at this point. Anything related to the throat or cancer would not be covered, for sure. Any other treatments he has had during the 15-year period with BUPA will be excluded from coverage by a new insurer as well, since it will be well documented.

I signed up for BUPA a few years ago and after having the policy for two years, I had surgery to correct a deviated septum at BNH hospital in Bangkok. BUPA delcined to cover it because they found I had had a consultation with a doctor at Bumrungrad (a few years before my joining BUPA) which diagnosed a sinus infection. Yes, they are quite efficient at doing research to deny a claim. I ended up going back to Bumrungrad and had the doctor amend my medical records to such an extent, that upon appeal, BUPA then paid the claim. Had the existence of a sinus infection 4+ years prior remained documented at Bumrungrad, BUPA would have excluded ANY treatment to the nose or sinuses. Apparently when I signed the enrollment forms, I gave them the right to access to all my medical records ... worldwide, if I understand correctly.

So, I feel I am pretty much trapped into keeping BUPA. Since my late 40's I've been developing a considerable medical consultation and treatment audit trail in Thailand. BUPA has covered most of it, but a new insurer would exclude all of it.

To Puckered_Penguin, who ponders about raising the level of his policy to Diamond: be aware that the increased coverage level is also linked to pre-existing conditions. Any pre-existing condition will be treated under the limits of your previous (Emerald) coverage level. Only "new" conditions will be covered by the increased (Diamond) level. I found this out when I increased the level of my OPD coverage last year.

[Geezer]

The subject of insurance is so important one doesnтАЩt want to divert this thread. However this is an appropriate place to mentioned that Dr. Peter Morley can be an invaluable resource in a difficult situation. I have an acquaintance who was near death as a result of multiple misdiagnoses. He finally was taken to Dr. Morley, was properly diagnosed, and recovered.

I When first I came to Pattaya I developed an itching rash in the groin. Upon visiting a large local hospital, herpes was diagnosed. What a bummer! I had just left my home country, begun the good life; now I would be afflicted with herpes the rest of my life.

After weeks of treatment the problem worsened and spread to my partner, with whom I shared only a bed and hugs. A friend suggested I consult Dr. Morley. I did. He pronounced it scabies. Scabies! (Think miniature crab lice.) A few applications of Jacutin, and the problem was solved.

Dear Catawampuscat,

Thank you very very much for your kindness. Without diverting the topic, you are correct as to why I cancelled the Pattaya thing. Life's too short and precious now for me to dwell or waste my time on petty Squabbles or local politics of Pattayaland.

With regards other posters who mention Dr. Peter Morley, he is a diamond who assists us all and puts us on the right track medically.

The thread now shows signs, which is what I wanted, to warn and help others to check their policies and never skimp or even worse, NOT READ your policies thoroughly.

It is amazingly laid back where I am now up in Kalasin but Tam always finds us something of interest to do or work that needs doing around the Houses.

I hope you all live long healthy lives, Money is nothing without health, I've learned!

How far back do the applications for health insurance go here? I have heard they only go back FIVE YEARS. Is that true?

[Aunty]

Yes, I was a smoker, My God, if I knew then what I know now! I have not touched one since nor had the desire.

Well I'm really glad that you finally got everything sorted out and I wish you nothing but the best of health from now on in. And I'm really pleased you shared your story as stories like these give us all pause to think and to make sure we have what we think we have when it comes to things like insurance. But dude, you were a smoker, you knew what was going to happen. You knew then, what you know now!! That's why I think your story is really important for that very reason, again it highlights what is likely to happen to people who smoke. Let's hope your story bursts the bubble of someone who smokes.

If you smoke, stop, and if you don't, don't start.

Aunty,

No defence. You are absolutely right. I used to follow the misguided theory that it always happens to someone else!

For my sins, I now have to breathe through my throat/neck area, I have no sense of smell, I cannot pursue my long time hobby of swimming.

I must attend Hospital regularly and worry at each occasion for at least five years and I have artificial speech and must cleanse my throat with a steamer two/three times a day.

I think I've learnt.

[TrongpaiExpat]

Mark: Thanks for sharing your story. We all learned something from your ordeal. Good luck and continued good health.

My father, a smoker too, had cancer of the larynx and had a laryngectomy. I found it interesting that they first tried radiation with you. They told my father that radiation of the throat was too risky and his only option was surgery and then radiation if necessary latter.

He came through fine and a year latter he relearned how to speak. He never sounded the same but you could understand what he was saying. He was a lot older than you and 5 years latter died of a heart attack.

His doctor refused to give him one of those electronic voice boxes and told him to learn to speak without it.

Here is an interesting site:

www.entusa.com/voice_box_cancer.htm (http://www.entusa.com/voice_box_cancer.htm)

Dear Trongpai,

The names Kevin.

I was told by them at all costs , the objective was to save the voice Larynx if possible. Hence, the Radiation. It is usual but not extraordinary for people to get this in later life.

I did have Radiation again [ 27 times] post operation.

I refused the electronic voice and instead had a prosthesis fitted into my windpipe.

I then went to the UK and had the remainder fitted, as they do not have this in Thailand. [ called Trachinaze plus]I speak without artificial electronic aids, but the prosthesis is of course artificial. Sorry, if I confused.

The voice, which I have learned, is caused by my blocking the airway in my throat and the air is forced through the prosthsis and my mouth. The voice and accent sounds the same as my voice was!!!

It really is clever. A lot of people have learned to speak again with this method.

I relied on cards I had printed and was without speech for four months. [ A long time, believe me! ]


Sorry about your Father, its sad to hear.

I had a long dispute with an Insurance Company, over a Travel Insurance Policy, following a serious accident in Paris. Luckily, in my case, they eventually paid up but I know that when you're feeling at your worst the last thing you want is a battle over money etc.

Very best wishes for a long, happy and healthy future and many thanks for highlighting this problem.

Hi John,

The Gospel truth on this issue is threefold. [ opening premises]

1. Some of the ideas I have/had are already being done as per your post at two new premises listed in your posts with both the opening of a resort and a Sauna/Guesthouse.

I have not visited either but both look[ judging by your web links ] to be of a similar standard that I would have wished to do.

2. The Throb/Splash theme worked and was good but has had its heyday/life cycle, as the saying goes, " It was nice while it lasted". If I entered that market area again, I would be doing something different from the norm and something other operators haven't tried. No point us all doing the same thing!

I am pleased that Pattaya is developing on the Gay front and there appears to be a lifting of both choices and standards to suit all tastes and budgets.

3.The Doctors have advised me to get out of this environment, Smoke even second hand either from bars and/or the pollution of Pattaya and Bangkok are not good for my condition with an open Stoma, even though I have filtration units.

I couldn't and wouldn't place this hefty burden on anyone else[ running a big operation alone] if there is a possibility I could be taken ill again.

Then there is the investment, if I did something it would be correct and not on the cheap!

Although Tam helped me a lot with authorities such as City Hall and gained the friendship of the boys in brown, he is not particularly business minded, which he has told me' A lot of people I relied on, in accounts etc are looking forward to retirement themselves! [ One or two have passed away]

Finally, although I won the silly case in the Appeal Court all that time ago on the " trumped up charges" and received an apology from the General of the National Police at that time, it has not, after seven years still been officially ended in the Supreme Court.

No, I think, nice and easy and sit on my hands for a while and see how things ' pan out '

:idea:

I might even take Tam down there and try out some of the new facilities on offer!


All the best,


Kevin.

PS John, the best man in Pattaya to offer advice on Health insurance as well as all other insurances with reputable companies I have found to be is Jack Levy on 081 6242702 . Call in office hours please.

[Bob]

Yes, the US does have a program where one can deduct from gross income certain amounts that one pays into a medical savings account; however, you can't use the account for other purposes.

And the plan has no connection with medical insurance, catastropic or otherwise. As ugly and hard as it is to pay for medical insurance in the US (about $5,000.00 per year for so-so coverage), I just can't imagine not having it, ending up in a hospital for 3 weeks, and then having to pay roughly $300,000.00 to the hospital and health care providers. If you want to go bankrupt, just don't have medical insurance and then get really sick.

Bunch of bull!
I was in a US hospital for three days. No surgery. One sophisticated test. Nothing wrong with me it turned out. Bill? 50 THOUSAND DOLLARS. Yes, I was insured at the time but it still cost me 4K dollars out of pocket. But imagine something really serious? Self funding is absurd. The US needs nationalized health care. As baby boomers age, it is that or millions of needless deaths and bankruptcies.

Anyone who seriously believes health savings accounts will save the US health care crisis is either a brain dead Bushie or has read one too many Ayn Rand novels.

I know the United States is the only "advanced" western democracy without a government health care system. I know health care in the US is the most expensive in the world, and that over 50 million Americans have no access to it. You are the pipe smoker. I am the realist. Nationalized health care in the US is coming within 10 years. You can bet on it.

BTW, do you pay for your own highway system and military? I doubt it.

I know the kind of idiot that you are. The kind that think government health care systems are communist. I guess you are against VA benefits and medicare as well. Crawl under a rock, your kind are now dinosaurs.

I have been reading over your posting again. and some things strike me as a little bit strange.

You say you were in the hospital for three days. Why? What was the complaint?

You say you received a "relatively sophisticated test," but you don't say what it was. If there was no surgery, one imagines that you were only in the hospital for that "relatively sophisticated test."

And then, CHECK BIN, $50,000!

Well, US hospital beds run about $1000 per day, so that gives us a bill of $3,000. There was no surgery, so most of the rest of the cost must have been that "relatively sophisticated test" we know so little about. Hell, I've paid $4,000 for an MRI of my brain, back in the 80s.

Then you go on, to say that you were insured, but STILL you had to pay $4,000 "out of pocket." You seem to be very angry about this -- that you had to pay anything at all for medical care. This strikes me as a supremely British attitude ("the first thing we do, is enslave all the doctors"). Have you read recent polls telling us that way over 70 percent of British doctors do NOT recommend their own profession? Are you familiar with the mess in Canada? (The Canadian socialists found a really "clever" plan: treat the injuries of the young with all possible speed, and let the old languish in the hospital corridors...)

Well, I imagine that you've dined out on that tale of American cruelty for 30 years or more. But, just an idea, if you're British, what were you doing in a US hospital? It wouldn't be connected with that "relatively sophisticated test," would it?
You're an idiot. I am American. I am not going into details about my health history but it was chest pain related. Thus, the urgency and need for hospitalization. The expensive test involved nuclear technology. I bitched about the extra money because I was already spending over 6,000 per year for this insurance that wasn't as good as expected.

And that is rich. You think I am lying about the total bill. I am not. I was amazed, but actually it was MORE than 50K. More ,like the mid 50's. Yes, a total ripoff and way out of whack for the value, but imagine being stuck with that bill yourself?

You're a Brit? Why do you care about the US system?
I meant you don't pay yourself for the highway and military. The government pays from taxes, as it should for health care.

Only the rich travel to the US for health care. The technology is the best in the world. The access is the worst in the advanced world. Balance of this: A CRAP SYSTEM. People are dying because of it, even the American Medical Association says so.

>>I meant you don't pay yourself for the highway and military. The government pays from taxes, as it should for >>health care.

Oh, a very subtle point. When I write a check to the US government, I am not "paying" for anything. No, the "government" is paying "from taxes."

I will spend the rest of the month contemplating the meaning of what you just wrote.

And remember, everyone, vote for Hillary!
You are even stupider than I thought. You don't get the point? The government is already "socialized" for many things: road, military, education, and yes, even health care, medicare. You don't pay for these things yourself at point of sale. They are already collectivized. No country is pure capitalist. Not a big step to progress to national health care. We already have it for those over 65.

I am supporting Bill Richardson for President. I don't like Hillary. I also supported Al Gore and John Kerry when they were nominated, and am proud of it. Richardson does not support single payer like I do, but his plan allows a way for access for ALL Americans.

BTW, the way Richardson has the best record on GAY RIGHTS of any of the top four candidates. Kucinich is probably better, but he really has no chance.

http://www.richardsonforpresident.com/

http://www.richardsonforpresident.com/i ... ec_summary (http://www.richardsonforpresident.com/issues/HCplan_exec_summary)

American voters, learn more about Richardson. Don't let the mass media tell you who is "winning" at this very early stage.

All the democrats support radical change in the US health care system, mainly around the unfairness of lack of ACCESS. The democrats will take the presidency in 2008 and keep the house and senate. Things will change, and soon.



in the online world, Richardson seems to have eclipsed Clinton and holds third place after Edwards and Obama in unscientific straw polls conducted by Democratic-leaning Web sites such as MoveOn and Daily Kos.

You are supporting Richardson for President. How good for you.
I beat you in an argument, and you put me on ignore. Good one, bushie!

[Aunty]

I have been reading over your posting again. and some things strike me as a little bit strange.

You say you were in the hospital for three days. Why? What was the complaint?

You say you received a "relatively sophisticated test," but you don't say what it was. If there was no surgery, one imagines that you were only in the hospital for that "relatively sophisticated test."

And then, CHECK BIN, $50,000!

Well, US hospital beds run about $1000 per day, so that gives us a bill of $3,000. There was no surgery, so most of the rest of the cost must have been that "relatively sophisticated test" we know so little about. Hell, I've paid $4,000 for an MRI of my brain, back in the 80s.

Then you go on, to say that you were insured, but STILL you had to pay $4,000 "out of pocket." You seem to be very angry about this -- that you had to pay anything at all for medical care. This strikes me as a supremely British attitude ("the first thing we do, is enslave all the doctors"). Have you read recent polls telling us that way over 70 percent of British doctors do NOT recommend their own profession? Are you familiar with the mess in Canada? (The Canadian socialists found a really "clever" plan: treat the injuries of the young with all possible speed, and let the old languish in the hospital corridors...)

Well, I imagine that you've dined out on that tale of American cruelty for 30 years or more. But, just an idea, if you're British, what were you doing in a US hospital? It wouldn't be connected with that "relatively sophisticated test," would it?
You're an idiot. I am American. I am not going into details about my health history but it was chest pain related. Thus, the urgency and need for hospitalization. The expensive test involved nuclear technology. I bitched about the extra money because I was already spending over 6,000 per year for this insurance that wasn't as good as expected.

And that is rich. You think I am lying about the total bill. I am not. I was amazed, but actually it was MORE than 50K. More ,like the mid 50's. Yes, a total ripoff and way out of whack for the value, but imagine being stuck with that bill yourself?


Others may not say it, but I will put it to you. You are telling lies. There is no non-invasive (by that I mean surgery) 'nuclear test' that could possibly cost you US$55,000 after a three day stay in hospital. BULLSHIT. PET scans (Positron Emission Tomography which I assume is what you mean by nuclear) cost around $4000, only, similar to a very long MRI scan. Nuclear medicine used in imaging is just not that expensive, ducky. You can fool some of the people some of the time, but you can't fool all of the people...................

I know what my hospital visit cost. I saw the bill with my own eyes. This was in a very high cost region of the US. Sorry if you don't believe me. I can't help that. It was three years ago. It would cost MORE now.

BTW, what would be my motivation to lie about this? I won't be having any personal benefit from nationalized US health care. I now live in Thailand. Not even eligible for medicare outside the uS.