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.

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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!