Ricky Batten

What you need to know about pre-existing conditions and insurance in Thailand

For expat teachers with pre-existing conditions, finding insurance coverage that covers these conditions can be challenging - but not impossible.

If you’re an expat teacher employed by a school in Thailand, chances are that you’ll have access to school-provided health insurance. Some of these plans may cover pre-existing conditions* under medical history disregarded (MHD) clauses, but many will unfortunately not cover pre-existing conditions. 

So does that mean you have no option? That’s not entirely true. Although it is hard to find health insurers who cover pre-existing conditions, it’s not impossible. As I work for a health insurance broker, I often get asked to help fellow expats find plans like these, and would like to share with you insurers’ reasoning and the terms under which they cover pre-existing conditions. 

*Pre-existing conditions are health conditions that you have before you were enrolled into a health insurance policy. 

Health insurers want to reduce their risk as much as possible

Think of insurance as a game of risk. Everyone gets health insurance to cover them in the event that they get sick. From the insurer’s perspective, insuring someone who is more likely to get sick and make claims is a more costly decision than insuring someone who is less likely to get sick. It’s no wonder that insurers prefer insuring healthy individuals rather than someone with a pre-existing condition. 

Individuals with pre-existing conditions like diabetes, high blood pressure, cardiovascular diseases, amongst others, tend to make more trips to the hospital to see to their health issues. Their pre-existing condition may also make it more likely for them to get other illnesses and need medical care further down the line. All in all, those with pre-existing conditions are insurers’ worst nightmare.

Health insurers tend to cover pre-existing conditions only under specific terms

Do you have a pre-existing condition? Are you worried about your lack of coverage? Fret not - you don’t necessarily need to go without health insurance coverage. Even though insurers are reluctant to cover pre-existing conditions, there are certain situations where an insurer will agree to cover pre-existing conditions.  From adding a ‘moratorium’ or ‘waiting period’ to a ‘premium loading’ and more, here are the most common terms under which insurers tend to cover pre-existing conditions. 

1. ‘Moratorium’ or ‘Waiting Period’

Moratorium or waiting period is a set amount of time that you’ll need to wait before you can receive coverage under the insurance plan. In Thailand, health insurers are able to place a waiting period on a prospective policyholder’s application if they have a pre-existing condition. This can be up to 2 years, but it’s a good idea to double check the specifics directly with the insurer. 

In plain English, this means that if you haven’t received treatment for your pre-existing condition during the waiting period then insurers will deem your condition as unlikely to make a comeback, and thereby decide to include cover for the condition when the policy is renewed in the following year. 

2. ‘Premium Loading’

Would you prefer that your pre-existing condition be covered immediately? You may be able to find insurers that cover your pre-existing condition for a higher cost. This means that you’ll need to pay a higher premium for the insurance plan compared to individuals who don’t have a pre-existing condition. 

While this is a good option for those who want to have their pre-existing conditions covered, you should note that only a limited range of pre-existing conditions are normally covered by premium loading options. To check if your particular pre-existing condition is covered, you should get in touch with the insurer in question. 

3. Exclusion

And, finally, the third option is to have your pre-existing condition excluded from cover entirely. This not only includes the condition itself, but also any other related health conditions. However, if you’re healthy when you apply for insurance and develop health conditions down the line, those conditions will still be covered. 

Although this option doesn’t technically cover your pre-existing conditions, it’s still a good option to consider. Going down the exclusion route means that you don’t need to pay more for your coverage or stress about your pre-existing condition making a comeback, and can simply pay for treatments related to your pre-existing condition out of pocket. 

As you can see, insurance isn’t straight forward. There are many nuances when it comes to coverage and terms, and policy specifics differ from insurer to insurer. If you’d rather not search for the best deal yourself, you’re welcome to get in touch with a broker like Pacific Prime Thailand. We’re completely impartial and can help you find the right plan for your needs and budget. 

Feel free to email me at ajarn@pacificprime.co.th to learn more or contact my team at Pacific Prime Thailand today


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