It needs clarification but for now, it does look like that this new regulation only applies to retirement visas for foreigners living in Thailand. The new regulation has already come into effect and will have far reaching consequences for many elderly foreigners living in Thailand. On a more positive note, the policies being offered by Thai firms working with the government and Thailand’s Office of Insurance Commission look competitive and a sincere effort to offer a solution to a pressing problem.

The announcement yesterday that the Thai government approved, on April 2nd, a new regulation requiring all foreigners holding Non Immigrant O-A (Long Stay) visas who are over 50, to have health insurance, has caused some confusion. Many people had initially interpreted the move as a requirement that all foreigners over 50 holding 1 year visas in Thailand are required to hold the prescribed health insurance according to the new regulations. On the other hand, the Head of Immigration at Phuket on Tuesday told the local media that the new requirements only affect those with or seeking retirement visas who are already necessarily over 50.

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Dr Nattawuth Prasert-siripong is the Secretary General of Health Services at the Thai Ministry of Health. This week he was upbeat about the prospects and effects of the new government regulation approved by the Thai cabinet on April 2nd and announced this week. It is not clear whether the new regulation only applies to Non Immigrant O-A (Long Stay) visas for now or whether it has general application to all visas for foreigners in Thailand over 50. In the last few days the wider interpretation has been gaining sway although official communications tend to suggest that the definition is the narrower one. The new rule has implications for many elderly foreigners in Thailand. A website has been made available showing a range of competitive health care policies from Thai firms that comply with the Thai government’s minimum threshold for health care cover.

The Thai government has made it official. All foreigners living in Thailand on Non Immigrant O-A type (Long Stay) visas will now be required to have health insurance cover to a set criteria. The move was endorsed by the Thai cabinet on April 2nd and takes effect under Thailand’s extensive 1979 Immigration Act. It now means that health insurance is compulsory and it will be required on all future visa applications and extensions at immigration offices for this type of visa and extensions. What has not been made clear is whether it applies to other non immigrant visas and marriage visas for those over 50 years of age.

Thai cabinet approved the new regulations drawn up by departments which now have force of law

The Director General of the Support Department of the Health Service, Dr Nattawuth Prasert-siripong, confirmed the situation on Monday. ‘The Cabinet has already approved the new rule,’ he said. The move is being made in response to the increasing number of cases involving elderly foreigners in Thailand who cannot meet medical bills at hospitals and care facilities. Thai hospitals and practitioners are required under ethical and legal grounds, to provide care in emergency situations and this has led to a growing number of problems.

Move comes after new tourist insurance scheme

Dr Prasert-siripong explained the basis for the new health care regulation yesterday while announcing the new visa requirement for elderly or retired foreigners in Thailand: ‘More than that, this is to protect the Ministry of Public Health, which is forced to pay for medical care for foreigners who do not have the funds to pay for their hospital bills,’ he said.

The problem has also been exacerbated by frequent cases of younger tourists who find themselves in need of emergency hospital care after mishaps in Thailand. Separately, the Thai government has also just launched a new Tourist Shield Insurance program last month aimed at independent tourists although this is not compulsory. 

Compulsory insurance required for retirement visas and renewals from this point

The Health Department Support services boss explained that compulsory health insurance would now be a requirement for new Non Immigrant type O-A visa applications and renewals or extensions of stay. The new regulation has come about as a result of a policy decision taken by the Thai Ministry of Public Health, The Ministry of Foreign Affairs and the Immigration Bureau late last year. Thai authorities are anxious to draw the attention of foreigners affected by the move to a range of new health insurance policies now on offer. These having been drawn up with the help of Thailand’s Office of Insurance Commission which was a key party to this reform.

Bad news for many elderly foreigners in Thailand

This week’s announcement comes as bad news for many elderly foreigners in Thailand. Many will already be facing difficulty with a high baht lowering their often fixed income yields from foreign countries and stricter immigration rules in the last few years on both income and ready cash requirements. It is already being admitted that many of the foreigners over 60s will not be able to obtain any form of health insurance while the range of firms participating in the Thai government’s scheme are quoting annual fees in excess of ฿100,000 per annum to meet the minimal cover thresholds for those aged 65 years and over. One of the reasons many elderly foreigners opt to live in Thailand aside from the warm weather and sunshine, is the cheaper cost of living. This move balances that equation somewhat.

Problem Thai government could not ignore

Some observers consider the move announced this week is simply inevitable. They see it as the only responsible approach considering the aging population of foreigners, particularly western foreigners in Thailand. The frequent reports of foreigners committing suicide in Thailand having deliberately refused hospital treatment for health problems is an indicator of the crisis that no responsible government could ignore.

Decision made on April 2nd this year

The proposal to make health insurance for retired foreigners in Thailand mandatory was agreed by a cabinet subcommittee on immigration and health at the end of last year. It is understood that this week’s announcement and the cabinet decision made on April 2nd is accompanied by more details worked out between the Thai Ministry of Health, Ministry of Foreign Affairs and the Immigration Bureau.

New regulation imposes another duty on retirement visa holders in addition to financial ones

Under the new rules, which already have the weight of law, foreigners applying for a new Non Immigrant O-A (Long Stay) visas or extension of visa to stay in Thailand must submit evidence of health insurance. The new criteria also allows for a requirement that foreigners show that appropriate health insurance has been in place for the duration of the period since the last renewal once the new regime comes fully into effect. In the future, any lapse in the health insurance cover requirement will be considered to be grounds for a termination of the visa. This could also theoretically open up foreigners to prosecution under the immigration laws if cases were to be pursued.

Existing policies outside Thailand acceptable but may run into complications later

The Secretary General of Health Services Support this week was anxious to highlight the positive nature of the new regulation. ‘Such health insurance is good for foreigners too,’ Dr Prasert-siripong said. He confirmed that foreigners with existing health insurance would be allowed to keep their existing policy for the purposes of applying for a visa or renewal but raised a number of concerns. The first is that Thai authorities must be sure that the provisions meet the criteria set and that the health insurance is valid. This could pose complications later not least in terms of translated documents and certification required for visa applications to officers at Thai immigration offices.

Thai insurance firms consulted on new health cover policies for elderly foreigners

The Health Service boss hinted at this when he suggested that the authorities would be consulting with foreign consular missions as part of their research into this issue. He drew attention to the new range of health insurance policies already on offer from seven respected Thai insurance firms to meet the government’s requirements. Thailand’s insurance industry has been involved in preparations for the new legal requirements since a second meeting of the immigration health committee, at the end of last year, recommended in principle that foreigners with long term Non Immigrant O-A visas should be required to hold health insurance.

Reform led by official at Thailand’s Ministry of Health

The decision and initiative is believed to have been driven by Dr Kittisak Klapdee who works with Thailand’s Ministry of Health. This lead to consultations between Thailand’s Ministry of Health, Ministry of Foreign Affairs, the Interior Ministry, the Immigration Bureau and a number of Thai insurance bodies at the end of last year. These included the Office of Insurance Commission and the Thai General Insurance Association.

Website for foreigners seeking cover under new visa health care regulation now online

The Health Services chief this week directed those interested and concerned with the issue towards a specially prepared website for foreigners seeking insurance cover in order to meet the new regulations. It is located at  longstay.tgia.org which is being coordinated by the Thai General Insurance Association. Dr Prasert-siripong warned that any policy bought outside Thailand must be shown to have the right coverage and that Thai authorities would be finalising methods of ensuring that such policies are both valid and suitable. ‘We are going to discuss with relevant authorities on to how to check the validity of health insurance bought from overseas,’ he said.

Problem for foreigners with pre existing conditions

The websites quoting premiums for foreigners show the minimum premium for one year for a 50 yr old will be ฿40,000 approximately and this rises to to Premiums of over 100,000 for those aged over 70 years of age. The problem for many foreigners in Thailand will be pre existing conditions. The incidence of elderly foreigners with diabetes for instance is far higher than the Thai average which is currently at over 10% of the population. It is estimated that 15% of foreigners in Thailand have diabetes and this figure could be as high as 20% of those foreigners over 50 and up to 30% of those over 65. This week the Health Services Secretary General when commenting on the new regulations, suggested that higher bank deposits may be required for foreigners who cannot purchase health insurance . This is an urgent area where clarification is expected.

Concern about ability of very elderly foreign retirees to obtain health coverage and comply

Another complication from the new health insurance regime may be an inability for very elderly Thai foreigners who have been resident in the country for some time, to purchase health insurance even where they are fit and healthy. Some of the insurance firms are already ruling out selling new policies to foreigners aged over 80 years of age. There are no firm figures for the number of such foreigners who are by by and large male, but many have been in Thailand for decades and also have property and investments in the country. This new regulation will certainly mean change for many people.

New healthcare policies from Thai firms look competitive and appear to offer choice

On a more positive note, the policies and premiums published this week by the Thai based insurance companies do look like a sincere attempt to offer competitive insurance cover for what is an older market. The premiums compare well with those offered by American and international competitors and are certainly an improvement on policies widely available since the decision was taken in principle to make health insurance mandatory. An average quote for an international American firm for a mid 50s male living in Thailand late last year was ฿6,000 per month of ฿72,000 compared to a what is now on offer from Thai firms with policy quotes from ฿40,000 to ฿50,000.

New regulations appear to apply only to Non Immigrant type O-A visas applications for now

The new regulations appear to apply only to foreigners over 50 who are seeking a new O-A immigration visa and to those seeking to renew such visas. It has been suggested that if the policy submitted for a new visa or renewal of a visa is with a Thai company then a new policy at a later stage from an international company may not be acceptable.

Confusion about  new over 50 compulsory health care requirement for foreigners in Thailand – Phuket Immigration chief says its retirement visas only

The Head of Immigration in Phuket, Colonel Kathathorn Kumthieng this week indicated to the local media that the instructions on the new regulations to his office only specified the requirement for health insurance be applied to applications for Non Immigrant O-A retirement visas. There has been a suggestion that the fact that this applies to foreigners aged 50 and over may be the reason for this confusion. There are a range of other Non Immigrant type visas as well as a marriage visa. It is still not clear if foreigners who are over 50 applying or renewing such visas are subject to the new provision requiring compulsory health cover.

Comments by Thai government official tend also to suggest just a specific visa type

Many foreigners in Thailand hold Non Immigrant visas for work is addition to foreigners with Thai wives who are also allowed to work in Thailand with an appropriate work permit. The brief given by the Health Services Secretary General, Dr Nutthawuth Prasert-siripong, has led to speculation on this point. On Monday he said: ‘The government has found that foreigners who are in their elder years staying on this type of visa have more health issues than other foreigners staying on other types of visas.’ This seems to suggest that the regulation is limited to the Non-Immigrant Visa O-A (Long Stay) which is specifically aimed at retirees of individuals not seeking work in Thailand.

New tourist health coverage offer

The move to tighten up regulation of health insurance has also extended to an attempt to provide convenient and effective coverage to tourists visiting Thailand. The incidence of tourist injuries and stories of young tourists not being able to pay bills and resorting to crowd sourcing has been a sign that actions has been required by the government.

Dynamic Thai insurance firms offer for visitors to Thailand known as Thai Travel Shield

The new scheme is being offered in conjunction with a number of dynamic Thai insurance firms including Muang Thai Insurance, Krung Thai Panich and Southeast Insurance. The Travel Shield insurance offer will be aimed at up to 10 million independently driven visitors to Thailand at an attractive rate of ฿400 for a 7 day period.

Travel insurance for Thailand can be bought online before entering Thailand by tourists

The insurance can be bought online before landing in Thailand through online sites and credit card payments. It becomes operational once the tourist clears Thailand’s Immigration checkpoint on entering the country and offers up to ฿2 million baht in medical and health care coverage of the kind needed for travelers particularly in an emergency.

Initially only targeting a 1% take up rate by independently driven visitors to Thailand

It is anticipated that the take up rate in the first year will be 1% or 100,000 travelers although this is a tourist offer that should be marketed on the backs of the scare stories that have emerged from Thailand. Quite a few of the visitors, particularly western men and women of a young age, seem to be vulnerable in Thailand, a country which they see as an exotic land of freedom and adventure.

For our readers, this certainly something to take up on your next trip to Thailand and will help boost the confidence of tourists seeking to enjoy the best that Thailand has to offer.

New health coverage proposals for foreigners in Thailand a concern for those with medical conditions

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