The minister’s comments suggested that the insurance requirement for non-immigrant visas was being extended now to include all foreigners over 50 whereas previously it was understood from briefings by immigration bureau officials that the new provision only applied to retirees in Thailand.

Many foreigners over 50 in Thailand were left confused and perplexed on Thursday after a Reuters report quoted the Thai Deputy Public Health Minister Sathit Pitutecha as suggesting that the insurance requirement approved by the Thai cabinet this year and later confirmed by immigration bureau officials as referring to retirement visas for the over 50s, is now being widened to cover all foreigners over 50 with other forms of non-immigrant visas. 

foreigners-insurance-visa-requirements-over-50s-thai-deputy-public-health-minister-sathit-pitutecha
Thailand’s deputy Public Health Mister in a statement published by Reuters on Thursday suggested that all expats in Thailand over 50 would require health insurance cover from October 31st. In May, the Public Health Ministry announced a health insurance requirement addressing the same issue following a cabinet meeting on April 2nd. It was later clarified by certain immigration chiefs that the requirement only applied to Immigration O-A visas required by foreigners retiring in Thailand or seeking extensions who are, by definition, over 50 years of age.

Today’s report quoted the minister as describing these foreigners as ‘risky’ as he pointed out that ฿500 million in unpaid hospital bills were racked up in Thailand health system every year, a situation that had to be addressed.

Just as the controversy over the TM30 reporting requirement appears to be dying down with a firm commitment from the Thai government to have its new app reporting system up and running soon, came more confusion on Thursday when the Reuters report published online and covered internationally, quoted the Deputy Minister of Public Health, Mr Sathit, saying that all non immigrant visa applications from October 31st must now be accompanied by appropriate health insurance.

The comments have led to huge online reaction with many foreigners simply seeking clarification in a very similar fashion to the furore over the TM30 reporting requirement.

April 2nd cabinet decision on Immigration O-A visas

On April 2nd, the Thai cabinet approved a measure requiring all those seeking an O-A visa and extensions to have health insurance with a certain level of preset coverage. The provisions also required applicants to show that this coverage was in place throughout the year for subsequent applications.

The announcement in May this year by the Secretary-General of Health Services at the Public Health Ministry Dr Nattawuth Prasert-siripong came with the publication by Thai insurance companies of a well-organised range of policies, competitively priced on a well-designed website developed in association with Thailand’s Office of the Insurance Commission.

The insurance requirement, it was clarified later, only related to foreigners applying for a Non-Immigrant 0-A visa or retirement visa which by definition are only required by those over 50.

Thai government’s new compulsory insurance may only apply to retirement visas for foreigners

Unpaid bills cited also cited by the Secretary-General of Health Services earlier in May

At the time in May, Dr Nattawuth made the same point as the Deputy Minister of Health did when speaking to Reuters on Thursday about the spiral of unpaid hospital bills left behind by foreigners.

Immigration police chief later confirmed that the requirement applied to retirement visas only

Later, the Head of Immigration at the Phuket Immigration Bureau confirmed that the requirement specifically applied to retirement visas.

Today’s statement by the minister on the face of it would suggest that the requirement is now being broadened. He mentions this group of older expats as the first steps towards requiring that all foreigners in Thailand have medical insurance. He pointed out that his group was more likely to require medical treatment.

However, this would leave many foreigners about to apply for visa extensions who are aged over 50 but outside the earlier specified group of retirees on Immigrant 0-A visas, now facing a rush to have insurance in place by October 31st or in three weeks time.

‘Risky’ over 50 foreigners cost the Thai taxpayer and medical system ฿500 million a year

The Deputy Minister for Public Health pointed out to Reuters that for ethical and legal reasons, hospitals may not refuse treatment. Many Thai doctors and health workers also view this as a cultural issue.

Tourism scare stories involving active young tourists were to be have been tackled by a tourism tax

The issue has been in the spotlight in recent years with many international crowdfunding efforts to raise money before stranded tourists who are predominantly younger adults engaged in dangerous activities but today’s statement for the minister cast a new light on the issue. 

The government is understood to have rejected a recently proposed tourist tax, for now, to deal with the tourism aspect of the problem some weeks ago fearing it would jeopardise an already fragile tourist economy this year.

Reuters report has perplexed foreigners over 50 in Thailand who  are not retirees

In the interview with Reuters, very short on detail and sweeping, he described foreigners staying in Thailand on long term visas and aged 50 years and up as ‘risky’ which is why the government is acting to avoid unpaid bills in the future.

‘Hospitals have to treat them because of human rights reasons, but when we ask them to pay us back, they can’t’ Mr Sathit stated.

The minister’s comments also appear to indicate that this is a new initiative taken by the current government which was sworn in on July 16th and not the provisions already announced in May. ‘These costs become burdensome for the public health ministry, so we pushed for the insurance policy,’ he announced.

Initial impetus for the April 2nd cabinet decision came from the Ministry of Public Health

The initial impetus however for the requirement of insurance on retirement visas approved in April by the cabinet originated from by the Ministry of Public Health and was first revealed at the end of last year.

Regulation of health care costs to foreigners at public hospitals a step forward as it defines costs

In September, the Public Health Ministry published a new regulation, now in effect, allowing Thai public hospitals to vary and increase rates for medical procedures offered to foreigners at approximately twice the cost of such services to the Thai public.

This was reasonable on the basis that such costs already reflect a subsidised price and the rates charged to foreigners still offer very good value.

The provisions also introduced a mechanism where hospitals now are required to publish such costs to the ministry which will be of benefit to foreigners living in the kingdom and insurers.

Mr Sathit specifically referenced medical tourism

The Minister specifically referenced medical tourism and suggested that this was linked to the issue in his interview.

It is also not clear if this new broader provision applies to visa extensions or just to new visas being issued. While the minister comments suggest a broader requirement coming into force, such language was also used late last year and again after the cabinet’s decision in April which was later clarified by immigration authorities. 

New requirement imposed through the 1979 Immigration Act which governs all visa matters

Aside from the Non-Immigrant 0-A visa for retirees over 50 in Thailand, there is a range of other long term non-immigrant visas applicable to foreigners, including those for businessmen, skilled workers, students, journalists and family or spousal visas.

The requirements for insurance and health cover will ultimately by introduced through regulation allowed under the same 1979 Immigration Act at the centre of the TM30 reporting controversy.

Further reading:

Thai Ministry of Health brings in tiered pricing for medical services to foreigners and tourists

50-year-old Dutchman suffering from cancer files complaint against Hua Hin hospital over fees

Battlefield friends help UK man and wife escape medical bill of £12k in Thailand. Now safely home

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

UK man stranded in Thailand facing a £100,000 medical bill may be rescued by crowd funding success

Thai government’s new compulsory insurance may only apply to retirement visas for foreigners

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