The Older Expat and Medical Insurance

The feedback fromPitfalls and Curveballs continues and, followingEssential Expat Healthcare on 4 August, a discussion has developed about the plight of the older expat and his medical care. Caught between a proverbial rock and a hard place they are damned if they try to secure insurance and damned if they do not.

Medical insurance is frequently looked on in a subjective way. Many see it as a waste of money but often agree that it is best to have some sort of cover for a catastrophe occurring which could  leave their life in financial tatters. Many continue to adopt an ‘it will never happen to me’ attitude, but if you did find yourself with a dread disease or a serious disability how would you cope?

In the past years medical insurance has improved in leaps and bounds. Ten years ago entry level to medical plans beyond age 65 was almost unheard of; then once covered, sometimes when you reached an age ceiling you would be thrown out on the street.

Today, there are a number of companies who will accept new entrants well into their seventies. But at what premium? In many cases it is prohibitive and unaffordable. Balanced against this, if you need medical attention, it may be cost prohibitive, too. So, do you just give up and suffer or die?

I’ve talked to many expats over the years and have some feel for costs of treatment. Simple procedures these days seem to be rather expensive. One patient recently had gall stones removed and the bill was THB 380,000. This included four days in a private hospital room. Another had a cartilage repair to his knee which required only one day in hospital but because it is micro surgery the bill came to a whopping THB 450,000.

Like many businesses, medical insurance requires balance between income and costs to ensure commercial viability. When insurers experience heavy claims you can bet your life that premiums will increase the following year.

All this certainly does not help the older expat who is in this catch 22. If he buys cheap local insurance he will end up disappointed because of the sub limits and restrictions. Many are ignorant of their policy limits until they make a claim and are shocked to realize that there is very limited or no cover for their condition. This can be earth shattering in their world.

There are more and more solutions emerging as time marches on. Some wise expats think carefully rather than just hoping that nothing disastrous will happen to them. They take a pragmatic view and make a plan to try and allow for future catastrophes. Some ‘self-insure’ by taking the amount they would spend each year on medical insurance and place it in a savings account. This is sensible planning, except that in the first few years there will be a low savings balance and if you needed treatment during this time you may find yourself in a very difficult position.

Others have managed to secure one of the new lower cost products available today. Insurance companies are becoming more competitive and designing plans which can be tailored to situations. For example, you can secure cover specifically for lower cost countries in Asia which excludes places like Singapore and Hong Kong and thereby reduce your annual premiums.

Higher deductibles are also available so that in combination with an area restriction the expat has insured against higher costs of medical treatment by covering for disasters where his costs will be limited.

One company offers no claims discounts of 5% per year up to a maximum of 25% overall. If and when you do make a claim it is not all taken away at the next renewal but assessed and partly reduced. This does help to an extent but the older you get the higher the premiums are loaded, still continuing to escalate your costs.

Just like a business, as an expat, you need to balance your costs against your income. For the older expat you are likely retired and have reduced income. Whilst it is good to know that you have protected yourself you still have a life to live and quality is important. As with so many things in our lives there is an element of risk in whether you will need substantial treatment in the future. Medical conditions develop overnight and can be disastrous.

Some will have the option to go back to their home country to seek treatment there. This throws up two problems. First you may contract a condition which renders you totally unfit to travel. Second is the fact that even if you get home there may be no free treatment for you there. When you are assessing your own situation you need to take this into account if you are to make this part of your overall plan.

If you intend to remain an expat, then making plans for your own situation is essential. Don’t wait until you have a problem and it is too late – act now! Get in touch with me to make sure you have all your bases covered.


Expat Healthcare

Questions to the author can be directed to PFS International on 02 653 1971 or email to

Andrew Wood has been an expat in Asia for 34 years and is Executive Director with PFS International. He has been writing Net Worth articles for six years and has made a significant contribution to the PFS library of financial service articles dating back over nine years. These articles which cover the complete A-Z of financial planning are available to readers on request


2 Comments to “The Older Expat and Medical Insurance”

  1. Voitto 18 September 2013 at 5:24 pm #

    Do you have any insurance company you recommend for a health and accident insurance for a 52 year old expat living in Laos?


  2. PFS International 22 September 2013 at 12:49 pm #

    Yes, we can do this for you. I have asked one of my team members to get in touch with you.

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