The future of compulsory medical insurance for visitors to Thailand remains uncertain

As Covid arguably declines, Thailand is left with many unanswered medical insurance questions.

The Ministry of Tourism is already suggesting that by next month the entire online pre-registration process for international visitors could become history. In this proposed scenario, all you would need to gain entry would be your passport, airline ticket, visa (if required) and proof of vaccination. Perhaps. The prime minister said he would wait until after the Songkran holiday to make a decision.

What is missing from the optimistic prognosis is the future of compulsory health insurance. Currently, all foreigners (except work permit holders) must have Covid coverage of US$20,000, including hospitalization. Although the Tourism Authority of Thailand has predicted that this could drop to US$10,000 sooner or later, no government agency has specifically said that the compulsory Covid insurance will end completely. It is readily available online for around $100 per month for pre-arrivals ages 1-99.

Although government sites currently speak of the need to obtain cover for the entire proposed stay, it is enough for the Thailand Pass pre-registration bureaucracy and the vital QR code to have just one month of Covid cover. This is because the Thai General Insurance Association website will only register you for 30 days, simply stating that you can renew once here if need be. But stay extensions in most cases do not require proof of current medical coverage. So very few people care.

Special rules apply to retirees holding an O/A annual retirement visa issued by Thai embassies abroad. They need full medical insurance, not just Covid, worth US$100,000 to get the visa in the first place. They will also need it to apply for an annual extension of stay at immigration offices, although the amount will be much lower – around 13,000 USD or 400,000 baht for hospitalization – until October 2022. Thai Cabinet press last year said the minimum insurance renewal would increase to US$100,000 by that date. Self-insurance was also declared possible as full cover, as opposed to Covid only, may be impossible for the elderly or those with pre-existing conditions.

Of course, most retirees don’t live here with the O/A option, but instead have obtained the annual “O” visa granted by Thai immigration offices to retirees and foreigners married to Thais, or have passed 5-year Elite visa. None of these options require any form of medical insurance at the initial stage, renewal or extension. The barely used special tourist visa and the ten-year O/X visa introduced several years ago also require continued medical insurance – perhaps a significant reason for their unpopularity with foreign visitors.

The future therefore remains uncertain. Will Thailand waive all medical insurance requirements and return in 2019, despite the barbed wire still surrounding the O/A anomaly? Or will short-stay tourists be exempted while those on long-stay visas face a new requirement? Or will the current Insurance for All policy be maintained to appease the country’s insurance company lobby which has profited (with some exceptions} beyond expectation from the Covid pandemic.

Some clues can be gleaned from Cambodia where the whole issue of insurance has gone through many stages. Late last year, Prime Minister Hun Sun announced that Cambodia was opening up to tourism, although entry health tests and medical insurance are required. Last month health insurance became “recommended” rather than compulsory and all testing on arrival was dropped for fully vaccinated tourists. The country now has the simplest admission rules in Southeast Asia and tourism is growing by leaps and bounds.

Of course, medical insurance is common sense and should be encouraged. The problem for Thailand is in the detail. It does not seem wise to confine a small number of expatriates when most remain virtually unscathed. While it’s commonly believed that uninsured long-term expats shouldn’t become a burden on Thailand’s healthcare system, the reality is that most unpaid bills come from the short-term tourism sector. The question then arises whether cheap insurance formulas can cover all risks and accidents that may occur without warning. Non-payment by companies can be as serious a problem as being uninsured. Time is running out for Thailand to pull itself together.

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