Most people choose health insurance by comparing premiums, which is the one variable that tells you least about whether a policy will do its job. Here is a method that works better.
Step one: pick the hospital first
Before looking at any policy, decide where you would actually go. Not in theory — tonight, in an emergency, with the traffic as it is. For most people that is one of two or three hospitals near home or work.
This matters because everything else follows from it. A limit that is generous at a mid-range hospital in Chiang Mai may be thin at a flagship Bangkok hospital, and no amount of comparing premiums will reveal that.
Step two: find out what serious treatment costs there
Call the hospital and ask what a standard private room costs per night, and what a common procedure — an appendectomy, say — typically runs to including the surgeon. They will tell you; this is a normal question.
You now have a real number to size cover against, rather than an abstract one from a brochure.
Step three: check direct billing
Ask the insurer, in writing, whether they bill that specific hospital directly. Do not accept "we work with most major hospitals" — get the hospital named.
This is the difference between presenting a card and putting a six-figure baht sum on a credit card while waiting for reimbursement.
Step four: decide about a deductible
If you can comfortably absorb the first slice of a claim, or you have employer cover that handles smaller ones, a deductible cuts the premium substantially with no reduction in the protection that matters.
Insurance is worth buying for outcomes you cannot absorb. Paying a premium to insure a ฿30,000 bill you could have covered from savings is poor value, and it is usually what makes policies feel expensive.
Questions to ask before signing
- What is the annual limit, and is it per year or per condition?
- Are there inner limits — a cap on room rate, or on surgeon’s fees — inside the headline number?
- Which hospitals near me do you bill directly?
- What are the waiting periods, and which conditions have longer ones?
- Show me the premium table to age 70 — not just this year’s figure
- What are the renewal terms after a large claim?
- What happens if I leave Thailand?
The premium table question, in particular
Health premiums are age-banded and step up as you get older. A policy that looks affordable at 35 can look very different at 60, and that is when you are least able to switch because your medical history is no longer blank.
Ask for the full table. Any advisor should provide it without hesitation; reluctance to do so tells you something useful.
What not to optimise for
Do not chase the longest list of covered conditions, or the largest headline limit you can afford, at the expense of the things above. A large limit with inner caps and no direct billing at your hospital is worse in practice than a moderate limit without those problems.
And the thing that overrides all of it
Timing. A merely adequate policy taken out while you are well beats an excellent policy you apply for after something has been diagnosed — because the second one will exclude precisely the thing you now need.
If you are weighing this up, an advisor can price several structures side by side so you can see the trade-offs rather than guess at them. Ours will do that at no cost.
