FYI: Cost of a Heart Attack in Thailand

[ItDontMeanAThing]

Haven't had a reason to post about medical costs for 4+ years because I was healthy. That changed. Now it's all good and looking better every day. As the Aussies say, 'No worries, mate!'

Costs were to my insurance company because I have 100% hospitalization coverage. Costs occurred at one of the 2 or 3 best and most expensive hospitals in Thailand.

What they treated: Heart attack with 3 blocked arteries plus congestive heart failure.

How they treated: Stabilization in ER at regional branch hospital. 135 mile lights and siren ambulance ride with 2 ER nurses and their cardiac carts. Surgery for 2 stents, 1 balloon and an intra-aortic balloon pump. Recovery for 5 days in cardiac ICU, 4 days in intermediate cardiac care unit.

Cost to nearest $100, at a conservative 34.8 THB - USD exchange rate: $ 24,000. Yeah - surprised me too.

 

[chris2008]

Congratulations. Now celebrate birthday 2xpy!

 

[audreyh1]

Oh man, bummer!! I'm glad the covered cost was so reasonable, but I wouldn't want to go through the rest of it!

Very glad you survived. Hope your recovery is swift!

 

[Tadpole]

Good to hear you are doing better after all of this.


Just for comparison to my local hospital: Five days in the cardiac ICU locally was $99K in 2011. Looks like the Thailand price would cover a little over one day in the room without the surgery. (This is regular insurance, not Medicare pricing.)

 

[MichaelB]

Glad to hear you've survived this trauma, wishing you a speedy and uneventful recovery.

 

[zinger1457]

Costs were to my insurance company because I have 100% hospitalization coverage. Costs occurred at one of the 2 or 3 best and most expensive hospitals in Thailand.

What's the cost in Thailand for the insurance coverage?

 

[rodi]

For comparison. A member of my extended family who had a heart attack earlier this year. And no insurance - so this has presented a family/financial crisis.

No ambulance - girl friend drove him.
ER to stabilize
3 days in cardiac ICU
2 surgeries to place 2 stents

85k for hospital charges. Since he had no insurance - that was not a negotiated rate. His mom and sister talked to the billing office and got an offer of "pay $40k NOW and we'll call it paid." So he borrowed money from various family members.

He's still waiting for surgeon and doctor bills... Unfortunately, those were not included in the charges. We expect these to be in the 10's of thousands.

Unfortunately, he dropped insurance this year because he was financially stretched too thin - he was making a choice between mortgage and insurance.... He made a bad choice. He is now enrolled in insurance again (so he can get follow on care). His work does not provide insurance, unfortunately. He works 6 days a week, is hard working... but it's not a high paying job. This is not someone who spends a lot of money on stuff..... Doesn't smoke, doesn't eat at restaurants, doesn't even have a car (uses work truck).

 

[Koogie]

Sorry to hear that. I've been following your blog for years and years...
good thing it didn't happen on one of your big overseas trips !

Wishing you a continued full and complete recovery.

 

[ItDontMeanAThing]

Thanks everyone for your well wishes.

What's the cost in Thailand for the insurance coverage?

2013 $2,048
2014 $2,230
2015 $2,564 (turned 60, expected a bigger increase)
2016 $2,792

Maybe this is useful. Wrote it last year for a friend in the US who was/is considering early retirement in Thailand.

Covers 100% of almost all hospitalization costs except limited payment for private room when not medically necessary. Maximum limit per year is 1,000,000 USD. No lifetime limit.

Full coverage while traveling or living in: Cambodia, Indonesia, Laos, Malaysia, Philippines, Taiwan, Thailand and Vietnam. Outside of those countries, excellent travel insurance for stays < 7 consecutive weeks. Covers inpatient and outpatient. If local quality of care is inadequate, covers evacuation to where it is adequate. No idea if there is a limit to number or cumulative duration of covered travel periods per year.

First policy with company must be issued before age 65. Coverage ends on Dec 31st after age 75, though, of course, one can voluntarily decline to renew at any time.

Insurance provider is a long established major French company.

 

[cooch96]

Amazing story. Thank you so much for sharing and May you make a full recovery.

May I ask what you're overall impression is of healthcare facilities is in SE Asia? I'm guessing Guam, Vietnam, and Thailand have excellent care for those who can pay, but Cambodia, Mayalasia, and the rest are more primitive. That's just my theory, I'd love any anecdotal evidence you, or anyone on this forum, can provide.

Rest easy.

 

[ItDontMeanAThing]

May I ask what you're overall impression is of healthcare facilities is in SE Asia? I'm guessing Guam, Vietnam, and Thailand have excellent care for those who can pay, but Cambodia, Mayalasia, and the rest are more primitive. That's just my theory, I'd love any anecdotal evidence you, or anyone on this forum, can provide.

I lived in the Philippines for about 18 months (2008-2010), much of that in Cebu. Consensus among expats with financial reserves was the health care was good enough in Manila and Cebu, but for serious matters it's the next flight to Bangkok. Expats who couldn't afford that trip disagreed.

In the Phils I became friends with a man who was there for the low cost of living as his personal finances recovered from the global economic meltdown. After extensive research, he left for Vietnam in 2012. One of his 2 major disappointments was their health care was disturbingly lower quality than he'd concluded.

I've yet to visit Laos or Cambodia because all evidence is their infrastructure, excepting major tourist destinations, is too primitive for me.

 

[ItDontMeanAThing]

Sorry to hear that. I've been following your blog for years and years...
good thing it didn't happen on one of your big overseas trips !

Thanks. My sister will be happy to know she's not the only one who reads my blog.

 

[tulak]

I've also been following your blog, since our own visit to Hua Hin, and I'm glad to hear that you are doing well. That's a scary episode and from the way you describe it, it sounds like it was handled very well. It's good to be prepared. Be well!

 

[NW-Bound]

Glad to know you are doing well.

$24K is inexpensive for that level of care compared to what it costs in the US. But in Thailand, I doubt that the natives would be able to afford this. Your hospital must be special and catering only to the rich natives and foreigners.

 

[athena53]

Was it at Bumrungrad? Do a search on "Medical Tourism" and you'll find that this facility is well-respected among people living in countries with subpar health systems, the uninsured who still have a few bucks for moderately-priced treatment, and even some employers outside the country. You can fly to Thailand, get knee or hip replacements, hang out on the beach for a few days and fly home for a fraction of the cost of the procedure in the US.


There's a big caveat: for better or for worse, the US system is burdened with heavy costs due to liability issues, including steep insurance premiums and a lot of defensive medicine. If something goes wrong in a foreign country, and even the best surgeon can have a bad outcome on occasion, you may have no recourse.

 

[brett]

At the hospital in Kuala Lumper last year (excellent hospital). Hospital apparently does a lot of medical tourism.

-day in emerg
-back Xrays
-consulatant
-MRI (radiologist called in)
-consultant (called in)
-full report for our insurer, the Xray, and a CD of the MRI
-prescription drugs

$550USD

 

[Just_Steve]

So my question is, If US insurance companies are trying to squeeze the last penny out of a dollar, why won't most pay for less costly overseas treatment?

 

[Meadbh]

So my question is, If US insurance companies are trying to squeeze the last penny out of a dollar, why won't most pay for less costly overseas treatment?

I can't answer that, but one time I looked after an American baby who was born prematurely in Canada. He required several weeks of intensive care followed by months of less acute hospital care. After approximately three weeks, he was ready to be transported to a hospital in his home community, and his family really wanted to go home. It was quite the battle with the insurance companies, because the longer he stayed in Canada, the more money they were saving. They were delighted to pay for healthcare in Canada (even at the nonresident rate) but not willing to fund the transport. I eventually persuaded them after many hours of negotiation, which cut into the time I had for patient care.

 

[zinger1457]

So my question is, If US insurance companies are trying to squeeze the last penny out of a dollar, why won't most pay for less costly overseas treatment?

I believe most US insurance policies will cover the cost of treatments overseas if it's considered an emergency, like a heart attack.

 

[Just_Steve]

I believe most US insurance policies will cover the cost of treatments overseas if it's considered an emergency, like a heart attack.

Your right, I should have been more specific. I am questioning more elective like a knee replacement or such.

 

[athena53]

So my question is, If US insurance companies are trying to squeeze the last penny out of a dollar, why won't most pay for less costly overseas treatment?

My guess is it's a reputational risk issue. If there's a bad outcome, which happens even to good doctors, or the patient develops an embolism on the flight home and dies, it's all because the Evil Insurance Company "outsourced" the poor person's care to lower-cost providers.

I've heard of employers whose health care is largely self-funded (with some Excess coverage for major claims) offering the foreign option, frequently with a cash bonus to the patient. You still have to tread carefully since lower-paid employees are more likely to accept that incentive. Then if things go wrong it's the Evil Employer exploiting the worker.

 

[Just_Steve]

My guess is it's a reputational risk issue. If there's a bad outcome, which happens even to good doctors, or the patient develops an embolism on the flight home and dies, it's all because the Evil Insurance Company "outsourced" the poor person's care to lower-cost providers.

I've heard of employers whose health care is largely self-funded (with some Excess coverage for major claims) offering the foreign option, frequently with a cash bonus to the patient. You still have to tread carefully since lower-paid employees are more likely to accept that incentive. Then if things go wrong it's the Evil Employer exploiting the worker.

LOL, "Evil insurance company" and "Evil employer"

What got me thinking about this was the threads about living or traveling abroad. I started reading my plan, most of it is related to emergency or urgent care. Then it says if you plan on living outside of US to call. I know with the makeup of the workforce where I worked I would have to say 30% are retiring to their home country.

 

[Options]

Heart surgery also entails psychological and emotional stressors in addition to those physical and financial, as detailed here:

For Many, Life After Heart Surgery Is Surprisingly Hard - WSJ

“Cardiac surgery is not just a physical thing, but a big stressor on cognitive function, psychological health, and overall health, and it distresses your social and personal environment as well,” says study co-author James L. Rudolph, associate professor at Brown University’s medical school and director of the Center of Innovation in Long-Term Services and Supports at the Providence VA Medical Center, in Rhode Island. “Medicine doesn’t do a good job of taking some of those things into account.”

Actionable takeaway might be to ensure one's support system are thoroughly considered and lined up beforehand.