Luma Health Insurance
in Thailand

Luma Asia Care plus plans are available to expats and locals who reside in Thailand, up to age 70.

Luma Asia Care Thailand offers excellent value plans for those seeking worldwide coverage.

All private insurance plans will cover you for illnesses and injuries that require overnight hospitalization for treatment (inpatient cover). Most also offer optional coverage for routine outpatient, maternity or dental expenses.

The types of inpatient expenses covered are fairly standard across the industry, including room and board, surgeries and treatment, hospitalization, emergency evacuation. There is more variability among the optional coverages; typically, greater benefits will trigger higher premiums.

Policies are managed on an annual basis: you pay premiums for a year of coverage and the insurer pays for your eligible expenses up to an annual limit.

Luma Asia Care policies offer a range of premium coverage options.

• Inpatient only limits: ฿32,000,000
• Outpatient limits: ฿32,000 to ฿192,000
• Maternity limits: ฿80,000
• Dental limits: ฿32,000

Luma Asia Care Plus Thailand plans offer 3 coverage areas:

• Worldwide excluding USA, China, Canada, Hong Kong, Israel, Japan, Switzerland, Russia, Singapore, Brazil, Taiwan and the United Kingdom
• Worldwide excluding. USA, China, Canada, Hong Kong, Israel, Japan and Switzerland
• Worldwide excluding USA

Outside this area, you are covered for unforeseen emergencies and illnesses up to ฿32,000,000, so long as your trip away from your residence country doesn’t exceed 60 days.

It’s important to understand that private health insurance is a for-profit business. People with pre-existing medical conditions represent a risk to profitability, since they are far more likely to make claims than people who are entirely healthy, which affects the bottom line. Insurers manage this risk in a number of ways.

Most insurers use medical underwriting to assess a potential customer’s risk based on medical history. Then they decide whether to:

• Exclude certain conditions from the coverage of a policy
• Impose a fee for covering specific conditions (called loading)
• Cover certain conditions despite the risk, or offer to reassess a condition at a later date.

Some insurers offer a moratorium policy: people with conditions that aren’t chronic (persistent, recurring, incurable) can take advantage of this special type of policy, which excludes non-chronic conditions from coverage for typically 2 years before covering them.

Employer groups of certain sizes can qualify for a policy that disregards participants’ medical history. This is the only way to cover certain conditions.

All Luma Asia Care Plus policies are based on the full medical underwriting model. Applicants with significant pre-existing conditions, particularly chronic conditions, are sometimes denied coverage. Typically, Luma will either exclude or accept milder conditions rather than loading.

Luma, like all legitimate international insurers, will cover COVID-19 treatment, subject to the policy rules. This means that inpatient treatment (typically at least an overnight stay) is covered up to the policy’s annual limits. However, if you don’t have outpatient coverage, any outpatient treatment will not be covered.

COVID-19 testing and vaccinations may be covered under outpatient health check or vaccination coverage.

Generally, COVID-19 quarantine expenses are not covered by any health insurance policy.

Tenzing can assist in obtaining a certificate that shows your COVID coverage, for travel or other purposes.

Your insurance is managed on an annual basis. Like most products, health insurance is subject to price changes, usually in the form of premium increases based on a number of factors.

Since this is a for-profit business, changes are based in part on past-year performance (generally premiums minus claims plus overhead) and medical inflation.

All of Tenzing’s international health insurance offerings operate on what is called a community rating basis, which takes into account all the covered individuals in a geographic insurance plan — if the plan did well, premium increases will be low, and vice versa. Any premium or benefit changes apply to everyone in the plan.

Some insurers use an experience rating approach, which looks at whether each individual’s premiums exceeded their claims and makes adjustments accordingly. This approach can result in wildly differing changes.

Your age is also a significant factor in determining your premium — as you grow older, your health generally declines and your risk increases. So annual premium changes also reflect your age. The increase can be larger if the insurer uses age bands: imposing a larger increase at 5-year intervals rather than a smaller increase each year.

Luma Thailand offers direct billing for inpatient and outpatient services. This means that payment for treatment will be managed between the insurer and the hospital or clinic so that you don’t need to pay directly.

The Luma network of direct billing partners extends throughout the coverage area and includes most of the top hospitals and clinics in each country.

All of Tenzing’s international health plans operate on an annual basis, and while some do allow you to make periodic payments rather than all at once, Thailand regulations require a single annual payment.

Luma Asia Care offers group health insurance plans that allow employers to provide peace of mind to valued employees.

There are two types of employer plans:

• Full medical underwriting (FMU) requires covered individuals to provide medical history, which the insurer uses to assess risk and assign premiums.
• Employer groups that are sufficiently large can qualify for a policy that disregards participants’ medical history (MHD). This is the only way to cover certain conditions.

Luma allows employers to establish plans with as few as 4 employees for FMU, 10 for MHD.