Aetna Thailand Health Insurance

Aetna UltraCare plans are available to expats and locals who reside in Thailand up to age 74.

If you live outside Thailand, there are other options available from Aetna.

Aetna is a world leader in health insurance. The UltraCare policies for Thailand residents reflect that expertise and experience while maintaining close ties to the local market.

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.

Aetna UltraCare policies offer premium coverage.

• Inpatient only limits: ฿60,000,000 to ฿200,000,000
• Outpatient limits: ฿200,000 to the Inpatient limit
• Dental limits: ฿40,000

The Aetna UltraCare plans offer worldwide coverage (excluding the USA).

Within the USA, you are covered for unforseen emergencies and illnesses while traveling, from ฿60,000,000 to ฿200,000,000.

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.

Aetna Thailand offers both full medical underwriting and moratorium policies. Those seeking coverage for significant pre-existing conditions, particularly chronic conditions, will usually find Aetna the most likely to offer it, with loading.

Aetna, 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.

Aetna UltraCare 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 have to pay directly.

The Aetna 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.

Aetna UntraCare 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 requires covered individuals to provide medical history, which the insurer uses to assess risk and assign premiums. There is usually a discount given based on the number of participants.
• Groups that are sufficiently large can qualify for a policy that disregards participants’ medical history — this is the only way to get private coverage for certain conditions.

Aetna allows employers to establish plans with as few as 3 employees for FMU, 5 for MHD.