The news that all foreign tourists to Thailand will soon need to obtain travel insurance to enter the country is causing the usual confusion from leaked sources. Thai public sector hospitals have complained for many years that they are having to fund the medical costs of foreigners who need treatment and can produce neither the cash nor a valid insurance letter. Estimates of the true costs vary but the total is probably in the region of three billion baht annually.
It seems that, from an unknown starting date, all tourists (likely defined as those able to stay between 15 days and three months before being required to leave) will need to show on arrival a valid travel insurance document which has either been bought in advance or obtained at the airport or border post from a dispensing machine. Travel insurance is not the same as full medical insurance and normally covers only matters such as delayed travel, loss of luggage and emergency treatment for accidents. It does not cover pre-existing medical conditions.
Critics of the move point to a number of potential problems. Does the new rule apply to every tourist including infants under one year and the elderly in their 80s and 90s as travel insurance often contains a cut-off age date? Will the responsibility to enforce the regulation lie with the airline which will need to check the documentation? Will there be long queues at immigration or custom counters as officers struggle to examine travel insurance papers which may not be written in Thai? Will the proposals actually work in practice as many medical emergencies are not caused by accidents? What about use of credit cards which often include the benefit of limited travel insurance as a perk for purchasing the air ticket on-line?
Travel sources say that the imponderables mean that any compulsory policy, if endorsed by the Thai Cabinet, will likely be delayed until next year. Government officials will be concerned lest a hasty start produces a deluge of bad publicity which will handicap the government’s stated aim of receiving 40 million foreign tourists annually in the next decade. Several years ago, the Shinawatra government introduced an optional, private-sector insurance scheme for tourists which had only limited success, partly because of poor marketing and weak support by hospitals.
Expats and holders of multiple non-immigrant visas are not covered by the recent announcement because travel insurance in this context obviously means visitors to Thailand and not those residing here as a base for long periods. Holders of one year extensions – retirees and those married to Thais in particular – are concerned that they may be required to hold full medical insurance at application or renewal time. Last year, the government announced the possibility of introducing such a regulation – requiring an insurance claim payment of at least US20,000 – for in-patient care. However, that prediction was linked to the possibility of a 10-year retirement visa which might (or might not) replace the current one year extension of stay. Nothing further has yet been heard of these particular proposals.
One problem area in requiring retirees to produce full medical insurance is that older people find it very expensive to fund ongoing cover, or even impossible if they have serious health issues. Some expats prefer to keep a sum of money here specifically to cover hospitalization. In any case, private sector hospitals these days will not perform surgery without clear evidence of repayment by cash or by agreement of the insurer, if any. One solution to this dilemma might be to insist on a larger cash deposit or proof of income at the application or the renewal stage of a one year extension. It should also be noted that, in the past, existing retirees were not required to abide by new financial regulations. This discretion has been known as “grandfathering”.
The whole subject of visitors to Thailand and their insurance is now likely to loom large in immigration publicity for the foreseeable future. But it is important to stress that there have yet not been any formal government announcements of policy changes.