One of the major concerns and topic of interest for us retirees in Thailand is health insurance and the medical cover it provides. There is endless discussion of the benefits of having insurance or not, the costs and exclusions. I am not going to make this post a medical one-stop reference point because my blog only deals with aspects of Thailand I have experienced directly and I am not about to offer specific advice on such a complex subject. However, what I can share with you is a recent stay I had at a private hospital in Udon Thani, in the northeast, for minor surgery and how that experience went for me including the performance of my Pacific Cross Thailand private health insurance. Obviously, every medical treatment process will be different but I will focus on the administrative and hospital process I experienced, which I think will have enough similarities across the board to make this a useful read for those of you interested in this important subject.
I realised that I had a hernia late 2017 (God knows why as I do almost nothing here) but as a total coward with respect to medical matters I postponed seeing a doctor until February this year. In my defence we had visitors dropping in to see us the first couple of months of the new year so I had a semi-excuse. I decided to get on with it (eventually), mainly because we had bought some new land next to our current house, which you can read about HERE and HERE, and were busy establishing a tropical garden. We had got most of the basics done so it was a good time to have the operation, which has a three-month no-heavy lifting recovery period so that I could resume work after the hot season.
I was reasonably relaxed about the financial side of things because since I moved to Thailand I have had medical insurance with a company called Pacific Cross, which would cover me for expenses up to 200,000 baht per incident. I say “reasonable” because I had never made a claim with PC and there’s always a slight concern as to how genuine they are based on a real situation requiring them to part with money. I will go into a little more information about Pacific Cross later but in the meantime, their excellent English website is HERE, if you wanted to have a browse. I have no relationship with Pacific Cross other than as a customer as this is one of the few non-commercial blog sites in Thailand.
There are three main private hospitals in Udon Thani that I know of plus, of course, you can pay to have treatment in the many local or city public hospitals. I selected AEK International but Bangkok Hospital would have been an equality logical choice. AEK have one of the most useless websites in the history of the internet but I will give you the link anyway HERE.
I selected AEK because they are a JCI accredited hospital, which didn’t mean a lot to me but it’s like choosing between two bottles of wine when one displays a gold medal. You may have no idea of the wine competition involved but any award is better than none 🙂 Anyway JCI accreditation might mean something and the organisation’s website (which wasn’t designed by a twelve-year-old) is HERE. I had also been to AEK once before, just to get an x-ray for my step-daughter, and they were very efficient, so the devil you know.
Our first visit to AEK was to get a formal diagnosis and, as I was pretty sure that an operation would be required, to get a date for the procedure. I will touch on the private v’s public hospital debate here. My only experience of the public hospital system in Thailand has been via my step-daughter Peng, who has six-monthly check-ups for a long-term medical problem related to her mobility, and in 2017 had a major operation at the huge Srinagarind hospital in Khon Kaen, a teaching facility attached to Khon Kaen University. You can read about our ten-day stay in that hospital for Peng’s operation HERE. The thing that really strikes me is the incredible variation in patient numbers between private and public. This is a worldwide phenomenon so I am not telling you anything new – money buys convenience and time-saving. We would go the Khon Kaen for Peng’s regular check-up and every time wait at least four hours for what ended up being a 15-minute visit with the doctor. Add a one and a half hour drive each way and it was a big day out. There is no doubt the public system does the job, but the main cost is time and you do need the patience to work through the process.
I have a couple of ideas as to why the public system is so overwhelmed, or the bit of it I have seen anyway. Firstly medical treatment in public facilities is almost free. The maximum people pay is 30 baht or A$1.20 per visit, under an arrangement introduced by a recent prime minister (now a resident of Dubai). Secondly, it is almost impossible to find a doctor to see you during the day! There are clinics everywhere but the doctors only work there maybe for an hour in the early morning and a couple of hours late afternoon. Where are they during the day you might ask? At the hospital 🙂 If you need a medical person to see you between 9:00 am and 5:00 pm then the local hospital is your best chance and maybe the only option, but be prepared to spend the day waiting. My brother-in-law Lud went to the local hospital in Si Bun Ruang for a blood test and x-ray and he was there literally all day.
Compare that to a private hospital such as AEK in Udon or Khon Kaen Ram (I had a full medical check-up there). In both situations, I walked up to the reception counter and was greeted by a sort of hostess, on the customer side who asks what you want and then deals with the forms and the booking people behind the counter. No waiting and very professional. One of these ladies will then walk you to the next stage and hand you over to the staff at that point. You are always taken to each new service desk within the hospital. Don’t be caught out thinking this is service provided out of kindness. There is nothing complementary given away in the Thai private medical system and you will be charged for “nursing services” or the like at the end! EVERY single action and consumable is recorded and charged.
In my case, I was referred directly to the surgeon who would end up being the guy who carried out the operation. No middleman. The initial consultation, an ultrasound and the follow-up discussion and booking for the operation took around an hour. You will find that many doctors have some grasp of English, as it is a requirement of their training, which was the case with the one I saw.
Now interestingly the other person who automatically made an appearance as part of this process was a representative from the hospital’s finance section! They had already noted my intention to claim on Pacific Cross insurance at the reception. This guy told me that I would have to pay a deposit on the day of the operation of 40,000 baht ($1,600). In Australia with my very limited experience of private hospitals, I remember having to give an imprint of my credit card when I booking in, which was to ensure any excess not covered by insurance was paid. I have never had to pay upfront like this so that’s one to keep in mind. It may be a unique situation with Pacific Cross because I have a friend in Udon whose son has spent some time in AEK and they have never paid a deposit up front. Mind you he hasn’t had an operation so who knows. My friend is with another insurance company.
Depending on the device you are reading this post with the back of Pacific Cross’s ID card may not be readable. Point 6 is the interesting one and it says:
Medical Treatment should be bourne first by the cardholder and claimed back from the company unless special arrangements have been made.
This didn’t end up being the situation with me, although I was expecting it and I will cover this later. So be prepared to make a deposit although in your case it may well never happen. I am sure that what WILL happen is that your ability to pay will be well and truly locked in by the hospital so expect a visit from a finance type person no matter which hospital you are in.
Back to medical stuff. I had an intermittent cough at the time that I couldn’t shake so I was then referred to a nose and throat specialist. A hernia operation and cough don’t mix well so the surgeon wanted to fix it before surgery. This doctor ordered a chest x-ray and that process took longer than my initial consultation because he had previous clients waiting. I was then prescribed a bunch of pills and because they wanted the cough cured before the operation they gave it a couple of weeks for the medication to kick in. Otherwise, I could have had the procedure almost straight away. The cost for the two consultations (both with specialists), an ultrasound, an x-ray plus medication and “nursing charges” came to 4,847 baht or around A$200.00. I seem to remember that even a visit with a GP in Australia cost $70.00 in 2014, the last time I was there, so I think this is probably pretty good value (P.S. I see that a General Practitioner consultation of under 20 minutes in Australia now costs a standard $76.00).
Two weeks later, with my cough a lot better, my in-laws kindly drove me and Gaun (my wife) the one and a half hours to Udon Thani to be at the hospital by 8:00 am with a 10:00 am operation time. They didn’t want me driving home so offered to drop me off and pick me up. I offered to pay for the fuel, which they wouldn’t accept. Just the nicest family you could possibly come across.
The hospital had given me an ID card previously and on presentation, I was taken to Emergency, which seemed a bit dramatic for a hernia operation! Thankfully it wasn’t full of motorbike accidents instead being a very peaceful place to be. Maybe they have their moments but it didn’t look to be set up for big dramas (that’s my TV observation talking) and I was the only person there. There were many nurses on duty, but you get used to that. I know that when Peng spent ten days in the Khon Kaen hospital for her operation the public ward had a daytime ratio of around one nurse to four patients, which sounds impressive. However, on the whole, the staff stayed in their air conditioning office except to dispense medications and take blood pressure. The majority of the hands-on caring work was expected to be done by the family. Gaun lived in the hospital and slept next to Peng’s bed. Back to AEK where I changed into a hospital gown (tied at the front, not the back like Australia – no bum hanging out of your robes in Thailand thank goodness!).
Guess who turned up shortly after I was on my trolley? The finance person who relieved me of my 40,000 baht deposit. I am in Thai mode, so brought cash, but they were expecting a credit card so were a bit surprised by that. I prefer not to use a credit card in Thailand and have got so used to paying for everything in cash that I never give it a thought. All being well a refund would be available sometime after the operation in the form of a cheque (check for my American friends!)
The work-up was done professionally by two nurses and I was hooked up to drip lines, never my favourite experience. The surgeon and the anaesthetist made an appearance the latter wanting to know if I wanted a spinal tap (no way) or to be knocked out (yes please). I am a total coward with medical procedures and I don’t want to be in the room when they’re messing around 🙂 On time I was wheeled into a very modern looking theatre and woke up post-op ready to be taken to my room. My brother and sister in law had stayed with Gaun to make sure all was OK after the operation. Family is there when you need them in Thailand (or mine always is). You will never be alone.
Now talking about rooms take note of the choices because this is a tip for new players. At the beginning of the day, I was offered a menu of rooms and chose one priced at 4,200 baht a day, which came within my 5,000 baht room and board insurance allowance. Please note that under room charges the hospital includes the room rate and nursing services and possibly food as the one billable package under the heading “room rate”. So you need to allow for the possibility that if you add these three components together it might exceed your room insurance coverage, which it did with me. Try and get a total room rate price including the extras and if you need to you can adjust your accommodation to suit your budget. In the case of AEK, my Udon friend Daryl was paying almost half for his son’s room, which was exactly the same as mine on the same floor, so there’s a bit of a smoke and mirrors thing happening here.
I didn’t get a photo of the room thinking I could pull one off the hospital’s website (no such luck) but it is like a standard motel room. Big full-length windows opening onto a small balcony, not that I was too interested, a couch, which is where Gaun slept (some bedding provided) and an ensuite. A big (50 inch?) flat screen TV that I checked out to see if it was screwed down. I thought it could be a little souvenir of the visit 🙂 You get a box of supplies in the room with bathroom essentials and some other things. Do bring instant coffee or tea as they supply a flask of hot water but there are no in-room drink making supplies. There is a bar fridge but no beer 🙁 The bed is an electric one so you can adjust it easily (Peng even had one of these in her public hospital). Air conditioned of course while Peng had to rely on overhead and floor fans.
The nurses made their usual regular visits to hand out medication and check blood pressure and temperature. I only had to push the buzzer once and got a response quickly. They leave you alone outside of that basic maintenance, which in my case was fine. You are, even in a private hospital, expected to have a family member present for the whole stay. If you read the small print of what you sign before the operation there’s a “fall indemnity” which is specifically geared for your support “team” and states you must have someone with you the entire stay. However, especially with a farang, I am sure the hospital is geared for a person who can’t bring a friend and I presume the nurses get to do more work in that case.
You have the opportunity to choose meals from a very extensive menu (at least 5 pages) but not surprisingly 95% of it is Thai dishes. Considering this is an international private hospital with a decent number of expats coming through I would have thought I was a bit disappointed they didn’t have even a very small menu for our tastes. I was told that they would collect food you ordered outside the hospital (a Big Mac with extra cheese, fries and a large strawberry shake springs to mind) but I suspect you would be handing over money for that service. The breakfasts had a few western options although their idea of an American breakfast was a pretty poor attempt. The food side of things was all a bit academic as I wasn’t hungry but Gaun and Tik were happy to eat whatever was provided. TV is Thai only, although there may have been one farang channel in there. The wifi works well enough to power internet browsing and emails.
Mine was only an overnight stay and as always there’s nothing better than getting out of hospital and back home. The nurses made an appearance the next morning to remove the drip lines and we then waited a couple of hours for the final invoice to be worked up. This was done along with three ladies from their PR section who handed over a basketful of goodies including a clock. I only raise the clock because Daryl, whose son has been having problems and is a regular visitor overnight, now had five clocks!

I am not sure that three people to hand over the basket is a good use of hospital resources (one lady was taking the photo) but there you go. If you take one of the cheaper rooms you still get this package but it’s in a box, not a basket 🙂
Expecting to pay for the outstanding cost over and above the 40,000 baht deposit I was pleasantly surprised to hear that the hospital and the insurance company had been talking and the only additional money required was 700 baht for the excess room charge (discussed previously). A wheelchair with orderly was on hand to take me to the car (Yuan and Lud having arrived by now) and all the on-duty nurses came to the lift to formally say goodbye.
My final invoice is below. Who knows what all of that means but I am sure it is well padded. My brother-in-law Lud had a hernia operation done at the local public hospital and it cost him nothing. Another brother-in-law had one and he paid an “express” fee to the surgeon of 2,000 baht for his. Mine at 76,000 baht is vastly expensive by these local standards. Even as a farang if I had mine done as a paid procedure in a public hospital it would have been significantly less. If I didn’t have insurance this is the route I would have taken. In a rural area where heavy manual work is a norm I am sure that the local doctors are pretty competent with hernia operations, so I wouldn’t have been concerned. However, having insurance cover it was an easy decision to go private.
About ten days later I went back to AEK for a checkup and to have the stitches removed. That cost me 1,200 baht (my insurance is only for in-patient costs so I had to cover this and the initial consultation). The hospital had previously phoned to say that my refund was ready to collect, which I did at this time. It is now five weeks since my operation and it has healed nicely.
So my first real experience of the Thai medical system was a pretty “painless” one. The hospital process all worked as intended and Pacific Cross lived up to expectations. The main oddity is that 40,000 deposit, which I would query if I had to do this again. Think of the money you’d have to put down for a triple bypass or something far more serious than my minor procedure. I have included my Pacific Cross invoice just to give you an idea of the coverage available on a modest plan and the cost involved for a 61-year-old:
Check out Pacific Cross for your health insurance. One of the big benefits over some of the pure Thai alternatives is that their information and policy terms and conditions are in English. Trying to work through a Thai version with a partner who may not be up for the specialised translation required can be risky. This is such a complicated area that the bonus of being able to see what you’re paying for is a useful one. You can download their very clear brochures as follows:
Standard Plan HERE
Premier Plan HERE
Maxima Plan HERE
and Ultima Plan HERE
If you would like to chat with an English speaker in Pacific Cross you can contact:
Jamie Connell, Director of Client Relationship
Office: 02-401-9189 I Fax: 02-401-9187 I Mobile 0924 063962
152 Chartered Square Building, 21st Floor, Room 21-01 North Sathorn Road, Silom, Bangkok Bangkok 10500
The only reason have added these links is not to promote Pacific Cross, although it may look that way, but that these PDF brochures give you an excellent start from which to compare other plans that may not be so well presented. If you know what your base standard is it then makes it easier to ask about what other maybe more Thai orientated insurers are offering. For example, these are the benefits to the plan I have:
If you have anything you can add to this post please leave a comment. As I said before it is a much-discussed topic on Thailand expat forums and any insights, tips or recommendations would be much appreciated, not just by me but the many others who follow my blog.
Thanks for reading.
Hi Tony,
I had an operation done last year in Bangkok. I think I had 3 days in hospital in total. I had to go in the night before to get hooked up to everything and to make sure that I didn’t eat as they had scheduled a 7:00AM surgery. The operation went perfectly and after a day, I was itching to get the IV removed and escape, but they still kept me in another day.
For the insurance side of the process, my insurance agent actually came to the hospital and did all of the paperwork on my behalf. Can you imagine getting that sort of treatment in Australia? He even sorted out the other paperwork so that I could pay the Thai price for my procedure rather than the foreigner price. Don’t laugh, this is a legitimate charge that hospitals apply based on your status in Thailand. Because I have been paying into the tax system here for at least 3 years, I qualify for the local rate which was a huge bonus.
The attention to detail about everything was impressive. There was a very detailed consultation with the anesthesiologist well before the procedure and another one on the day to double check my answers. The surgeon was really helpful, explaining exactly what he was going to do and what I could expect post operation. One of my most important questions was how quickly I would be able to wear a motorcycle helmet and rotate my head safely again which surprised him, but he gave me a good answer.
Post operation, the nurses were very attentive, checking my vitals every couple of hours, but they did let me sleep most of the night. The surgeon also visited and discussed what had transpired during the procedure and we sorted out when I could leave which made me feel much better. I really don’t like being cooped up in a hospital and they were getting worried when I unplugged my drip and took it for a walk along the corridors to stretch my legs. Perhaps they thought I was going to abscond without paying the balance. 🙂
I also read the thing where you need to have someone stay with you for your stay. My poor wife had to endure sleeping on the couch in the room and i know from personal experience just how uncomfortable they are. In reality, she didn’t need to be there other than to do some translating for the nurses in some cases.
Peter
Thank you for that insight Peter. I am going to write a post on health insurance soon and incorporate some up to date feedback from readers.
On a more personal note I am pleased all went well for you and that the Thai medical system delivered the goods.
Tony
Hi Tony,
One thank you for this testimony, very well written and documented.
I am French ( 54 years) and in search of an insurance company, I already had to spot Pacific Cross and your experience consolidates my opinion
I hope that you totally restored.
Maurice.
I am very pleased you found the post useful Maurice. I have just renewed for another year with Pacific Cross. I did look at a Thai insurance company but the documentation was mostly in Thai, which meant I had to rely on someone translating, always risky with a technical document, and the premium wasn’t a lot cheaper. I have always found Pacific Cross to be efficient and their paperwork is easy to follow.
Good luck and yes I am fully recovered thank you.
Tony
Hope you are well on the way to a full recovery. Just a quick observation as I have recently been looking at Pacific Cross myself. I am not sure that the 200 000 limit you have mentioned per incident is correct. As far as I can see they do not offer a policy with such a low limit. Likewise the premium and daily bed rate cited is more in line with a 1 200 0000 Baht coverage per incident. Might also be worth mentioning age factors here affect insurance premiums greatly and that those over 70 have limited options even if insured with a company beforehand. Insurer choice becomes limited, premiums increase significantly. I have been looking at a 5 million coverage myself as a minimum. Being in Chiang Mai, and a scooter rider, it is a question of if not when, and the coming up to the annual Songkran cull has made me look at my insurances again.
Thank you Geoff.
You are right on the maximum claimable. The 200,000 relates to hospital expenses only and I will clarify the wording in the post for that. There is also 5,000 baht per day up to 45 days for room costs and 200,000 for surgical plus some other benefits. I wish it were more but not to be for the money. Tne type of coverage you are after is in their Ultima PLan, which would be well outside my budget and maybe yours. 5 million seems like a lot for a Thai coverage. OK for America where that would get you treatment for a strained finger 🙂 but I would have thought that it was more than you needed locally, but I am no expert.
You are correct on the age factor too. I don’t know your country of origin but in Australia, our private health insurance premium isn’t based on age. The younger people subsidise us older folk. Here that’s not the case and at some time I suspect I will be relying on the Thai public system because the insurance costs will become unsustainable.
We lived in Chiang Mai for 12 months so I can understand your realistic view of being a motorcyclist there. It is anything other than the quiet backwater many tourists expect. I had a car and statistically, the numbers improve dramatically once you get off a bike and into a motor vehicle. I ride a scooter here but only in the moo ban and the backroad to the family farm. I refuse to let my wife go out on the main roads on the bike as it is only in that situation does Thailand become one of the most dangerous places in the world to be on the road.
Thanks for your comment Geoff. Stay safe over Songkran and beyond.
Tony
You are very correct on the motorcycle dangers side of things, and that would be the prime determinant for my level of cover. I would look at a lot less coverage if/when I swap to a car. Soon I hope, it’s not just the accident risk but aircon/rain/comfort/shopping in older age makes a car the next significant leap here. Of course if you could kindly arrange something to be done about the current AUD (Pacific Peso) exchange rate to Baht…my car aspirations and both our health insurance premiums would be a lot brighter. Hope you, your family, and extended family have a great Songkran.
Hi Tony
Very interesting blog. Hope you are well on the road to a full recovery. Know you are being well looked after!
Cheers
Pippa
Thank you as always Pippa and Andrew. Yes recovering well and double yes, the nursing is excellent 🙂
Hi,
Thank you for the post.
Can you share the email address of Jamie at Pacific Cross?
I am currently living outside Thailand and phone isn’t practical for me.
Thank you.
I am sorry to be so slow in responding to your question. For some reason I didn’t get a notification of your comment.
Jamie is no longer with PC as far as I know and I have only dealt with policy renewal people since. There is an email address link on their website HERE that will put you in touch with their sales areas I am sure. You have probably done this already rather than wait for my delayed response. Do be aware with Pacific that they have the option of adding a 25% excess to your premium for up to three years if you make a claim, something you won’t find in their literature. Motor bike related claims are also a no-go, which is detailed in the documentation you get after you buy the policy! Both of these aspects are worth asking questions about.
Cheers. Tony
G’day Tony
Sorry to hear you had to have an operation, however I am glad that all went well for you :-).
As is always the case your blog was very incisive and loaded full of excellent advise.
Take it easy with your latest garden development project, I know you have an amazing Thai family to support you, especially Gaun, you are very blessed.
Hope to talk to you soon, via the old school telephone!
Best wishes to you and your lovely family.
Kind regards
Chris
Perth WA
Thank you Chris. Obviously only minor in the scheme of things but nice to have it out of the way so easily.
I am dying to get on with extending the garden paths with brick paving but I am being very good and holding back until the three months is up. Even then it isn’t a heavy job so a good way to get back into being useful again rather than letting Gaun do absolutely everything.
Thanks for getting in contact. Always a pleasure.
G’day Tony and happy that you are in good spirits and recovering very well. Telling us with so much detail about the process is very useful for us who live or are about to live in Isaan. Planning a visit Phon-Ngam in July so hope to meet up with you both at that time as we undertake our home building research. Best wishes, Ian
Many thanks Ian. We look forward to meeting up with you later in the year. I hope that works out.
Cheers. Tony
Glad to read all is well now Tony
As always, full of invaluable information to the benefit of others who will be following in your foot steps.
Pacific Cross and the Thai private hospital system make a mockery of what we endure here in Ozz.
As of tomorrow health insurance costs rise for the 16th consecutive year, well above inflation.
Surin is looking better all the time.
Cheers…Greg
Cheers Greg. It is always great to read your comment because they are so positive.
Like a lot of things in Thailand medical outside the Thai version is cheaper but not necessarily cheap. It’s a bit like the food. If you only eat Thai/Isaan then it is very inexpensive but once you add farang requirements in there there’s a bigger hit on the budget. I will stick with health insurance for as long as I can afford it just because it gives me peace of mind. I have heard of people saying they don’t take insurance because in the case of something major they can go back home. Well, in a lot of cases that just isn’t an option for all sorts of reasons and you have to rely on the system here. My operation paid for the last two year’s premiums so I am sort of even so far.
Here’s wishing you a good lottery win and a wonderful retirement sooner than planned.
Hi Tony,
Thanks for writing another fine article. You have very good insight into Thai things and now you’ve shared more personal matters which I’m sure will be useful to a lot of expats at some point in our lives. Thanks again for all your efforts.
Much appreciated Mike. Thank you.
Tony
Thanks Tony for such an insightful article.
Hope all is well now.
Cheers
Brian
All fine and thanks for the comment Brian.
Hi Tony
Good info once again. I had mine fixed in 1976, so yours should last a while more. I will have a look at your insurance website, I stopped my previous BUPA as it raised the fees on age not medical fitness.
Don’t lift anything heavier than a pint glass for a few weeks.
Geoff
Cheers Geoff. This is the second one for me and the original has lasted for decades. I presume you are a highly qualified doctor so will be following your recovery advice relating to the pint glass. I’ll get the certificate from you later.
All the best. Tony
Agreed, will have to be Lao beer later in the year.
Take it easy.
Geoff