Health Insurance Thailand Expat: My Recommendations for Long-Term Coverage

My second year with the Non-Immigrant O-A visa was coming to an end. I needed long-term international health insurance for my extension. The government had just changed the requirements for health insurance in Thailand, so I had to take action. 

This is a common situation for anyone looking for health insurance Thailand expat coverage for long-term stays. 

After looking around, researching online, and asking friends about their experiences, I decided on the health insurance described here. Today, I am still glad I made that choice. My policies became cheaper each year. 

Please note: I try to keep the information in this article up to date and hope I manage to do so. Please let me know if you find different information, including the source. Thank you. 

Is Health Insurance for Thailand Expat Really Necessary?

I received several questions about this. Some people said that health insurance for Thailand was not necessary at all. My answer is: it depends on the visa. In this article, I therefore make the difference between the two Non-Immigrant visas O and O-A clear again. 

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Health Insurance Rules in Thailand for the So-Called Retirement Visa Non-Immigrant O-A

Since October 1, 2021, coverage of USD 100,000 or THB 3 million has been required. To extend my permission to stay, I had to take out suitable health insurance. Having proper health insurance Thailand expat coverage is actually quite sensible, do you not think? It covers larger health risks. 

While long-term international health insurance is still not required for the Non-Immigrant O visa in Thailand, health insurance is mandatory for the O-A visa, with coverage of USD 100,000 or THB 3 million. Source: Thai Immigration Website. 

You can therefore buy affordable travel health insurance first and then take out the insurance described here for the extension of your permission to stay. 

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For Whom Does This Apply?

Only holders of the Non-Immigrant O-A visa must provide proof of health insurance. This is not necessary for a Non-Immigrant O visa. The differences are described on the website of the Royal Thai Embassy responsible for you. 

This article mainly affects expats who need health insurance Thailand expat coverage for visa purposes. 

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Health Insurance Thailand Expat: Costs

In Europe, we are not used to accepting limitations in health insurance benefits. Social security in these countries is a luxury and a valuable achievement. If I want to emigrate and spend my retirement years in Thailand, I have to rethink things. Suddenly, I have to deal with premiums that increase with age and pre-existing conditions that limit benefits. 

So I have a choice: extensive benefits and high costs, or heavily restricted benefits and low costs. For me, this is an unfamiliar and uncomfortable topic. It requires personal responsibility and weighing risks that are difficult to grasp. 

The various Pacific Cross plans offer a good middle ground for anyone looking for health insurance Thailand expat coverage. You can keep your premiums very low through a deductible and by excluding outpatient treatment. That is enough to meet the requirements for the Non-Immigrant O-A visa. Or you can choose the Ultima plans for the best possible care and cost coverage. 

I chose this middle ground and accepted limitations in benefits. This matches my currently very good health and my fairly healthy lifestyle. It can save a lot of money. 

Choosing the right health insurance for expats in Thailand can make a significant difference in long-term costs. 

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Health Insurance Thailand Expat: Experiences

I had already had experience with travel health insurance from HanseMerkur and TravelSecure (here and here). For health insurance Thailand expat coverage for long-term living, I relied on the experience of a friend. 

He assured me that he had felt well looked after by Pacific Cross for years. His inquiries were answered quickly. Nothing was ever pushed on him, and the insurance company tried to make things possible rather than restrict them. 

Honestly, I am not eager to have any experiences with health insurance in Thailand. After all, that would mean illness, an accident, or something similar. I would gladly do without that. Ideally, I would file the insurance policy in the folder marked IMPORTANT and forget about it. 

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My Criteria for Health Insurance Thailand Expat Coverage

When comparing insurance providers, the following criteria are especially important to me: 

No Age Limit

It is important to me that there is no age limit, or at least no limited insurance period. Okay, Pacific Cross is limited to age 99. But first, a deviner told me that I will “only” live to 89, and second, I could imagine getting an extension with a correspondingly high risk surcharge if it really became necessary. We will see.

Flexible Options

It is also important to me that I can influence the amount of the premiums. With Pacific Cross, this is possible by excluding certain benefits or by not using the insurance. For example, I can take advantage of the low cost of living in Thailand and pay for possible doctor visits myself. 

Travel

Short stays in my home country are another important criterion. I do not want to have to take out extra insurance for that. An exception could be a planned treatment in my home country if the premium is to be reduced by not making claims. 

Easy to Take Out

The insurance must, of course, be available locally in Thailand. 

Anyone who considers a German-speaking contact person important will also be well advised. At Pacific Cross in Bangkok, the office is not only internationally staffed; since February 2025, there has also been a German-speaking contact person on site. 

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The Most Important Points at a Glance

Other Important Points

• Pre-existing conditions may be insurable with a risk surcharge 
• Free choice of hospital 
• Premium scale according to age groups 
• No limited insurance duration 

Special Features at Pacific Cross

There are group discounts and family discounts. In addition, the following no-claim discounts apply: 1 year 10% / 2 years 15% / 3 years 20%. 

A stay in Thailand of at least 6 months per year is required. 

If you enter after the age of 65, a health check is required in order to exclude possible risks. It is best to ask the Pacific Cross contact person directly about this. 

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How Much Does My Health Insurance for Thailand Cost?

When I first looked, I was 61 years old. At that time, Pacific Cross cost me THB 6,347 per month, including 0.4% tax. At the exchange rate at the time, that was about EUR 171

How I Save on the Premium

By excluding OPD, meaning outpatient cost coverage, I can reduce the premium by 20%. In other words, only hospital costs are covered. If I go to the doctor because of a cold, I pay myself. Spoiler: I do not do that. 

A deductible of THB 20,000 per year, currently about EUR 540, brings another premium reduction of 15%. That is about EUR 405 per year. This means I can spend up to EUR 405 per year on doctors and still not have paid extra. If I manage without seeing a doctor, I save money. 

If I do not use my health insurance for Thailand for one year, I pay 10% less in the second year and then 15% less the following year. So I save twice through good health, or I am rewarded for a healthy lifestyle. I am fully aware that this rule can be socially unfair. 

Regular Increases

From 2023 to 2024, premiums were increased by a full 8%. 

Reason: The basic premium for all New Normal policies starting from May 1, 2024 was increased by 8% in order to take into account rising healthcare costs, inflation, and other external factors. 

Fortunately, this was offset by the 20% reduction I had already received because I had not used the health insurance for 3 consecutive years. I now pay THB 44,363 per year, which is about EUR 100 per month. 

In addition, I had transferred a larger amount to Thailand at a time when the exchange rate was very good. I use WISE for transfers to Thailand. 

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Do You Want to Know How High Your Premiums Would Be?

Then request a quote from Pacific Cross by sending an email: stefaninthailand@th.pacificcrosshealth.com 

I have arranged with the sales team there that your inquiry will be clarified quickly and comprehensively. The international sales team in Bangkok will do everything they can to help you get health insurance in Thailand and therefore a visa extension. 

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Questions and Answers

Here are the most common questions about health insurance Thailand expat options. 

Do I Need Health Insurance as an Expat in Thailand at All?

This question is answered by the immigration authority: anyone who wants to get an extension of stay with a Non-Immigrant O-A visa must provide proof of health insurance from an official approved list. There is no requirement for the Non-Immigrant O visa. 

Regardless of the visa, I think it makes sense to insure yourself against expensive health risks. 

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What Are Pre-Existing Conditions?

A good example: suppose you have high blood pressure. In that case, the medication used to treat this high blood pressure, such as beta blockers or similar medicines, would not be covered. However, treatment for a possible consequence, such as a heart attack, would be covered. That is how Pacific Cross explained it to me. 

My pre-existing condition is a few screws in my heel bone. If they ever have to be removed, the insurance would not cover that, but it would cover the treatment of a broken bone in this foot. 

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Should I Declare All My Pre-Existing Conditions?

For everyone who tends to be very conscientious when applying. Do not be too conscientious. Anyone who lists every health problem, even one that is not recorded in a medical file, risks unnecessary exclusions. For example, I stated my mild high blood pressure, which I had long since brought under control without medication, and suddenly I had an exclusion for all circulatory diseases. Only after negotiations with the insurance company was I able to limit this exclusion to two years. 

At the same time, concealing information is not an option. In the case of serious pre-existing conditions, the insurance company may refuse payment in the event of a claim if a proven connection exists. 

The golden middle way: answer the questions asked precisely and truthfully, but only answer what is actually being asked and what could lead to problems. 

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Can I Take Out International Health Insurance in Thailand?

Yes, you can take out international health insurance in Thailand with Pacific Cross. 

However, when applying for a Non-Immigrant O-A visa, you must already have taken out this insurance before submitting the application. 

For entering Thailand with other types of visas, or even without a visa, I recommend EKTA Traveling. 

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What Happens in a Medical Emergency? Do I Have to Pay First and Get Reimbursed Later?

With Pacific Cross, you receive an insurance card that you can show at a wide range of hospitals throughout Thailand. The treatment is then billed directly to the insurance company. The list includes, for example, all hospitals in the Bangkok Hospital chain. 

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What If I Do Not Want to or Cannot Take Out Health Insurance in Thailand?

In that case, you can alternatively prove to the Thai government that you have set aside THB 3 million exclusively for your healthcare. As far as I know, the money must be in a blocked account and may only be used with permission. 

Also read the article Expat Health Insurance – Yes or No?, in which a doctor friend discusses the pros and cons of this type of self-provision and shows a way to live in Thailand without health insurance.

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Will the Costs of My Long-Term International Health Insurance Increase?

Yes, they will. Both companies have an age-based premium scale that allows you to estimate quite well how the premiums will develop. We also have to expect a normal price increase. From 2023 to 2024, this was a full 8% at Pacific Cross. This will happen approximately every 3 years. People are living longer thanks to very good medical care. But this care has to be financed. 

Incidentally, the increase in premiums is also due to the behavior of the insured. Following the motto, My insurance also pays for Bangkok Hospital, expensive and sometimes unnecessary examinations and treatments are used in expensive hospitals. See also the article by a doctor friend who argues for personal responsibility in health insurance, further below. 

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Disclaimer: Please note: I am not an insurance agent. This is not advice. You should always clarify your questions with representatives of the two insurance companies. 

For inquiries, please contact Pacific Cross by email.