The stakes are high when you gamble on health

The Danish Embassy’s consular team is composed by 7 members who take care of Danish citizens in need of help or a certificate: prison cases, cases involving death, cases in connection with hospitalization, cases of financial assistance, renewal of passports, complicated cases of citizen services, divorce cases, legal cases on behalf of Danish authorities, cases of Danish citizenship, adoptions, certificates for visa-renewal in Thailand, residence certificates and certificates in connection with marriage in Thailand.
The Danish Embassy’s consular team is composed by 7 members who take care of Danish citizens in need of help or a certificate: prison cases, cases involving death, cases in connection with hospitalization, cases of financial assistance, renewal of passports, complicated cases of citizen services, divorce cases, legal cases on behalf of Danish authorities, cases of Danish citizenship, adoptions, certificates for visa-renewal in Thailand, residence certificates and certificates in connection with marriage in Thailand.

Every year Scandinavians without health or travel insurance involuntarily end up putting family members in lifelong debts. Uninsured people who do not have relatives or other means of funding their treatment are at risk of being thrown out of a hospital despite a vital need for hospitalization.

Forget about your national insurance cards. If you live in or travel to a country outside of the European Union, the blue health insurance card or any national health insurance card becomes useless. You need to buy an insurance policy if you want to make sure not to end up with a dizzying bill. Most people are well aware of this, often people underestimate the costs related to medical treatment and some decide to take the chance in order to save a little money in the short term.

Insurance or not, accidents and unexpected illness can knockout anyone. According to the Danish Consul Birgit Sarah Carlstedt, just last year, the Royal Danish Embassy in Bangkok had 85 cases concerning uninsured people in need of financial assistance for treatment they could not afford themselves. The money usually comes from the family or from a pension. Most of the 85 unlucky Danes needed treatments worth several hundred thousand DKK. If the Embassy cannot find the necessary funds people will be denied vital treatment because funds are not available.

Even though living costs in Thailand are considerably lower than in Scandinavia, an unexpected visit to a hospital can be a very costly affair. According to Birgit Sarah Carlstedt, this applies to both private and public hospitals. In both places you will have to pay for everything from taking up space in a bed to medicine, nursing care, examinations and operations.

“Typically the cost will add up to hundreds of thousands DKK depending on the patient’s needs. If the relatives of a patient, who does not have the financial means him- or herself, have to come up with these kinds of funds, most of them will be in debt for many years to come. If the relatives are even capable of obtaining ammounts this size,” she says and adds that the Danish Embassy’s advice is clear; get an insurance before you go to Thailand.

However the insurance market is somewhat blurry with large differences in price and coverage. Some people might be able to acquire a cheap health or travel insurances through their home insurance, while others will have to find an insurance on a market where prices vary several thousand Kroner on what seems to be the same insurance policy. We spoke with the Danish Consul Birgit Sarah Carlstedt, to hear just why it is so crucial to get an insurance and what you should make sure your insurance cover.

Blackmailing your own family

A large number of the Danes that end up in Thai hospitals have been involved in accidents. According to Birgit Sarah Carlstedt a lot of these accidents include motorbikes. Even though riding with a helmet is required by law in Thailand, it is widely known that tourists and Thais alike, often ride without one. But this is not only a foolish decision because of safety issues. The fact that it is illegal to ride without a helmet means that an insurance company can categorize injuries as self-inflicted and therefore have the right to reject the request for coverage. So with or without insurance Birgit Sarah Carlstedt urges you to avoid the potential dread and protect your head.

To show how the case of a person without health insurance develops, Birgit Sarah Carlstedt gives a fictional example that displays a representative case, where a person involved in a traffic accident, gets an open cranial fracture and is brought to a hospital floating between life and death.

“The hospital will keep the person alive while figuring out if further treatment can be funded. The money may come from relatives, who put themselves in debt for the rest of their lives through loans in what should have been a retirement fund in bricks. They do this because the alternative is that the hospital will turn off the switch and their relative will die” Birgit says.

No money – big problems

In a scenario like this, the hospital will contact the Embassy to hear if they can fund the treatment. While The Embassy cannot cover the expenses directly, but will act as an intermediate between hospital and relatives, they will try to locate funds and make sure the hospital keeps the patient until all options for fund raising have been tried.

The process is longer when the hospital is not in direct contact with an insurance company. The Embassy will notify the Foreign Ministry and ask them to make the police notify the closest relatives. Once the relatives have been notified the Embassy can act as a link between family and hospital.

“As long as we are trying to find funds, the hospital will keep the patient stable, but it is obvious that they can’t keep a patient hospitalized and cared for open ended without having a certainty that they will be paid. In the worst cases they have to throw the patient out on the street,” Birgit says and adds that the funds often can be found within a day if everything plays out perfectly, but if the relatives are hard to reach or their banks slow or unwilling to grant a loan, the patient can risk waiting a long time perhaps even up to a week before the necessary resources are located.

The money does not have to be on the hospital’s bank account for the doctors to start operating, as long as the Embassy can get a written guarantee from a bank in Denmark that the money will be transferred, the Embassy is able to guarantee the hospital that the money is on its way and the operation can begin.

“Usually we find the money one way or another, but we have had experiences where there were no funds. Then it is often up to the doctor, and his interpretation of the Hippocratic Oath (An oath taken by all doctors, where they swear to heal the sick and hurt) to choose if he will operate or treat the patient. But this is not something you can take for granted,” Birgit Sarah Carlstedt says

Even healthy saving accounts comes short

The Embassy has previously been contacted by people who thought they would be able to afford a treatment if they ever needed it, just to realize how high the cost actually is. When you enter a hospital the meter starts ticking immediately and you will be charged for every single service.

“We are sometimes contacted by people who want to hear if it can be true that the prices are so high. They usually want us to negotiate a lower price. But the Embassy is not in a position where it can bargain with the hospitals,” Birgit Sarah Carlstedt says.

As a tourist or resident a great and overlooked expense is when a person needs to fly back to Scandinavia in a hospitalized state. This type of journey can rarely be booked far in advance, you are going to take up at least three seats, on the flight you will have the nice but expensive company of a doctor or nurse and often other types of medical equipment you need to survive the trip. The bill for such a trip typically adds up to an astronomic amount.

Cover the essentials

Regarding both health and travel insurance Birgit Sarah Carlstedt advices everyone to make sure that all types of hospital treatments are covered. When it comes to travel insurance it is important to have the option for accompanied transport home. As mentioned above accompanied home transport means that a you will have medical trained personnel accompanying you on the flight. As a tourist or expatriate you have to remember that a health insurance is different from a travel insurance and might not cover the same things.

“It is important to have an insurance that covers legal expenses. The smart cheats the less smart. A good lawyer is expensive and with the right insurance you can make sure that you can afford a lawyer who can assist you if this is part of your hospitalization like for instance a traffic accident,” Birgit Sarah Carlstedt says.
When all the essentials are covered you should make sure that all your extracurricular activities are covered as well. For instance diving is categorized as an extreme sport by some companies. This means that diving accidents will not be covered unless you pay an extra charge. In general you should adjust your insurance to your needs. According to Birgit Sarah Carlstedt, even though there might be large differences in the price, most travel insurances basically cover the same, with extreme sports as the main exception.

Even though it might sound obvious, it is important to draw an insurance policy before you get sick. You cannot draw an insurance that covers expenses related to a chronic illness you have while signing the policy. The same pretty much goes for age. You have to find an insurance company, before you are in an age where few companies want to take you as a customer. As you get older insurance companies demands a more and more thorough health report.

Bigger might be better

When it comes to health insurance there can be a larger variation in the coverage, it is important to make sure that the insurance covers the more expensive operations or procedures, like being submitted to an intensive care unit.

“It is really important to study the terms and conditions of your insurance, to see what it actually covers, that it covers more than patching up a wound and getting a tooth pulled out,” Birgit says. Apart from investigating how you will be covered, you have to consider the company’s credibility as well.

“I myself would take an insurance with a bigger international renowned company, partly because you know they have the financial capacity to cover the claims and generally they don’t want their brand to be damaged by bad stories. Smaller, local companies might not have the same feeling about their reputation,” Birgit says.

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