# Medical insurance



## Dr who (Jul 26, 2015)

hI
Just wondering what kind of healthcare plans people have gone for? Do we need to include dental, or is it cheaper to pay when you need it for family with 2 kids? What kind of prices are we looking at? Thanks


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## cvco (Mar 20, 2015)

This is complicated since local plans are not like western plans. Its more like personal accident insurance and cuts off when you are about 60. Its annual, with annual physical checkups. Any illnesses reported during the year are excluded for the next year. There is no obligation for a company to continue to insure you. You pay the doctors and hospitals yourself and then submit bills to the company and start negotiating. You may be quoted a giant premium because western bodies are bigger and heavier. The rates are based on a thin, small, lightweight person (compared to westerners).

That said, after trying with several companies I didnt take any. Prices too high, too many exclusions, not sufficient coverage. I pay cash and pray I dont get a major problem.

You can apply with several and try. Prudential, AXA and AIA are local large ones. Find them online. There are also international insurance companies for expats and the prices are about USD7000 a year for the average person, according to what I found. That would cover medical and medical transport home if needed.

Generally, the local plans offer low coverage, high deductibles, and low lifetime maximums, compared to western plans. Major events like cancer, transplants, are either not covered, covered a bit, or severely limited. Wellness and routine checkups are not covered.

I cant explain it all and terms and conditions also change at times and who can keep up? Check with those companies I mentioned, see the latest info.


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## casey1 (Jun 21, 2009)

Wow RM28000 per annum I think this must be a typing error it is more like RM1500 per annum approx. $400


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## cvco (Mar 20, 2015)

casey1 said:


> Wow RM28000 per annum I think this must be a typing error it is more like RM1500 per annum approx. $400


Actually, my aunt is an american living in Greece and she pays about USD7000/year on an international plan and thats just for major medical, with high deductible. Myself, I was quoted USD1200 per MONTH on an international plan which included medical evacuation if needed. So it was not a typo.

For a local plan, I was quoted about...USD125 per month....but after I told them in my medical history that I had had colds and flus in my life, they excluded all ailments related to the circulatory and respiratory systems; when I said I knee surgery 25 years ago, they excluded all muscle and bone systems from coverage; when I said I had food poisoning once, they excluded all intestinal tract problems; when I said I got headaches once in a while, they excluded brain and central nervous system problems from coverage. There was nothing left to insure and I asked, you are giving this to me for FREE, right??

For those who havent filled out medical histories locally before, they dont ask if you are a chronic sufferer of a problem, they ask if you EVER had the problem and when you say yes, then they chop that coverage off. If you say NO, they know you are a liar and they kick out your app. Its a lose-lose situation for an adult. As they have told me, they want to insure healthy children who have never had problems yet, and then milk the cow as long as they can.

Cigna is a real insurance company advertising for expats and as yet I havent dared to fill out their online application.

DENTAL....I havent found any policy containing dental coverage, but as i said in my first post, problems resulting from an ACCIDENT, like getting your jaw smashed to pieces when you went flying through the windshield when that lorry hit you, then yes dental is covered. But normal care? No way (as yet).

All three that I mentioned, AIA, Prudential and AXA, told me they cannot and will not lose money in the insurance business and will not insure people who are likely to be sick later on. Thats also why they stop insuring at about 60 years old. In developed countries, insurance companies pay out roughly 106% of premiums. They invest the premiums, make 120%, pay out 106% and have a 14% profiit. (dont hold me to exact numbers, I read it before somewhere and it can be researched). But in Malaysia, they try very hard to pay out nothing and there are no firm laws governing their business. For this reason they structure the policies like Personal Accident insurance and weigh the risks of accidents. But in health itself, they quickly exclude items in your health to cancel the risk and thats it.

So yes, you probably can get insurance for RM1500 a year but what age is the person? What prior conditions? What deductible? Whats included and what isnt? What height and weight? International coverage for any hospital or doctor? Yes, they quoted me RM1500 but most everything was excluded so what are really talking about here?

Also....to remind about local policies, lets say you get cancer one day. Yes, some will cover cancer, no problem! But only the first RM50,000 of treatment or some such low number. It could cost a million, then what? Need an iron lung? No problem! But only for the first 6 months. Then what? Need kidney dialysis three times a week? Come and get it! But only for once a month, not 12 times a month. Then what? You see the point anyway. OH! And my favorite question from the insurer---"Now, Mr. CVCO, tell us the REAL reason you are applying for insurance today." Gotta love those guys.

Yes im extremely cynical about this because I beat my head against the walls for years trying to get decent and real coverage. If there IS such a thing, please let me know!


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## prof.ishack (Jul 4, 2014)

I have Cigna and it costs me about $122 USD, it's a very high deductible plan. But I've found that the cost for healthcare is very reasonable and may drop it in the future (my former employer is paying for it for 3 years). I had some minor surgery a while back and the cost was $600 USD, had a visit to the OR for x-rays after a minor accident and it cost about $120 USD. Had some major dental work done (3 crowns and an implant) it was under $1000 USD. My wife had full spinal MRI for less than $200. 

And as others have said the local plans have some pretty low caps, which is why I didn't look at them. I want insurance for the $100K problems, I can handle the $5000 bill, but not the $50000 ones.


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## cvco (Mar 20, 2015)

ishack, yes the low caps are part of the problem. Blue Cross in US is, if I remember, $2 million lifetime cap, and local can be as low as $50,000 cap. I agree, i can handle the $5000, not the $50,000. I can check out Cigna.

I had Blue Cross before I came to Malaysia but when it wouldnt cover me after 90 days, I had to drop it. That was $300 a month for zero deductible, $5 co-pay and $5 meds. I'll never see that again.

But now there is Obamacare and there is a problem. Previously, being abroad more than 6 months a year was an exemption and now it appears thats been taken away. In fact the question wasnt even on my HR Block tax software in April. This means what, pay penalty now even though I dont live in US now? Does anyone know?

I would take Obamacare if its would cover me here but I think there is no such thing.


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## prof.ishack (Jul 4, 2014)

Interesting to think about the Obama healthcare. Here's a pretty good website, it was updated a couple of months ago so it looks up to date. 

5 Things Expats Need to Know About ‘Obamacare’ - Expat - WSJ

From the site I'm fine because I've been out of the US ALL of 2015, and will meet the requirements for 2016 as well. From the site. 

_The good news is that most U.S. expats will be exempt from Obamacare—but it’s not a given. If you qualify for the Foreign Earned Income Exclusion by either the Physical Presence test or the Bona Fide Residence test, you are exempt. Note that you don’t actually have to use the Foreign Earned Income Exclusion—you simply have to qualify for it by being physically present inside a foreign country for 330 of any 365-day period._


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## cvco (Mar 20, 2015)

Thanks and I will read the site. Ive been out since August 2014 so I guess Im good on that. See, previously it was 181 days, now 330....ahh.....is that site 100% truth, or how to verify it elsewhere?

( I dont want to digress but have to. That 181 days is significant for expats. Example, lets say you must be out 181 days to skip Obamacare. But if out 181 days or more, you may lose your bank account and resident status in your state. These catch-22s are all over the place. You need the time out for one thing, but are penalized for something else)


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## prof.ishack (Jul 4, 2014)

I'm going to double check with my CPA when I go visit my kids in January
If I find out more I'll post it.


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## cvco (Mar 20, 2015)

I read the WSJ site and wasnt very encouraged. Plus, IRS seems to indicate that whatever the rule was it ends this year--or thats the way i read it. Previously, not long ago, I read somewhere that expats would be treated as locals for this, meaning we follow the same rules as anyone, living outside means nothing. Im going to call an insurance agent in California this week and discuss it. Last thing an expat needs is to pay Obamacare AND not even be able to use it. Unbelievable.


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