Medical care is one of Thailand’s booming ‘tourist’ industries. With highly-trained doctors and equipment as sophisticated as in any US or UK hospital, you can get any treatment under the sun for around 1/10th of the price of the equivalent treatment in America. Medical tourists come to get their tummy tucked, their face improved, their heart fixed, their breasts augmented or even their sex changed; and the cost of the treatment plus flights and accommodation in 5-star hotels is still a fraction of what it would cost back home.

And no waiting time. You can walk in to any major hospital without an appointment and get seen within the hour. You can then have your surgery the next day and be discharged within a week.

Read about David’s experience at a hospital in Bangkok.

Finding a hospital and getting treatment

The important thing to realize about hospitals in Thailand is that the doctors are generally independent practitioners who ‘rent’ their clinical space from various hospitals. They may have their own clinic as well, but will invariably find their patients at the hospitals and have access to the advanced equipment, nursing care and administrative services.

So if you treatment or operation is complex then it’s important to find out who is the recommended doctor – not which is the best hospital. Once you’ve decided on a doctor, then you can decide which hospital you’d like to go to for the treatment or operation. The top hospitals have English-speaking staff, are more luxurious (and have prettier nurses) and have the best equipment. You also pay ‘resort’ prices for staying there and making use of the facilities.

The other thing to be aware of is that doctors and hospitals do not have liability insurance. If something goes wrong then generally there is no claim – the most you might get is to have your fees refunded and maybe get the error fixed.

This is one of the main reasons why medical care in Thailand is so incredibly cheap and why it’s so expensive in the US for instance. If there is any malpractice or medical incompetence then there are no punitive law suits and exorbitant compensation bills to pay.

It may sound a bit like a cowboy show where barbers perform blood-letting operations with leeches and rusty razor blades. But it seems to work in everybody’s favor. It’s important to do some due diligence research – check out the doctor with other patients, see if there have been any complaints posted in the internet, find out as much about him or her from the hospital, etc. You’d probably do the same in your home country.

Nobody wants there to be problems or complications, but sometimes these happen even in the top US hospitals. The only difference is you can sue a US hospital if things go wrong, but you can’t sue a Thai hospital or doctor. I’m not sure you’ll make much headway in a lawsuit against a shrewd US hospital – and even if you did, it would take years and cost you a fortune in legal fees. That’s what thousands of other patients feel when coming to Thailand. It’s a risk wherever you go, so you may as well go where it’s cheap and convenient and quick and comfortable.

Besides, Thai hospitals and doctors are much more inclined to value their reputation and track record in order to attract medical toursists in the future and referrals and repeat business from you. They will do their utmost to avoid or minimize complications and resolve any difficulties that do occur.

The big hospitals are also investing a fortune in obtaining the latest gadgetry and recruiting doctors who have been trained extensively at home and overseas. There are several hospitals that now offer a wide range of non-invasive operations such as angioplasty at Bangkok Heart Hospital.

The other thing that seems to be the deciding factor for most people is the quality of care at the hospital itself. You don’t feel like a sheep in a dreary ward of sick animals. You are made to feel like a guest in a resort. The meals are superb. You have a private room – or if you share a ward it’s usually quite cozy and comfortable. Your friends and family can share your room and even sleep with you (there’s usually a separate cot made available for a family member) – there’s no such thing as restricted visiting times. In fact, it’s the Thai way. The family is expected to help look after the patient – it’s not considered the responsibility of the hospital to do so. The hospitals who cater for foreigners do in fact look after the patient as well – and it often amazes us how sensible and caring the nurses are in general.

Dental Care

All dentists are private. But some are more private than others.

The dentists who cater for foreigners usually have smarter, more comfortable clinics and more expensive prices. And everybody speaks English. Routine treatments are usually fairly cheap, $30 for a filling or to get your teeth cleaned (properly, by the dentist not a technician), $200 for whitening. As you climb up the ladder of more complex treatments, such as crowns and implants, the costs become roughly the same regardless of where you go – $300-$400 for a crown, $3,000 per implant – and it may be that these treatments cost not that much more in your home country.

The main difference is that there is hardly any waiting time.

Insurance

I strongly recommend that you look into the insurance options for medical care. You may need to change to a different plan at home in order to be covered for treatment in Thailand.

You can also purchase insurance specifically designed for expats seeking treatment in Thailand. The ballpark figure (dependent on age and circumstances) is about $1,000-$1,500 p.a. for accident cover, and $2000-$3,000 p.a. to cover elective treatments as well. There’s usually an excess amount and the policy will often cover a percentage of the fee, usually 90% of hospital treatments and 70% of dental treatments up to a certain maximum. Some policies even cover new glasses.

If you are planning to get a range of treatments then it’s well worth buying the insurance in advance that will help to reduce the costs. I can put you in touch with local insurance brokers who can advise on the best package for you. Or you can check with your existing insurance provider and see what they can offer.

Bear in mind the following:

  1. Many policies will not cover you if you have an accident while riding a motorcycle – even if you are a passenger (or if they do then the cover is halved). This is especially important, because even if you never own a bike you will at some point take a ride on a motorbike ‘taxi’. And accidents happen.
  2. Check whether the policy can be renewed for the remainder of your life, regardless of what claims you make or whether you get certain ‘dread’ diseases like HIV or cancer.
  3. Many policies have individual limitations on what they pay. Just because you have, say, ฿500,000 cover, doesn’t mean that the insurance company will pay this amount for medical treatment. They may only pay the first ฿100,000 for surgery, and no more than ฿50,000 for ICU, etc. So if you’re surgical bill is ฿300,000 and ICU cost ฿100,000 – they will only pay ฿150,000 and you will have to pay the balance of the bill yourself!
  4. Read and understand and double-check the exclusions very, very carefully. Many policies won’t cover you for “extreme” sports, but what this is can often be very subtle. You are unlikely to be covered for a bungy jump or if you go up in a hot air balloon (e.g. at the annual festival) or if you play ice hockey or even go ice skating; nor for boxing (which means no Muay Thai, one of the most popular sports activities in Thailand). The inpatient/outpatient conditions are also usually quite strict. If you receive same-day surgery under local anesthetic, say, without having to spend a night in bed then you also might not be covered.

Self-Insurance

Self-insurance might be an option because many polices have so many exclusions and limitations, you might still end up forking out an extra ฿50K or ฿100K if you get ill.
It’s a gamble either way, a kind of double-or-nothing poker game.
A serious illness could cost you around ฿300K-฿500K. I’ve yet to find a policy that will pay anywhere near that that costs much under ฿100K (for old people).
Put away ฿10K each month (or ฿100K each year starting NOW) into a deposit account. Or if you have the funds handy already then keep a separate pot of, say, ฿300K that you never touch, and keep topping it up…
The gamble is whether you’ll get seriously ill more than once in three years. (If you’re insured, you might not be covered for subsequent illnesses anyway. The devil’s in the details; read and understand the policy terms thoroughly!)
If you don’t get ill then you get to keep the money. (Trouble is, you can never spend it, because you’ll need to keep it in case of old age incapacity… or you die. So you won’t ever get to enjoy the money anyway!)
And then there’s the cost difference between private and government hospitals. Treatment in a private hospital isn’t necessarily much better than at a good government one, just more comfy, and with prettier nurses. Maybe you won’t need so much cover (or savings) if you’re happy to be treated at a government hospital. The cost for exactly the same treatment can often be a quarter that of a private hospital.

More about insurance and private hospitals

Firstly, you are right that private hospitals are usually much more comfortable (and feel “cleaner”) than government hospitals. They are medical “hotels”. And that’s why they are usually so much more expensive.
And to be fair, because they have so much more income, they can also usually afford better doctors (although this isn’t necessarily always the case) and more modern, more advanced equipment.

However, the bigger government hospitals also sometimes have much bigger budgets than private hospitals (because the available funding isn’t decimated by paying out most of the profits to the private owners).

At the end of the day, the most important criterion is usually how well and competent and successful your treatment will be.

Secondly (and this is the crux of the matter), long-term and serious illnesses can become hugely expensive, *especially* in a private hospital.

Something very serious could easily cost a million baht (e.g. angioplasty at Bangkok Heart Hospital).

But if your insurance policy only covers you for ฿500K (and perhaps worse, limits surgical intervention to only ฿200K, say) – then you will still have to pay for the treatment yourself. Being insured won’t help you pay for expenses that exceed the policy cover.

And most of the insurance policies I’ve looked at do not provide sufficient cover, unless you pay through your nose.

Maybe people in the USA are used to paying several thousand dollars each year for (equally limited) insurance. So when the price of a similar policy in Thailand is only $3,000 then it seems very cheap.

It seems, however, that the cost of a policy is ballpark about 10% – 20% of the maximum amount that will paid out in the case of a claim.

And the trouble is that it’s very rare for the maximum amount to be paid out in a particular situation, because of the various limitations for each item (such as surgery or ICU or physiotherapy, etc.).

So in reality, the cost of the premium is closer to the 20% mark of what you would get in a claim.

That’s why I think about five years of “self-insurance” is about equivalent to buying private insurance.

Finally, I’ve noticed that (private) hospitals seem to charge differently if you are self-paying or insured. When you pay your own bills, you can sometimes shop around or negotiate the fee.

And government hospitals might not be as comfortable, they’re crowded, the staff is overworked and not as well paid, and have long waiting times – and are often surprisingly quite dirty! Another important disadvantage is that you can’t always choose your doctor.

But the difference is that you only pay what the treatment costs, no more. You’re not paying for hotel accommodation and the substantial markups on medication and equipment.

Addictions and Rehabilitiation

Thailand is probably not the place for psychiatric treatments (and I’m not convinced that UK or USA is either!!). However, there are a number of centers that are extremely successful.

One of the best and most successful residential drug and alcohol rehabilitation resorts in the world is DARA, who offer treatments on the exotic and isolated island Ko Chang.

The total cost for 4-week program is about $7,000 (incl. accommodation) + travel, plus about $1,200 for the required three months’ after care therapy back in your home country with a therapist of your choice… or just $300 if you stay in Thailand.

Cancer and Palliative (or Terminal) Care

It’s not cheap or easy to treat cancer anywhere in the world, because of the high-tech equipment and the long-term care required. Thailand is as advanced (or as backward) as anywhere else in the world. And there are also many dubious ‘alternative’ treatments available that are mostly ineffectual, despite the smart, modern-looking hospital environment and famous doctors involved.

Depending on what kind of treatment you require, you will find a specialist hospital with resident oncologist who will treat you for a lot less than the cost at home – unless you are already fully covered by insurance, of course.

The cost of flights and accommodation and treatment is often about a quarter of what it costs for the same treatment at home. As a UK resident, you might get your treatment free but the conditions are usually relatively squalid and you often have to wait a long time to get seen to.

At least in Thailand – even if your condition is terminal – you can spend your time in the comfort of a hotel-class hospital room or be cared for by a live-in nurse in your cozily-furnished condo. If I had only a short time to live then I’d want to live out my final days in Chiang Mai in Thailand surrounded by pretty nurses and beautiful scenery and the opportunity to indulge in a wide selection of delicious food.

The only potentially problematic area is whether your family and friends will be with you. The cost of living here is low enough to seriously consider bringing the whole family over to live and be with you for the duration of your treatment.

And if you are religious then there is no shortage of support from a considerable number of churches (over 50 Catholic churches and over 90 Protestant ones in Chiang Mai alone, not to mention at least a dozen mosques) and a strong Christian community. The Mormons (Church of the Latter Day Saints) and the Evangelists are well represented everywhere in Thailand. And Jewish support is provided by local Chabad houses, one in Chiang Mai, 3 in Bangkok, one in Ko Samui and one in Phuket.