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A Guide to the New Mandatory Health Insurance Rules for Retirees

If you've got questions about the mandatory retirement visa health insurance requirement (O-A visa), this FAQ will answer those questions, and much more.

I'll cover the following

  • Why you need health insurance.
  • Who the approved companies are.
  • How much you can expect to pay.
  • How to get it cheaper than advertised.
  • And how you can avoid this requirement altogether!

o-a-visa-insurance-guide

What is an O-A (Retirement) Visa?

The O-A is commonly known as a ‘retirement visa', though there isn't officially a visa called the ‘retirement visa'.

It is for those aged 50+ who want to stay in Thailand for a period of 1 year, without the intention of working. You can extend after the year is up, provided you meet the financial requirements.

The O-A is obtained in your home country and, when you enter Thailand, you are stamped in for a year.

The new mandatory health insurance rule applies to both new Non-Immigrant O-A visa applicants and current Non-Immigrant O-A visa holders who obtained the visa after the enforcement date.

When did the new retirement visa insurance rule commence?

The rule came in to effect on October 31, 2019.

What if I got my O-A visa before this date?

The official line is as follows:

“An alien, who has been granted Non-Immigrant Visa Class O-A (not exceeding 1 year) and has been permitted to stay in the Kingdom before this order takes effect (October 31, 2019), will be able to continual to stay in the Kingdom for the granted length of stay”.

What other visas are affected by this rule?

None. However, holders of the Non-Immigrant O-X visa have needed mandatory insurance since 2017.

Why introduce mandatory health insurance?

Back in May 2019, a representative of the International Health Division (Health Service Support Department), stated that in 2017 and 2018, foreigners incurred non-paid medical bills amounting to 349 million Baht, and 305 million Baht, respectively.

The records show that in 2017, 565,000 out of 3.3 million visitors didn't pay their medical bills. In 2018, the figure rose to 680,000 out of 3.42 million visitors.

They say the majority of unpaid bills were from retirees on long-stay visas.

I'm not convinced of that, but what is true is that those 50+ years old are more likely to develop long-term illness. The bill for heart disease, cancer, type-2 diabetes complications, etc., can be a very expensive one.

But don't most expats have insurance anyway?

You would think so. Most I meet do. And the majority of stories in the papers surrounding unpaid medical bills are usually regarding tourists in motorbike accidents.

A better solution might have been:

A. charging a 500 Baht entry fee to each person entering the country (per year) – this would have covered the cost of unpaid bills cited by the health department.

B. making sure everyone who enters the country has medical insurance!

But we are where we are now. Let's move on.

How much cover do I need?

The new rule specifies that the applicant or visa holder must have health insurance that covers not less than 40,000 Baht for outpatient and 400,000 Baht for inpatient medical fees.

Where do I get my retirement visa health insurance?

Those in charge have come up with an approved list of local insurance providers:

The companies are as follows:

  1. Thai Health Insurance
  2. LMG
  3. The Viriyah
  4. Pacific Cross
  5. Falcon
  6. Thaivivat
  7. AXA
  8. Navakij
  9. Dhipaya
  10. Asia Insurance
  11. Aetna
  12. Sompo Insurance

You have to use one of these providers and present your premium with your visa application. The premium must meet the minimum requirements.

How much are the premiums?

Reasonable, I guess, depending on your exchange rate, and if the insurance cover is solely for Thailand. Once you get to 60+ years it starts to get expensive. And if you want regional or international cover the price rockets.

I've had a fair few emails from disgruntled readers. Here's one that explains how restrictive this new rule can be for those over 65 and 70:

4 carriers on the Thailand Long Term Insurance website will insure me at 70 years or older. For me at age 71, the rates range from 69,000 to 81,000 Baht per year. This is prior to an exam and underwriting and subject to change.

The rates are almost double what a 65 year old pays.  At 75 years they increase 33% and at 80 66%, respectively.

So only 4 out of the 7 will actually insure those who are 70+. And for those 80+, there are no options.

Indeed, Thaivivat Insurance goes highest in terms of age. They will insure you at 76 years old, with renewals up to 100 years old – starting at 120,000 Baht.

Is there a cheaper option?

Yes. I found that if you use the Mr Prakan website you can can shave a bit off the premiums.

This site covers numerous companies and five on the approved O-A list:

  1. AXA
  2. Pacific Cross
  3. LMG
  4. Viriyah
  5. Thaivivat

So you can get cover from one of those approved providers and save money on going through the government website.

Here's a couple of quotes I got based on being 50 years old and exceeding the 40k outpatient and 400k inpatient cover. I'm 41 but to be eligible for an O-A visa you have to be 50.

thailand-mandatory-health-insurance

I don't want this insurance/have my own, what can I do?

Don't get an O-A visa.

But I want to retire in Thailand, is there another way?

Yes. Get a Non Immigrant O Visa. You don't need the mandatory health insurance for this visa.

How is a Non Immigrant O Visa different from the O-A?

An ‘O' category visa can be issued for a range of purposes such as visiting family or friends in Thailand, taking a voluntary job, getting medical treatment, attending a judicial process, and even to work as diplomat's housekeeper.

It can also be issued for the purpose of retirement. Good news.

Where retirement is concerned, you can obtain a single entry Non Immigrant O Visa from your home country, or neighboring country to Thailand, which gives you entry to Thailand for 90 days.

After 60 days in Thailand, you can apply for a 1-year extension at an immigration office – providing you meet the financial requirements, as stipulated in my retirement visa post.

Put simply: the Non O Visa does not require the mandatory health insurance, and the O-A does.

I want still want good health insurance. Any recommendations?

Yes. Check out these providers here. Also, you can get an immediate quote from Cigna by clicking here. It takes 2 minutes to do.

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Got a question? Did I miss something? Leave it in the comments section below.

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  1. Ken F says

    Well, sadly this may very well be the last nail in the coffin when it comes to my plans of retiring in Thailand in a few years. After all, the only reason I’m even considering retiring overseas in the first place is because I will not have sufficient monthly retirement funds to continue to live here on the California coast – well, that and the fact that I’m beginning to really hate even the relatively mild and short winters we have here. Anyway, it’s bad enough that I would have to put at least $15,000 dollars of my savings aside that I would never be able to touch for the rest of my life simply to have a visa. But now I would also have to pay these mandatory and, in my opinion, unreasonably high insurance premiums (unreasonable in relation to actual Thai medical costs). Frankly, if given the option, I would probably just as soon put up a surety bond for 400,000 baht than to pay the overpriced insurance premiums every month.Of course I can’t really blame the Thai government for not wanting to get stuck footing the bill for all these deadbeat foreigners – even if they are going about remedying the situation in totally the wrong way. No, I’ll reserve all my ire for all those deadbeat foreigners who caused this situation in the first place. If the statistics given in the article are correct this means that about ten percent of all visitors to Thailand require some sort of medical treatment while there, and that of those people who do, a whopping twenty percent of them do not pay their hospital bills. That’s an astoundingly high percentage, particularly when you consider that most of these visitors came from countries that are much wealthier than Thailand. And if we exclude medical tourism from the statistics and only include those who did not plan on getting sick or injured while in Thailand then the percentage of non-payers is more like 25%. Speaking of which, how on earth is it that someone on a Thai retirement visa cannot afford to pay his own medical bills? After all, if these people have either the required 65,000 baht a month income (500% more than the average Thai income) or 800,000 Thai baht in the bank, they should have absolutely no trouble whatsoever paying their medical bills in Thailand (even major surgery is fairly cheap in Thailand compared to the USA). Not to mention the fact that people with good salaries and large savings accounts are typically responsible enough types that they would likely already have medical insurance.So I guess the real question is, are these deadbeats somehow circumventing the visa requirements, or are they just so addicted to prostitutes and booze that they are habitually broke? Or perhaps the Thai government is incorrect in its assertion that most of the offenders posses long term visas. By the way, I actually have absolutely no problem with either prostitution or booze but I do have a big problem with people who live beyond their means and then expect others to ultimately pick up the tab for them.In any case, there is really no excuse for someone who meets these income requirements to become a financial liability to their new adopted country. When I lived in Phuket ten years ago with my Thai girlfriend I actually splurged on a very nice and very modern house with a private pool, but aside from rent our total combined monthly expenses only came out to about $450 US, and we lived a pretty comfortable life. And even when you include rent we were still living on about half of what I would be required to have in income in order to qualify for a retirement visa. So, basically, if I lived in Thailand today and I had the required $2100 a month in income I would have more money than I knew what to do with and I certainly would have no problem paying any medical bills I might incur. Also I would think that most people who decide to retire in a foreign country are going to have a substantial amount in savings as well as at least one credit card with a decently high limit on it for emergencies.But then again, perhaps Thailand has just become a magnet for deadbeats from around the globe – deadbeats who mostly just sit around all day bitching and moaning about how “unfairly” they are being treated in their new host country. Basically these are people who think the world owes them a living and who probably can't handle the fact that THEY are now suddenly the minority race.
    Reply

    • TheThailandLife says

      You can currently avoid the insurance by getting a single entry O visa and then extending that based on retirement after spending 60 days in Thailand. I'm unsure why they specifically choose the O-A for the health insurance. Probably to bring it in line with the O-X rules.
      Reply

      • Ken Furber says

        Peter,It sounds to me like you are saying that if I get the O Visa first and then change over to the O-A Visa after 60 days (which I was planning on doing anyway) that I will not be required to get medical insurance, not even after the changeover. That can’t be right. Can it? It would certainly be nice if true. Of course, I have to say that the exchange rates also have me a bit worried lately. When I was spending a lot of time in Thailand in the early 00’s the exchange rate was about 45 baht per US dollar but for the past decade its been hovering around 32 and the 5 year projections show it dropping to 28 by 2024. That means that my $75K in savings may only be 2.1 million baht rather than the 3.4 million that it would have been at the higher exchange rate. And more importantly my already laughably inadequate monthly social security payouts will likely get even less adequate as time goes by.
        Reply

        • James E says

          The early '00s was an anomaly following the Asian crisis in 1997. Since 2006 the Baht has traded in the low-mid 30s with some brief excursions higher in 2015/16 and the recent test of the low. Your 3.4MegaBaht estimate is an overstatement. Read through the comments and there are a number of posts detailing how to do the visa conversion. Currently there are only a few neighboring countries who will issue a plain-vanilla O visa. Max, in particular, has written about the procedure for converting to and O-by reason of retirement as opposed to an O-A.
          Reply

          • Ken Furber says

            James,Yes, as someone who has been visiting Thailand since 1990 I am actually intimately familiar with the financial crisis and its aftermath – as well as what led up to it. In any case, I’m not really quite sure what you meant by “overstatement”. After all, when I made the comparison between converting savings at these two different time periods I was in no way suggesting that 45 baht per dollar was normal. I was simply using these two extremes to make a point - the point being to illustrate how drastically things can change and how a retiree living in Thailand on a very small pension in US dollars has to consider that fact that this could get even smaller at any time due to changing exchange rates. Of course this is only really a factor if your pension amount is right on the edge of what you calculate you will need to live in your new country. If you have a suitable buffer on the other hand you needn’t really worry because it’s a fairly safe bet that the exchange rate will stay between 28 and 32 for the foreseeable future.Still, thanks for pointing me in the direction of some good reference material in the comments. Since things have certainly changed since I last lived in Thailand nearly 10 years ago I will certainly have to brush up on current visa procedures and requirements.
            Reply

    • Steve Ginn says

      Ken F. It appears that Americans are about the only ones to whinge about the cost of living in Thailand when the country you are leaving is much more expensive than here?! If things are so bad here, stay where you are!Is this you, "deadbeats who mostly just sit around all day bitching and moaning about how “unfairly” they are being treated in their new host country."
      Reply

      • Ken Furber says

        Steve,Well, fortunately most of the foreigners I’ve met while visiting Thailand over the past 30 years have been really great people so I can’t see any reason for anyone to stay away just because of a few bad apples like yourself. And lets face it, if it actually bothers you that I am bothered by the thought of a person from a rich country becoming a financially liability to a poor country then its pretty clear that you are definitely one of those bad apples.Also, I hate to burst you bubble but there is actually no correlation whatsoever between nationality and this particular negative personality type. And even if there were, this could only be determined by extensive statistical data and not by personal observations. For example, even if men were statistically better drivers then women, every woman you personally know might still be a better driver than every man you know. Still, many people delude themselves into thinking that their own limited personal observations are somehow statistically relevant in determining a pattern among a group consisting of tens of millions of people (they are not). And then there is the fact that when a person grows up harboring feelings of resentment and animosity toward a particular group he will tend to only see what he expects to see in his encounters with members of said group. And this naturally just goes to further re-enforce his already badly skewed perspective. Believe it or not I’ve actually met a few idiots who are convinced that all Toyota’s and Honda’s are junk even though all the statistical data shows that the exact opposite is true. They believe this because this is what they need to believe and little things like facts and reason are not allowed to enter into the equation at all.By the way, I think you may need to work a bit on your reading comprehension skills. I never once suggested that things are "bad" in Thailand. The problem is I always make very thorough calculations before moving to another country and if the math doesn't work out I will not go because I will not take even the slightest chance of becoming a financial liability to my new host country.
        Reply

        • Steve Ginn says

          Ken,Like most [slur removed], you talk a lot and say nothing! There are enough whining [slur removed] here as it is so feel free to go to Panama or Costa Rica or somewhere else so we don't have to listen to your problems! And your $75k won't last long! That is only 2.3 million baht and after you lock up 800,000 baht of that in a bank account you are left with 1.7 million baht!, so your "very thorough calculations" aren't very good then!
          Reply

    • James E says

      Ken, I've thought about this a lot, too, and can't figure out why people who don't like the Thai system don't just change plans and head to Malaysia, Vietnam, Indonesia or any of the (2n+1) other tropical paradises the world has to offer. Thailand over the past few years has been making it more difficult for people of moderate means to retire there. I think they are consciously trying to drive out what they see as riff-raff - those retirees who came to Thailand *just* because it was cheap. This was facilitated by the burgeoning Chinese tourist and retirement trade so there was an economic incentive to clean out the basement. It'll be interesting to see going forward if these more draconian measures come back to bite them in the butt. And, as TTL hints at, this is Thailand, there is always a way around the rules...
      Reply

      • Ken Furber says

        James,Yes, its true that they have been making it more difficult for people of moderate means to retire in Thailand but it seems to me that these efforts have mostly consisted of cracking down on existing laws and eliminating the loopholes that foreigners have been taking advantage of for ages. And let’s face it, even with all this, the requirements for a retirement visa in Thailand are still actually pretty similar to those in most other countries in Southeast Asia. In Indonesia, believe it or not, you are actually required to hire a domestic servant when you retire there.As for the notion that the influx of Chinese tourist over the past decade was the impetus for the recent crackdown on the western "riff-raff, I’m not sure I completely buy into this theory – although it does seem to be the prevailing opinion. The Chinese probably do bring in more money while causing less problems than some other groups but personally I suspect that the crackdown still would have happened regardless of the Chinese tourist influx.In any case, when the Thai government does make things a bit more difficult for prospective retirees of limited means, like myself, I don’t get angry about it or take it personally in any way. But then again, I don’t have the massive sense of entitlement that some other western expats seem to have. The problem is that when people are allowed to get away with circumventing the rules for a very long period of time they will eventually come to believe that they are somehow entitled to continue doing what they have been doing. And because of this they tend to have an absolute hissy fit when the powers that be suddenly decide to crack down and actually start enforcing these rules. These people will then also invariably insist that their rights are being violated or that they are the victims of discrimination or some other such nonsense. And while this is obviously a rather childish reaction by these people I’m afraid it’s also just human nature.
        Reply

        • James E says

          Ken, The history of the loosely enforced rules and regulations is important too. Most of the restrictive laws, for the TM30, land ownership, restrictive visas, etc., have been on the books for decades or longer. Seeing the experience of the rest of SE Asia during colonial and post-colonial times forced Thailand into a more defensive posture which is easily seen as an ethnically defensive posture. That being said, when any of these policies do start getting enforced or enhanced, as we're seeing with the retirement visas now, many people take umbrage at the insult to their decision to live or retire in TLOS. But, the whiners are correct in that they are being discriminated against, that's the whole purpose of immigration law. It works that way in Thailand and it works that way in the US. Whining about it, though, doesn't help. They just have to remember that the slogan has always been: Thailand - The Rules Are Different Here.
          Reply

  2. Patrick says

    Well well... an 'approved list'. Again thinking inside the box. Follow rules, don't think. More money for Thai insurance companies? I have health insurance that covers treatment costs anywhere in the world (with some exceptions for the USA, because there health costs are crazy and no one from the USA is allowed to compare health costs in Thailand IMHO because their reference level makes no sense) and Thailand thinks they need to make their own rules? It smells.It just seems like another way to bully those retires out of Thailand. Unwelcome element apparently. In select cases I agree. How about giving access to the Thai basic health care to long stayers? Impossible huh. Always second range citizens. Just good for paying and bureaucratic paper work.
    Reply

  3. Stephen says

    Hi, Greetings ! Just needed to know if an O-A (retirement visa) can be obtained if your 50 years of age since you mentioned 50+If so & if the visa is valid for a year and if I were to get a job during that period, would I be able to change my visa to an employment visa.Cheers ! Stephen
    Reply

    • TheThailandLife says

      Yes, you can get one at 50. You would need to obtain a B visa from outside of Thailand, with a letter from your perspective employer. They would then arrange a work permit for you. I'm pretty sure you can't swap from 0-A to B inside Thailand; but don't quote me on that because someone will no doubt say they know someone who did it.
      Reply

  4. Brian says

    Hello I may have missed this.. if I keep my government insurance in Canada and residency and buy supplemental in surance like Blue Cross or other international coverage like I did last year for my Retirement OA will this work?Are you talking about expats who are non resident in their home countries? or is this not relevantThanks kindly Brian
    Reply

  5. sidney leonard says

    Allow me to clarify my question. Would an official letter from my state teachers retirement system, showing a sufficient monthly income, suffice for the income verification requirement (in lieu of said verification from the US embassy in Thailand which is no longer allowed) when applying for a 1-year extension to an O-visa. Thank you.
    Reply

  6. Steve Ginn says

    The junta already has an office formed specifically for chasing up these "non payers". Wonder what precisely these bludgers are actually doing, because they are obviously not doing what they are there for!When an expat attends a hospital, their passport number is recorded as a part of their record. As Immigration has this wonderful, whiz bang computer system to track every bodies movements, one would think that these idiots at the hospitals would have the nous to notify Immigration that passport number **** owes x amount! Then when that passport holder goes for a 90 day report or a visa renewal, the dullards at the Immigration office refuse to do the 90 day report or the visa renewal until a receipt from said hospital is produced!! But then that would be too bloody easy!!
    Reply

  7. Jeffrey Lockwood says

    I saw rumours that a foreign insurance company not on the Thai government list that meets or exceeds the minimum requirements for O-A Visa might be accepted at some point by the Thai government. But I don't see any mention of that in your article. There's nothing come of that?
    Reply

      • Jeffrey Lockwood says

        Thai Embassy website does not say that. Please see below. Do you have information from the government that contradicts their website?https://thaiembdc.org/consular-services/non-immigrant-visas/non-immigrant-category-oa/8.1. Health insurance policy document issued by a Thai or foreign insurance company, stating that the applicant is medically insured for the period and with coverage as mentioned above:(a) In case of a foreign insurance company, the applicant must submit the original insurance policy document with 2 copies;(b) In case of a Thai insurance company, the applicant must submit 2 copies of the insurance policy document or, if available, the original insurance policy document with 2 copies. A list of Thai insurance companies participating in the scheme can be found here: http://longstay.tgia.org8.2. Foreign Insurance Certificate as stipulated by the Office of Insurance Commission and Health Insurance of Thailand, which must be completed, signed and stamped by the insurance company. The form can be downloaded here: Foreign Insurance Certificate FormThank you.
        Reply

        • TheThailandLife says

          Yes, that's what we initially thought, until stories came flooding in of people's insurance being shunned by immigration and instead handed a list of the approved Thai insurers. Different embassies in different countries say different things. The UK embassy website advises to use the approved companies:"Copy of evidence stating that applicants have insurance as stipulated by the Office of Insurance Commission and health insurance of Thailand which has insurance coverage for outpatient not less than 40,000 Baht and for inpatient not less than 400,000 Baht. Please check longstay. tgia .org for more information regarding the insurance requirement. It is recommended that applicants buy insurance policies from the companies listed in this website, and bring a copy of insurance certificate or policy with them when travelling to Thailand".
          Reply

  8. Michael Stewart says

    This is a very useful article. Can you tell me if I will be required to obtain medical insurance as I got my OA ("retirement" visa) before 19th October 2019. I will be applying for a 12 month extension in November 2020 and wonder if I will have to supply evidence of medical insurance then?
    Reply

  9. Edward E. Moss says

    I have lived in Thailand of an on for the past 15 years . I have helped a village near [Thamaka ] . BY BUYING THEM ABOUT 20 ACERS [RHYE] I HAVE BUILT A HOUSE FOR THEM AN A RESTURANT . THE VALUE OF THE PROPERTY HOUSE WITH POOL IS ABOUT 12 MILLION BAHT. CURRENTLY IN THE U.S.A. IS THERE ANY WAY I CAN USE THAT AS COLLATERAL INSTEAD OF GOING THE BANK ROUTE /
    Reply

  11. sidney leonard says

    When I applied here in CA at the Thai consulate several years ago for an O-A visa, an official letter from my state teachers retirement office showing a sufficient monthly income sufficed for the income verification requirement. Would such a letter suffice for an O visa applied for in Thailand?My Thai wife of 27 years and I decided not to stay permanently then (2017), but have decided that we may do so in the next few years. Since I am 85 years old, the new health insurance rules will, of course, require of me an O-visa.Thank you for all the great information your provide in TheThailandLife.
    Reply

    • TheThailandLife says

      Hi Sidney,You would apply for the O visa in your home country and then do the 1-year extension (based on marriage) in Thailand. The requirements for applying for the O visa may differ depending on the Thai embassy of your home country. Generally, however, you will need bank statements covering 3 months, which show a monthly income of more than £1,500 (not sure what the amount is for US citizens).After 60 days in Thailand you will be eligible to do the 1-year extension at immigration. The requirements for doing the extension in Thailand have changed a little because the UK and US embassies no longer issue income verification letters. More on that here: https://www.thethailandlife.com/thai-marriage-visa
      Reply

  12. BA says

    I hear people talking about how "easy" it is to switch to a type O, but unless you are married to a Thai person or have family, you must be legit volunteering and per the Thai embassy website you must have "Original letter of invitation or acceptance from the non-profit foundations AND foundations registration with Thai government". Is there something I'm missing? Honestly, I think the insurance requirement makes sense, but I'm not sure how to go about buying it from a Thai insurance company when I have to apply for the Visa in my home country.
    Reply

  14. James E says

    Good info! Coming from the U.S. our Medicare system will cover overseas medical emergencies but not ongoing treatment or "casual" medical needs. I like the O-visa option and hopefully they won't be adding the insurance requirement to that anytime soon.
    Reply

    • TheThailandLife says

      I just wonder how long it will take some bright spark to realize everyone is just using the O visa route instead. I also forgot to mention that the Elite visa doesn't require the health insurance either, surprise surprise.
      Reply

      • Keith Livingston says

        The O Visa requires either money in the bank in Thailand, or a regular income coming into the bank in Thailand. With an OA, you can keep the money in your home country, at first.Perhaps that's the loophole they were trying to close.
        Reply

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