Healthcare in Thailand: there is no treaty route, and that is the real risk

Of all the steps in the Thai journey, this is the one people misjudge later. Not because the care is bad — Thai private healthcare is excellent and much cheaper than Dutch — but because the safety-net construction you are used to in Europe is entirely absent here.

What falls away

Your Dutch basic insurance ends on the day you deregister. That is not a choice and not a notice period: to be insured under the Zvw you have to be insured under the Wlz, and you no longer are as soon as you live outside the Netherlands.

With an EU destination something takes its place. With an S1 form from the CAK you register with the local health fund and pay the Netherlands a treaty contribution. That is the route to Spain, Italy, Greece and every other EU country.

To Thailand that route doesn't exist. There is no treaty that places you in the Thai system, and there is no treaty contribution. From the day of deregistration your cover is entirely your own purchase.

What the visa requires as a minimum — and why that is too little

For the O-A visa health insurance is compulsory, with at least 400,000 baht cover for inpatient care (IPD) and 40,000 baht for outpatient care (OPD) a year. A foreign policy is allowed, provided the insurer fills in the official certificate form. For the O-X it is stricter: there a Thai policy is required.

Pay close attention to what that figure is: a minimum requirement of the government, not sensible cover. A serious admission with surgery and intensive care in a good private hospital in Bangkok goes well beyond it. Whoever insures at 400,000 baht has a visa — not security.

So insure yourself for what you would actually need, and use the visa requirement only as the floor for the paperwork.

The three things that determine the premium

Age, and it weighs more than anything. Around fifty an international policy is a modest amount. Above seventy it is a multiple of that, and the rise is not linear. So ask for quotes for now, for ten years from now and for twenty years from now — not just for your current age.

Existing conditions. With new policies these are often excluded or covered at a hefty surcharge. What you got reimbursed in the Netherlands without questions can fall outside your cover here.

The acceptance limit. Above a certain age many insurers simply no longer take you on as a new customer. Whoever has a policy at sixty-five can usually continue it; whoever wants to take something out for the first time at seventy-five runs into closed doors.

That last point is the reason the order matters: arrange the medical acceptance while you still live in the Netherlands, and only cancel your Dutch policy once the new one actually starts.

The question you have to ask before departure

Not "what does a policy cost now", but: what do we do if this policy is cancelled or becomes unaffordable in fifteen years?

There are three honest answers, and you have to choose one of them:

1. We keep capital in reserve that can carry a serious treatment without insurance.
2. We go back to the Netherlands if it comes to that — and then you need to know that you have to register again and that the basic insurance is then open to you again.
3. We accept the risk.

What doesn't work is not asking the question. This is the item that determines whether Thailand is sustainable in the long term, and it therefore belongs in the orientation phase and not at the point of signing up.

What a policy costs roughly for your situation is in the cost indication for Thailand.

In Vertrekklaar this is phase 3 of 5 of the journey: the same steps, but applied to your situation — in your order, tickable, and with the deadlines monitored. See the whole journey to Thailand.