Living abroad for several years and faraway home is one of the challenges for Expats, especially considering buying health coverage as life safety protection.
There are options and policies to choose from, and knowing the right type depends on the situation.
By reading the reasons listed below, you can pick one that fully covers your accident insurance, medical needs.
The top reasons Expats in Vietnam prefer buying medical insurance
Due to Covid, health insurance for Expats was made compulsory to enter Vietnam. Most Expatriates or Employers will buy for the following reasons: accidents, poor Vietnam healthcare, family protection and post-Covid traveling.
Workplace and Traffic accidents imply high medical, evacuation costs
We have a saying in the insurance industry about traffic accidents: “it is not the question of IF but of WHEN and HOW BAD you will get your traffic accident?”.
Road accidents: whether you commute via the highway to work, motor or leisurely ride to dine out, you will witness 1 accident or a crazy move on the road. Call it drunken drivers, piling up transportation, racing, truck/ bus speeding for clients, young people practicing driving skills…
NB. In Vietnam, motor and car insurance never covers passengers for treatment costs due to accidents.
Factory hazards: depending on if your factory is recently built by a foreign contractor and run by Expatriates, most factory workers are straight from the countryside, therefore SSHE Security, Safety, Health and Environment is a meaningless acronym.
Most homes and offices: are built without international standards of architecture, plumbing or electrical wiring. Or sometimes construction shortcuts and savings resurface in the form of accidental fire or damage.
Human errors: when it comes to applying basic standards of risk management, are tripled by the lack of education in international standards of SSHE.
The poor healthcare system in Vietnam
Surgery in Vietnam, the urban myth of war surgeons
The saying goes among newcomers: “Vietnamese surgeons have so many cases that they must be very good… and cheap”. Good hospitals nowadays are about processes from hygiene, technology equipment, nurse education, imaging, latest lab testing pharmacy and nutrition. Successful treatment of a complex medical condition is 30% surgeon’s skills and the 70% remaining are processes and controls of a well-run hospital.
Specialty hospitals do not exist in Vietnam
The central Soviet system relies on big hospitals to deal with volumes: 100,000,000 Vietnamese to treat. The professors work less and an army of younger specialist doctors assist them with nurses on low pay. The Ministry of Health payroll at a couple hundred USD per month, definitely not a financial motivation to deploy your talents. On the other hand, the job is safe. The state budget pays for good equipment -sometimes financed by foreign countries’ aid- but the running costs and maintenance are poor. Training is provided by the State workers; expensive foreign assistance is limited to the bare minimum. Priority is given to local supplies and generics to save on running costs.
It is well known that Vietnam is lacking ICU, international standard specialist hospitals like: heart, neuro surgery, burns, cancer oncology, blood bank, microsurgery, virology, state-of-the-art, neonatal care, lab testing (biopsy) etc…
This explains so many evacuations to the nearest country of excellence: namely Thailand or Singapore.
The best doctors and nurses
The government centralisation stipulates “the bigger the hospital the better” because of: bigger budget and benefits; the result is the masses of patients end-up in big hospitals. Wealthy patients follow the best doctors in their private and specialized clinics. The rationale behind it: budget and hospital size go to populated areas. Patient volume rather than quality of treatment is the government criteria.
Private hospitals, owned by reputable doctors, are sprouting with good salaries, thus attracting the best medical personnel.
Prices are not decided by the Ministry of Health, therefore prices are freely established. Unfortunately, these privately financed healthcare providers face mainly 2 problems:
- Big property ownership in populated districts
- The financial burden to equip the hospital with the latest technology equipment. NB. To purchase a state-of-the-art 3 Tesla MRI machine, the price tag can reach US$ 3 million
The Vietnamese doctors have 2 tendencies that may be harmful to your health:
- For most, they are transactional in Asia, as opposed to transformational in Europe. Transactional mode is ‘you come to me with cancer, I am a cancer surgeon, I am specialist at ablation so let’s go; surgery is done and pay! No question asked’. In Europe, ‘transformational’ goes ‘you are a patient with cancer, you walk out cured by the best solution for you; as per your choice’. Here are the solutions our oncology hospital can offer: surgery, chemotherapy, radiotherapy etc. Money is a powerful incentive where patients become clients.
- No referral to peer specialists: culturally professors do not want to lose face admitting they do not know how to cure you. As a result, the doctor will not refer your case to another specialist more able to cure you. Your treatment is limited to the best knowledge of your treating doctor. Most Vietnamese do not even dare question the doctor, let alone refuse to take the bag of medicines prescribed by the physician.
MEDICAL EVACUATION to the nearest place of excellence
Evacuation by air ambulance to better international standard hospitals usually in Thailand or Singapore costs between US$ 5,000 to US$ 35,000 depending on the type of medevac plane you need. Repatriation is the medical evacuation to your home country.
Why is medical evacuation necessary for Vietnam residents?
Nowadays, good hospitals are specialty hospitals where the most serious illnesses are treated with all resources focused on say cancer or Mother and Child treatment for instance. In case of accidental emergency or serious illness where language barrier and medical teams are not specialized or all alternative treatments are not available for you to choose (neurology and oncology), you just want to be evacuated to the best possible specialized hospital. For illness and people where your native language is necessary, the repatriation option can fly you back to your home country; this is called repatriation as opposed to medical evacuation to Thailand or Singapore, the nearest countries with 100% specialty treatment ready and world class.
As mentioned earlier, Vietnam is lacking state-of-the-art medical centers for: cardio-vascular conditions, accidental brain injury, neurology and rehab, skin burns, oncology-cancer, blood bank, hand and foot microsurgery, neonatal care, lab testing (biopsy) etc…
As a plan B, here are the most used medical centers where Expats are evacuated:
https://www.rafflesmedicalgroup.com/services/specialist-centres/
https://www.parkwayhospitals.com/specialties/medical-specialties
https://www.bangkokhospital.com/en/center-clinic
https://www.bumrungrad.com/en/clinics-and-centers
How much does a medical evacuation cost?
Not all Evacuations will need a medical air ambulance. The minimum will cost would be around US$ 5,000 on a commercial airline flight as you have immigration paperworks in Vietnam, medical procedure in Thailand, maybe a special seat.
You may add US$ 2-3,000 to the cost of a nurse or emergency doctor to accompany you + their cost for the roundtrip + accommodation. But of course, if your condition necessitates an air ambulance, it can reach US$ 15,000 in total. Evacuation to your home country -what we call repatriation in insurance jargon- from Vietnam to Europe, counts US$ 70,000 for medevac by air ambulance.
Without evacuation or when not possible, the international hospital may transfer you to the Vietnamese hospital with the right equipment and team to treat you locally.
Your treatment costs?
Employers liability paying all treatment costs to Expat employees
As you may know by Vietnamese Laws, your employer is liable to pay any medical and disability costs your family may incur during employment. Social security is compulsory for all employees, therefore all staff-duly registered will have access to the hospital designated by the social security.
Who is going to pay treatment costs when you have no insurance?
Without health insurance, here are the most common plan B some Expats count on to pay medical and hospital bills: my friends, my parents, my company, Vietnamese government hospital, Gofundme, my Embassy.
The urban tale goes “Vietnamese hospitals are cheap and the government will not let me die of accident injury or sudden illness”. Both are wrong, in the end your parents or siblings will pay the treatment costs or you will end-up in a military hospital, with no proper treatment.
One evacuation to Thailand/ Singapore is US$ 17,000 – ranging from US$ 5,000 to US$ 35,000 depending if done by commercial line or Intl SOS air ambulance. A common sports injury like torn knee ligaments can reach US$ 20,000.
Let’s check the wrong belief of Expats in critical emergency conditions about who will end-up paying the bills.
The Vietnamese government hospital
First, they may simply deny treatment to foreigners to avoid the ‘foreign affairs’ responsibility they may incur, leaving it to a military hospital. Without the money to treat you, the diagnosis will be the same: “There is nothing we can do, let’s find a room to park him and see if he gets better”. No money, no surgery as nobody will be out-of-pocket paying for the necessary supplies and equipment.
Gofundme
No way. Much too often, we see Gofundme, crowdfunding requests on social networks, for an emergency for evacuation or surgery due to motor accident or stroke. Over the years, we have seen a few purses call-for-help and the average is in the US$ 3,700, merely enough to pay for the evacuation costs to Thailand or 5 nights of ICU Intensive Care Unit.
My government and the embassy pay my hospital bills?
Really? Here is what happens if you contact your embassy, they will reach your parents or siblings for immediate cash transfer or act as a guarantor to the State treasury, who in turn will disburse the cash advance to pay for your hospitalization costs. Those who are informed now want to avoid their parents or siblings ending up in huge debts as guarantors to your country’s government for the hospitalisation costs. In some cases, expatriate’s parents had to mortgage their home to the state budget.
Medical insurance provides a range of benefits with special rates for expats and foreigners:
Our suggestions are based on your country of residence, goals and requirements. We will offer you the accident and health coverage that is best suited for you.
