27 August 2026 · Cogotec, Bangkok
We work from Bangkok, so this is the question we are asked more than any other. Below is what cover actually costs here, what the visa rules require, and the two gaps that catch people out — the area-of-cover gap and the pre-existing conditions gap.
What it costs
On 26 August 2026 we ran a live market comparison for a 40-year-old British national living in Thailand wanting inpatient + outpatient, worldwide excluding USA. The engine returned 26 plans from 13 insurers, priced from $117 to $852 per month — $1,403 to $10,229 a year. Same person, same day, a seven-fold spread. The full breakdown of that run shows which plan sat where and why.
The spread is not a trick. It is annual limit, room class, outpatient allowance, deductible and brand. What it means practically: a Thailand-based expat who buys the first plan they are shown, without seeing the panel, has a very good chance of paying multiples of what their actual requirement costs.
What the visa requires
This depends entirely on which visa you hold, and the figures have been revised more than once. As things stand, the Non-Immigrant O-A category requires cover of at least USD 100,000 (or THB 3,000,000) including COVID-19 treatment. The O-X category is published with sublimits of THB 400,000 inpatient and THB 40,000 outpatient per policy year.
Treat those as a starting point, not the register. The authoritative source — the list of qualifying insurers and the current minimums — is the Thai General Insurance Association's long-stay portal at longstay.tgia.org. Check it before you apply, and check it again if your application spans a rule change.
One thing worth separating: a policy that satisfies a visa officer is not the same as a policy that covers a serious illness. The visa minimums are low relative to what a long private admission in Bangkok costs. Meeting the requirement and being adequately insured are two different exercises.
Local policy or international cover?
Both are legitimate. A Thai policy is usually cheaper and works well if Thailand is your whole life. International cover follows you across borders, carries much higher annual limits, and includes evacuation.
The deciding question is usually not price but movement. If you travel for work, hold business across the region, split the year between countries, or would want treatment outside Thailand for something serious, a local policy will not follow you. We see that discovered at the point of claim more often than at the point of sale, which is the expensive moment to find out.
The two gaps that actually bite
Area of cover. Read it before you read the premium. "Worldwide excluding USA" is the common configuration and is meaningfully cheaper than worldwide; if you are genuinely never in the United States, that is money saved. If you are occasionally there, it is a hole.
Pre-existing conditions. How an insurer treats your history — excluded, loaded, or moratorium — varies enormously between the plans on the same comparison screen, and it is the single largest source of declined claims. Disclose fully at application. Underwriting that looks generous at the quote stage can be the one that pays nothing on the condition you actually have.
Hospitals and how billing works here
Thailand's private hospitals are genuinely good, which is much of why people move here. They are also commercial: for an inpatient admission they will want either a guarantee of payment from your insurer or a card and a deposit at the desk. The practical value of a decent international policy is direct settlement — the insurer deals with the hospital, and you are not funding a stay on a credit card and reclaiming it later.
That is also where having someone reachable matters. A hospital admissions office at 9pm that wants a guarantee letter is not a situation improved by a call centre in another timezone.
Where to start
See the market before you choose from it: run a live comparison with your own age and configuration, or talk to us. Cogotec is an international insurance consultancy based in Bangkok — the engine shows you the whole panel, and a person here stays with you through the decision, the application and the claim.
Premiums are indicative until underwritten and vary with medical history and final configuration. Visa requirements are summarised in good faith and change — verify at longstay.tgia.org. This is general information, not personal advice.