Health Insurance in Thailand: What I’ve Understood, What I’m Still Looking For

by Mário Ferreira  |  2026  |  Health & Insurance

✍️  Transparency note: this article is different from the other guides on this blog. I have not yet found a health insurance solution that fully suits me. I share here my analysis, research and hesitations — as they are. If you have found a solution, your comments are invaluable. My situation is a little particular: I hold a spouse visa (Non-Immigrant O, known as the ‘Thai Wife visa’), which does not impose mandatory health insurance — unlike the O-A retirement visa. I am therefore not legally required to have one. This does not mean I consider the risk negligible — quite the contrary. But it explains why I am taking the time to choose carefully rather than subscribing hastily to meet an administrative obligation.

Health insurance is without doubt the most important — and most complicated — subject for a European expat settling in Thailand. It is not just a question of money. It is a question of real security in the face of a healthcare system one does not know.

I have analysed several options — SafetyWing, Cigna Global, AXA, Allianz Care, and a local Thai insurer (Aya). I have not yet decided. Here is why.

1. What the Retirement Visa Requires

The Non-Immigrant O-A visa imposes mandatory health insurance. Minimum requirements:

• Inpatient (IPD) coverage: 400,000 THB minimum
• Outpatient (OPD) coverage: 40,000 THB minimum
• Recommended total coverage for peace of mind: 100,000 USD
• Insurer must be listed on longstay.tgia.org. Since October 2021, the required total coverage is 3,000,000 THB or 100,000 USD per year (COVID-19 included). Some consulates still apply the old system — always verify with your local consulate.
• An official Foreign Insurance Certificate must be issued, signed and stamped by the insurer

⚠️  The legal minimum is deliberately low. In practice, a serious hospitalisation in a Thai private hospital can quickly exceed 500,000 THB. Do not settle for the minimum.

🚑  Medical evacuation to another country is not covered by the legal minimum. This is a criterion I consider essential — and one that considerably complicates the choice.

2. The Options I Have Analysed

SafetyWing — Nomad Insurance

This is the most accessible option in terms of cost and simplicity. Monthly payment with no commitment, online subscription in a few minutes.

• Strengths: price, flexibility, simple subscription, international coverage
• Weaknesses: limited basic coverage, fairly low caps on some benefits and medical evacuation not systematically included in all plans
• Retirement visa acceptance: yes, if the chosen plan meets the required thresholds

🏥  SafetyWing — Flexible and accessible option. Check that the chosen plan covers the retirement visa requirements. → See pricing

Cigna Global

One of the references for expats. Solid coverage, international network and medical evacuation available. But the price rises quickly after 50.

• Strengths: very complete coverage, medical evacuation and a hospital network in Thailand
• Weaknesses: high price for over-55s, pre-existing condition exclusions sometimes restrictive
• Retirement visa acceptance: yes

AXA

AXA offers specific plans for expats with international coverage. Customer service quality varies by country. The application procedure is more complex.

• Strengths: recognised European brand, solid coverage
• Weaknesses: heavy subscription process, high price after 50

Allianz Care

Similar to Cigna and AXA in terms of positioning. Premium international coverage. Premium price too.

• Strengths: very broad coverage, medical evacuation included
• Weaknesses: high cost, complex subscription

Aya Insurance — The Local Thai Option

Aya is a Thai insurer offering plans at significantly lower prices than international insurers. It is the solution used by many long-term expats in Thailand.

• Strengths: very competitive prices, accepted for retirement visa, knowledge of the Thai hospital system
• Weaknesses: coverage limited to care in Thailand, international medical evacuation not included in basic plans, documents and procedures in Thai or basic English

💡  Aya is very popular among long-term expats who do not plan to travel frequently outside Thailand. For those who return regularly to Europe, international coverage becomes indispensable.

3. Comparison Table

Insurer	Price approx. 50–59	Evacuation	Ret. visa	Complexity
SafetyWing	~161 $/mois (Essential)	⚠️ By plan	✅	Easy
Aya Insurance	~40–80 €/mois	❌ Base	✅	Medium
Cigna Global	~200–400 €/mois	✅	✅	High
AXA	~180–350 €/mois	✅	✅	High
Allianz Care	~200–400 €/mois	✅	✅	High

⚠️  Prices shown are estimates. They vary considerably depending on age, medical history and chosen coverage level. Always request a personalised quote.

4. The Obstacles I Encountered

The Price After 50

This is the first wall. Quality international insurers (Cigna, AXA, Allianz) have premiums that explode after 55–60. What costs €150/month at 50 can easily reach €300–400/month at 60 — a considerable budget item.

Pre-existing Condition Exclusions

All expat health insurers have exclusion clauses for pre-existing conditions. Hypertension, diabetes, cardiac problems — anything diagnosed before subscription can be excluded or loaded. For European retirees over 55, this is often a real obstacle.

Medical Evacuation — My Non-Negotiable Criterion

I live in a rural Isaan village. Surin hospital is decent, but for a serious emergency, Bangkok or even repatriation to Europe may be necessary. International medical evacuation is only included in premium plans — and that is precisely where prices become prohibitive.

✍️  My current situation: I am without specific expat health insurance at this time. I am aware this is a risk. I continue to analyse the options. This is not a situation I recommend — it is simply the reality I share.

5. What I Recommend Nevertheless

Even without having decided for myself, here is what I would advise someone arriving in Thailand:

• Don’t come without minimum coverage. Even a basic SafetyWing plan is better than nothing.
• Check that your insurer is listed on longstay.tgia.org before subscribing.
• Declare your medical history honestly — a false declaration can invalidate the entire contract.
• If you are under 55 and in good health, Cigna or AXA remain accessible at a reasonable cost.
• If the budget is tight, Aya Insurance is a viable option for care in Thailand — supplemented by a separate evacuation plan if necessary.
• Ask about public hospitals: the 30-baht health card is not accessible to foreigners, but public hospitals accept foreigners with direct payment, at significantly lower rates than private hospitals.

🏥  SafetyWing — The most accessible option to start. Check the caps for your situation. → See pricing

6. What I Expect from You

This article is deliberately incomplete — because my thinking is incomplete. If you are an expat in Thailand and have found a solution that suits you, your feedback is invaluable.

Questions I am particularly interested in:

• Have you taken out Aya Insurance? How does reimbursement work in practice?
• Do you have a separate medical evacuation solution?
• How did you handle pre-existing condition exclusions?
• Are there insurers I have not mentioned that deserve attention?

🔄  This article will be updated as soon as I have decided for myself. I will publish my complete personal experience, with the concrete details of subscription, cost and coverage.

— Mário Ferreira  |  Surin, Isaan, Thailand

💬 Found a suitable health insurance in Thailand? Share your experience in the comments — you’ll help the whole community!

📌  Also read: our complete Thailand Retirement Visa guide and the mandatory insurance conditions.