Reviewed 2026-11-04. General independent information; check current official immigration, financial and medical guidance before acting.
Expert take — Cost of Asia editorial team Since 20 March 2025, Thai-regulated health policies can add a co-payment of up to 30% at renewal if you make three or more inpatient claims for minor or general illnesses above set claim ratios, with the total co-payment capped at 50% of covered costs a year. Once triggered, the co-pay applies to all of your claims the next year, serious ones included, according to The Thaiger. It lifts again after a year under both thresholds. International plans sold outside Thailand's insurance regulator are not subject to this rule. So compare more than the premium: ask any Thai insurer, in writing, whether your policy carries the co-payment clause and how it is triggered.
Commercial transparency: Cost of Asia has no contracted partner in this category. Providers are compared on published criteria, and no provider has paid for inclusion. If this changes, affiliate links will be labelled.
If you live in Thailand, you can insure your health two ways. A Thai local plan is sold by an insurer licensed in Thailand and regulated by the Office of Insurance Commission (OIC). An international plan is sold by a global insurer and is built to follow you from country to country.
Local plans can be excellent value if you buy them young enough and stay put. International plans cost more, but keep accepting applicants at ages when local plans have closed their doors. Your visa, your age, how much you travel and whether you pay Thai tax all change the answer. This page is for retirees, remote workers and families living in Thailand most of the year.
At a glance
| Best for | Pick | Why |
|---|---|---|
| Under-60s settled in Thailand | A Thai local plan, such as Allianz Ayudhya Superior Health Plus | Lower premiums, local direct billing, renewable for life if bought before 60 |
| Under-70s who want an English-language local plan | Luma Hi5 (underwritten by Navakij Insurance) | THB 5 million a year, entry up to 70, for people in Thailand 180+ days a year |
| Over-65s, frequent travelers, people who may leave Thailand | An international plan, such as Cigna Global | No upper age for new applicants, choice of cover area, outside the OIC co-pay rule |
| O-A retirees extending their stay in Thailand | International plan plus a Thai long-stay policy | Immigration offices generally expect a Thai policy at extension time |
| Healthy people with savings who want low premiums | Either type with a high deductible | Deductibles can cut Thai premiums by up to 60% |
Local vs international: the key differences
| Factor | Thai local plan | International plan |
|---|---|---|
| Regulator | OIC (Thailand) | Outside the OIC framework |
| Entry age | Often capped in the 60s or at 70 | No upper age at Cigna Global (The Thaiger) |
| Renewal | Can be age-limited | Guaranteed, with price rises by age band (The Thaiger) |
| Residency | Luma Hi5 requires 180+ days a year in Thailand | Designed for people who move or travel |
| Area of cover | Built around Thailand | You choose the region (Cigna) |
| 2025 co-pay rule | Applies to OIC-regulated individual policies | Does not apply |
| Thai tax deduction | Up to THB 25,000 of premiums, paid to a Thai insurer | Not listed as deductible |
| Retirement visa extension | Thai long-stay certificate generally expected | Foreign certificate acceptance varies by office |
How we chose
- Age rules: published maximum entry age and maximum renewal age, stated separately.
- Regulatory exposure: whether the 2025 OIC co-payment rule can apply.
- Visa fit: whether the plan's certificate is usable for the O-A at application and at extension.
- Portability: area of cover and evacuation.
- Total cost: deductible options, tax relief and claims-based pricing, rather than headline premiums.
We do not rank by price, because premiums depend on age, health and deductible. Checked on 4 November 2026. Terms change, so confirm with the insurer and your immigration office before you buy.
Expect renewal prices to move on either type: Aon projects Thailand's medical cost trend at 14.8% for 2026, up from 14.3% for 2025.
1. Thai local plan (example: Allianz Ayudhya Superior Health Plus) — best for under-60s settled in Thailand
Who it suits
People under 60 who plan to stay long term. Allianz Ayudhya's May 2026 brochure for Superior Health Plus lists three plans paying up to THB 2 million, 5 million or 10 million per confinement. Plans 2 and 3 accept applicants from 15 days old to 65. The rule that matters most: if you buy before 60 and renew continuously, you can renew for life. Buy after 60 and renewal ends at 80.
Cover is worldwide excluding the US, where only accident injuries are covered; transplants and dialysis are covered only in Thailand. The brochure lists emergency medical assistance of up to US$1 million. No work permit is needed to apply, according to Allianz Ayudhya's page for foreigners.
As a reference point for limits, The Thaiger reports a major Bangkok private hospital's coronary bypass package at THB 1.17 million to 1.44 million. That fits within Plan 1, with little room for complications.
Trade-offs
Pre-existing conditions are excluded. There is a 30-day waiting period for illness and 120 days for listed conditions such as tumors, hernias and cataracts. The co-payment rule can apply at renewal, and the brochure says the insurer may change terms without prior notice.
Check before you commit
- Ask whether "emergency medical assistance" includes evacuation from Thailand to another country, and up to what amount.
- Ask whether the co-payment clause is in your policy wording and what triggers it.
- If you are 58 or 59, weigh buying now against losing lifetime renewal.
2. Luma Hi5 — best for under-70s who want an English-language local plan
Who it suits
Thai residents, Thai or foreign, who spend at least 180 days a year in Thailand. Luma's Hi5 page lists an annual limit of THB 5 million on both plans, with room and board capped at THB 5,000 or 8,000 a day. Entry is open from birth to 70. The plan is underwritten by Navakij Insurance, a Thai insurer, and Luma lists Samitivej Hospital as a direct-billing partner.
Outpatient cover is optional: THB 40,000 a year with a 50% co-payment, or THB 200,000 a year.
Trade-offs
The 180-day rule excludes people who split the year between Thailand and home. Elective treatment abroad excludes 13 countries, including the US, UK, Japan, China and Singapore. The page does not state a maximum renewal age.
Check before you commit
- Ask Luma for the maximum renewal age in writing.
- If you need it for a visa, ask whether the certificate meets the O-A minimum of THB 3 million and whether Navakij is on the long-stay list for your visa type.
3. International plan (example: Cigna Global) — best for over-65s, frequent travelers and people who may move
Who it suits
People past local insurers' entry ages, who spend months outside Thailand, or who may not stay. The Thaiger's July 2026 comparison says Cigna Global has no upper age limit on new applications and that renewals are guaranteed. Thailand Starter Kit's 2026 review lists annual limits of THB 35 million (Silver), 70 million (Gold) and 150 million (Platinum). You choose the area of cover: Asia excluding China, Hong Kong and Singapore; worldwide excluding the US; or worldwide.
The 2025 co-pay rule does not apply, and Thailand Starter Kit reports that direct billing is generally available at hospital.
Trade-offs
Price. The Thaiger says local plans are often well below international ones for healthy people in their 30s and 40s, sometimes by a factor of five or more, and the gap widens with age. Thailand Starter Kit, which earns affiliate commission, lists Silver premiums for ages 50 to 59 from US$2,518 to US$6,927 a year. Evacuation and outpatient cover are optional modules.
Check before you commit
- Make sure the evacuation module is on your quote if you want to be flown elsewhere for treatment.
- Ask how premiums change at each age band, and how pre-existing conditions you disclose will be treated.
What would this move really cost you?
Use your own rent, insurance, transport and visa assumptions. Compare options before committing.
4. International plan plus a Thai long-stay policy — best for O-A retirees extending in Thailand
Who it suits
O-A visa holders who want international cover but must pass the annual extension. The O-A requires at least THB 3 million or US$100,000 of cover per policy year, including COVID-19 treatment, for the whole stay. At the first application abroad, a foreign policy works if the insurer completes Thailand's Foreign Insurance Certificate, signed by two different authorized people (The Thaiger, updated August 2026). At extension time in Thailand, The Thaiger reports that immigration offices generally expect a Thai policy from the long-stay list, and that acceptance of foreign certificates varies by office.
Trade-offs
You pay two premiums, one of them for a basic visa product. Our retirement visa insurance guide compares the Thai options.
Check before you commit
- Ask your local immigration office whether it accepts the Foreign Insurance Certificate before you rely on it.
- Check the sum insured printed on the Thai certificate reaches THB 3 million, not just the product name.
5. Either type with a high deductible — best for healthy people with savings
Who it suits
People who can pay the first slice of a hospital bill. Allianz Ayudhya says its deductibles can cut premiums by up to 60%. Cigna's Thailand brochure offers cost shares of 0% to 30%. Rajah & Tann notes Thai insurers can also offer a voluntary co-payment from day one for a lower premium.
Trade-offs
The Allianz deductible applies per confinement, so two admissions mean paying it twice. A voluntary co-pay applies to every claim.
Check before you commit
- Price a typical admission at your nearest private hospital and decide whether you can carry it.
Thai tax: a small point in favor of local plans
PwC's Thailand tax summary says health premiums of up to THB 25,000 a year paid to an insurer in Thailand are deductible, within a THB 100,000 cap shared with life insurance. A question for a qualified Thai tax adviser: can you claim it if your only Thai-taxable income is remitted foreign income? Our page on Thailand expat tax mistakes explains the 2024 remittance rule.
What to check before you decide
- Both age limits: entry age and maximum renewal age.
- The co-payment clause: whether your Thai policy has one, and whether it is claims-based or voluntary.
- Your days in Thailand: some local plans require 180 days a year.
- Visa certificate: whether the policy will be accepted at your immigration office at extension, not only at the embassy.
- Evacuation: whether it is included, optional or missing, and to where.
- Pre-existing conditions: read the exclusions in the policy wording.
FAQ
Is Thai local health insurance good enough for expats?
For many people under 60 living in Thailand full time, yes. The weak points are age limits on entry and renewal, residency rules, the 2025 co-pay rule and limited cover abroad.
Can I switch from international to local insurance later?
Only if a local insurer still accepts you: Allianz Ayudhya's Plans 2 and 3 close at 65 and Luma Hi5 at 70. A new policy excludes conditions you already have.
Does the co-payment rule apply to my existing Thai policy?
Rajah & Tann says it covers new policies and renewals from 20 March 2025, applied at renewal, not mid-term. Ask your insurer whether your renewal documents include it.
Does international insurance work for a Thai retirement visa?
For the O-A application abroad, yes, if the insurer completes the Foreign Insurance Certificate and the cover reaches THB 3 million. For extensions in Thailand, plan on a Thai long-stay policy unless your immigration office confirms otherwise.
Related guides
- Thailand cost of living
- Expat health insurance explained
- Best expat health insurance in Thailand
- Best health insurance for the Thailand retirement visa
- Top 5 hidden costs of retiring in Thailand
- Budget calculator
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