It’s undeniable that health insurance has attracted a lot more people due to the COVID-19 pandemic. Health-related expense is also one of the significant expenditures when we’re at retirement age. As we age, we are more likely to get sick. Also, when we retire, we no longer get welfare benefits from employers such as group insurance, so we have to manage our own expenses. Therefore, planning for health insurance is essential and truly needed in order to ease the medical expense burden.

Things to consider in planning for health insurance before retirement are as follows:  

1. Check Guarantee Terms & Conditions

When we apply for health insurance at old age (or close to retirement), we should carefully consider its guarantee conditions. Don’t be much worried if we’re still healthy and without congenital disease as we’ll get expected coverage at a standard premium price (standard health). Suppose we already have the congenital disease, we’ll be offered full coverage (including pre-existing disease before insurance application) but an extra premium is added. The extra premium rate depends on the consideration of the insurance company and how risky we are; higher risk, the higher premium.

If the risk of pre-existing disease is much more than limited coverage, the insurance company will offer conditions without extra premium but won’t cover pre-existing disease. For example, if a breast mass is found but the doctor diagnoses that the lump is still small and no operation is needed and recommends that we follow up its symptom by mammogram checking-up every year. In such a case, the insurance company will provide health insurance coverage for the Assured with standard premium but without breast coverage because the company is uncertain if that lump will further develop into cancer.

If that congenital disease has a tendency to become a severe disease in the future and is too much for the insurance company to take risks such as Diabetes, High blood pressure, the company will refuse to offer insurance.

For that reason, before making the decision to apply for health insurance, we should thoroughly study the insurance coverage package including its terms and conditions so that we’ll get the most benefit and won’t have any problem making a claim in the future.

2. An Ability to Pay Premium After Retirement

The next factor to consider is our ability to pay insurance premium when getting older as premium increases with age. As we grow old, the premium percentage will be higher accordingly. Many people haven’t thought about that issue so they may not be able to pay a premium, especially those who have applied for health insurance since a very young age as premium is considered cheap. We take that for granted as we think we can afford to pay it. Once we hit full retirement age and earn no income, we then face difficulty in paying gradually increased premiums. If we can’t pay it, we may have to discard that health insurance and it’s ashamed to do so.

Therefore, we should examine future premiums that we have to pay at the moment to prepare things beforehand such as setting additional investment plans to pay higher premiums for the long term. Besides, if we find that the premium is too high to afford (not worth the given coverage), we may consider not extending that coverage, and prepare cash in our investment fund to pay for medical expenses. We’ll eventually have more alternatives for retirement if we plan well ahead.

3. Mistakes in Health Insurance Planning

A sickness is an unforeseen event that will affect our financial wealth because we may have to lose more money than we’ve expected. For example; when we develop appendicitis, we need medical treatment right away. Unfortunately, some people get cancer and will need a huge amount of money for a long duration. Mistakes occur as we think that we’re still young and healthy so don’t want to rush applying for health insurance. And once unexpected things happen, it’s too late to handle. We may not be able to get health insurance if we develop a disease that’s not under coverage by the insurance company.

The next mistake is to applying for health insurance with too little coverage as the Assured perceive they’re too young and will buy additional insurance when getting older. As time passes, they may not follow up or review if they still get continuation coverage. Perhaps, when there’s a case to admit in hospital, they find that the coverage is not enough so have to pay a large amount of the difference, and that will affect the other financial plan. Thus, we should check our insurance policy from time to time if its coverage meets our needs, and if we should buy something extra.

4. What Options are there for People without Health Insurance?

Those who can’t apply for health insurance because their congenital disease is under the no-guarantee category by the insurance company may consider making use of government privileges such as Gold Card. It’s recommended to study about benefits and accept the Card restrictions such as limited service at listed hospitals and the queue is quite long, etc.

If we want more convenience in medical treatment or prefer private hospitals, we may create our own investment portfolio to earn medical expense funds. In case of sickness, we can withdraw cash from that fund to pay for the treatment. To create an investment port, we need knowledge, expertise, and appropriate timing for investment in order to grow the port.

In summary, health insurance planning is an important issue that should be done ahead of time, and it may be too late to realize that when we get closer to retirement. As we age, it’s more difficult to buy insurance because we tend to develop congenital diseases like High Blood Pressure, Diabetes including a history of pre-existing diseases. If we plan well and buy health insurance from a young age, it’ll be safe and secure in the long term.


Nipaphan Poonsathiensap CFP®, ACC

Freelance Financial Planner, Writer, and Lecturer