Hello and good day. I am sending this message to all my heart valve related groups so if you are on more than one of my groups please accept my apologies as my intent was not to spam.
My name is David and I am an American living overseas in Bangkok Thailand. I have moderate aortic stenosis, which was diagnosed last year at age 56. Year over year progression was terribly slow. I am keeping myself healthy in the interim. Bangkok has great doctors many who have trained stateside and speak fluent English as do the nurses and staff. Thailand is filled with lots of retirees from the West, drawn by the climate, dating scene, food, temples, islands, low cost, medical care, etc. etc. Thailand is a famous medical tourism destination and our Covid 19 cases are at zero. The quality of life here is amazing and I have no interest or intention of ever moving back to the states.
About me: Single, 57, no kids wife girlfriend pets de; family in USA all dead; no career or job no home in USA no one to stay with in USA. I get by by my investments which are doing well and my simple low cost of living here in Asia. In good health at present but family history of heart disease. I am fanatic about health—vegan bp meds and statins and aspirin, lifelong exerciser, never drink or do caffeine, do constant screenings, meditate, LDL down to 60 weight at 159 low BP etc. etc. Slight LVH. Calcification score and Lpa high. Other #’s outstanding. Low stress low cost easy life with zero commitments.
My question is this: Insurance in Thailand does NOT cover preexisting conditions i.e. valve related issues as well arrythmia issues. I am covered for heart attacks and strokes. My concern is any out of pocket expenses should I have the surgery in Thailand. Depending on any complications and/or cost of the actual surgery my estimates are from $30,000 up to $100,000; most likely closer to 50K USD. I can afford that as I am single and live cheaply. However, that would cut into my ability to buy a home stateside in the future.
1) Scenario #1—I miraculously find an insurance here that covers preexisting. Unlikely and if so costly. I have checked into this before and looks grim.
2) Scenario #2—Do all surgeries here in Bangkok and hope when that day comes cost and complications are low
3) Scenario #3 I can get medi-cal to fund my surgery here. I passed my USA insurance info on to my hospitals here. Thailand has some of the best healthcare in the world at the lowest prices and they are setup to work with all kinds of insurance. This would be my top scenario.
4) Scenario #4 Move back to states—ugh-I would almost rather die.
5) Scenario #5—favorite scenario after #3—get surgery done in California and bounce back to Bangkok when I recover. Tricky part: where to stay? This is where I need support: Skilled nursing facility; short term air bnb either solo or as a roommate? Or other short-term rental options? Again, no family or friends to stay with and I have no housing stateside. Also, I am utterly single and alone so I may need outside assistance post op.
1) Cost and quality of valves when I need surgery
3) Age when I get surgery
4) How technology evolves
5) My health at time of surgery
6) My finances at time of surgery
7) If I will need a 2nd valve surgery in my lifetime
8) If a pacemaker is needed
9) Will I have a partner to help me post op?
I have vetted this plan by my American doctor at UCLA, my American doctor here, and my Thai heart doctor as well as a few trusted friends and they like it. I am trying to vet the plan with Medi-Cal Anthem Blue Cross, 1-2 more heart drs here in Bangkok and a heart doctor I saw in Los Angeles a year ago.
Further thoughts Questions? Thanks!
Anyone living in Asia ? I live in Thailand-my cardiac issues are pre existing/not covered by insurance. So I'd have to go back to California and do it there if I am still ok to fly...and then there is the issue of where to stay and who to take care of me post op as I am single and have no living family and no home