THAILAND · INSURANCE
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The travel insurance bundled with your credit card will stop long before your visa does. Mine ran 90 days, which is the standard on Japanese cards. If your card was issued somewhere else the number will be different, and it is often shorter. Either way, if you are moving to Chiang Mai rather than visiting it, that number is the single thing most likely to catch you out — it caught my own family out, on a date I can point to. Below: what happens when the cover ends, the four kinds available to long-stayers, roughly what each costs, and what we chose. If you just want a number for your own age and dates, run a SafetyWing quote — it takes about a minute.
The 90-day wall, with real dates
Here is the problem in the most concrete form I can give it: our own calendar.
I carry a Saison United Mileage card. My wife and daughter are covered through a Saison American Express Gold. Both include travel insurance, and both stop at 90 days from the date you leave Japan.
My clock started on 3 July, on my most recent entry. My wife and daughter’s started on 21 May. Those are not abstract policy terms — they are two dates in our calendar after which, if nothing changed, we would be living in Thailand with no health cover at all.
None of this was hidden from me. It is in the policy wording, in plain language, and I had simply never needed to read that part before, because I had never stayed anywhere for six months. The failure mode is quiet: you do not get an email at day 89. You simply stop being insured while your life continues exactly as before.
If you are moving rather than travelling, work out your own day 91 before you do anything else. Count from the date you left, not from the date you arrived.
90 days is a Japanese number, not a universal one
I wrote most of this article assuming 90 days was simply how card travel insurance worked. It is not. It is the standard on Japanese cards, and I had never had reason to look further than my own wallet.
Looking at the general guidance on card-issued travel cover elsewhere, the common cap is 15 to 30 days per trip. Annual policies range roughly 30 to 180 days depending on the product. One widely held premium US card prorates its trip cancellation and interruption cover to the first 60 days and drops emergency evacuation entirely beyond that.
And the line that matters most: benefits vary widely by country and by issuing bank, even for cards carrying the same name. A card branded identically in Tokyo, London and New York can be three different policies.
So if you are reading this from Japan, 90 days is probably your number too. If you are reading it from anywhere else, do not take my 90 as yours. Go to your own card issuer’s terms and find the actual figure, and expect it to be smaller.
Everything below still applies either way. The wall is real. Only the distance to it changes.
What healthcare here actually looks like
Before the options, it helps to know what you are insuring against, because Chiang Mai is not one thing.
Most guides describe two options — cheap clinics, or expensive international hospitals — and that is not what it looks like on the ground. There are three layers, and knowing which one you are aiming at changes what you should buy.
Neighbourhood clinics. The photo above is ours: a pharmacy counter, a GP, a dentist through the back. Prices are posted on the wall — orthodontic treatment was advertised at 36,000–54,000 THB while I was there. For a consultation, a prescription, a filling, this is where we actually go, and it costs little enough that insurance barely enters the conversation.
Mid-range private hospitals. This is the layer nobody writes about, and it is the one most long-stayers actually rely on. Ten minutes from us there is a private hospital with a 24-hour emergency room, an outpatient and an inpatient building, a check-up centre, CT scanning, mammography, endoscopy, orthopaedics and obstetrics — plus an evening clinic running until 23:00. Signage is in Thai and English. It is a real hospital, and it is not priced like an international one.
International hospitals. At the top sit places like Bangkok Hospital Chiang Mai and Chiang Mai Ram: English throughout, short waits, and prices low by Western standards but high by Thai ones. This is where you would go for something complicated, or where an insurer’s cashless network is most likely to be useful.
That structure matters for how you choose. You are not insuring your daily life here. You are insuring the day something goes badly wrong — the day you move from the first layer to the third — and the bill jumps from hundreds of baht to hundreds of thousands.
The four kinds of cover, and what they cost
| Option | Rough cost | What it is for |
| Credit-card travel insurance | Included with the card | Trips, not lives. Stops well before your visa does — 90 days on my Japanese cards, often 15–30 elsewhere |
| Nomad insurance (e.g. SafetyWing) | From around $60–110 per 4 weeks per adult, by age | Long, flexible stays; monthly; start it after you have flown |
| Thai local health insurance | 98,154 THB a year for my wife and daughter (real quote, July 2026) | Living here full-time, serious cover, treatment inside Thailand |
| Japanese expat cover | Well over ¥1.2 million a year for a family | Maximum protection, Japanese-language support |
Those are ranges on purpose. Insurance pricing moves with age, family size, dates and the specific plan, and any number I print here will be wrong for you. The ranges are enough to tell you which conversation you are in.
A note on the third row. That is not an estimate. It is the annual premium on a quote we took out in July 2026 with Allianz Ayudhya, for my wife and our four-year-old, on a plan with a 5 million baht ceiling per hospitalisation and worldwide cover outside the US. Two details in that document are worth more than the headline number.
Outpatient care was not included. It is an optional extra, and without it the policy does not pay for the ordinary GP visit at all. Even a serious local policy assumes you will handle everyday medicine yourself — which is exactly why the clinic economy above exists.
Children under 11 carry a 30% co-payment. Our daughter’s own premium was 34,502 THB for the year, and on top of that we would still pay 30% of any covered expense.
That second clause matters more than it looks, because of what sits next to it. An adult on this policy can cut their premium by as much as 60% by accepting a deductible — a child under 11 cannot choose one at all. So the adult premium is negotiable and the child’s is not: it is a floor, with a 30% share of every claim on top. If you are pricing family cover anywhere, that is the pair of clauses to look for. Neither is hidden. They are just in footnotes nobody reads until afterwards.
And a note on the fourth row. We also hold formal quotes from two Japanese insurers for our family, an order of magnitude above the nomad plans. I am not going to summarise those in one line, because the comparison deserves every number side by side — that is the next article.
Why we ended up with SafetyWing
Two things decided it for us, and neither is price.
It exists in monthly form. Annual expat policies want a decision and a payment for the whole year. We were still working out how our two-base year would actually split. Being able to start after we had already flown, and stop without penalty, was worth more than a discount.
Children can be added to an insured adult’s plan at no extra premium. For a family this is the difference between one bill and three. The age limit and the number of children allowed have changed more than once, so treat this as a reason to check rather than a promise — confirm it on your own quote before you rely on it.
On price, the only thing worth saying is that paying for 364 days in one go is 10 per cent cheaper than renewing every four weeks. My own quotes match the published discount exactly: $102.76 per four weeks rolling, $92.48 on the annual. The trade is commitment. The rolling plan you can stop next month; the annual one you have already paid for.
And one limit I want to flag rather than sell, because it is the one that actually applies to me. Cover in your home country is capped at around 30 days per 90 days of active insurance. For someone who leaves and does not come back for a year, that is irrelevant. For a two-base life it is tight. I fly to Japan roughly every two months, and this is the clause I have to keep an eye on. Paying for the year does not change it. Check the current wording on your own quote, because this is exactly the sort of term that gets revised.
- Monthly, cancel anytime — and you can start it after you have already left.
- Covers you past day 90, where credit-card travel cover has already quietly expired.
- 10% cheaper if you pay for 364 days in one go rather than renewing every 4 weeks.
- Children can be added free to an insured adult’s plan (confirm the current terms on your quote).
Reader offer: new SafetyWing members can get 8 weeks of electronics-theft cover free with the code CROSSHORECHIANGMAI. Click the pink camera icon on the Nomad Insurance page and apply the code before you create your account. It works on 28-day or annual Nomad Essential subscriptions, for new members only. Worth knowing: after the eight weeks, the add-on renews as a paid extra unless you cancel it — set a reminder if you do not want to keep it.
What I actually pay
Published prices start at around $62 per 4 weeks, but that is the 18–39 bracket. I am in my forties, so here is my own quote rather than the headline.
| Plan | My quoted price |
| Essential, 4-week rolling | $102.76 per 4 weeks |
| Essential, 364-day | $92.48 per 4 weeks |
That is the published 10 per cent discount for paying in full, and you can check the arithmetic: 102.76 less ten per cent is 92.48. The trade is commitment. The rolling plan you can stop next month.
Both are the Essential plan, and Essential caps cover in your home country at around 30 days per 90 days of active insurance. Paying for the year does not buy you more time at home. It buys the same cover for less money.
There is also an electronics-theft add-on available on contracts longer than 28 days, covering up to $1,000 per item. If you work from a laptop in cafés, price it in.
Two honest limits. Essential is built for emergencies, not for managing an existing condition — pre-existing conditions, pregnancy and cancer treatment sit outside it, and that is what the Complete tier is for. And nomad cover is not a substitute for a real expat policy if your plan is to be here permanently with a family. Know which one you are buying.
Does the DTV require insurance?
In my case, no. I applied for the Destination Thailand Visa through the e-Visa portal, processed in Tokyo, and was never asked for proof of cover. Insurance is not part of the headline DTV requirements.
Some embassies and immigration offices have asked applicants for evidence anyway, so having a policy ready costs you nothing. But do not buy insurance because you think the visa demands it. Buy it because the DTV is built around 180-day stays and your card stops well before that.
→ The full story of how I applied and was approved: the DTV visa, first-hand. For everything else about the move, start with my Chiang Mai relocation guide.
How to decide, in four questions
How long is your longest single stay, and what is your card’s actual cap? Under the cap, your card is genuinely enough. Over it, you need something else. Find the number before you compare anything.
Where will you be treated? Mostly in Thailand, and a local Thai policy starts to make sense. Moving between countries, and nomad cover fits the shape of your life better.
Who is with you? Children change the maths sharply, in both directions — check what each option charges for them before comparing adult premiums.
What are you actually afraid of? A broken arm and a hospital stay is one product. A long-term condition managed over years is a different one, at a different price. Most people buy for the first and worry about the second.
FAQ
Does credit-card travel insurance work if I live abroad?
Only up to a point. Mine capped at 90 days from departure, which is the Japanese standard. Cards issued elsewhere commonly cap at 15 to 30 days per trip, and terms differ by country even within the same card brand. Fine for travel, not enough for a long stay. Go to your own card issuer’s terms rather than any article, including this one.
How much is health insurance in Chiang Mai?
From effectively free with a credit card, to roughly $60–110 per 4 weeks for nomad cover, to 98,154 THB a year for the local Thai policy we were quoted for two people, to over ¥1.2 million for Japanese expat cover.
Do Thai health insurance policies cover children the same as adults?
Not always. On the policy we were quoted, insured members under 11 carry a 30% co-payment on covered expenses and cannot take a deductible. Check this clause before comparing premiums.
Is SafetyWing enough for living in Thailand?
For emergencies and a flexible long stay, yes — it is what we use. For pre-existing conditions or permanent residence with a family, look at Complete or a proper expat policy instead.
Are children covered free on SafetyWing?
Children can be added to an insured adult’s plan without an extra premium, but the age limit and number allowed have changed over time. Confirm the current terms on your own quote.
Does the Thai DTV visa require health insurance?
Not in my application. Some embassies request proof anyway, and the visa’s 180-day stays exceed most credit-card cover, so it is worth having regardless.
What do doctors actually cost in Chiang Mai?
Routine care at a neighbourhood clinic is cheap enough that you pay cash without thinking. Insurance is for the private hospitals, where a serious admission gets expensive quickly.
Is this financial advice?
No. I am not an adviser and I am not qualified to be one. Everything above is what I was quoted and what I decided for my own family, with dates attached so you can see how old it is.
Next in this series: the actual quotes, side by side — what two Japanese insurers, a Thai local insurer and SafetyWing each came back with for our family of three.
Last updated: August 2026. Insurance terms and prices change — confirm current details before you buy.