Summary
Health insurance is mandatory for some Thai long-stay visas and optional (but sensible) for others.
The big one for retirees is the Non-Immigrant O-A visa: applicants must hold qualifying health cover for the whole stay, and most Royal Thai Embassies now require USD 100,000 / ~3,000,000 THB of coverage including COVID-19 — though some Immigration offices still accept the older 400,000 THB inpatient + 40,000 THB outpatient standard for in-country extensions. The figure you must satisfy genuinely depends on whether you are applying at an embassy or extending in-country, so this is not a single certain number.
The O-X (10-year) visa uses the lower 400,000 / 40,000 THB inpatient/outpatient figures. The LTR visa requires USD 50,000 of cover (with at least ~10 months remaining at application) or proof of USD 100,000 in savings as an alternative. By contrast, the ordinary retirement extension (Non-O based on retirement) and the DTV do not impose a mandatory insurance figure — but the rules tightened again in 2026, requirements vary by embassy and office, and you must use an insurer/certificate the relevant authority will accept.
Key points
- Visas that REQUIRE insurance: O-A and O-X (mandatory cover) and LTR (insurance or a savings alternative). The plain retirement extension and DTV do not carry a mandatory coverage figure.
- O-A is the strictest at the embassy stage: most missions now want USD 100,000 / ~3,000,000 THB with COVID-19 cover for the full year.
- O-A extensions in-country are sometimes accepted on the older 400,000 THB IPD + 40,000 THB OPD standard — but this is office-dependent. Verify with your Immigration office; do not assume one figure applies everywhere.
- O-X uses 400,000 THB inpatient + 40,000 THB outpatient minimums.
- LTR: USD 50,000 medical cover (with ~10 months or more remaining at application) OR USD 100,000 in a savings/current account as security. Social-security and pension benefits can also be combined for the Wealthy Pensioner category.
- Approved insurers: Thai insurers on the Office of Insurance Commission (OIC) / Thai General Insurance Association (TGIA) long-stay list are reliably accepted. Foreign insurers can qualify if they meet the limits, but acceptance varies by office and you generally need a signed and stamped Foreign Insurance Certificate.
- 2026 note: retirement/LTR insurance rules tightened in 2026 — confirm the current figure with the specific embassy or office before buying a policy.
Step by step
- Identify whether your visa mandates insurance — O-A / O-X / LTR yes; plain retirement extension / DTV no mandatory figure.
- Get the exact figure from the issuing authority — the specific embassy (for an O-A application) or your Immigration office (for an extension), since the 3,000,000 THB vs 400k/40k question is office-dependent.
- Choose an accepted insurer. For O-A/O-X, a Thai insurer on the OIC/TGIA long-stay list is the safest. If using a foreign insurer, confirm it will be accepted and that it will issue the required certificate.
- Buy a policy that meets the limits for the full visa period — for LTR, ensure ~10 months or more remain at application.
- Obtain the certificate — for O-A, the signed and stamped Foreign Insurance Certificate; for LTR, the policy document showing the USD 50,000 limit (or your USD 100,000 savings evidence instead).
- Submit with your visa/extension application and keep proof of continuous cover for renewals.
Figures & thresholds
| Visa | Requirement | Dated / note |
|---|---|---|
| O-A (most embassies, 2026) | USD 100,000 / ~3,000,000 THB, including COVID-19, for the policy year | As of 2026 |
| O-A (older in-country extension standard) | 400,000 THB inpatient + 40,000 THB outpatient | As of 2026 — office-dependent; still accepted by some offices |
| O-X (10-year) | 400,000 THB inpatient + 40,000 THB outpatient | As of 2026 |
| LTR | USD 50,000 medical cover (~10+ months remaining) OR USD 100,000 savings as security | As of 2026 |
| LTR Wealthy Pensioner alternative | USD 100,000 deposit held ~12 months can substitute for insurance; passive income ~USD 80,000/yr also required (USD 40k–80k/yr with a USD 250,000 Thai investment) | As of 2026 |
| Approved-insurer list (OIC / TGIA) | Maintained at longstay.tgia.org | Unverified — the portal returned a fetch error; confirm the live OPD/IPD numbers |
Watch out for
- Embassy vs Immigration mismatch: the embassy O-A requirement (3,000,000 THB) is often higher than what some Immigration offices accept at extension (400k/40k). Buy for the stricter one you must satisfy, and confirm before paying.
- COVID-19 clause: many missions still require COVID-19 to be explicitly covered on the O-A policy.
- Foreign-insurer acceptance is not guaranteed — confirm the insurer issues the required certificate and that your office accepts it.
- Coverage gaps at renewal: you must usually show continuous cover for the whole permitted stay; a lapse can block renewal.
- 2026 tightening: figures and accepted documents changed in 2026 — do not rely on a pre-2026 forum post.
- DTV / plain retirement extension: no mandatory figure does not mean "skip insurance". Thai hospital bills are real — it is a personal-risk decision, not a free pass.
When to get professional help
Use a Thailand-licensed insurance broker who specialises in visa-compliant policies (O-A/O-X/LTR) — they know which insurers each embassy or office accepts and will issue the correct certificate. For LTR, confirm with the BoI whether you are using the insurance or the savings route. If in doubt about the figure for your specific embassy or Immigration office, ask them in writing before buying.
Sources
- Mandatory Health Insurance For Expats In Thailand, 2026 Guide (Pacific Prime)
- Guidelines Non-Immigrant Visa (O-A) — Health Insurance for Long Stay (TGIA official portal)
- LTR Visa Thailand 2026: Requirements, Benefits & How to Apply (Siam Legal)
- Health Insurance Requirements for Thailand's Retirement (O-A) Visa (Pacific Cross)
- Thailand retirement visa insurance requirement explained, 2025 update (Thaiger)
Sources accessed 24 May 2026.