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I've bought a travel health insurance which covers all emergency treatments for the first 18 months of my stay in Asia. I think they offer to extend it by another 18 months should I wish to do so at the end of the first period, so theoretically, that should give me 3 years of the most important health cover. Nonetheless, being German like yourself, I am a bit paranoid and obsesses with insurance, lol. And that's why I wonder if cover for emergency care is enough.
The reason is that I wonder what will happen in worst case scenarios, i.e. long-term chronic diseases, cancer etc. As you write yourself, the company behind my current travel insurance might pay for the flight to Germany but that's it, they would not pay for any necessary treatments for the long-term illnesses. Did you, when you arrived in Thailand, think about "topping up" your travel insurance with another local health insurance so that in a worst case scenario you could stay in Thailand rather than going back to Germany? Do you happen to know if there are any insurance companies that offer such "top up" health policies that only cover such long-term illnesses, so that I could use the travel insurance for emergencies (at least for the first 18/36 month) whilst having the "proper" local health insurance for other illnesses that travel insurers don't cover?
Or am I just too paranoid here?
Travel medical plans will cover you for up to the 3 year period but then terminate. Typically they will have additional benefit period to continue covering you after the policy expires for illnesses that occur during the policy period – but that might be as few as 30-60 days.
A Global Medical Insurance Plan, or Expat Health insurance, would be available that would cover you long term for all medical conditions. If you chose a high deductible, the premiums would be less and you would be able to access it to cover large medical bills long term.
I think my initial insurance was limited to 3 years. I didn't get a local insurance on top as the 'temporary health insurance' covered pretty much everything (not just accidents). Accident only insurance is very thin coverage and if illnesses aren't covered, you might want to look into getting something that covers that.
The main question is if you get sick/in an accident, does the insurance get extended until you are recovered. Easiest way to handle it is to ask your broker/insurance by e-mail 'what happens if…' – this way you have something 'written' in case there's an issue.