PMNL

Update...The agent just come to my home to explain to me the problem, and brought the bill I didn't saw..because in theory was covered.

II never used the insurance before. First Time. I went to the hospital to check for acid reflux, and the doctor said that will be better to do an endoscopy..but..in Thailand I will have to spend one night at the hospital. In other private hospital, without insurance, an endoscopy price was 6000 THB. The agent asked the price for the endoscopy in this hospital and was told 8000THB plus "extras". The room rate, 2000THB/night was cover by the policy.

The agent said that I will be cover up to 20000THB.....and I was very close to ask for a colonoscopy too. Thanks God I didn't.

Surprise. The bill total is 27000 THB for the room for a day and the endoscopy, that...by the way.. shows not problems. All very clean. No biopsy or pathology need it. Doctor said that was the cleaner picture ever. I do not drink or smoke.

The charge for the room was 2200 THB plus.... Some extras? 850 THB for one hospital meal (not include on the room rate??) . Blood and urine test, 3000 THB, A bunch of antacid pills giving to take home 4000 THB....etc, etc, etc, Insurance paid 23000THB.

Tomorrow..another confrontation in sight....asking for explanations. I am tired already.

I am sorry, this is obviously too late to tell you but certain procedure such as endoscopy( gastro/colonoscopy), some type of biopsy, though most insurance state they do pay only for inpatient, 99% of them consider those procedure as a day case surgery and they do pay even though you not staying over night, so they can save the money on room rate, food, and unnecessary nursing check.

Your agent are clueless and advised wrong strategy.

Home medication normally has a very little coverage in thai policy, say ~1000 THB, I suspect that is the majority of the extra you have to pay for.

Get the intermixed receipt and the coverage detail form the hospital then you will know what is that 4K for, simple.

Agent in thailand mostly are incompetent know nothing more than commission, having said that there are a few good competent ones know what they are doing. If you want to know the coverage you might be able to get more information calling the call center, health claim section.

To be fair, You said you requested a few extra tests, you should not moan about paying extra then, as the insurance especially small policy( I would not call it cheap) cover the test related to the illness at the time of admission and requested by attending dr not the patients.

Alprazolam has been on a strict control substance since the year before last. Every single medical center being clinic or hospital, private or government can only order the med directly via the Thai FDA. In order to do so those will have to present their substance controlled licenses which issued by the provincial health department, only clinic and hospital can carry this kind of licenses, so now figure that out?

As an active RN, familial with the thai health system, I am sure Sheryl does not take much to aware of the fact and give the correct info about this meds.

For those who still sell, they might have their old supply from 2013 or the old lot that some of the drug rep sneaked out to sell just to make profit( this is another fact) or illegally bring the meds in from neighboring country and obviously sell them to those doggie people UNDER THE COUNTER.

In ROiet might be hard to find even at hospital, at district hospital, I my opinion, do not carry this drug anymore.

but at the big provincial

Hospital with psychiatrist usually carry them.

It will not cost you much. Dr 200-500 THB, meds 100-500 depends on govt or private.

I suggest you try to find out if there is any private hospital,

If there is, call and ask first if they have the med. Easier than a trip to govt hospital.

Well, here's what the doctor yesterday said I needed:

Hepatitis A

Hepatitis B

Japanese Encephalitis

Measles, Mumps, Rubella (MMR)

Pneumococcus (IPD)

Tetanus-Diphtheria-Pertussis (Tdap)

Typoid

Varicella

and later in the year

Influenza.

The one thing I didn't need, apparently, was Rabies since I'd had a full course of pre-exposure jabs 12 years ago.

MMR and Varicella? That's a bit unusual for adult, MMR a is sometimes recommended a booster for international travelers.

pneumococcal is recommended for people over 65, unless indicated with specific condition, i.e. splenectomy, COPD, pre-op certain type of eat surgery....

Just found it strange you need that much unless this is a recommendation for kids,

But again typhoid is recommended for kids over 2 years old.

L

Meant to say they use CRP and ESR to follow up inflammation not infection in my previous post, could not edit.

In RA / Psoriasis arthritic/ other autoimmune arthritis CRP is being used for follow to see how the inflammation is being responded by the prescribed meds.

A knowledge of more than 5 years medical is considered very old. Not to say correct or not!

Last year the recommendation for blood thinner ( anti platelets) in heart patients with PCI (stent) was 6 months, the year before was 12 months and this year there are studies, suggesting the longer the better so my point is if one try to offer any medical advise / suggestion to others please be sensible and be reliable. If not so, better not to mis inform others.

I don't intend to attack anyone in particular just read a lot of poor advises from dr Google on here and I am feeling sorry for those who genuinely seek sound advise.

CRP is not used as indicator to deferential between bacterial or viral. It is used as a follow up marker for inflammation.

Quite pretentious of you to issue a blanket statement about how CRP tests are used.

There is enough litterature out there that point out other possible uses.

Some doctors do use it because the test is cheap and quick, the test can be done on-premise, it yields good results and allows for earlier antibiotics prescription with 90% accuracy.

I guess Google answer it all. I haven't seen any dr use the CRP by itself as a screening test for bacterial infection both Thais and westerners. CBC and CRP sometimes are requested especially in orthopedic infectious type of infection.

They use CRP and ESR to follow up infection.

Well this is not just a personal observation thus believe as you wish sir.

CBC is the initial step of checking bacterial or viral infection. Strep rapid test is not widely available, so not being offered mostly because of that reason. Culture for bacteria takes normally 2-3 days to long to wait so most Drs overlook on the option as it does not give any information to the treatment option on the visit.

CRP is not used as indicator to deferential between bacterial or viral. It is used as a follow up marker for inflammation.

Sheryl answered all the questions very clearly.

The OP what do you really refer to thai medicine? Thai herbs ?Thai doctor prescription ? Or you really meant local/generic medicine and original. You should be clear before more quacks come.

In my personal opinion, the generic is effective enough BUT come with stronger side effects compared to original ones. Some local ones are really poor quality so depend on which company and brand you use as well.

Siam pharmaceutical is very good for generic antibiotics.

Berlin pharma industry is very reputable for cardiovascular meds as well as the DM. They start selling some Indian generic antibiotics as well but in my medical background opinion, Siam is better.

GPO is no good on antibiotics, certain thing they use subcontractor such as rabies( from Sanofi Pasteur) vaccine is good, or import from Europe, cholesterol meds, are good generic.

Shingles..............

Quite likely..

Correct the fact: DKHS sells the vaccine it might be available again after the Sanofi stopped importing.

To my understanding, it is no longer available in thailand as the Sanofi Pasteur no longer import the product. You might want to call the Travel med center to confirm before going there just to find out the fact they don't have.

It is covered but at her registered hospital. Nearly all illness and investigation but many times the hospital seem to make a speed bump policy on the investigation to try safe cost.

Paying 750 baht a month would not get anyone into Bangkok hospital or Bumrungrad for free treatment, does not sound right.

Though if it was emergency, stated on medical report by attending dr, she could be partially reimbursed by the SSS.

Hence Gardasil is also recommended for boys for that particular reason.

Plenty at Fascino of the branch you approach don't have, they will bring in from the others.

Chiangmai Ram hospital and I would expect that most big private hospital perform the test.

everyone has access to government hospitals.

What the poster perhaps meant to day was free access to vaccines at government health facilities.

These may or may not be better supplied, depends on which supplier they use. Govt hospitals in my experience have less flexibility in terms of changing whom they order from than do private, as procurement is centralized and bogged down in bureaucracy.

I have been refused fluvax at the Chiangrai Hospital even on a pay for basis as the people administering the needles say it is only for Thai people. My only complaint about the hospital. Sadly the vaccine they use at the private hospital while not out of life is not the one covering the last few outbreaks as it is nearly a year old.

Not good as I am in a vulnerable group.

The Flu shot at govt hospitals are free Only for those under universal coverage so they won't give it to you though you willing to pay for it. Chiangrai has quite decent private hospital( not to western standard obviously) I doubt it very much if they offer expired flu shot out or old series which also mean expired technically. You can always check on the sticker or label comes with the vaccine. Unless they don't have one for your age group that's another story.

Sorry Sheryl that is the point. I did check the lable. The vacine was produced 10 months before the private hospital in Chiangrai intended to inject me. I read the lable as I was waiting for the doctor and refused it as it would not have been up to date for the more recent outbreaks. 6 months is my personal limit for that.based on the fact vaccines are produced based on the frequency of outbreaks in the opposite hemisphere. On questioning I was told they had to use the stock before ordering more.

To my understanding the flu vaccine imported to LOS twice a year, during end of May and October, perhaps you were about to get the shot early in October ?

Sometimes the flu strain stay the same, you can check on CDC website.

And may I take the word 'decent' back then. lol

The taiwanese chickenpox vaccine is expected to be available early 2015, the GSK has problem with contamination on their production line and will not be able to supply chickenpox vaccine throughout 2015 as well as the DTap, DTaP IPV, DTaP IPV HIB and well as DTaP IPV HIB and Hep B.

So I don't think it's a 3rd world country's problem really.

http://mobile.in-pharmatechnologist.com/Regulatory-Safety/Chicken-pox-vaccine-shortage-likely-after-problems-at-GSK-plant#.VGh3zYpXec0

everyone has access to government hospitals.

What the poster perhaps meant to day was free access to vaccines at government health facilities.

These may or may not be better supplied, depends on which supplier they use. Govt hospitals in my experience have less flexibility in terms of changing whom they order from than do private, as procurement is centralized and bogged down in bureaucracy.

I have been refused fluvax at the Chiangrai Hospital even on a pay for basis as the people administering the needles say it is only for Thai people. My only complaint about the hospital. Sadly the vaccine they use at the private hospital while not out of life is not the one covering the last few outbreaks as it is nearly a year old.

Not good as I am in a vulnerable group.

The Flu shot at govt hospitals are free Only for those under universal coverage so they won't give it to you though you willing to pay for it. Chiangrai has quite decent private hospital( not to western standard obviously) I doubt it very much if they offer expired flu shot out or old series which also mean expired technically. You can always check on the sticker or label comes with the vaccine. Unless they don't have one for your age group that's another story.

The vaccine is quite easy to get in Thailand, less than 1000 THB.

Have a look at Sipental 400 by Siam pharmaceutical. It is normally a good generic substitution, not equivalent, which work well for claudication. You should talk to your dr about changing over though, there might be condition or medication interact with it.

Talk to her and give her the right information as much as you can, this is a controllable disease to date and all the new ARV is very effective and much less side effect than decade ago. You can live almost a normal life only have to be very faithfully taking the meds and avoid any bad habit that might reinfected yourself with different strain and avoid bad behavior.

She obviously needs to go see doctor, get all her baseline lab work done like CD4, viral load and if the viral load is high, the genotype testing would also a good idea, initial metabolic

panel will help for future follow up once she on the ARV.

Psychological support and understanding are very important for this diagnosis in my opinion.

I bought a manual single auger juicer at the pharmacy near the supermarket in bottom floor Central Airport, i juice carrot, apple, beetroot and greens with no probs, its only 1450baht. i have a twin gear green power $600+ juicer back home and this does the same job

Thanks.

Where do you get your beetroot here in CM? [/quote

MuangMai Market further down from American consulate, walk into the market you will see a small intersection, take right and walk though all the smelly chicken and pickled shops, then you will see one shop on your right selling carrots beetroot, veggies in big bags, go straight to their fridge: Never fail to find the beetroot there and at a good price.

Used to see at Robison not sure if they moved to Ban and Beyond, or look for Hurom on true select. Blender heat up all the veg and Fruits cause so much oxidation by the time you get to drink it. Slow juicer seems a better choice in my opinion.