Decent Health Insurance for Thai people

[bbi1]

What are the good Thai health insurance companies for Thai people to cover them for hospitals in BKK? Something that has reasonably priced premiums for Thai middle class people that overs IPD and OPD is preferred.

[Pravda]

There isn't one. 

 

I am shocked how little health insurances cover here. My current gf has probably the best one from company she works at. Only good for doctor visits and free pills. For the rest she uses her "Thai" insurance. 

[Sheryl]

Thai health insurance policies are compartively low in value and high in cost.

 

Very, very few Thais get private health insurance since all Thai citizens have free health care through one of the 3 schemes that comprise the universal health care scheme.

[bbi1]

1 minute ago, Pravda said:

There isn't one. 

 

I am shocked how little health insurances cover here. My current gf has probably the best one from company she works at. Only good for doctor visits and free pills. For the rest she uses her "Thai" insurance. 

What is the name of that company which is the best one? Is it true that when health insurance is offered by an employer, the employer deducts the yearly premium from the employee's salary so basically it's the employee paying for their own insurance coverage anyway?

 

With the 30 baht Thai insurance coverage, does that cover everything for a Thai person? Eg. any surgery, any scans like Xray, MRI, CT scan

[bbi1]

5 minutes ago, Sheryl said:

Thai health insurance policies are compartively low in value and high in cost.

 

Very, very few Thais get private health insurance since all Thai citizens have free health care through one of the 3 schemes that comprise the universal health care scheme.

What about the many Thais who work in BKK but have their universal health care scheme registered in their home town many hours away? I've read there's many that aren't registered in BKK. They wouldn't be covered for hospital visits, for surgery, for scans like Xray, MRI, CT scan

 

Another thing I'm curious of, what do the rich Thai people do when they go to those expensive hospitals like Samitivej? You see that most customers there are Thai. Do they usually pay for all their hospital bills in cash as they skip having health insurance?

Edited March 8, 2020 by bbi1

[lopburi3]

3 minutes ago, bbi1 said:

What about the many Thais who work in BKK but have their universal health care scheme registered in their home town many hours away? I've read there's many that aren't registered in BKK. They wouldn't be covered for hospital visits, for surgery, for scans like Xray, MRI, CT scan

They get emergency service anywhere and can then transfer to home hospital.  But if living in Bangkok they should add there name to a home register in Bangkok and register at Bangkok facility.  It is not hard to do and most landlords are more than willing to add your name to house book.  

[Sheryl]

15 minutes ago, bbi1 said:

What about the many Thais who work in BKK but have their universal health care scheme registered in their home town many hours away? I've read there's many that aren't registered in BKK. They wouldn't be covered for hospital visits, for surgery, for scans like Xray, MRI, CT scan

 

Another thing I'm curious of, what do the rich Thai people do when they go to those expensive hospitals like Samitivej? You see that most customers there are Thai. Do they usually pay for all their hospital bills in cash as they skip having health insurance?

1. They can either:

 

A. Change their registration

 

Or

 

B. Pay out of pocket for minor things and travel back to their place of registration for anything major. (Note that in emergency it is free at any govt hospital)

 

Most people seem to opt for (B).  Beaurocratic hassle is one reason but so is preferring to be hospitalized for anything significant back home where their family are.

 

This issue doesn't pertain only to health care.  Same is true of voting which is why hundreds of thousands of people travel back to the provinces at election time.

 

2. They usually pay out of pocket.  Some of them will switch to a government hospital if it becomes a matter of something really costly.

[bbi1]

7 minutes ago, Sheryl said:

1. They can either:

 

A. Change their registration

 

Or

 

B. Pay out of pocket for minor things and travel back to their place of registration for anything major. (Note that in emergency it is free at any govt hospital)

 

Most people seem to opt for (B).  Beaurocratic hassle is one reason but so is preferring to be hospitalized for anything significant back home where their family are.

 

This issue doesn't pertain only to health care.  Same is true of voting which is why hundreds of thousands of people travel back to the provinces at election time.

 

2. They usually pay out of pocket.  Some of them will switch to a government hospital if it becomes a matter of something really costly.

What about health insurance offered by an employer (which is really deducted from an employee's salary anyway), are these policies all really worthless too only covering very low values? By low values what are we talking about, something like a maximum of 1,000 baht per hospital visit?

Edited March 8, 2020 by bbi1

[Sheryl]

Just now, bbi1 said:

What about health insurance offered by an employer (which is really deducted from an employee's salary anyway), are these policies all really worthless too only covering very low values?

Are you talking about Social Security or private health insurance?

 

All people employed in the formal private sector  except for private schools are by law  enrolled in Social Security for which payroll deductions (very modest) are made. This is one of the 3 schemes that make up the government univetsal health coverage system. It is not private health insurance. The other 2 schemes in the systemare a Vivil Setvant Social Securotu and the "universal" health scheme. It is this last which is based on house registration

 

For Social Security it does not matter where the person is listed in a hoise registration but rather where they are employed.

 

A few (very few) employers also offer private health insurance. Typically of very low value and not entailing payroll deduction. Their employees still have to pay into and be covered by Social Security. 

[bbi1]

2 minutes ago, Sheryl said:

Are you talking about Social Security or private health insurance?

 

All people employed in the formal private sector  except for private schools are by law  enrolled in Social Security for which payroll deductions (very modest) are made. This is one of the 3 schemes that make up the government univetsal health coverage system. It is not private health insurance. The other 2 schemes in the systemare a Vivil Setvant Social Securotu and the "universal" health scheme. It is this last which is based on house registration

 

For Social Security it does not matter where the person is listed in a hoise registration but rather where they are employed.

 

A few (very few) employers also offer private health insurance. Typically of very low value and not entailing payroll deduction. Their employees still have to pay into and be covered by Social Security. 

I had no idea what it was as I'm not working here, but I was under the impression that private Thai companies had to provide some sort of health insurance coverage for their employees.

[Sheryl]

As explained, by law all people employed in the formal private sector must be enrolled in Social Security with the exception of private schools. There is a small payroll deduction for this. In addition to comprehensive health care (in and outpatient but must be at one nominated hospital) the system includes other benefits e.g. retirement pension, disability, matetnity benefit.

 

This is a government scheme. Private employers ate not required to provide private health insurance and most do not. They few that do must still entoll all their emplpyees in  SS.

[AussieBob18]

45 minutes ago, Sheryl said:

Thai health insurance policies are compartively low in value and high in cost.

 

Very, very few Thais get private health insurance since all Thai citizens have free health care through one of the 3 schemes that comprise the universal health care scheme.

 

 

And that is why health insurance policies for Expats are so expensive - there is no pool of many millions of Thais holding private health insuranc. And those Thais that do have private health insurance are the wealthy who are capable and happy to pay a high premium.  Expat insurance is basically what the wealthy Thais get and is the main reason why it costs so much - especially OP.

 

[TallGuyJohninBKK]

31 minutes ago, Sheryl said:

All people employed in the formal private sector  except for private schools are by law  enrolled in Social Security for which payroll deductions (very modest) are made.

 

I wonder about that, Sheryl.  My wife works for a subsidiary private company of one of Thailand's largest corporate conglomerates having nothing to do with private education. And thru her work, she has private medical insurance coverage thru Alllianz Ayudhya that she's supposed to use anytime she needs medical care. 

 

As best as I understand it, the coverage is basically 100% medical up to 25,000 baht of expenses per year, and then like 75% coverage from 25K to 100K of expenses in a year, and then a different rate beyond 100K.  And it doesn't matter whether those expenses are incurred at a government or private hospital.

 

My wife's boss recently received a diagnosis of having an advanced stage of cancer, and has been racking up a goodly amount of chemo and other medical bills at one of the top-line govt. hospitals in BKK. And she's facing a sizable amount of out of pocket expenses for that.

 

All of which makes me wonder, if my wife's company was participating in Thai SS, why would they have a separate private medical coverage policy as primary cover for all their employees, and why would be wife's boss be in the situation she's in?

 

I've asked my wife about it before, and her response is the Allianz policy is her main health insurance, and the only other cover she has is if she was to go back to her home province (where her tabien ban is registered) and use a designated govt. hospital there.

 

It makes me wonder if there isn't some other kind of exemption that exists other than the one for private education employees.

 

Edited March 8, 2020 by TallGuyJohninBKK

[Antonymous]

My wife has found AETNA (Thailand) to be very good. Decent coverage at low premiums. AETNA has a choice of several levels and you can opt for OPD as well as IPD if you wish.

 

She has (unfortunately) had to make multiple claims and all have been met quickly and efficiently. in the years following claims the premiums have not been hiked above normal inflation increases.

[Sheryl]

1 hour ago, TallGuyJohninBKK said:

 

I wonder about that, Sheryl.  My wife works for a subsidiary private company of one of Thailand's largest corporate conglomerates having nothing to do with private education. And thru her work, she has private medical insurance coverage thru Alllianz Ayudhya that she's supposed to use anytime she needs medical care. 

 

As best as I understand it, the coverage is basically 100% medical up to 25,000 baht of expenses per year, and then like 75% coverage from 25K to 100K of expenses in a year, and then a different rate beyond 100K.  And it doesn't matter whether those expenses are incurred at a government or private hospital.

 

My wife's boss recently received a diagnosis of having an advanced stage of cancer, and has been racking up a goodly amount of chemo and other medical bills at one of the top-line govt. hospitals in BKK. And she's facing a sizable amount of out of pocket expenses for that.

 

All of which makes me wonder, if my wife's company was participating in Thai SS, why would they have a separate private medical coverage policy as primary cover for all their employees, and why would be wife's boss be in the situation she's in?

 

I've asked my wife about it before, and her response is the Allianz policy is her main health insurance, and the only other cover she has is if she was to go back to her home province (where her tabien ban is registered) and use a designated govt. hospital there.

 

It makes me wonder if there isn't some other kind of exemption that exists other than the one for private education employees.

 

To my knowledge there is not such an exemption and by law her company is required to enroll their employees in SS. I suggest you have your wife first ascertain that she is not enrolled in SS (there will be a small monthly payroll deduction if she us) and if so contact the SS head office.

 

Some private companies do opt to provide basically worthless private policies such as you describe as a "perk". It does not relieve them of their obligations under the Social Security Act.

 

What you describe is not a "primary cover". It is completelly insufficient cover. In fact at those loe levels it cannot be described as "cover" at all. Just a piece of fluff.

[TallGuyJohninBKK]

10 hours ago, Sheryl said:

To my knowledge there is not such an exemption and by law her company is required to enroll their employees in SS. I suggest you have your wife first ascertain that she is not enrolled in SS (there will be a small monthly payroll deduction if she us) and if so contact the SS head office.

 

Some private companies do opt to provide basically worthless private policies such as you describe as a "perk". It does not relieve them of their obligations under the Social Security Act.

 

I finally nailed down the Thai wife, and got her to produce her company health insurance documents, and it turns out they do have Thai SS coverage plus the company-provided private health insurance, with the benefits broken out as follows:

 

 

The fly in the ointment appears to be, at least from her telling, that it's very hard if not impossible these days to get registered under TH SS with any of the more prominent Thai govt hospitals in BKK like Siriraj, Chula and Ramathibodi.  And supposedly, a lot of the hospitals that are accepting new SS registrants aren't necessarily ones you might want to choose.

 

So, in my wife's company's case, the private insurance gives their employees the option at will to choose/use any Thai government or private hospital they want, without having to deal with the TH SS registration requirement, but does provide reduced benefits for those going that route for expenses between 25K and 250K per year.

 

[Sheryl]

Those "benefits" are for the private insurance not SS. SS pays 100% with no cap.

 

What she says re the best hospitals being closed to new SS enrollment is, however, true. in the Bangkok area choice is limited but there is still choice and not all are bad.

 

25K will not cover even a simple non-surgical hospitalization in a private hospital in Bkk and even 250K will not cover much. Not even simple appendectomy. This is a non-benefit IMO. Just for show.

 

She should takje care to enroll in the best of the available SS hospitals and refrain from entering a private hospital for anything other than the very simplest procedure or you will find yourself shelling out a fortune.

 

In the case of a major accident or catastrophic illness the tab  can exceed 250K in just the first 24 hours.

 

[stament]

On 3/8/2020 at 8:08 AM, Sheryl said:

Thai health insurance policies are compartively low in value and high in cost.

 

Very, very few Thais get private health insurance since all Thai citizens have free health care through one of the 3 schemes that comprise the universal health care scheme.

Interesting, what are the 3 schemes you mention?

[Sheryl]

3 hours ago, stament said:

Interesting, what are the 3 schemes you mention?

 

Social Security

Civil Service Social Security

Universal (AKA "30 baht") scheme