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Hospitalization insurance in Thailand: a guide for expats

 

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Hospitalization insurance, also called inpatient or major medical plan, is designed to cover expensive medical care incurred for injuries and ongoing medical issues, for example, cancer. Hospitalization insurance is usually the basic feature of most health insurance plans, for the following three main reasons:
 

  • High hospitalization and surgery costs, especially in private hospitals. 
  • Increased occurrence of non-communicable diseases, such as high blood pressure, that can silently develop into a serious condition and might require acute and sudden emergency medical care.
  • Unforeseen accidents and injuries, or even a global infectious disease pandemic, such as Covid-19, that require hospital care. 

 

Stay with us, as with the help of Pacific Prime Thailand insurance brokers, we will expose what hospitalization insurance is, what it covers, and explain the advantages of private health insurance for expatriates when it comes to hospital treatments in Thailand. 

 

What normally is covered by hospital insurance?

 

Hospital treatments are usually more costly than other medical treatments, so securing hospitalization insurance is an excellent way of protecting yourself from these costs.

 

Plans will differ in the coverage elements offered, so we recommend that you read the fine print on your policy to find out exactly what you are covered for, and what the coverage limits are.

 

Hospital insurance plans tend to offer the following coverage benefits:

 

  • A semi-private or private hospital room during surgery;
  • Rooms for intensive care;
  • In-patient diagnostic tests such as X-rays, MRI, CAT scans, and laboratory tests;
  • Medicines provided during hospitalization;
  • Ambulance expenses;
  • Surgery charges;
  • Anesthetist and operating theatre fees.

 

Please note that the degree of coverage on each item will differ depending on the plan, so if you are unsure about which plan will best suit your requirements, you should always contact your insurer, or broker for more information. 

 

What hospital insurance plans will not cover?

 

Now that you have an idea of what a hospital insurance plan will cover, let’s look into what a typical hospital insurance plan is unlikely to provide:

 

  • Outpatient medical benefits
  • Dental treatment
  • Vision/optical coverage
  • Maternity coverage
  • Fertility treatment
  • Psychological or substance abuse treatment
  • Physical rehabilitation
  • Sports injury treatment
  • Skin treatment
  • Outpatient diagnostic scans and testing
  • STI treatment

 

As you can see, the above list of benefits is not exhaustive as there are plenty of other healthcare items that a person may want, but are not included in a hospital insurance plan, and certain groups of benefits are clearly excluded from hospital insurance. 

 

First among these would be chronic conditions that need consistent, long term outpatient treatments to address. Next, checkups and non-emergency treatment are usually excluded from hospital insurance plans. Finally, items that are not critical to physical health, but are still important for quality of life, like fertility or substance abuse treatments, are also not covered by hospital insurance.

 

Public vs Private Hospitals in Thailand 

 

Hospitals in Thailand usually fall under two categories: government public hospitals and private hospitals. Even though both types will be able to provide treatment, they will offer an entirely different experience. 

 

While both public and private hospitals offer good quality treatment, private hospitals offer more comfort, shorter waiting times and English speaking staff and doctors, which makes a tremendous difference for someone who doesn’t speak Thai. 

 

In September 2019, Thailand introduced dual pricing for foreigners at public healthcare facilities, sometimes charging up to double the price a local Thai person would pay. This move, regarded as unfair by many, pushes many expatriates to seek treatment at Thailand's private hospitals, where they can enjoy private rooms, great customer service, and price transparency. 

 

And of course, whether you decide to use public or private healthcare systems in Thailand, it is advisable to secure private medical insurance for expats, that covers at least the hospitalization costs. 

 

Hospital Claims 

 

Many private medical insurance policies are making an in-patient claim easy. If you have a scheduled appointment or elective surgery, then notifying your insurance company, or Pacific Prime’s claims support team, before treatment allows you to confirm that the treatment is covered by your policy. Also, in most cases the insurer can arrange a direct settlement with the hospital, so you don’t have to pay upfront.

 

In cases of emergency where you require overnight hospitalization, your inpatient plan will cover most of the costs, but only if it is an eligible treatment. Keeping hospital receipts, doctor’s notes, and providing a completed claims form will speed up the reimbursement process.

 

However, since there are many details of which you may not be aware of when filing an inpatient claim, Pacific Prime's dedicated claims team can help you throughout the entire process; from filling out the forms to reimbursement. If you require any information or would like to receive a free quote please contact Pacific Prime Thailand today

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