Thai Social Security Health Coverage

[dinga]

I've started this new thread to cover this question asked on another thread:

 

Dinga said:  I'm fortunate to maintain medical coverage under the Thai Social Security arrangements by continuing to pay the some 500 baht in monthly subs  -  so guess it's a matter of time really before unaffordable costs force me to abandon an International Policy. 

Question:  Did anybody here try that? What is your experience with that?  (Sorry, I hope this fits into this thread.)

 

 

This link provides commentary on the Thai SS Health Coverage (note - I've only had a cursory look, and while it seems accurate and up-to-date, I don't vouch for its 100% accuracy) 

 

https://www.thaicitizenship.com/thai-social-security/

[bigt3116]

14 minutes ago, dinga said:

pay the some 500 baht in monthly subs 

 

You pay 432 baht per month

[dinga]

2 minutes ago, bigt3116 said:

 

You pay 432 baht per month

Correct (I put 'some 500 baht' as I couldn't be bothered going upstairs to drag the payment records out of the safe)

[Celsius]

I don't understand the point of this thread.

 

Many foreigners would not qualify. It is not simply about paying 500 baht a month.

 

If that was the case, my wife's parents would be on social security, but they do not qualify.

[FritsSikkink]

22 minutes ago, Celsius said:

I don't understand the point of this thread.

 

Many foreigners would not qualify. It is not simply about paying 500 baht a month.

 

If that was the case, my wife's parents would be on social security, but they do not qualify.

People who work here and want to stay living here qualify. Not every thread is for everybody.

[Celsius]

10 minutes ago, FritsSikkink said:

People who work here and want to stay living here qualify. Not every thread is for everybody.

 

So the original post shouod clarify that.

 

Just sayin

[Neeranam]

I've been paying this 432 baht per month for 3/4 years and it has paid off, getting free treament in the local hospital.

I'd pay more for the Asthma inhaler I use every month.

[Ralf001]

1 hour ago, dinga said:

I've started this new thread to cover this question asked on another thread:

 

Dinga said:  I'm fortunate to maintain medical coverage under the Thai Social Security arrangements by continuing to pay the some 500 baht in monthly subs  -  so guess it's a matter of time really before unaffordable costs force me to abandon an International Policy. 

Question:  Did anybody here try that? What is your experience with that?  (Sorry, I hope this fits into this thread.)

 

 

This link provides commentary on the Thai SS Health Coverage (note - I've only had a cursory look, and while it seems accurate and up-to-date, I don't vouch for its 100% accuracy) 

 

https://www.thaicitizenship.com/thai-social-security/

 

Yeah SS has covered me for million's of baht, this year alone.

 

cost me Bt.750 a month though as am still working.

[dinga]

17 minutes ago, Celsius said:

 

So the original post shouod clarify that.

 

Just sayin

Read the link.....(it does)

 

[Sheryl]

He is asking about people's experiences using SS.

 

Many, many, many people have used it.

 

The main drawback -- and it can be a considerable one - is that you must use only your nominated hospital, or another facility it refers you to. And the number of hospitals to chose from in making that nomination (which can be changed) is limited. Most government hospitals accept SS but the really big university affiliated ones are often at their quota and not taking new SS enrollees.

 

What hospital are you registered at under SS? 

 

 

[OneMoreFarang]

Thanks for starting this tread.

 

I have no answers but maybe some more questions what to expect.

 

I was working for one company in Thailand, and they provided a private health insurance for me. It was a group policy for that company, and I won't be able to continue with their group policy.

Now I work for another company, and I have only Thai social security.

I think about paying myself for a private insurance. But there is one problem. I have a preexisting condition, diabetes. It seems any private insurance with exclude that, ask me to pay extra, or they won't allow me to get into the insurance at all.

 

So now I have to decide if I am willing to pay 5,000 USD (just a rough amount) for a private insurance, which won't pay for my diabetes, or if I should just rely on the Thai social security cover and maybe pay some things out of my own pocket.

My regular medication cost roughly 3,000 USD per year. Will I get the same medication from the Thai social security? Or similar medication? Or does it make sense that I pay myself for high quality medication if the Thai insurance does not pay it?

 

And what about an emergency? If I have an accident with my bike, will the Thai insurance coverage be adequate? Or would an international insurance be much better?

 

This is just my personal situation, but it gives you an idea what this is about.

I am sure others are in similar situations.

 

[Sheryl]

17 minutes ago, OneMoreFarang said:

Thanks for starting this tread.

 

I have no answers but maybe some more questions what to expect.

 

I was working for one company in Thailand, and they provided a private health insurance for me. It was a group policy for that company, and I won't be able to continue with their group policy.

Now I work for another company, and I have only Thai social security.

I think about paying myself for a private insurance. But there is one problem. I have a preexisting condition, diabetes. It seems any private insurance with exclude that, ask me to pay extra, or they won't allow me to get into the insurance at all.

 

So now I have to decide if I am willing to pay 5,000 USD (just a rough amount) for a private insurance, which won't pay for my diabetes, or if I should just rely on the Thai social security cover and maybe pay some things out of my own pocket.

My regular medication cost roughly 3,000 USD per year. Will I get the same medication from the Thai social security? Or similar medication? Or does it make sense that I pay myself for high quality medication if the Thai insurance does not pay it?

 

And what about an emergency? If I have an accident with my bike, will the Thai insurance coverage be adequate? Or would an international insurance be much better?

 

This is just my personal situation, but it gives you an idea what this is about.

I am sure others are in similar situations.

 

 Most insurers will not newly enroll a diabetic, full stop. Definitely Thai insurers will not, but also many international ones won't. 

 

if they do, exclusion would likely be not just diabetes but also kidney and cardiovascular disease (heart, circulatory etc)  since diabetes substantially increases the risk of both. SO very extensive exclusions.

 

What is the medication you refer to? If it is on the MOPH list SS will cover it, otherwise not.

 

SS will cover medical care related to an accident or illness. However you must get care at the specific nominated hospital. Exception is in case of emergency, can receive care elsewhere for up to 72 hours. (Although that is the law, in practice the other hospitals often try to bill patients and it often takes a call to the SS head office to resolve this). 

[OneMoreFarang]

3 hours ago, Sheryl said:

 Most insurers will not newly enroll a diabetic, full stop. Definitely Thai insurers will not, but also many international ones won't. 

 

if they do, exclusion would likely be not just diabetes but also kidney and cardiovascular disease (heart, circulatory etc)  since diabetes substantially increases the risk of both. SO very extensive exclusions.

 

What is the medication you refer to? If it is on the MOPH list SS will cover it, otherwise not.

 

SS will cover medical care related to an accident or illness. However you must get care at the specific nominated hospital. Exception is in case of emergency, can receive care elsewhere for up to 72 hours. (Although that is the law, in practice the other hospitals often try to bill patients and it often takes a call to the SS head office to resolve this). 

 

Thanks Sheryl

 

maybe you also know about the following: What happens if a foreigner is in an accident, and he is not conscious?

I guess many Thais will assume the foreigner is a tourist and/or they will assume the farang should be transported into a private hospital.

 

But then, what happens if that farang has only Thai social security? Will they expect that he pays from his own money for the cost in that private hospital?

Or will no private hospital provide any (expensive) service until it is clear who pays?

 

I have my Thai social security card with me, but obviously that can be lost or damaged at an accident.

[Sheryl]

2 hours ago, OneMoreFarang said:

 

Thanks Sheryl

 

maybe you also know about the following: What happens if a foreigner is in an accident, and he is not conscious?

I guess many Thais will assume the foreigner is a tourist and/or they will assume the farang should be transported into a private hospital.

 

But then, what happens if that farang has only Thai social security? Will they expect that he pays from his own money for the cost in that private hospital?

Or will no private hospital provide any (expensive) service until it is clear who pays?

 

I have my Thai social security card with me, but obviously that can be lost or damaged at an accident.

No telling where you will be taken if not conscious. It will be up to the emergency vehicle which responds.

 

This scenario is exactly what the 72 hour law is designed for. 

 

By law, SS will reimburse any hospital that provides you with care in an emergency for up to 72 hours...the idea being that by then it should be possible to transfer you to your SS hospital.

 

The problem is that hospitals will often try to recoup directly from the patient. Do not pay, tell them you have SS and SS will pay for the first 72 hours. Call the Head Office if necessary. 

 

Good idea to inform your friends/family of your SS status (and which hospital is your SS hospital) and give them copy of the card.

 

You might also consider getting just Personal Accident insurance, it's not expensive and diabetes shouldn't be a problem for that.

 

 

[dinga]

20 hours ago, Sheryl said:

He is asking about people's experiences using SS.

 

Many, many, many people have used it.

 

The main drawback -- and it can be a considerable one - is that you must use only your nominated hospital, or another facility it refers you to. And the number of hospitals to chose from in making that nomination (which can be changed) is limited. Most government hospitals accept SS but the really big university affiliated ones are often at their quota and not taking new SS enrollees.

 

What hospital are you registered at under SS? 

 

 

Thanks (as usual) Sheryl.

 

I'm registered with the Rayong Hospital since it's the main hospital in my Province (Chantaburi is a little further away from my home in Mae Phim).  I've been there a couple of times (last time for a colonoscopy) - favourable comparison with my Bumrungrad experiences [aside from the queues...].  Every year you get the opportunity to request a change in hospitals and, as you say, in particular circumstances there is the possibility of getting a referral to a higher rated hospital/specialist.  

[Sheryl]

3 hours ago, dinga said:

Thanks (as usual) Sheryl.

 

I'm registered with the Rayong Hospital since it's the main hospital in my Province (Chantaburi is a little further away from my home in Mae Phim).  I've been there a couple of times (last time for a colonoscopy) - favourable comparison with my Bumrungrad experiences [aside from the queues...].  Every year you get the opportunity to request a change in hospitals and, as you say, in particular circumstances there is the possibility of getting a referral to a higher rated hospital/specialist.  

That is a regional level facility. About as good as it gets in terms of government hospitals outside Bangkok, Chiang Mai, Khon Kaen and Hat Yai.  And certainly the best choice in Rayong area. 

 

That said, given that your issue is whether or not to maintain an international policy, personally I live near a Regional Hospital but still prefer to go into Bangkok for most health care.  I like to be able to select my doctor and I want the best. (Also do not want to spend whole day or days waiting in crowding uncomfortable surroundings, but the doctor part is the more important ). And really, really not up for being an inpatient on a crowded non air conditioned ward, I've stayed with friends on same and it is grim in the extreme. Not always possibel ot get a private room).

 

One other point to seriously consider before dropping your private insurance is whether you ever travel outside Thailand. Because your SS insurance will be of no help then. I had a major accident while in Cambodia a few years back, thank god for my April policy. 

[scorecard]

On 12/22/2023 at 8:19 AM, bigt3116 said:

 

You pay 432 baht per month

The basic fee is 432Baht per month however the SSO does from time to time adjust that amount, always downwards. Friend has mentioned before several times it's gone down to 200Baht a month member contribution, then back to the max. amount of 432Baht a month.

 

This is why the SSO want 'Voluntary insured' members (Members who have elected to continue their membership after retirement) to pay by the SSO claiming the monthly payment from your bank. It gives the SSO the flexibility to change the monthly payment amount.

 

If the member sets their internet banking to make an automatic payment of 432Baht every month then this creates problems in the SSO because they receive 432Baht but (as above) it's very possible the SSO has reduced the monthly member contribution for that month, therefore the member has overpaid. Bottom line - let the SSO setup the deduction from your bank account. And there's an SSO website where you can check you payments history.

[bigt3116]

25 minutes ago, scorecard said:

however the SSO does from time to time adjust that amount, always downwards.

 

That was just during COVID

[OneMoreFarang]

31 minutes ago, scorecard said:

The basic fee is 432Baht per month however the SSO does from time to time adjust that amount, always downwards. Friend has mentioned before several times it's gone down to 200Baht a month member contribution, then back to the max. amount of 432Baht a month.

 

This is why the SSO want 'Voluntary insured' members (Members who have elected to continue their membership after retirement) to pay by the SSO claiming the monthly payment from your bank. It gives the SSO the flexibility to change the monthly payment amount.

 

If the member sets their internet banking to make an automatic payment of 432Baht every month then this creates problems in the SSO because they receive 432Baht but (as above) it's very possible the SSO has reduced the monthly member contribution for that month, therefore the member has overpaid. Bottom line - let the SSO setup the deduction from your bank account. And there's an SSO website where you can check you payments history.

Interesting

 

Do you know if it is necessary to visit the ss office to setup the automatic deduction from the account?

 

And about their website and payments: Do you have an URL? Is it necessary to register or good enough to enter a ss number or how does that work?

Thanks

[Sheryl]

7 minutes ago, OneMoreFarang said:

Interesting

 

Do you know if it is necessary to visit the ss office to setup the automatic deduction from the account?

 

And about their website and payments: Do you have an URL? Is it necessary to register or good enough to enter a ss number or how does that work?

Thanks

You need to go to SS office in person to set it up continuation of SS after you stop working and must do so not more than 6 months later. Be fore-warned that some wrongly tell people that it is not possible, or not possible for foreigners. If you encounter that ,call the head Office. Another bit of wrong information many give is claiming that taking a lump sum retirement benefit rules out continuing the insurance. Not true. 

 

Very few Thais continue their SS insurance upon retirement because they automatically get covered under the 30 baht" system. As a result many SS offices have little experience in this. 

 

For automatic deduction from bank account might also need to visit your bank or set it up on your banking app.

[scorecard]

On 12/22/2023 at 8:05 AM, dinga said:

I've started this new thread to cover this question asked on another thread:

 

Dinga said:  I'm fortunate to maintain medical coverage under the Thai Social Security arrangements by continuing to pay the some 500 baht in monthly subs  -  so guess it's a matter of time really before unaffordable costs force me to abandon an International Policy. 

Question:  Did anybody here try that? What is your experience with that?  (Sorry, I hope this fits into this thread.)

 

 

This link provides commentary on the Thai SS Health Coverage (note - I've only had a cursory look, and while it seems accurate and up-to-date, I don't vouch for its 100% accuracy) 

 

https://www.thaicitizenship.com/thai-social-security/

 

I have several foreigner friends who elected to continue their SSO membership (SSO call this 'Voluntary Insurance') after they retired and all of them are very satisfied with the actual medical treatment and the attitude of hospital staff etc.

Also, I wonder if all Voluntary Insurance SSO members know that in many locations the participating hospitals are the local government hospitals plus 1 or several private hospitals. My nominated hospital is Rajavet private hospital in Chiang Mai. Excellent / polite admin., services, nursing doctors attitudes and the quality of the medical care for SSO members is excellent and the same as the private patients receive.

 

Plus Rajavet have a dedicated 'International Office' staffed my 2 Thai ladies who speak perfect English and a long-term resident Philippin lady, perfect English and she reads and writes Thai. This team are very welcoming and friendly, good listeners and good focused clear answers regardless of whether it's a tourist, a resident foreigner on some type of visa or an SSO Voluntary Insurance Foreigner.

 

Wait time to see a Dr. for full private patients generally 30 minutes or less. For SSO Voluntary Insurance patients perhaps 10 minutes longer. Not an issue.

[BigStar]

7 minutes ago, scorecard said:

Also, I wonder if all Voluntary Insurance SSO members know that in many locations the participating hospitals are the local government hospitals plus 1 or several private hospitals. My nominated hospital is Rajavet private hospital in Chiang Mai.

 

But the SSO coverage at a private hospital is actually only part coverage, right? At least that was the case when I looked into changing to Phyathai Sriricha. It's a good percentage. There was also a list of about 300 people waiting to get accepted into the quota.  

[scorecard]

12 minutes ago, Sheryl said:

You need to go to SS office in person to set it up continuation of SS after you stop working and must do so not more than 6 months later. Be fore-warned that some wrongly tell people that it is not possible, or not possible for foreigners. If you encounter that ,call the head Office. Another bit of wrong information many give is claiming that taking a lump sum retirement benefit rules out continuing the insurance. Not true. 

 

Very few Thais continue their SS insurance upon retirement because they automatically get covered under the 30 baht" system. As a result many SS offices have little experience in this. 

 

For automatic deduction from bank account might also need to visit your bank or set it up on your banking app.

 

Further, If a retiring foreigner who has been an SSO member is told that foreigners cannot continue  as Dr. Sheryl mentioned just above this is not true.

 

In this situation please take a look at the attached document, an English language version of the Social Security Fund Act, a lot of good and clear information, especially Article 39 of the act. 

 

If you strike a road block (e.g. '...foreigners cannot continue ... ) initially call the SSO 1506 Hotline and select English. Sometimes the call is automatically switched back to a Thai speaker because at that moment there are no English speaking staff available.

 

If this happens call back later or the next day. When you do get an English speaker it's quite likely to be a Thai lawyer from the SSO HO office at Nonthaburi. They listen carefully and are very polite, and you will get clear / correct answers and advice of what to do next.

 

I went this route and the 1506 Hotline lady advised me to write a very detailed letter in English, then make a Thai language copy (Google translate is acceptable), then post the letters to the SSO HO Legal Division at Nonthaburi (full address is on their website).

 

I did that and 2 days later I got a call from an SSO lawyer. She listened well then told me clearly and politely that I had been given a totally false illegal reason (by the local SSO office) as to why I could not continue my membership / benefits. The Lawyer said she would send copies of my letters plus some further information to the Snr. officer at their Chiang Mai office.

• Note: The SSO lawyer also mentioned the SSO is aware that some HR managers (who in fact have very little knowledge of the Social Security Act) have told retiring foreigners they cannot continue their membership/benefits. As stated above, this is not true). 

 

Then several e.mails, phone calls, check of various documents and 6 months later I got an official letter that my membership had been reinstated as a Voluntary Insurance member, and the SSO had set up an auto deduction from my nominated K Bank savings account on the 15th of every month.

SOCIAL_SECURITY_ACT_2533_SSO_1...3.pdf

[scorecard]

10 minutes ago, BigStar said:

 

But the SSO coverage at a private hospital is actually only part coverage, right? At least that was the case when I looked into changing to Phyathai Sriricha. It's a good percentage. There was also a list of about 300 people waiting to get accepted into the quota.  

Good question but I'm sorry I don't know the answer to this point. I nominated Rajavet private hospital here in Chiang Mai and that was accepted with no further discussion. 

[BigStar]

34 minutes ago, OneMoreFarang said:

Do you know if it is necessary to visit the ss office to setup the automatic deduction from the account?

 

My company's HR office set everything up and gave me the form to give my bank years ago. Automatic deduction like clockwork ever since.

 

36 minutes ago, OneMoreFarang said:

And about their website and payments: Do you have an URL? Is it necessary to register or good enough to enter a ss number or how does that work?

 

When I tried to login to the website, I couldn't. I went by the SSO office and got that sorted and also signed the form for changing my nominated hospital. Some years ago I went by when they had stopped sending out ID cards and the old number didn't work when I tried to use it--for the first time. Fortunately, I'd brought along my pink card, which is exactly what they wanted. They were quite nice and helpful both times.

 

I have a new tool for use in large waiting rooms at government offices, when you're stuck at the back: a small pocket telescope for reading the number boards! LOL.

[Sheryl]

4 hours ago, BigStar said:

 

But the SSO coverage at a private hospital is actually only part coverage, right? At least that was the case when I looked into changing to Phyathai Sriricha. It's a good percentage. There was also a list of about 300 people waiting to get accepted into the quota.  

I am not sure what you mean by "only part coverage"?

 

Most private hospitals do not accept SS, and some (but not all) of those that do are best avoided. 

 

But if registered at a private hospital under SS., it is the same full coverage as at any hospital. 

 

SS does have a maximum reimbursement for room charge (I think 700 baht) so some private hospitals might require you to pay that difference, you would also pay extra if you chose an optional private room in a government hospital under SS. (Usually well worth it). 

 

But treatments, meds, surgery etc all fully covered.

[Sheryl]

4 hours ago, scorecard said:

 

I have several foreigner friends who elected to continue their SSO membership (SSO call this 'Voluntary Insurance') after they retired and all of them are very satisfied with the actual medical treatment and the attitude of hospital staff etc.

 

 

I do know some who are very dissatisfied but this is due, in every instance, of being registered at a sub-standard hospital.

 

Many people make the mistake of not choosing the hospital carefully (some just let their employer's staff decide it, usually a bad move). And in some localities the choices are poor due to the better hospitals being fully subscribed already.

 

As long as you can register at a decent hospital, it's a good deal. Just remember if you travel out of country to get travel insurance as Thai SS is of no help abroad.  And be prepared to argue the point if, due to emergency, you are charged for initial care at a different hospital in Thailand. 

[BigStar]

18 minutes ago, Sheryl said:

I am not sure what you mean by "only part coverage"?

 

Most private hospitals do not accept SS, and some (but not all) of those that do are best avoided. 

 

But if registered at a private hospital under SS., it is the same full coverage as at any hospital. 

 

SS does have a maximum reimbursement for room charge (I think 700 baht) so some private hospitals might require you to pay that difference, you would also pay extra if you chose an optional private room in a government hospital under SS. (Usually well worth it). 

 

But treatments, meds, surgery etc all fully covered.

 

OK. Seems to me I had seen a table showing that SSO patients getting, basically, large discounts on medical coverage. A quick search can't locate it, however. I'm happy to stand corrected. Maybe in 2025 I'll get on the waiting list for Phyathai. :)  

[scorecard]

44 minutes ago, Sheryl said:

I am not sure what you mean by "only part coverage"?

 

Most private hospitals do not accept SS, and some (but not all) of those that do are best avoided. 

 

But if registered at a private hospital under SS., it is the same full coverage as at any hospital. 

 

SS does have a maximum reimbursement for room charge (I think 700 baht) so some private hospitals might require you to pay that difference, you would also pay extra if you chose an optional private room in a government hospital under SS. (Usually well worth it). 

 

But treatments, meds, surgery etc all fully covered.

 

Re the room charge / private room charge for SSO members, this is a bit complex and at some hospitals gov't or Private which accepts the SSO membership) it can depend on the medical situation at hand, and of course depends on whether the SSO member wants a private room, or some hospitals have rooms with only 2 bed and of course full ward size (my understanding is that this is usually 10 beds).

 

The above para is of course regarding the 'room' charge'. Nursing fees, medications, Dr's visit to the ward, medications, food are cover mostly covered by the SSO membership, the charge for actual room is what changes and can be not that cheap.

 

For example at Rajavet hospital here in Chiang Mai for private room:

 

- Nursing, Dr's visit, medication. food is covered by the SSO membership, as mentioned above.

- Room charge can be as high as 1,700Baht per night but usually with 700Baht reimbursed by the SSO. 

 

                        As an aside: I recently asked for a quotation from 2 international mainstream medical insurers  'room only' not including nursing,                              Dr's visit, medications and food.  Both indicated they could do that but when they sent the quotation:

                       - it was just 10% cheaper than full cover.

                       - I was already way older than the maximum age they stipulated (both sias max age 78, I am 79 in 2 weeks)

                       Bottom line, of no value.

 

Therefore is pays to check these charges in advance case by case / hospital by hospital to be prepared.

 

My SSO membership also provides full ambulance services as needed at Rajavet hospital, covered by my SSO membership.  

[OneMoreFarang]

2 hours ago, Sheryl said:

I do know some who are very dissatisfied but this is due, in every instance, of being registered at a sub-standard hospital.

I think I am registered at Lerdsin Hospital, Silom Road. But I am not sure.

I just checked on my social security card, but I don't see any information about the hospital on that card. How can I find out?

Thanks