Government hospital cardiac surgery bill

[drenddy]

I am sure, I am not the first one to ask.

 

One friend's  mother in law (thai citizen) has suffered an acute miocardial ischemia.

Now they are struggling to find around 70-80.000 THB to cover operation.

Doctor said, the decision must be made within hours.

 

Don't they have 30 baht scheme for thai nationals?

Isn't this supposed to be free or at least lower than 70-80 k?

Even with private room, at government hospital, it cannot be that much?!

 

From what I know, the old lady is registered in other city, than Bangkok, where she actually lives.

 

Regards.

[NorthernRyland]

They may want a premium for expediency. My wife's dad needed an MRI recently and it cost around 20k baht. It's 30baht*** (see below for details) and doesn't cover everything I think. Maybe if he could wait months if it would be, but short notice is another matter because it's rationed.

[drenddy]

Does anyone knows what qualifies as "expediency"?

 

I mean...If they can hold her alive with medicine for 2-3 or more days, will the price be cheaper...I know, dumb question.

 

I just don't get it...I read on reddit as well...It should cover major surgery as well, the 30 baht scheme.

[drenddy]

Me again

Can they really charge upfront, for skipping the queue?

Isn't acute myocardial ischemia an medical emergency?

[KhunLA]

At a guess, since registered out of the area, she wasn't cover for the procedure at that hospital.  So yea, upfront payment is quite standard.

 

After stabilizing her, also at a guess, considering the price point, they probably wanted to place a stent, to open the blood vessel up.

 

My wife had elective surgery, and over the phone, had her coverage changed from Nong Bua LamPhu to Prachuap Khiri Khan.  Seemed easy enough, but TBH, not sure how long that took.  I think just during the phone call.

 

Her ID was already changed, so may have made it easier, quicker to do.

 

If OP's incident happened over the weekend, and stent was required right away, then oops, yea, should have changed her coverage area a long time ago.

 

Moral of story ... have your Thai partner check their coverage area, and keep current.  In an emergency, will save you a few baht.

 

Also paying to 'jump the queue' is quite standard also, though technically, it may not be 'jumping' the queue, but simply paying for 'off duty hours' service.  Either before or after regulate work hours.

 

I paid that myself as the Q was months long, and I wanted it done ASAP, and was done a week later.

[drenddy]

6 minutes ago, KhunLA said:

At a guess, since registered out of the area, she wasn't cover for the procedure at that hospital.  So yea, upfront payment is quite standard.

 

After stabilizing her, also at a guess, considering the price point, they probably wanted to place a stent, to open the blood vessel up.

 

My wife had elective surgery, and over the phone, had her coverage changed from Nong Bua LamPhu to Prachuap Khiri Khan.  Seemed easy enough, but TBH, not sure how long that took.  I think just during the phone call.

 

Her ID was already changed, so may have made it easier, quicker to do.

 

If OP's incident happened over the weekend, and stent was required right away, then oops, yea, should have changed her coverage area a long time ago.

 

Moral of story ... have your Thai partner check their coverage area, and keep current.  In an emergency, will save you a few baht.

 

https://eng.nhso.go.th/view/1/DescriptionNews/NHSO-to-expand-30-baht-get-treatment-anywhere-pilot-project-in-eight-provinces/601/EN-US

 

Looks like, it doesn't require any registration update as from last year?

[KhunLA]

3 minutes ago, drenddy said:

 

https://eng.nhso.go.th/view/1/DescriptionNews/NHSO-to-expand-30-baht-get-treatment-anywhere-pilot-project-in-eight-provinces/601/EN-US

 

Looks like, it doesn't require any registration update as from last year?

I guess if you live in these provinces, it's not an issue.  But does someone have to notify them in advance for the extra coverage.

 

I don't see Bangkok listed ...

 

"These provinces are Phetchabun, Nakhon Sawan, Nakhon Ratchasima, Amnat Charoen, Nong Bua Lamphu, Sing Buri, Phang Nga, and Sa Kaeo.
 
The expansion is a result of the NHSO board’s meeting on February 21, which acknowledged the positive outcomes of the phase-one pilot in four provinces - Phrae, Roi Et, Phetchaburi, and Narathiwat"

[scubascuba3]

Emotional blackmail for money, i think she needs to be in the province she's registered in. If she's in an old age maybe a good time to go anyway

[BritManToo]

7 hours ago, drenddy said:

Does anyone knows what qualifies as "expediency"?

 

I mean...If they can hold her alive with medicine for 2-3 or more days, will the price be cheaper...I know, dumb question.

 

I just don't get it...I read on reddit as well...It should cover major surgery as well, the 30 baht scheme.

Life threatening emergency treatment is covered free at any hospital.

Non-life threatening is covered free at registered hospital only.

 

But why worry about other people's problems.

Let them ask the advice of a fellow Thai.

Unless they're scamming what they see as a gullible foreigner.

 

When a Thai lady asks for help paying her mom's hospital bills, the correct answer is always, "why is that my problem?"

[IvorBiggun2]

All adult Thais know the rules of the 30 Baht scheme. Don't  get drawn into Thai problems.

[Sheryl]

There are a number of possibilities:

 

1. Might be stent placement and while the procedure and hospitalizarion is free the family may have   to pay the cost of the stent device (if really 70k then likely 2-3 stents).

 

2. Scheduled on a private basis in order to expedite things especially given the Songkran holidays.  There definitely IS a wait list for cardiac surgeries in many public hospitals. And people  do die as a result, or get worse outcomes (more permanent damage to cardiac muscle) . The system is overburdened, especially in Bangkok.   I have friends who went deeply in debt to pay for  bypass surgery at a private hospital recently because the wait for it in govt hospitals in Bangkok was up to 6 months. This was for bypass; stent placement wait time would have been less, but still a wait list for it. 

 

3. Due to not having a referral letter from her registered hospital under the 30 baht scheme. Actually in case of emergency where patient cannot be safely transferred, emergent care can be received in any govt hospital. But cashier will not know if something qualifies as an emergency and will demand payment and yes, will be required in advance.  It usually needs a call(s) to the NHSO hotline to resolve this. Which family should certainly try if this is the issue.

 

Last possibility is that whole thing is a scam to borrow money, only OP is in position to  know  if family really does have critically ill relative. 

 

In cases like this, any delay can seriously affect the outcome because the heart muscle is not getting enough oxygen and will die. Keeping the patient alive with  conservative treatment （medications etc) risks both death and long term disability because even if they survive till surgical intetvrntion there will be more  permanent damage to the heart muscle. 

 

 

 

 

[drenddy]

It's a bypass surgery.

Or it was.

 

Because it has been done.

Not paid yet.

[Sheryl]

14 minutes ago, drenddy said:

It's a bypass surgery.

Or it was.

 

Because it has been done.

Not paid yet.

Then lack of referral letter is probably not the issue. If it was, cost would be much higher, around 200-300k.

 

Likely a private fee to the surgeon  & hospital  to jump the public sector queue.  Was the surgery performed aftet hours? 

[Sheryl]

14 hours ago, KhunLA said:

I guess if you live in these provinces, it's not an issue.  But does someone have to notify them in advance for the extra coverage.

 

I don't see Bangkok listed ...

 

"These provinces are Phetchabun, Nakhon Sawan, Nakhon Ratchasima, Amnat Charoen, Nong Bua Lamphu, Sing Buri, Phang Nga, and Sa Kaeo.
 
The expansion is a result of the NHSO board’s meeting on February 21, which acknowledged the positive outcomes of the phase-one pilot in four provinces - Phrae, Roi Et, Phetchaburi, and Narathiwat"

In addition to being still a pilot and not in all provinces, I am not sure this new scheme allows people  to go directly to any govt hospital. I think the emphasis is on primary level care and linkages with privste pharmacies etc. 

[drenddy]

37 minutes ago, Sheryl said:

Then lack of referral letter is probably not the issue. If it was, cost would be much higher, around 200-300k.

 

Likely a private fee to the surgeon  & hospital  to jump the public sector queue.  Was the surgery performed aftet hours? 

 

As of this morning.

 

Admitted yesterday, as planned, for her dialysis.

 

Has diabetes as well.

 

LE.Should they change her ID card, so shes registered in Bangkok, would it make a difference in future cases?

[Sheryl]

4 hours ago, drenddy said:

 

As of this morning.

 

Admitted yesterday, as planned, for her dialysis.

 

Has diabetes as well.

 

LE.Should they change her ID card, so shes registered in Bangkok, would it make a difference in future cases?

It would  be easier if she were registered in Bkk if that is where she lives.

 

I an quite confused, you say now she was admitted for dialysis and diabetes.  But previoudly said MI and had a bypass? 

[drenddy]

2 hours ago, Sheryl said:

It would  be easier if she were registered in Bkk if that is where she lives.

 

I an quite confused, you say now she was admitted for dialysis and diabetes.  But previoudly said MI and had a bypass? 

 

Its me, who does not have a timeline.

 

Her medical history :

 

She receives dialysis 3 x week.

She has diabetes as well.

And high blood pressure : 2 weeks ago she had above 280

 

Her condition was bad the last weeks : not eating, poor sleeping, very fatigued

 

Planned as usual on Monday and, as her state worsened after dialysis, they discovered MI and got bypass as of this morning.

 

Now back on ICU.

Shes old, perhaps time to let go, but who are we to decide.

Maybe the 3 × weekly dialysis takes its toll now...

 

 

[Sierra Tango]

22 hours ago, KhunLA said:

At a guess, since registered out of the area, she wasn't cover for the procedure at that hospital.  So yea, upfront payment is quite standard.

 

After stabilizing her, also at a guess, considering the price point, they probably wanted to place a stent, to open the blood vessel up.

 

My wife had elective surgery, and over the phone, had her coverage changed from Nong Bua LamPhu to Prachuap Khiri Khan.  Seemed easy enough, but TBH, not sure how long that took.  I think just during the phone call.

 

Her ID was already changed, so may have made it easier, quicker to do.

 

If OP's incident happened over the weekend, and stent was required right away, then oops, yea, should have changed her coverage area a long time ago.

 

Moral of story ... have your Thai partner check their coverage area, and keep current.  In an emergency, will save you a few baht.

 

Also paying to 'jump the queue' is quite standard also, though technically, it may not be 'jumping' the queue, but simply paying for 'off duty hours' service.  Either before or after regulate work hours.

 

I paid that myself as the Q was months long, and I wanted it done ASAP, and was done a week later.

Lots to not understand right there.

[FritsSikkink]

22 hours ago, drenddy said:

 

https://eng.nhso.go.th/view/1/DescriptionNews/NHSO-to-expand-30-baht-get-treatment-anywhere-pilot-project-in-eight-provinces/601/EN-US

 

Looks like, it doesn't require any registration update as from last year?

Just get the referral letter to be sure.

[Andycoops]

The medical coverage for Thai's as I understand it, is related to the address on the ID card.

 

If you are from Buriram but working in Pattaya and need hospital treatment in Pattaya the 30 baht scheme doesn't cover you.

 

It only covers you where you are officially registered and most people don't change their ID card registration to another province from the one they are from.

[Lorry]

On 4/9/2025 at 6:36 PM, KhunLA said:

My wife had elective surgery, and over the phone, had her coverage changed from Nong Bua LamPhu to Prachuap Khiri Khan.  Seemed easy enough, but TBH, not sure how long that took.  I think just during the phone call.

@PPMMUU once posted the phone number which one has to call (i think he posted it last year)

[scorecard]

On 4/10/2025 at 8:57 AM, IvorBiggun2 said:

All adult Thais know the rules of the 30 Baht scheme. Don't  get drawn into Thai problems.

 

Yes but Thais including government agencies  (and including many farang) are very poor at communicating anything and that includes changes / updates to regulations etc.

 

My Thai daughter in law's mother had a serious heart condition, the local upcountry hospital was very small, head dr, and 1 more doctor.

 

Stubborn head dr. refused to sign and documents for the old lady to be moved to a much bigger much better  hospital 100 km away which had a lot of modern equipment and well capable of the heart surgery the old lady needed. Head dr. insisted this was not allowed by the 30Baht regulations. 

 

The old lady died. A family member (senior in another ministry) conduced some research and discovered a notice which cancelled the rule the stubborn dr. was quoting several years previously.

 

More investigation and the notice was found buried  in one of the  big piles of old correspondence on the stubborn dr's desk. 

 

Stubborn dr. was reminded that all staff should have been advised about the change of policy. Stubborn old dr. insisted 'they don't need to know'.

 

A team was formed in each majn province tasked to go to every hospital, give briefings and a pack of all notices for the preceding 10 years to all staff. Attendance compulsory. 

 

Stubborn old dr. was quickly given early retirement.

 

The lack of communications / not keeping people informed is par for the course for my own Thai family. 

 

extended