Expats With Yellow Book To Prove Residency

[sinbin]

Go to any Govt. hospital and you will see Pay in windows in most departments, which are busy and usually queues, and some of the payees are paying huge sums of money.If all health care for the Thais was free why have pay in windows.? All Thais by the way.

The 'Pay in window' is for all people, as well as farangs, that have to pay for treatment/private rooms/dental treatment etc that aren't provided under the umbrella of the free service. Some are not even registered at that particular hospital. So under the scheme they have to pay for everything automatically. It's a way to make Thais use the hospital they are registered at.

Edited December 16, 2011 by Sheryl
civility

[GarryP]

Just to add a little. Under the universal health care scheme you must use the services of the public hospital with which you are registered, otherwise you have to pay for the service. The exception is when you put in an application for referral due to living in another province from the hospital with which you are registered, etc. or your doctor refers you to another hospital such as in the case where you need specific treatment that is not provided by your regular hospital.

There is a list of medicines which can be prescribed under the universal healthcare system, but if you go off that list then you must pay for such off-list medicines yourself. A simple example is fluoride tablets. When undergoing radiotherapy of the throat or mouth, they are often recommended to help protect ones teeth, however, they are not listed as an essential medicine under the system, so if you want them you must pay. You will find that a number of medicines prescribed by private hospitals are not listed. It is up to the individual as to whether that is going to be a major concern. However, you will find that the majority of people on the universal system are not that knowledgeable about their treatments and could not afford private care anyway, so it becomes a non-issue for most.

In addition to the universal healthcare scheme is the social security system for those who are or have worked and paid in. However, one of the strange anomalies these two systems is that universal healthcare provides better healthcare coverage than social security, but if you have the latter, you cannot (are not supposed to) avail yourself of the former. Weird huh?

Having said that, if you have social security coverage, then you would be wise to maintain it, as despite long waits in public hospitals, poor facilities and service, the actual treatment is the same as at most private hospitals and it is a hell of a lot cheaper paying your monthly dues for this than going through private health insurance systems.

Edited December 16, 2011 by GarryP

[BAYBOY]

SIN BIN

Over the last 18 months I have been a constant visitor accompanying my wife to Thonburi Hospital, Siriraj hospital, Ratchaburi Hospital and Singburi Hospital for her treatments. I have been a patient at Chula for 12 months and now go there every 3 months as an out patient. I can only tell you about what I see, what I hear, what I have been asked to do. All my comments are based on personal experience and how it has effected us over the time.

I should must point out that in all these visits, which would be in excess over 30 times, I have only seen 2 foreigners actually being at the hospital for attention. I have sat in out patient depts. for endless hours and I am the only foreigner about. Farangs as such do not use the Govt. system as I see it. The Medical director at Thonburi hospital ( a Private hospital) told me that only about one foreigner is admitted into that hospital in a month. I imagine most foreigners here frequent the several major Private hospitals, as they sure don't use the Govt ones

She has been using the 2 schemes available to the Thai people who don't have medical insurance, social security systems, or Govt employee systems to pay for their health care.

She started off paying the hospitals at the going rate for various treatments and the cost was great in relation to our income and savings.The doctors suggested she go into the '30 BAHT" scheme as she may have a long protracted time in treatments and the cost of that would be out of our range. Currently she is staying at Siriraj and has been there for two and a half weeks having spinal radiation, and has another 2 weeks to go. This will be free unless she incurs extra costs to the actual treatment she is in for. Imagine the cost if she was at one of the top Private Hospitals.

It is not a problem to register at any Govt Hospital. I walked into the Heart Care Center at Siriraj and was given a hospital card in minutes.Under the 30 Baht scheme if you go to another hospital outside your area you have to register first before any thing is started as regards treatment. Usual waiting time and paper war to get registered.

BAYBOY.

[sinbin]

Just to add a little. Under the universal health care scheme you must use the services of the public hospital with which you are registered, otherwise you have to pay for the service. The exception is when you put in an application for referral due to living in another province from the hospital with which you are registered, etc. or your doctor refers you to another hospital such as in the case where you need specific treatment that is not provided by your regular hospital.

The rest of your post I agree with, but this part above needs clarifying. I have the Thai/farang medical card which allows me to get free assistance at the hospital I'm registered with. Today I had to see the doctor due to me having 2 ankle fusions done on the 29th at Suranaree Military Hospital (Government) in Korat. My local hospital phoned some central data base to see if I'm eligible for a transferal under the scheme. The answer was 'NO' as I'm not on the data base, even though I have a card that gives me free treatment. So, even if you have the Thai medical card it's not clear cut that you're entitled to a referral.

[sinbin]

It is not a problem to register at any Govt Hospital. I walked into the Heart Care Center at Siriraj and was given a hospital card in minutes.Under the 30 Baht scheme if you go to another hospital outside your area you have to register first before any thing is started as regards treatment. Usual waiting time and paper war to get registered.

This quote is not true BAYBOY. Under the '30 Baht scheme', call it what you will for your sake, you cannot register at more than one government hospital and get treatment from them all. To go to another government hospital under that scheme, you need a referral. And that isn't guaranteed.

[Sheryl]

Here's another question to be raised if farangs aren't supposed to get 'free medical treatment'. What happens with a farang woman, married to a Thai, that's pregnant. Does she have to pay for all her pre & post natal treatment along with the cost of the birth ? After all when she gets her annual visa, she and her husband do not have to show money in a Thai bank account. Different rules for the sexes it appears. And if her treatment is free, then she has to have the medical card. Whoops, farangs can't have one. Just a thought.

There is no special exception made for pregnant farangs (and how on earth would the Thai government or NHSO ascertain the nationality of the father?)

The child, on the other hand, once born, would qualify as a Thai citizen

One area where I am uncertain is foreigners with permanent resident status (as opposed to those here on visas, be they spousal, retirement or whatever). I do not know whether they would qualify for the universal health scheme or not, but of course that is a very small portion of the farang living in Thailand.

And of course should a foreigner somehow obtain Thai citizenship, they would have al lthe rights of a Thai with regard to this and any other government entitlements.

[Sheryl]

2 posts have been edited in the interests of civility. No need to get irritable with one another, folks. We're all trying to get the facts straight on a matter that directly affects us all.

[ludditeman]

On the contrary, visa rules are set up to try to ensure that only foreigners who can fully support themselves, hopefully to the benefit of the local economy, get visas. Retirement visas are allowed solely because it is expected that well-off retirees will be a money-maker for the country.

Around last January there were articles in several major papers to the effect that the government was considering asking for proof of health insurance for retirement visas in future because government hospitals have been taking a loss on foreign retirees who can't fully pay their bills. (Little did they know some are being issued "gold cards" and riding the system for free altogether!).

What a strange post!

As a foreigner, I pay 2x-3x the tax of most Thais (sales tax), because I buy more.

Most Thais pay no income tax at all, but I do pay tax on my bank account interest.

I also provide completely for 4 Thai citizens.

Tell me how you, or anyone else can consider, I am not paying my way?

I'm certainly contributing more to the Thai economy than any TEFL teacher.

The UK government allows any Thais living in the UK to claim health care, as is only reasonable in any civilised country.

Edited December 16, 2011 by ludditeman

[sinbin]

On the contrary, visa rules are set up to try to ensure that only foreigners who can fully support themselves, hopefully to the benefit of the local economy, get visas. Retirement visas are allowed solely because it is expected that well-off retirees will be a money-maker for the country.

Around last January there were articles in several major papers to the effect that the government was considering asking for proof of health insurance for retirement visas in future because government hospitals have been taking a loss on foreign retirees who can't fully pay their bills. (Little did they know some are being issued "gold cards" and riding the system for free altogether!).

What a strange post!

As a foreigner, I pay 2x-3x the tax of most Thais (sales tax), because I buy more.

Most Thais pay no income tax at all, but I do pay tax on my bank account interest.

I also provide completely for 4 Thai citizens.

Tell me how you, or anyone else can consider, I am not paying my way?

I'm certainly contributing more to the Thai economy than any TEFL teacher.

The UK government allows any Thais living in the UK to claim health care, as is only reasonable in any civilised country.

I too support 4 Thai citizens (directly). My wife and 3 Luk Kreung children of Thai citizenship. I spend 700-800,000 Baht a year trying to intergrate into the Thai way of life but all I get is 'them & us"attitude from the Thais. I sometimes have to ask "is it worth it" ?

[sinbin]

On the contrary, visa rules are set up to try to ensure that only foreigners who can fully support themselves, hopefully to the benefit of the local economy, get visas.

That's not true Sheryl, because farang women, married to a Thai, do not have to show they "can fully support themselves". Or even support themselves basically. Farang women, married to Thai men, do not have to show any money to stay in Thailand. Neither does her Thai husband. A case of double standards by the Thais. Obviously you already know that ??

Please don't take offence at my avatar. It's aimed at Mario299 who requested it.

Edited December 16, 2011 by sinbin

[harrry]

Possibly some of the strong views on this topic depend on where the poster originates from. US people are used to a pay for service system in healthcare with very limited (and in my view very poor)options for those without money.

People from countries such as the UK Australia and Canada largely have an expectation of at least a serviceable degree of healthcare provided to all.

I understand the Health Care in Thailand originated as a result of a Constitutional right which in fact was based on rights of all people and not just citizens.

How this has been applied seems to vary but after all this is Thailand.

Edited December 16, 2011 by harrry

[sinbin]

Sorry double post.

Edited December 16, 2011 by sinbin

[sinbin]

Possibly some of the strong views on this topic depend on where the poster originates from. US people are used to a pay for service system in healthcare with very limited (and in my view very poor)options for those without money.

People from countries such as the UK Australia and Canada largely have an expectation of at least a serviceable degree of healthcare provided to all.

I understand the Health Care in Thailand originated as a result of a Constitutional right which in fact was based on rights of all people and not just citizens.

How this has been applied seems to vary but after all this is Thailand.

I hate people that say "this is Thailand". Does that make everything okay ???

[Sheryl]

Let's not get off topic into debating whether or not Thailand ought to provide free health care to foreigners. That sort of debate doesn't belong in the health forum.

My post was not intended to convey a personal opinion of that sort but rather what I understand to be the government's perspective and what they are/are not likely to do.

Regardless of whether or not one thinks they ought to, the Thai government does not have a policy of providing free health care to foreigners and are not likely to anytime in the forseeable future. Furthest thing from their minds.

And sooner or later the fact that some hospitals have issued cards to foreigners will come to the notice of powers that be and they'll put a stop to it. Those who have such cards would do well to make contingency plans. My strong advice is to get health insurance now if you can, as it is harder to do as you get older and/or develop health problems. Do not count on getting free health care here, even if you have been issued a "gold card".

[BAYBOY]

SINBIN re post #65.

As i have said before I can only relate my experiences at Govt. hospitals as they have happened to my wife and I.Any experiences you may have encountered that are not the same as ours are yours.....not mine.

Early November my wife was not well, I rang the doctor dealing with her in Bangkok who told me Siriraj was closed due to flooding. The hospital was OK, but staffing was the problem.

He told us to go to Ratchaburi Hospital, register there on the 30 baht system, then go to the outpatients Dept. This we did, in fact I did it, as my wife was on a stretcher. No mention of a referral from another hospital or doctor, nor one asked for. Not questioned why she was from Singburi and was a patient at Siriraj in Bangkok, just handed the forms across and job done. Then went into the out patients dept, saw the senior nurse who told us that the hemotogist doctor, would see us as that who the Bangkok doctor told us to see. We traveled across 4 provinces to get to Ratchaburi and referrals never asked for. Eight days later we were back there again, and again never asked for referral.... showed the paper work again and admitted.

SO what ever you think, understand or know about the system, I have experienced different outcomes to your knowledge and I am more than happy with how we have been treated at all of the Govt hospitals under the free system. By now, you should know, what you read, what you are told, and what you think and the eventual outcome may be 4 totally different things here in Thailand.

Why... for a man who professes to spend 700-800,000 baht a year in Thailand,... want to use the free system???

BAYBOY

[sinbin]

Let's not get off topic into debating whether or not Thailand ought to provide free health care to foreigners. That sort of debate doesn't belong in the health forum.

My post was not intended to convey a personal opinion of that sort but rather what I understand to be the government's perspective and what they are/are not likely to do.

Regardless of whether or not one thinks they ought to, the Thai government does not have a policy of providing free health care to foreigners and are not likely to anytime in the forseeable future. Furthest thing from their minds.

And sooner or later the fact that some hospitals have issued cards to foreigners will come to the notice of powers that be and they'll put a stop to it. Those who have such cards would do well to make contingency plans. My strong advice is to get health insurance now if you can, as it is harder to do as you get older and/or develop health problems. Do not count on getting free health care here, even if you have been issued a "gold card".

Once again Sheryl. Obviously you're married to a Thai. If you, theoretically, fell pregnant, would you, as a farang, get pre & post natal treatment free of charge at a government hospital ? Answer the question honestly and I'll finish.

Edited December 17, 2011 by Sheryl
civility

[TerryLH]

"However, one of the strange anomalies these two systems is that universal healthcare provides better healthcare coverage than social security,..."

GarryP, can you give an example?

I use SS, and what you are saying has not been my experience. I have relatives who use the '30 baht' system, so have some experience with that system, as well.

Terry

[ludditeman]

There is no special exception made for pregnant farangs (and how on earth would the Thai government or NHSO ascertain the nationality of the father?). The child, on the other hand, once born, would qualify as a Thai citizen

For a married couple, they would ascertain the nationality of the father by reading the marriage certificate.

Edited December 17, 2011 by ludditeman

[sinbin]

There is no special exception made for pregnant farangs (and how on earth would the Thai government or NHSO ascertain the nationality of the father?). The child, on the other hand, once born, would qualify as a Thai citizen

For a married couple, they would ascertain the nationality of the father by reading the marriage certificate.

Too obvious. But farang women are given 'special exceptions' that she can live here without a show of money ?

Edited December 17, 2011 by sinbin

[Sheryl]

Once again Sheryl. Obviously you're married to a Thai. If you, theoretically, fell pregnant, would you, as a farang, get pre & post natal treatment free of charge at a government hospital ? Answer the question honestly and I'll finish.

I am not married to a Thai. Projection on your part. .

The question regarding pregnant farang married to a Thai was answered already. Perhaops you failed to read that post. It's # 66 or 68.

[Sheryl]

Once again Sheryl. Obviously you're married to a Thai. If you, theoretically, fell pregnant, would you, as a farang, get pre & post natal treatment free of charge at a government hospital ? Answer the question honestly and I'll finish.

I am not married to a Thai. Projection on your part. .

The question regarding pregnant farang married to a Thai was answered already. Perhaps you failed to read that post. It's # 66 or 68.

But again, the point is not the fairness of existing laws/policies nor what they "should" be. The point is to clarify the facts as they are, and what farang living in Thailand -- of either gender and under any type of visa -- need to do to be assurred of access to health care when they need it. Something that not infrequently becomes a serious, life-threatening, problem. These pages have certainly seen their share of tragic stories and circumstances because someone did not realize the need to have insurance, or let their coverage under the SS scheme lapse.

As such, it is an appropriate one to hash out in the health forum.

Those who for some reason want to have an ideological debate, please take it elsewhere. (And keep it civil when you get there!)

[GarryP]

"However, one of the strange anomalies these two systems is that universal healthcare provides better healthcare coverage than social security,..."

GarryP, can you give an example?

I use SS, and what you are saying has not been my experience. I have relatives who use the '30 baht' system, so have some experience with that system, as well.

Terry

I forget the exact differences, but it was quite a big issue earlier in the year with many complaints by Thai workers that they could not take benefit of universal coverage when on SS. The issue arose because certain treatments are not available under SS that are under universal. So workers ended up paying for those treatments. It was in the Thai press and English language press and also on broadcast media. More information may possibly be found at the ilo.org website. There was a nice table of the differences which appeared in an English language newspaper which was not the Nation on the 15th February 2011.

There is also another scheme for civil servants (public workers). But simply, no aids drugs under SS, limited dialysis coverage, no cover for extended hospital stays, etc. Basically, Universal is the better of the two.

[Sheryl]

Yes, it is not an issue of ease of use but rather what treatments/procedures/medications are covered.

Over time this has been expanded for those under the universal ("gold card" scheme band the SS has not kept pace.

Lots of discussion about this and I expect that the two systems will eventually be made the same in terms of what they cover.

[sabaijai]

Just for the record, I've been treated at a couple of government hospitals in Bangkok under the free health plan, and neither asked for a work permit or yellow house registration (both of which I do hold). Most recently it was emergency treatment for a kidney stone at Kluay Nam Thai. When I asked for the bill at the end of the ordeal, I was told I was covered by the free health plan instituted under the Abhisit administration.

I also know several foreigners in Chiang Mai who regularly use the free health plan, without using a thabian baan.

Perhaps it varies from hospital to hospital. Policy is one thing, reality another

[GarryP]

Just for the record, I've been treated at a couple of government hospitals in Bangkok under the free health plan, and neither asked for a work permit or yellow house registration (both of which I do hold). Most recently it was emergency treatment for a kidney stone at Kluay Nam Thai. When I asked for the bill at the end of the ordeal, I was told I was covered by the free health plan instituted under the Abhisit administration.

I also know several foreigners in Chiang Mai who regularly use the free health plan, without using a thabian baan.

Perhaps it varies from hospital to hospital. Policy is one thing, reality another

I can also get free treatment at Kluay Nam Tai, but that is because it is the hospital I named when I got my last "Confirmation of Right to Medical Treatment Card" issued by the Social Security Office, Ministry of Labour. The hospital is even named on the front of the card. However, if I go there without my card they can still check whether I am eligible or not. Actually, it is not free as ss payments are deducted from my salary every month, however, no payment would be made by me directly to the hospital when seeking treatment under this scheme (for most things). So far I have not needed to use it as I also have private coverage provided by my employer. Nevertheless, once retired I intend to keep my payments up.

[jakhoeblal]

<p>Dear all,</p>

<p> </p>

<p>I have a yellow book as most of you and I would like to request the gold card at my local hospital. It would be very helpful if one of you can sent me a copy of 1 page of your yellow book with your name and a copy of the corresponding gold card. Please, please...(maybe user SINBIN?</p>

<p>This can be very helpful for me, to explain the admin at the local hospital (in fact a clinic).</p>

<p> </p>

<p>Thanks a lot guys for the useful information !!!</p>

<p> </p>

<p> </p>

<p>Please sent to my email:   jakhoeblal AT gmail DOT com</p>

Edited May 2, 2013 by jakhoeblal

[jakhoeblal]

Dear all,

I have a yellow book as most of you and I would like to request the gold card at my local hospital. It would be very helpful if one of you can sent me a copy of 1 page of your yellow book with your name and a copy of the corresponding gold card. Please, please...(maybe user SINBIN?

This can be very helpful for me, to explain the admin at the local hospital (in fact a clinic).

Thanks a lot guys for the useful information !!!

Added info: please sent to my email: jakhoeblal AT gmail DOT com

[Sheryl]

As has already been explained several times in this thread, a yellow book does not entitle you to a gold card.

A yellow book is simply proof of where you live, useful for things like buying/registering a vehicle. It caries no entitltements.

[sinbin]

Why... for a man who professes to spend 700-800,000 baht a year in Thailand,... want to use the free system???

Why not? Why shouldn't I get something back from the government for what I spend here, compared to the average Thai? The real reason as to why I use the "free system" is because it was the hospital staff that told me to get it as other farang had it.

If a Thai was to go to the UK I'm sure he too wouldn't pay for his medical costs.

Edited May 15, 2013 by sinbin

[sinbin]

yellow book is simply proof of where you live

Sheryl a 'Yellow Book' isn't simply proof of where you live. It's the 13 digit number that's in the 'Yellow Book' that is important part. Without the 13 digit number you're stumped to getting a 'Thai medical card'.

Edited May 15, 2013 by sinbin