Thai Government Insurance For Husbands Of Thai National?

[liberty9133]

I am 68. I have done some research on health care. there are some few questions maybe some of you could answer.

I understand that if you marry a Thai you get the wife's coverage also. THen again I have been told that only applies if her employer allows it . In the case of government workers it appears that one is automatically covered.

Is any of this true?

[colinneil]

Yes it is true my thai wife is a school director , i get free health care.

[cooked]

As far as I know, only for government employees. There may well be some private companies around that provide health care for spouses.

I wonder what standard of health care we are talking about here?

[TerryLH]

Family members are usually covered for Government Civil Service workers.

Some government jobs are not Civil Service, so don't have family coverage.

[citizen33]

Yes, Terry is quite right. Spouses will be covered if the worker is covered for health care under the civil servant medical benefit scheme. However, there has been a trend in recent years to employ some workers as public service officers rather than civil servants, even in occupations like university teachers and medical doctors where all employees were previously civil servants. So it comes down to civil service status and which insurance scheme applies rather than occupation per se,

The standard of care seems quite good. Comparisons between the three public schemes show that the spend per episode of treatment in the CSMBS is considerably higher than in the Social Security Scheme or the Universal Coverage Scheme. As a footnote, I don't know if you noticed that the co-payment for the UCS came back at the beginning of September (at least for hospital care) - so we may be calling it the 30 baht scheme again soon.

Edited September 30, 2012 by citizen33

[Mario2008]

As has been said, the children, parents and spouse of a civil servant are covered. You can register yourself at the hospital so you don't have to pay up front, if yu don't do that you will need to pay first and get it back through your wife's "employer".

Regestering takes a while as it goes through Bangkok, but after that most is free. Not everything, things such as prevention (medical check-ups, vaccinations etc) you have to pay for yourself as it is not covered.

[Saan]

As has been said, the children, parents and spouse of a civil servant are covered. You can register yourself at the hospital so you don't have to pay up front, if yu don't do that you will need to pay first and get it back through your wife's "employer".

Regestering takes a while as it goes through Bangkok, but after that most is free. Not everything, things such as prevention (medical check-ups, vaccinations etc) you have to pay for yourself as it is not covered.

Can anyone please tell me what is the process for registering at the hospital under the scheme? What documents are required?

Also does anyone know how the co-payment system works?

Thanks in advance.

[Mario2008]

You can already make use of the government workers insurence of your wife, but have to pay for it yourself and give the receipt to your wife's employer. She will then be re-imbursed.

With registering at a hospital, you don't have to pay first and get it back later. The hospital will get the payment direct from the government health insurence.Your wife has to fill in some forms through her employer and at the hospital and it will be arranged in about 1 month. You do this for every hospital where you register yourself.

I'm currrently registred at 3 hopsitals this way. My local hopsital, the provincial hopsital and a very big hospital in another province.

[Saan]

You can already make use of the government workers insurence of your wife, but have to pay for it yourself and give the receipt to your wife's employer. She will then be re-imbursed.

With registering at a hospital, you don't have to pay first and get it back later. The hospital will get the payment direct from the government health insurence.Your wife has to fill in some forms through her employer and at the hospital and it will be arranged in about 1 month. You do this for every hospital where you register yourself.

I'm currrently registred at 3 hopsitals this way. My local hopsital, the provincial hopsital and a very big hospital in another province.

Thanks Mario, good news.

[edwinchester]

I think I have mentioned this previously but here's the info again.

I was issued a government health card at the same time I was given my yellow house book.

The number on my health card is the same as that in my yellow book.

If you have a yellow house book it is worth going along to your local health care centre or hospital. You may find you are already in the system.

[citizen33]

Two other points about the Civil Servant Medical Benefit Scheme are:

(1) Members are normally treated in public hospitals, except where the scheme has negotiated the provision of specialist care services with certain private hospitals. This is not necessarily a disadvantage, as the average annual spend per member is higher in the CSMB scheme than the other two public schemes.

(2) There is no general co-payment, but I believe there may be some circumstances in which you can top-up by paying extra, for instance for a private room.

Regarding Edwin's last post above, you'll see this issue discussed in many past threads. I've been told by senior people in NHSO that, although a few expats slipped though the net in the past, only Thai citizens are entitled to treatment under the Universal Coverage or 'gold card' Scheme (and that goes for Blue Book holders as well as Yellow). It would be nice if the rules were re-written in future and there is some discussion of the position of non-nationals at present.

Edited January 15, 2013 by citizen33

[TerryLH]

"There is no general co-payment, but I believe there may be some circumstances in which you can top-up by paying extra, for instance for a private room."

I've done this a couple of times. I would pay the difference between a shared room and a private room.

I've done it at both a private and at a government hospital.

Terry

[edwinchester]

"There is no general co-payment, but I believe there may be some circumstances in which you can top-up by paying extra, for instance for a private room."

I've done this a couple of times. I would pay the difference between a shared room and a private room.

I've done it at both a private and at a government hospital.

Terry

Wifeys dad is doing that right now as he is in a Govt hospital for a cataract op. Private room with two beds is an extra 700 bht a night.

[Saan]

You can already make use of the government workers insurence of your wife, but have to pay for it yourself and give the receipt to your wife's employer. She will then be re-imbursed.

With registering at a hospital, you don't have to pay first and get it back later. The hospital will get the payment direct from the government health insurence.Your wife has to fill in some forms through her employer and at the hospital and it will be arranged in about 1 month. You do this for every hospital where you register yourself.

I'm currrently registred at 3 hopsitals this way. My local hopsital, the provincial hopsital and a very big hospital in another province.

Mario, can you tell me more explicitly what the forms are needed from the employer to register at a hospital. My wife's boss says he is unaware of such forms - maybe he is just being recalcitrant and if I can specify the forms he might be more co-operative.

[Mario2008]

Not sure, if I recall correctly we went to the hospital and they did (at least part) of the paperwork, through the Central Office for Healthcare information.

all in Thai: http://cs3.chi.or.th/

[Saan]

Not sure, if I recall correctly we went to the hospital and they did (at least part) of the paperwork, through the Central Office for Healthcare information.

all in Thai: http://cs3.chi.or.th/

Thanks again Mario. My wife is away working but I will get her to translate it for me when she returns on the weekend.

[BB1955]

Its my understanding that if you are married to a Thai and here on a marrage visa and are listed in the yellow book you can register for the 30 baht plan . I have talked to a few people who have got on it and have used it . Waiting for my yellow book now and will attempt it myself soon .. But I still probably will keep my private coverage as well ....

[thetefldon]

Glad I found this thread since I was going to start one to inform qualifying members about the scheme. My wife is a retired teacher so is covered by teachers scheme(civil service?). Her family + me are also covered for all costs.

I just signed up at the local hospital and now have a card.

Paperwork from me was passport pages(usual) marriage cert from Amphur. Wife did other stuff at teachers office and hospital. But mostly was ID etc.

For info I do have a yellow book and I use a retirement extension to remain in Kingdom since it involves less paper.

[BB1955]

Its my understanding that if you are married to a Thai and here on a marrage visa and are listed in the yellow book you can register for the 30 baht plan . I have talked to a few people who have got on it and have used it . Waiting for my yellow book now and will attempt it myself soon .. But I still probably will keep my private coverage as well ....

I got the yellow book today with my name in it . We went to the hospital and tried to enroll . They entered my ID number and it would not except it . Anyone had any experience with this ? Pm me if you have I really would like on the sytem

[Phil_Pattaya]

I am in the system but I believe it has now ceased for new enrolment. I am married to a thai and have yellow tabien bann. I was originally in yellow book in Pattaya but moved house in 2010 to Phetchabun. Because I moved house after they stopped this and I did not register in my local hospital at that time. I am now only entitled to emergency treatment in Phetchabun where I now live, but am entitled to free routine treatment in Pattaya (strange but true). This has been confirmed by both Phetchabun and Pattaya hospitals. As for above posts no-one slipped through the net as it was a right but has now ceased for new entrants. I have seen my details on hospital computer and have print out of same details. I could not get a "Gold Card" as it has now stopped but as said was already automatically registered for healthcare. If you have a yellow tabien bann is worth asking in the area where you first received the yellow book as you may well be registered there and it is up to you to transfer you details to new location, but will probably be like myself and have 2 areas for treatment.

[TerryLH]

"I have seen my details on hospital computer..."

Anyone can register at any hospital. When you register they give you a number. That's how they track your medical records.

I believe that many people think they have some kind of special deal because the normal fees are so inexpensive.

[citizen33]

"I have seen my details on hospital computer..."

Anyone can register at any hospital. When you register they give you a number. That's how they track your medical records.

I believe that many people think they have some kind of special deal because the normal fees are so inexpensive.

Terry is quite right. Unfortunately all the stuff above about yellow tabien baans and the universal coverage (30 baht) scheme is incorrect. Some westerners were registered by mistake when they were ineligible, but the loophole has been closed. The legislation and operational regulations have not changed. I got this information via my work from a high-level source in the NHSO. It is possible that some lower-level staff still don't properly understand the rules. The good news is that (1) a westerner married to a civil servant (or in a dependant relationship) can get cover under the civil service medical benefits scheme, and (2) many westerners can join the social security scheme through their employment and pay to maintain their coverage when they finish working. You need to understand that there are three public schemes: the UCS, the SSS and the CSMBS. Edited May 4, 2013 by citizen33

[Phil_Pattaya]

BB Yes Terry is quite right however you must both be talking about a different scheme then. I did not register at any hospital, I was registered by the office who gave me my tabien bann in Banglamung with the same number that is in my yellow book. I only found out I had been registered when I went to the local hospital in Phetchabun who then told me the above. When I enquired about transfering to them they told me I could no longer change hospitals as the scheme had now ceased but as I said before would still be entitled to emergency cover there, and routine in Banglamung.

Strange how 2 hospitals in 2 separate provinces are wrong and some high ranking official is right, as in my experince most high ranking officials in most places of work havn't got a clue and rely on the lower level staff to get things done. They always misinterpret rules in all departments so I fear your expert is wrong also. All the expats who I have spoken to in Phetchabun are receiving free treatment in the local hospital who hold yellow books there. There was no loophole to close they simply ended new enrolment into the system.

Edited May 4, 2013 by Phil_Pattaya

[Phil_Pattaya]

BB Yes Terry is quite right however you must both be talking about a different scheme then. I did not register at any hospital, I was registered by the office who gave me my tabien bann in Banglamung with the same number that is in my yellow book. I only found out I had been registered when I went to the local hospital in Phetchabun who then told me the above. When I enquired about transfering to them they told me I could no longer change hospitals as the scheme had now ceased but as I said before would still be entitled to emergency cover there, and routine in Banglamung.

Strange how 2 hospitals in 2 separate provinces are wrong and some high ranking official is right, as in my experince most high ranking officials in most places of work havn't got a clue and rely on the lower level staff to get things done. They always misinterpret rules in all departments so I fear your expert is wrong also. All the expats who I have spoken to in Phetchabun are receiving free treatment in the local hospital who hold yellow books there. There was no loophole to close they simply ended new enrolment into the system.

Meant to add, I think I probably got registered as I was not working in Thailand which was another option for poor people. In any case if not free then will have to pay the 30 baht, so be it.

[citizen33]

There was no loophole to close they simply ended new enrolment into the system.

I will keep my response polite and simply ask what programme or system this is? In fact the only general programme that would cover beneficiaries on a residency basis (where the house registration book is relevant) is the UCS (AKA the goldcard or 30 baht scheme). Most of the rules are on the NHSO website. If you can get a Thai speaker to help you, you'll see that the scheme only applies to Thai nationals (Q1) and that you need to produce both a citizen ID card and a house registration document to register (Q5).

http://www.nhso.go.th/FrontEnd/page-forhospital_faq.aspx

If you are interested in where the rules come from look at the National Health Security Act 2002. It is the senior executives of the NHSO who translate the legislation into the regulations, and I have spoken to at least three on the question of westerner entitlements and more than once.

Edited May 5, 2013 by citizen33

[TerryLH]

"There was no loophole to close they simply ended new enrolment into the system."

As mentioned above, there are three systems for health coverage here.

I think what has ended is enrollment into a system without meeting the requirements for that system.

Other than that, enrollment in any of the three systems continues, as long as the persons are eligible.

Enrollment in a specific hospital, under the SS system, might not be allowed because of a couple of reasons.

The hospital might have reached the limit as to the number of people they feel they can accept - under that system.

Or

The hospital has opted out of the system.

In this case the SS Office will arrange to have your records transferred to another hospital in the area.

Terry

[Mario2008]

They didn't foresee that since 2008 foreigners can easily be added to a household registration book and under the regulation than you were entitled to free healthcare if you were on a household registration book. That situation has now been rectified and being on a yellow tabien baan does no longer qualify you for free medical care.

Some amphurs and hospitals seem not to be aware of this change and still issue a card, but that is not according regulations. Old cases, before the rule change seem to have been grandfathered.

[Phil_Pattaya]

They didn't foresee that since 2008 foreigners can easily be added to a household registration book and under the regulation than you were entitled to free healthcare if you were on a household registration book. That situation has now been rectified and being on a yellow tabien baan does no longer qualify you for free medical care.

Some amphurs and hospitals seem not to be aware of this change and still issue a card, but that is not according regulations. Old cases, before the rule change seem to have been grandfathered.

It was after the coup and around 2008 they changed the system and I believe that "gold cards" are no longer issued. As far as I know no-one after that date in or around 2008 will be registered by the Amphur who issued the respective Yellow Tabein Bann to recieve free treatment. I can confirm that gold cards are no longer issued as I do not have one but am in their system for free healthcare, and as I said previously I was registered by them before the change. So anyone getting a new yellow book for the first time will have dipped out.

[citizen33]

It was in 2009 that the issuing of gold cards was phased out.

http://www.nhso.go.th/eng/Files/content/255503/df7750b0-8e26-400d-b8f0-21ff4fce159d-129775528334741250.pdf

The conditions for enrolment are clearly stated on the NHSO website (in Thai) in the link posted above and are still related to residency and registration with a local contracting unit for primary care. The 2002 Act states who is covered and this remains in force.

It is important that the information we provide on topics like this don't mislead TV members, but unfortunately misinformation abounds. It seems that believing westerners are eligible for the UCS is rather like believing in UFOs. It is hard to disprove through rational means.

That being said, it is interesting to collect stories about expats who may have been incorrectly issued with gold cards in the past. I wonder what was entered in the system in lieu of the Thai ID card number. How did this work when a patient was referred to a provincial or tertiary care hospital outside the local district?

Re: Mario's point above the regulation was always blue book plus ID card. The regulation did not change, only the enforcement.

Edited May 7, 2013 by citizen33

[Mario2008]

If you are on a tabian baan (blue or yellow) you automatically have a Thai ID-number assigned to you, stated in the registration book.