30 Bht Health Scheme

[swissie]

As I learned by now, farangs can join the 30 Bht health-program, as long as they can produce a valid "housebook". Thai's call this the "Gold-Card".

I questioned my Thai-Neighbors, as if this would cover "serious-stuff" like hospitalization (heart attack, stroke, etc.)

MUCH TO MY SURPRISE: None of them could give me a conclusive answer. !!??!!

Anyone?

Cheers.

[PalMan]

Don't know about "gold card" but I was under the impression that one needed to be a permanent resident to be entered into the house registration book (tha bien baan).

[Soutpeel]

to quote Sheryl who is the mod on the health forum, where this has been discussed at length...

"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"

http://www.thaivisa.com/forum/topic/517331-expats-with-yellow-book-to-prove-residency/page-4

[stoneyboy]

I believe a friend recently,long term expat of 25 years was given a card based on house book marriage etc,as to what he gets I'm not sure,i would need to speak with him,but I do recall him telling me that he's likely going to get his monthly meds for free and I believe a reduction in the overall cost of health care.

[Gsxrnz]

According to the following article, the scheme is now called "The Universal Coverage Scheme". If you read it you will see that members are entitled to "Universal" health treatment, without exception. By inference therefore, if you are a qualifying member, you get unlimited health care in Thailand. Good luck with that.

http://maytermthailand.wordpress.com/2012/05/05/the-health-care-system-in-thailand-3-2/

[citizen33]

Unfortunately the UCS only covers Thai citizens. Westerners in yellow house registration book and even permanent residents in blue books are not covered by the scheme, although in the past a few were registered by mistake. I fear that the idea that a yellow book gets you coverage is becoming a bit of an urban myth. Something that may confuse some people is that anybody can register as a patient at a local public hospital and get routine treatments at very affordable cost. Westerners n jobs may be covered by another public scheme - the social security scheme, and spouses or dependents of civil servants (e.g. teachers) are covered by the civil service scheme.

The NHSO is a bit slow to translate its annual reports into English and get them on its website, but look at p 12.

http://www.nhso.go.th/eng/Files/content/255503/d0bf51c2-1121-4d35-aeae-691c1fdc1fb4-129775552736772500.pdf

Edited May 17, 2013 by citizen33

[swissie]

Unfortunately the UCS only covers Thai citizens. Westerners in yellow house registration book and even permanent residents in blue books are not covered by the scheme, although in the past a few were registered by mistake. I fear that the idea that a yellow book gets you coverage is becoming a bit of an urban myth. Something that may confuse some people is that anybody can register as a patient at a local public hospital and get routine treatments at very affordable cost. Westerners n jobs may be covered by another public scheme - the social security scheme, and spouses or dependents of civil servants (e.g. teachers) are covered by the civil service scheme.

The NHSO is a bit slow to translate its annual reports into English and get them on its website, but look at p 12.

http://www.nhso.go.th/eng/Files/content/255503/d0bf51c2-1121-4d35-aeae-691c1fdc1fb4-129775552736772500.pdf

As it were: So far, I have met 2 Farangs that were able to actually show me their "Gold-Card". = House-Book plus proof of marriage to a Thai-National were the requirements and no more. According to above comment, those gold-cards must have been issued "by error".

Nevermind and lets keep it simple. Next week I shall go and apply! It can only be yes or no!

I will allow myself to report the result back to this forum.

Of course, if this matter is dependent on the daily-mood of the official in charge handling the request (similar to immigration authorities), then...............no further comment.

Cheers.

[Satcommlee]

I am registered to a hospital in Prathum Thani, I have some sort of paper card. but this is because I pay into the social fund and have work permit etc..

I'd actually like to know what this is and what I am entitled to (I'm guessing not very much).

[citizen33]

I am registered to a hospital in Prathum Thani, I have some sort of paper card. but this is because I pay into the social fund and have work permit etc..

I'd actually like to know what this is and what I am entitled to (I'm guessing not very much).

It sounds as though you have been enrolled in the social security scheme (bpragan sangkhom) through your employer, If you read the report at the link I posted above you will see that there are three main public health insurance schemes in Thailand. Details of the SSS are here.

http://www.sso.go.th/wpr/eng/

Regarding Swissie above, we will await his report with interest. The problem is that even if a local contracting unit for primary care mistakenly registered him, the likelihood is that the error would be discovered if he were ever referred to a larger hospital with a serious condition and he would find himself facing a very large bill. Incidentally the issuing of gold cards was phased out a few years ago, and the intention is that people now use either the multi-purpose smart ID card or old gold card plus old citizen ID card.

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

Edited May 18, 2013 by citizen33

[harryfrompattaya]

Sorry to say no way you are covered. Stop dreaming

Edited May 18, 2013 by harryfrompattaya

[Sheryl]

I am registered to a hospital in Prathum Thani, I have some sort of paper card. but this is because I pay into the social fund and have work permit etc..

I'd actually like to know what this is and what I am entitled to (I'm guessing not very much).

It sounds as though you have been enrolled in the social security scheme (bpragan sangkhom) through your employer, If you read the report at the link I posted above you will see that there are three main public health insurance schemes in Thailand. Details of the SSS are here.

http://www.sso.go.th/wpr/eng/

Regarding Swissie above, we will await his report with interest. The problem is that even if a local contracting unit for primary care mistakenly registered him, the likelihood is that the error would be discovered if he were ever referred to a larger hospital with a serious condition and he would find himself facing a very large bill. Incidentally the issuing of gold cards was phased out a few years ago, and the intention is that people now use either the multi-purpose smart ID card or old gold card plus old citizen ID card.

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

Exactly correct.

Foreigners who are or have beenb leglally employed for a certain time period (I think 13 months?) are fully eligible for coverage under the Thai Social Security scheme and can keep that coverage for life as long as they ocntinue to pay into it.

Foreigners legally married to Thai civil servants are covered under the civil service scheme.

Foreigners are not eligible for the UCS, period, full stop. Occasionally hospitals make a mistake and register them, mostly seems to happen in smaller community hospitals. Dies indeed get foudn out and corrected if you are referred up the system to hgiher levels, and is definiotley not supposed to happen.

[swissie]

Unfortunately the UCS only covers Thai citizens. Westerners in yellow house registration book and even permanent residents in blue books are not covered by the scheme, although in the past a few were registered by mistake. I fear that the idea that a yellow book gets you coverage is becoming a bit of an urban myth. Something that may confuse some people is that anybody can register as a patient at a local public hospital and get routine treatments at very affordable cost. Westerners n jobs may be covered by another public scheme - the social security scheme, and spouses or dependents of civil servants (e.g. teachers) are covered by the civil service scheme.

The NHSO is a bit slow to translate its annual reports into English and get them on its website, but look at p 12.

http://www.nhso.go.th/eng/Files/content/255503/d0bf51c2-1121-4d35-aeae-691c1fdc1fb4-129775552736772500.pdf

As it were: So far, I have met 2 Farangs that were able to actually show me their "Gold-Card". = House-Book plus proof of marriage to a Thai-National were the requirements and no more. According to above comment, those gold-cards must have been issued "by error".

Nevermind and lets keep it simple. Next week I shall go and apply! It can only be yes or no!

I will allow myself to report the result back to this forum.

Of course, if this matter is dependent on the daily-mood of the official in charge handling the request (similar to immigration authorities), then...............no further comment.

Cheers.

As promised, I shall report back now on this matter:

- Went to apply for the 30 Bht program today with my housebook and proof of marriage to a Thai-National.

The verdict: ONLY AVAILABLE TO THAI-NATIONALS ! Period. "Gold-Cards" already issued (in error) to Farangs, need not to be honored by hospitals.

This information from the chief-administrator of the local hospital in Chat-Pa-Way, Ratchabury province.

Cheers.

[NancyL]

Yes, unfortunately some foreigners think they've got full coverage because they have a gold card and used it a time or two at the local hospital. I know of one unfortunate case where a foreigner really should have got himself back to his home country to use their free medical care, but stayed here getting treated for a terminal condition, starting at the local hospital -- he thought he'd have complete care during the entire course of the illness.

Once the condition became too serious for the local hospital to handle, he was sent to the regional hospital where the error was discovered. He left his family with high medical bills and, in my opinion, didn't receive the quality of care he would have received if he'd just gotten himself back to his home country when he could still travel.

Edited May 21, 2013 by NancyL

[swissie]

Yes, unfortunately some foreigners think they've got full coverage because they have a gold card and used it a time or two at the local hospital. I know of one unfortunate case where a foreigner really should have got himself back to his home country to use their free medical care, but stayed here getting treated for a terminal condition, starting at the local hospital -- he thought he'd have complete care during the entire course of the illness.

Once the condition became too serious for the local hospital to handle, he was sent to the regional hospital where the error was discovered. He left his family with high medical bills and, in my opinion, didn't receive the quality of care he would have received if he'd just gotten himself back to his home country when he could still travel.

Now I just wonder: Who is going to inform all the Farang "Gold-Card" holders (issued by error), about this fact?

- The issuing hospital? Hardly.

- The Farangs embassy? Hardly.

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

And who is finally going to explain to Farangs here, boasting of "I have international-coverage", that those insurance-companys mostly have their Business-Domicile in places like The Bahamas, Cayman-Islands, Panama etc.

They are not in the habit of paying any claims at all ! (If you don't like it: Take legal action against us!)

The Farang, seriously ill, should therefore file legal proceedings against an insurance-company, officially located somewhere in the Cayman-Islands and consisting of nothing more than a mailbox? Good luck!

Cheers.

[PalMan]

I would suggest buying your global-coverage insurance in either your home country - where you would most likely want to return anyway if you had anything very serious but were still able to travel - or in a country with laws in place that don't allow them to discontinue your coverage based on your age hitting some magic high number or based on heavy claims.

If such things even exist anymore, I'd really like to know myself, will be hitting mid-fifties soon and am willing to pay even high rates (back home USD 10,000 per year would be cheap for good cover) as long as I knew they can't cut me off in thirty years just because I get cancer and and.

[TerryLH]

"I'd actually like to know what this is and what I am entitled to (I'm guessing not very much)."

You'd be guessing wrong. Thai Social Security is actually pretty good.

It covers meds, in / out patient care, surgeries etc.

With your card you should have been told which hospital you are assigned to. It could be either a private or government hospital, depending on which hospitals in your area are in the system. If you don't like the hospital you've been assigned, there is a period each year when you can ask to be assigned another hospital in the area, as long as it's in the system, of course.

When you go to the hospital, show the card and make sure they have you registered there. Once that is done, my experience is that they don't ask to see the card at every visit.

When you lose eligibility for Social Security through employment, you can sign up and pay on your own. The cost to continue on your own is 432 baht a month.

Edited May 21, 2013 by TerryLH

[PalMan]

Employers in Thailand should be required to give a full explanation of this in writing with each foreigner's last paycheck.

[craigt3365]

Let's move this over to the health forum.

Topic Moved.

[TallGuyJohninBKK]

I would suggest buying your global-coverage insurance in either your home country - where you would most likely want to return anyway if you had anything very serious but were still able to travel - or in a country with laws in place that don't allow them to discontinue your coverage based on your age hitting some magic high number or based on heavy claims.

If such things even exist anymore, I'd really like to know myself, will be hitting mid-fifties soon and am willing to pay even high rates (back home USD 10,000 per year would be cheap for good cover) as long as I knew they can't cut me off in thirty years just because I get cancer and and.

There are several health insurance companies in Thailand that offer policies that don't have any automatic age cut-off. You have to sign up for coverage initially before a certain age. But once covered, they claim they won't terminate coverage as you get older or incur covered medical expenses.

However, while that's a good step in the right direction, what that doesn't address is that while coverage may be continued, there's no cap or limitation of how high the annual premiums can be increased once the insured gets older and older. Clearly, everyone ideally needs to have some kind of coverage for medical care.

But it certainly would be worthwhile for anyone with private insurance to ask to examine their age-based rate sheets, and see what the premiums are today for the policy you currently have, assuming you were 65 or 70 or older. If nothing else, it's a good exercise for prudent financial planning.

[TallGuyJohninBKK]

Meanwhile, related to this topic, I'm trying to understand something about how these systems work, in this case, relating to my Thai wife.

She used to work for the government, and was covered under the government scheme.

But lately, she's shifted to a private company, where they have issued her a health insurance card underwritten by a private insurer, and insurance premiums are deducted from her paycheck each month. I'm assuming that means she's covered by private insurance -- not the government's SSO plan for private employees.

But my question is -- the private medical insurance does have limitations in coverage. So if she was ever to have something very serious that exceeded the coverage of her private insurance, would she have the ability to, so to speak, fall back on either the SSO or UCS coverage schemes? Or having the private insurance coverage renders her ineligible for the government coverage???

Appreciate any insight into this!

[Esset]

I am registered to a hospital in Prathum Thani, I have some sort of paper card. but this is because I pay into the social fund and have work permit etc..

I'd actually like to know what this is and what I am entitled to (I'm guessing not very much).

It sounds as though you have been enrolled in the social security scheme (bpragan sangkhom) through your employer, If you read the report at the link I posted above you will see that there are three main public health insurance schemes in Thailand. Details of the SSS are here.

http://www.sso.go.th/wpr/eng/

Regarding Swissie above, we will await his report with interest. The problem is that even if a local contracting unit for primary care mistakenly registered him, the likelihood is that the error would be discovered if he were ever referred to a larger hospital with a serious condition and he would find himself facing a very large bill. Incidentally the issuing of gold cards was phased out a few years ago, and the intention is that people now use either the multi-purpose smart ID card or old gold card plus old citizen ID card.

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

Exactly correct.

Foreigners who are or have beenb leglally employed for a certain time period (I think 13 months?) are fully eligible for coverage under the Thai Social Security scheme and can keep that coverage for life as long as they ocntinue to pay into it.

Foreigners legally married to Thai civil servants are covered under the civil service scheme.

Foreigners are not eligible for the UCS, period, full stop. Occasionally hospitals make a mistake and register them, mostly seems to happen in smaller community hospitals. Dies indeed get foudn out and corrected if you are referred up the system to hgiher levels, and is definiotley not supposed to happen.

Sheryl,

Do you have any more information about this?

"Foreigners legally married to Thai civil servants are covered under the civil service scheme."

[Mario2008]

The spouse, underaged children and parents of a civl servant are automatically covered under the civil servant health scheme.

If she is covered, so are you. She can ask with her boss how to go about. it works the same as for Thai spouses, but might need to get a registration number first.

There are two options, one is that you pay up-front and get the money back and the other one is that you register at a hospital (you can register at more hospitals). Registration takes about 1 month, once registered the hospital declaretes the expenses directly so you don't have to pay first and get it back later.

I'm registered at several hospitals for this, my local, the provincial and a bigger regional university hospital. Each have their own level of specialised care.

It are mostly government hopsitals where you can get free treatment (but not all is covered, just like with an insurrence it has limitations). In case of an emergency and every second counts you can go to any hospital, government or private.

[Sheryl]

Mario,

Am I correct in assuming that coverage continues after retirement from the civil service, for both the employee and family?

And, what happens if someone leaves the civil service prior to retirement (as seems to be the case in post #20)?

[bunnaag]

I believe a friend recently,long term expat of 25 years was given a card based on house book marriage etc,as to what he gets I'm not sure,i would need to speak with him,but I do recall him telling me that he's likely going to get his monthly meds for free and I believe a reduction in the overall cost of health care.

you can believe me he is entiteled to no free health care.I am here more than 30 years married yellow book. No meaning you have to be a Thai citizen.Must be a misunderstanding.Is his wife a government employee?

[impulse]

I am registered to a hospital in Prathum Thani, I have some sort of paper card. but this is because I pay into the social fund and have work permit etc..

I'd actually like to know what this is and what I am entitled to (I'm guessing not very much).

It sounds as though you have been enrolled in the social security scheme (bpragan sangkhom) through your employer, If you read the report at the link I posted above you will see that there are three main public health insurance schemes in Thailand. Details of the SSS are here.

http://www.sso.go.th/wpr/eng/

Regarding Swissie above, we will await his report with interest. The problem is that even if a local contracting unit for primary care mistakenly registered him, the likelihood is that the error would be discovered if he were ever referred to a larger hospital with a serious condition and he would find himself facing a very large bill. Incidentally the issuing of gold cards was phased out a few years ago, and the intention is that people now use either the multi-purpose smart ID card or old gold card plus old citizen ID card.

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

Exactly correct.

Foreigners who are or have beenb leglally employed for a certain time period (I think 13 months?) are fully eligible for coverage under the Thai Social Security scheme and can keep that coverage for life as long as they ocntinue to pay into it.

Foreigners legally married to Thai civil servants are covered under the civil service scheme.

Foreigners are not eligible for the UCS, period, full stop. Occasionally hospitals make a mistake and register them, mostly seems to happen in smaller community hospitals. Dies indeed get foudn out and corrected if you are referred up the system to hgiher levels, and is definiotley not supposed to happen.

This interests me (the underlined part). I've been working here 2 years and continue to work here. How would I go about applying for and extending my coverage once I am no longer employed? Then the question is, do I have to live in Thailand to continue coverage, or just send money for payments?

Given the low cost (probably), it would seem to be a good backup plan in case my US insurance coverage stiffs me like US insurance companies are known to do. The cost of a round trip plane ticket to Thailand is less nowadays than the first hour in a US hospital and I'd envision flying to Thailand for any extensive but non-emergency treatment.

Doable? Sounds too reasonable to be true.

Edited May 22, 2013 by impulse

[Sheryl]

When you leave your place of employment ask the admin there how to continue under the SS scheme.

If you cannot get an answer from them, contact your nearest SS office. http://www.sso.go.th/wpr/eng/contactus.html

I am not aware of any specific rule that says you have to be living full time in Thailand to keep it (the issue would likely rarely arise) . But of course you need to have a Thai address on file, be registered at a Thai hospital, and make the monthly payments.

So yes, what you mention should be possible.

In any case I would strongly urge not letting it drop as it is by far the best insurance deal open to foreigners in Thailand. Even if you leave, you may some day want to move back. Once you let it drop, you're out and can't get back in except through re-employment.

[Mario2008]

Mario,

Am I correct in assuming that coverage continues after retirement from the civil service, for both the employee and family?

And, what happens if someone leaves the civil service prior to retirement (as seems to be the case in post #20)?

I saw a post the other day confirming that after retirement it continues, including for the spouse.

I don't know what happens if someone leaves the civil service prior to retirement or if the civil servant dies.

[citizen33]

My knowledge of the scheme is hazy, but I believe that on leaving the civil service a member may opt to receive a cash sum in lieu of his/her entitlements or continue (not sure what the minimum number of years is and so on). There may be something in the FAQs here.

http://www.cgd.go.th/wps/portal/Home/

The useful bits are in Thai only I'm afraid and there isn't a clear statement of the benefits package, as there is on the SSO's site (re the social security scheme).

The civil service medical benefits scheme is known in Thai as rá-bòp sà-wàt-dì-gaan rák-săa pá-yaa-baan kâa râat-chá-gaan (literally something like the system of welfare benefits for health care for civil servants)

ระบบ สวัสดิการ รักษาพยาบาล ข้า ราชการ

[citizen33]

P.S. A friend who left the civil service after 9 years and subsequently became a public service officer has told me the following. A person leaving the civil service with up to ten years service has no continuing entitlement and receives no cash settlement. A person with between 10 and 25 years service will receive a cash payment in lieu of entitlements but then has no coverage and no pension. A person with over 25 years service is entitled to a pension and continuing healthcare coverage. This is just hearsay but sounds about right.

Edited May 22, 2013 by citizen33

[Mario2008]

Sounds about right to me too.

I know a civil servant can opt for a large sum or monthly payments, but that is for their pension. Not heard the one time pay out also includes health insurence, or that it doesn't include.

25 years service is I believe the right criteria, many retire at age 60 (mandetory) but a lot do so 5 years early, while I know a person who will retire soon and is about 50. He started working young and that is the reason he will retire early..