Affordable health insurance.

[MadMac]

Chiang Rai...They also said that only are accepting applications from residents of this province..That's the reason they are asking for proof of residence..

Not required in Chiang Mai. I went first to Nakornping Hospital which is the main hospital for the city and got an appointment for checkup 2 days later. In the meantime I went to Hang Dong Hospital, closer to our place. Both only wanted the main page of the passport. No visa required. I had the yellow tabien baan in addition, this was also not look at until I reminded them to use the transcribed name in Thai from that. My tabien baan is from Bangkok. No proof of local residence in any form required nor requested.

[bangkokstick]

Anybody else applied at any Pattaya hospital ?

[scorecard]

I would like to thank harry for starting this topic to help the expats in Thailand. I dont know you harry but if we should ever meet lunch is on me,OK. alt=wai.gif width=20 height=20>

While I have my finger on the like button, I would also like to thank Sheryl for the countless hours she spends on here trying to help the expats and her fellow human beings.

If TV ever had an award for the hero of TV it should go straight to Sheryl, Im sure she has helped thousands of members here over the years. alt=wai.gif width=20 height=20>

Don't forget NancyL.

[Sheryl]

Anybody else applied at any Pattaya hospital ?

Several people have gotten the card at Banglamung Hospital

[Pinot]

Anyone have any Phuket experience with this?

[Sheryl]

No reports from Phuket or other points south as yet.

[harrry]

There are some reports of ChiangRai not accepting people from outside their border. I am not sure if that is the ampure area or the provance but I think Ampher. This means people in ChiangSaen or Chiang Khong should probably try there first.

[Sheryl]

Indeed. there seems to have been only 1 account of someone getting the card and that was second hand.

As you have the phone number of someone there, suggest calling periodically to ask rather than making the trek. And please report back results, thanks

[Issangeorge]

Once again my card has come in handy. I just had two skin cancer tumors removed from my left leg and right leg. Done in the operating room. Including the antibiotics, no charge, the last similar operation I had the charge was around ฿6,000 baht.

Sent from my i-mobile IQ 6 using Thaivisa Connect Thailand mobile app

[mikekim1219]

Just picked up my card this morning at Chiang Rai 2 hospital (behind police station). USA citizen, single, age 55 living in Muang Chiang Rai. Only documents required were my passport and condo chanote which I own. Nurse told me kindly that I can go to Chiang Rai hospital if any medical needs arise. Still not sure exactly what is covered and hopefully won't need to find out. Does anybody know if colonoscopy is covered under this plan?

Edited November 8, 2013 by mikekim1219

[Issangeorge]

Colonoscopy probably isn't covered unless s doctor prescribed it. I doubt if you could just ask for one.

Sent from my i-mobile IQ X using Thaivisa Connect Thailand mobile app

[seajae]

I will have to check out the local hospital in Surat Thani, a few local thais here(one owns a pharmacy and is a nurse at the hospital as well) have told me I can get a card so I will have to go see. Will post the reply I get.

Edited November 8, 2013 by seajae

[wimpey1946]

Yes good news for many you would think? thanks.

yes could be good news if the treatment was the same alover Thailand, but its not

[ridge runner]

didn't make it to hospital as planned. wife had to be admitted for 10 days and didn't take the time while she was in hospital. she has <deleted> apt for Monday and will check then. but one question. my son called today and said he saw a nurse that worked in register office and she wanted to know when I was coming to get card. having spent most of his life in u.s. his english is better than his thai sometimes. he understood her to say that I should wait till after new years then would be good for full year. I had assumed(bad thing to do) that would be good for one year from date of issue. doesn't make sense for everybody to renew in january. question when does the card expire? thanks

[wpcoe]

How would the government insurance plan work if you also had private insurance? Is there "co-insurance" where, say, the government policy would pay up to its limit, and then private insurance would take over?

Or, are the policies mutually exclusive: You choose one or the other to pay the bills?

[NancyL]

At Nakorn Ping hospital in Chiang Mai, we were told that we can't use the gov't insurance if another insurance would pay -- for example if a vehicular accident insurance would pay in case of an accident.

In our case, our health insurance has a deductible of $1000 U.S. per event (not per year), so presumably, they'd ask us to submit a claim once a Nakorn Ping bill was over the equivalent of $1000 U.S. Don't know how that would work in reality, since the one time we submitted a claim the insurance company was a real sticker about how the paperwork was presented -- we had to contact the hospital several times to redo the forms because we hadn't initially thought to show the insurance card on admission because we didn't think the bill would be over $1000. That time was at a private hospital used to dealing with foreigners; don't know how NKP is going to respond to repeated requests to fill out forms "properly" in English for an insurance company.

Also, there's the issue of foreigners who decide to drop their private health insurance in favor of the gov't insurance. Hubby turns 66 next year and thus jumps into a new "age band" with much higher health insurance rates. We may decide to drop his insurance and go with a combo of self-insurance, personal accident insurance and Nakorn Ping's for gov't health insurance. He's very healthy, has comprehensive annual check-ups yet doesn't have to take any meds for conditions like high BP, diabetes, cholesterol, has appropriate BMI, etc. His biggest risk are personal accidents and an accident policy would be much cheaper than comprehensive health insurance with this new gov't plan there for the low chance of him developing a health problem, like stroke, heart attack or cancer.

Edited November 10, 2013 by NancyL

[Issangeorge]

didn't make it to hospital as planned. wife had to be admitted for 10 days and didn't take the time while she was in hospital. she has <deleted> apt for Monday and will check then. but one question. my son called today and said he saw a nurse that worked in register office and she wanted to know when I was coming to get card. having spent most of his life in u.s. his english is better than his thai sometimes. he understood her to say that I should wait till after new years then would be good for full year. I had assumed(bad thing to do) that would be good for one year from date of issue. doesn't make sense for everybody to renew in january. question when does the card expire? thanks

The card expires one year after it is issued.

Sent from my i-mobile IQ X using Thaivisa Connect Thailand mobile app

[citizen33]

At Nakorn Ping hospital in Chiang Mai, we were told that we can't use the gov't insurance if another insurance would pay -- for example if a vehicular accident insurance would pay in case of an accident.

I'm still trying to get firm information about the new insurance scheme, but if the basic arrangement is similar to the UCS, this requirement only applies in relation to specified insurance schemes. For instance there is a long standing arrangement where UCS-participating hospitals are supposed to recover the cost of treatment arising from road traffic accidents from the insurance company covering the vehicles involved or the government compensation scheme that supports cases not covered by private vehicle insurance. Sometimes this lead the hospitals to ask for an upfront payment, which the patient is then expected to recover. Similarly SSS and CSMB scheme members are not supposed to claim under the UCS. I do not think this obligates a person who carries private health insurance to always claim on the private insurance first. They might well do so anyway, but there might be cases where an excess or no claims consideration makes it unattractive.

[harrry]

Still trying to befuddle us with your abbreviations, citizen 33. Please have a bit of compassion. I, and I'm sure many others, don't understand SSS and CSMB. I've just about got used to UCS. Hard to read when you have to stop and think what the abbreviations might mean.

Won't worry C33 in 0 time b4 we 2blinks will grok SSS CSMB UCS AND RVAS cya l8er.

Edited November 11, 2013 by harrry

[Sheryl]

SSS = social security system, the one for people employed in the private sector.

CSMB = the social security system for government employees (civil service something something)

And I think what C33 said re other insurances is correct, they were not thinking of private insurance which very few Thais have.

If one has both private insurance and this, I'd use the government card for any services received at the government hosp and the private insurance for s=care elsewhere.

And I'd caution against dropping private insurance altogether, this govt system may not last, and has its limitations. People 60 and over especially, once they drop private insurance will usually not be able to get it again. If the premiums are the problem, you could perhaps reduce the level of cover, but don't drop the policy.

[Madgee]

Add Roi-Et hospital to the list of participating hospitals accepting westerners.

As I was going there today for the first time, I enquired whether they knew about it and was given an impromptu tour of the hospital and shown the reception area where they do the administration. In fact, there was a westerner who was just finishing his application process; he had been there approx. 7 hrs !

Luckily, I'm fully covered by the Thai Gov. officials policy.

[MrMuddle]

Has anyone got this card at Phetchabun Hospital ? And how do I get proof of residence (Tambien Bahn ?) ?

[sinbin]

At Nakorn Ping hospital in Chiang Mai, we were told that we can't use the gov't insurance if another insurance would pay -- for example if a vehicular accident insurance would pay in case of an accident.

If involved in a motor accident in Thailand you cannot get free treatment at any government hospital even for a Thai. Which is why Por Ror Bor insurance is compulsory for all motor vehicles. Also they won't treat you free for attempted suicide amongst a few other things. So I'm told.

[harrry]

At Nakorn Ping hospital in Chiang Mai, we were told that we can't use the gov't insurance if another insurance would pay -- for example if a vehicular accident insurance would pay in case of an accident.

If involved in a motor accident in Thailand you cannot get free treatment at any government hospital even for a Thai. Which is why Por Ror Bor insurance is compulsory for all motor vehicles. Also they won't treat you free for attempted suicide amongst a few other things. So I'm told.

or a third delivery

or for drug addiction

'

[Sheryl]

Add Roi-Et hospital to the list of participating hospitals accepting westerners.

As I was going there today for the first time, I enquired whether they knew about it and was given an impromptu tour of the hospital and shown the reception area where they do the administration. In fact, there was a westerner who was just finishing his application process; he had been there approx. 7 hrs !

Luckily, I'm fully covered by the Thai Gov. officials policy.

Noted, thanks

[Sheryl]

Has anyone got this card at Phetchabun Hospital ? And how do I get proof of residence (Tambien Bahn ?) ?

I haven't heard any reports one way or the other for Phetchabun.

Some hospitals do not ask for proof of residence, some do. If they do, a tabien ban if you own your home, or a rental agreement if you rent will usually suffice.

[seajae]

I will have to check out the local hospital in Surat Thani, a few local thais here(one owns a pharmacy and is a nurse at the hospital as well) have told me I can get a card so I will have to go see. Will post the reply I get.

UPDATE, wife has just come home from the hospital and they said to bring in my passport and I can get the card, same conditions as mentioned earlier, 600 baht test and 2,200 baht for card. They informed her that it has been available since August so I will be doing it asap.

Cheers

[NancyL]

At Nakorn Ping hospital in Chiang Mai, we were told that we can't use the gov't insurance if another insurance would pay -- for example if a vehicular accident insurance would pay in case of an accident.

If involved in a motor accident in Thailand you cannot get free treatment at any government hospital even for a Thai. Which is why Por Ror Bor insurance is compulsory for all motor vehicles. Also they won't treat you free for attempted suicide amongst a few other things. So I'm told.

or a third delivery

or for drug addiction

'

What's a "third delivery"?

Sheryl, can you verify the claims that these situations discussed above aren't covered?

Thanks!

[citizen33]

Perhaps Sheryl can provide a view from the front line, but here is the theory, at least as it applies to the main gold card scheme (UCS).

Currently the UCS provides a relatively comprehensive range of treatments, including cardiac surgery and neurosurgery, neonatal intensive care, selected prostheses, and mental health and rehabilitation services. Patients are entitled to receive all drugs on the National List of Essential Medicines, which includes almost 900 western pharmaceuticals and 71 Thai traditional products, and can also receive off-list medicines when these are deemed to be clinically necessary by a physician. Among the interventions that are not provided are infertility treatments, assisted reproductive technologies, gender re-assignment, aesthetic treatments that are not clinically indicated, organ transplantation (except kidney transplant for end-stage renal disease), and hospitalization exceeding 180 days except on clinical grounds.. Child birth is covered for no more than two deliveries per mother. Drug addiction treatment and rehabilitation (except Methadone replacement therapy) is covered by a separate national programme and not funded from the UCS. The cost of treating road traffic accident victims is covered by mandatory vehicle accident insurance and the Victim Compensation Fund, and (in theory) reimbursed from these sources and not the UCS. Although many injuries sustained in RTAs are treated under the UCS, most hospitals now require direct payment from patients, who in theory can reclaim the costs but in practice may be left paying out of pocket (HISO, 2010).

New interventions need to be assessed all the time and the NHSO has a mechanism for doing this. Selected interventions are appraised by calculating quality-adjusted life years (QALYs) gained and incremental cost-effectiveness ratios (ICER). The Benefit Package Subcommittee of the National Health Security Board currently recommends an ICER threshold of one unit of average gross national income (GNI) per capita for one QALY gained. A budget impact analysis is also completed to assess affordability within present UCS funding constraints. Haemodialysis, for example, has remained controversial because it costs four times the established threshold of one unit of GNI per capita per QALY gained. Since 2008 the NHSO has pursued a policy of “PD first” where the cheaper peritoneal dialysis has been favoured: haemodialysis has generally been available only on payment of a 500 baht user charge per treatment.

I had the above blurb to hand and haven't time to paraphrase it - so it many be a bit wordy for the TV readership. This was up to date about a year ago but things change quite quickly, so one or two details may be wrong.

More detail on RTAs and the UCS here:

Health Information System Development Office (HISO) (2010). Dismantling the traffic accident: victim protection to provide justice to victims, Thai Health 2010: 74-77. Available online at:

http://www.hiso.or.th/hiso/picture/reportHealth/ThaiHealth2010/eng2010_24.pdf

P.S. From an earlier post - CSMB scheme = Civil Servant Medical Benefits Scheme.

Edited November 12, 2013 by citizen33

[harrry]

Perhaps Sheryl can provide a view from the front line, but here is the theory, at least as it applies to the main gold card scheme (UCS).

Currently the UCS provides a relatively comprehensive range of treatments, including cardiac surgery and neurosurgery, neonatal intensive care, selected prostheses, and mental health and rehabilitation services. Patients are entitled to receive all drugs on the National List of Essential Medicines, which includes almost 900 western pharmaceuticals and 71 Thai traditional products, and can also receive off-list medicines when these are deemed to be clinically necessary by a physician. Among the interventions that are not provided are infertility treatments, assisted reproductive technologies, gender re-assignment, aesthetic treatments that are not clinically indicated, organ transplantation (except kidney transplant for end-stage renal disease), and hospitalization exceeding 180 days except on clinical grounds.. Child birth is covered for no more than two deliveries per mother. Drug addiction treatment and rehabilitation (except Methadone replacement therapy) is covered by a separate national programme and not funded from the UCS. The cost of treating road traffic accident victims is covered by mandatory vehicle accident insurance and the Victim Compensation Fund, and (in theory) reimbursed from these sources and not the UCS. Although many injuries sustained in RTAs are treated under the UCS, most hospitals now require direct payment from patients, who in theory can reclaim the costs but in practice may be left paying out of pocket (HISO, 2010).

New interventions need to be assessed all the time and the NHSO has a mechanism for doing this. Selected interventions are appraised by calculating quality-adjusted life years (QALYs) gained and incremental cost-effectiveness ratios (ICER). The Benefit Package Subcommittee of the National Health Security Board currently recommends an ICER threshold of one unit of average gross national income (GNI) per capita for one QALY gained. A budget impact analysis is also completed to assess affordability within present UCS funding constraints. Haemodialysis, for example, has remained controversial because it costs four times the established threshold of one unit of GNI per capita per QALY gained. Since 2008 the NHSO has pursued a policy of “PD first” where the cheaper peritoneal dialysis has been favoured: haemodialysis has generally been available only on payment of a 500 baht user charge per treatment.

I had the above blurb to hand and haven't time to paraphrase it - so it many be a bit wordy for the TV readership. This was up to date about a year ago but things change quite quickly, so one or two details may be wrong.

More detail on RTAs and the UCS here:

Health Information System Development Office (HISO) (2010). Dismantling the traffic accident: victim protection to provide justice to victims, Thai Health 2010: 74-77. Available online at:

http://www.hiso.or.th/hiso/picture/reportHealth/ThaiHealth2010/eng2010_24.pdf

P.S. From an earlier post - CSMB scheme = Civil Servant Medical Benefits Scheme.

Basicly the new scheme has the same benifits and restriction as the "Gold Card" scheme except that hospilisations have to be paid for at about 340 a day for standard ward though extra may be paid for better rooms. The medical care, nursing and medicine is free.