Affordable health insurance.

[Issangeorge]

Because of preexisting conditions, I am too restricted on the private insurance I can buy, so the plan works well for me. My second to last year of teaching I was covered by the social security plan they have, but only for 11 months. I tried to extend it on my own, but you have to have been covered for 12 months. On my next teaching job I was over 60 and couldn't get it.

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[thaiduncankk]

Three of us got our cards in Khon Kaen hospital today, and one is over 70 years of age.

2,200 baht and 600 baht for the medical.

[casicook]

Health card / health insurance for foreigners canceled

21.02.2014 - 19:03

Today we've received a report from Chiang Mai on the current situation of the health card / health insurance for foreigners.

http://udon-news.com/en/news/health-card-health-insurance-for-foreigners-canceled

Looks like that the insurance is going to be history soon!

[ricklev]

Bummer!

[ricklev]

bum·mer

ˈbəmər/

noun

informal

1. 1.

   a thing that is disappointing.

[Sheryl]

CM stopped issuing the cards some months ago but some parts of the country are still doing so. Several in Issan as I recall.

AFAIK cards already issued will be honored, at least until their expiration.

[TallGuyJohninBKK]

Health card / health insurance for foreigners canceled

21.02.2014 - 19:03

Today we've received a report from Chiang Mai on the current situation of the health card / health insurance for foreigners.

http://udon-news.com/en/news/health-card-health-insurance-for-foreigners-canceled

Looks like that the insurance is going to be history soon!

The above link wasn't working earlier, but now it is and I read the item posted there.

Basically, it talks about a report out of CM that the hospital is planning to contact those already issued cards and offer refunds for the insurance fee paid, saying the whole inclusion of farangs had been a mistake.

Obviously, no way of knowing if that report is correct or not, or if it's an isolated episode or part of a broader response.

But either way, the whole insurance for expats debacle appears to be going down.

[DonaldBattles]

For what it is worth on thursday I used my card in Chiang Rai and the total bill was for 30 Baht. 2,300 Baht of medication was issued to me.

[Sheryl]

Yes, some parts of the country haven't heard yet.

It was never the government's (central government) intent to issue these to expat residents, it was developed and priced for migrant workers. but the government directive that went out just said "foreigner" so some provinces understand it to mean just that. In CM a large number of cards were issued then it came to the notice of the central govt and they were told this was not the intent.

Would recommend that anyone who has it decline a refund and keep using it while you can (it expires a year after issue anyhow) but as was originally explained when this whole thing started, no one should forego private insurance if they are able to get it.

The Ministry does eventually plan to eventually establish a system for residents expats, as well as for tourists without health insurance, but migrants were the top priority. Due to the present political upheaval, most new initiatives are on hold now.

[casicook]

...

It was never the government's (central government) intent to issue these to expat residents, it was developed and priced for migrant workers. but the government directive that went out just said "foreigner" so some provinces understand it to mean just that. In CM a large number of cards were issued then it came to the notice of the central govt and they were told this was not the intent.

...

Hmmm,

the central government didn't know about this?

In this video conference between a representative of the Ministry For Public Health and the administration offices of all Thai provinces a question had been asked by one of the participators if the health scheme was designed for all foreigners or only for immigrants from ASEAN countries. The clear answer that was given by the representative was that it is designed for all foreigners, regardless from which country they are. This is the link to the conference http://fwf.cfo.in.th/Portals/0/clipVdo/ConHealthcard14082013.zip and here you can download a compatible player to watch it. http://fwf.cfo.in.th/Portals/0/DownLoadDoc/TrueMVviewer.exe

After the confusion had begun, HIGTHAI published this info brochure to clarify for whom the insurance was designed.

Attention: 'The Ministry of Public Health (MoPH).....'

Health Care for Immigrants and Foreigners

The Ministry of Public Health (MoPH) provides a health care program for immigrants and foreigner, who are not enrolled in the Social Security System. These individuals can now receive medical services and health insurance with the following rates:

1. For immigrants currently waiting for their applications to be processed in the

Social Security System, their payment will be 1,150 Baht for a service coverage

period of 90 days.

2. For immigrants who are not enrolled in the Social Security System, Their payment

rate is 2800 Baht , which covers the following rate:

- Health Care Cost: 600 Baht

- Health Insurance Cost: 2,200 Baht

3. Children ages 7 or less will have a payment rate of 365 Baht. In addition, children from the second and third payment plans will have a service coverage period up to one year. They will be able to receive medical services and insurance in the medical facilities which under Office of Permanent Secretary within their area of residence.

4. Include Foreigners who are residence in Thailand without any Health Insurance coverage.

Benefits

1. General Health Care and Rehabilitate

2. High health care cost as stipulated in the Ministry of Public Health committee regulations.

3. In case of Accident and Emergency

4. Referrals System

5. Disease Control for Immigrants/Foreigners

6. Diseases Surveillance

7. Administering antiretroviral

8. Benefits are not provided for individuals with mental disorders

9. Services provide health support, preventative and Disease Control.

Health Insurance Group, Office of Permanent Secretary Ministry of Public Health (MoPH)

Phone 0 2590 1580, 0 2590 2415,

0 2590 2417

Fax 0 2590 1579

The file was originally linked at http://www.higthai.org/, it should be detectable somewhere there.

To me it looks like that someone hadn't done his homework before starting the health scheme. It's not that difficult to figure out that with a annual premium of 2,200 THB the costs for this scheme can by far not be covered, but that of course also counts for immigrants of the ASEAN countries!

[TallGuyJohninBKK]

In this video conference between a representative of the Ministry For Public Health and the administration offices of all Thai provinces a question had been asked by one of the participators if the health scheme was designed for all foreigners or only for immigrants from ASEAN countries. The clear answer that was given by the representative was that it is designed for all foreigners, regardless from which country they are.

I've tried to follow all the news and information on this ever since the issue arose, including personally contacting the MOPH in BKK to try to identify any hospital here that was offering the cards. And was referred to some by the MOPH insurance people, but the hospitals demurred.

The best thing I can say is, it appears there were different opinions and interests in the MOPH when it came to the implementation of this, some having one idea, and others having a different idea. So the answers people got depended on who was answering the question.

But, it appears, the most telling sign of the MOPH's ultimate position, at least for now, came when hospitals upcountry that had been issuing the cards to farangs were told to STOP and now perhaps even try to claw back some of the cards that were issued. In any kind of logical world, if the leadership of MOPH really intended this program to include farangs, then the hospitals issuing the cards would not have been slapped down.

[Issangeorge]

OK had my cataract operation on Monday, all went well and my vision seems to be good. There was some problem with the insurance, which I will start a new topic about, but to cut a long story short, the insurance did pay and I was out of pocket ฿20.

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[Jessi]

Thanks for the up-date George, a good result.

Cheers

[mikekim1219]

I have received referral from Chiang Rai Hospital to see a specialist in Chiang Mai hospital (Maharaj Nakorn Chiang Mai Hospital) for my blurring left eye problem. I will go down there this week. I was told by the nurse that there are two buildings in the hospital. One private and one govt.

Question: Does my govt issued health insurance card from Chiang Rai still accepted in Chiang Mai?

Thanks in advance.

[harrry]

I have received referral from Chiang Rai Hospital to see a specialist in Chiang Mai hospital (Maharaj Nakorn Chiang Mai Hospital) for my blurring left eye problem. I will go down there this week. I was told by the nurse that there are two buildings in the hospital. One private and one govt.

Question: Does my govt issued health insurance card from Chiang Rai still accepted in Chiang Mai?

Thanks in advance.

Present it and see. If you have a referal it should be but may not be.

[Issangeorge]

Make a copy of it for your use, also beware that if the Chiang Mai Hospital schedules you for a follow up appointment you will need another referral, or at least that has been my experience at Kalasin Hospital. Makes no sense, but this is Thailand.

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[TallGuyJohninBKK]

fyi on the broader subject:

there was an interesting article in the BKK Post a couple of days ago (which can't be linked here under TV policy) saying that almost 100,000 "Thais" had their universal healthcare coverage revoked back in December and still haven't had it restored.

According to the article, the National Health Security Office (NHSO) removed those people for having "dubious citizenship" from the 30-baht universal coverage health care plan. Those disqualified included Thai-born Chinese residents who didn't have the documentation to prove their family histories or apply for Thai citizenship.

The article said some of those folks only found out their coverage had been revoked when they went to hospitals trying to use that coverage, and were turned away. Meanwhile, the Thai Public Health Ministry, according to the article, says the number of people removed from coverage was actually about 200,000.

And somewhat ironically for us, the article quotes the Public Health permanent secretary as suggesting that perhaps those kicked out of the UC plan should be encouraged to buy the 2,800 baht per person/year "migrants" health coverage.

Not a very encouraging sign about the prospects for farangs being likely to obtain continued coverage, even under the migrants coverage.

[citizen33]

Some interesting points there... We are in a period of political instability and uncertainty, with a recent shift of power from the (last) Minister to the Permanent Secretary. I talked to a few senior people about this issue a few weeks back, and it seems there was more discussion towards the end of last year about creating a scheme that would provide cover for expats at a price that reflected their age and risk profile.. Minister Pradit had argued that the aim should be to cover all those resident in Thailand rather than just citizens, but changes in law would be needed before that could happen and legislative change is not feasible until the political situation becomes clearer. My informants seemed to think that, though there will need to be adjustments to meet the requirements of the AEC, healthcare cover for westerners won't be a priority for the Government they expect to come to power. More generally, the message was that the MoPH is now clear that westerners should not be registered under the migrant workers scheme and memberships won't be renewed (at least when the hospitals get up to speed) - pretty much what Sherrill has been saying for a while. So I think Tallguy's last sentence is correct.

[DonaldBattles]

Has anyone had their cards renewed yet? If I remember the program did not start until August.

[BradinAsia]

It is possible to get a private room (hong piset) at a government hospital and the charges are quite reasonable. AFAIK you can do this even if covered by SS or the UC scheme though you'd of course have to pay the room charge out of pocket.

The big disadvantage isn't the room. It's not being able to choose your doctor, not being able to directly access a specialist, needing to get letter of referral to access a higher level of care (not so easily obtained, sometimes) etc. It is for these reasons only that I'll keep shelling out ~USD 2,000 a year to BUPA for my coverage.

The private rooms up here in the N/E cost around Bt.3500 per day. A very reasonable price. I agree you cannot choose your own doctor but there is very little choice in that matter here anyway.

FWIW, private room with aircon, TV and small fridge at McCormick Hospital in Chiang Mai is 1,100 baht per night as of 29 May 2014.

[Keesters]

21 pages, 507 posts and I still don't know if I qualify, if my local public hospital will do it, what papers I require and what to ask for at hospital or even what it is called in Thai and English.

Is there somebody who can offer a simplified guide to this? I and I'm pretty sure many others will be appreciative of anyone who can.

I don't want to wait until I'm ill to try and get it.

[harrry]

21 pages, 507 posts and I still don't know if I qualify, if my local public hospital will do it, what papers I require and what to ask for at hospital or even what it is called in Thai and English.

Is there somebody who can offer a simplified guide to this? I and I'm pretty sure many others will be appreciative of anyone who can.

I don't want to wait until I'm ill to try and get it.

Sorry too late. This projectg has been cancelled

[Issangeorge]

It would be nice if the new PM would start up another plan, that was financially viable, maybe ฿500 to ฿1,500 a month. Just a bare bones plan that is available at your local government hospital, and hospitals they refer you too. Ward only, covers pre existing conditions, or at least those that are not prevalent at the time. For instance I have high blood pressure, it is mostly controllable with medicine, but I would hate to sign on with say bumpa, pay them thousands of baht and then in a year or two have a stroke or heart attack and for them to tell me I had a pre-existing condition and they won't cover it.

[meatboy]

It would be nice if the new PM would start up another plan, that was financially viable, maybe ฿500 to ฿1,500 a month. Just a bare bones plan that is available at your local government hospital, and hospitals they refer you too. Ward only, covers pre existing conditions, or at least those that are not prevalent at the time. For instance I have high blood pressure, it is mostly controllable with medicine, but I would hate to sign on with say bumpa, pay them thousands of baht and then in a year or two have a stroke or heart attack and for them to tell me I had a pre-existing condition and they won't cover it.

yes i.g.I was only thinking the same yesterday as my yearly gov.hospital fee is due in the next 2weeks[2,200bht].

me and mrs.meat have opened a savings acc.putting in every month as cover,i wouldn't or she pay 40,000bht yearly for only a couple of 100k's cover,you would be lucky to get a week in one of the private hospice's.

[citizen33]

It would be nice if the new PM would start up another plan, that was financially viable, maybe ฿500 to ฿1,500 a month. Just a bare bones plan that is available at your local government hospital, and hospitals they refer you too. Ward only, covers pre existing conditions, or at least those that are not prevalent at the time. For instance I have high blood pressure, it is mostly controllable with medicine, but I would hate to sign on with say bumpa, pay them thousands of baht and then in a year or two have a stroke or heart attack and for them to tell me I had a pre-existing condition and they won't cover it.

This would indeed be very helpful to a segment of the expat population who are effectively uninsurable, and there were/are many senior people in the NHSO/MoPH who understand this problem. Ex-Minister Pradit had pushed the line that health care coverage should be extended to be available to all residents of Thailand, but his ideas were opposed by more conservative elements in the MoPH, who believe this is unaffordable and that westerners should arrange private health insurance. Unfortunately it is this latter group who are close to the new government and have been given power to move policy more in their preferred direction (you may have noticed some of them joining in anti-government demonstrations a few months ago).

[TerryLH]

"It is possible to get a private room (hong piset) at a government hospital and the charges are quite reasonable. AFAIK you can do this even if covered by SS or the UC scheme though you'd of course have to pay the room charge out of pocket."

My experience has been, in private and government hospitals, that with SS coverage you just pay the difference between the room you'd normally get and a private room.

[96tehtarp]

"It is possible to get a private room (hong piset) at a government hospital and the charges are quite reasonable. AFAIK you can do this even if covered by SS or the UC scheme though you'd of course have to pay the room charge out of pocket."

My experience has been, in private and government hospitals, that with SS coverage you just pay the difference between the room you'd normally get and a private room.

In government hospitals where I live the private room surcharge is approx. 500 baht. Thai and foreigners pay the same price. Room includes satellite TV, Air-con, fridge, and private bathroom with shower.

[TallGuyJohninBKK]

It would be nice if the new PM would start up another plan, that was financially viable, maybe ฿500 to ฿1,500 a month. Just a bare bones plan that is available at your local government hospital, and hospitals they refer you too. Ward only, covers pre existing conditions, or at least those that are not prevalent at the time. For instance I have high blood pressure, it is mostly controllable with medicine, but I would hate to sign on with say bumpa, pay them thousands of baht and then in a year or two have a stroke or heart attack and for them to tell me I had a pre-existing condition and they won't cover it.

This would indeed be very helpful to a segment of the expat population who are effectively uninsurable, and there were/are many senior people in the NHSO/MoPH who understand this problem. Ex-Minister Pradit had pushed the line that health care coverage should be extended to be available to all residents of Thailand, but his ideas were opposed by more conservative elements in the MoPH, who believe this is unaffordable and that westerners should arrange private health insurance. Unfortunately it is this latter group who are close to the new government and have been given power to move policy more in their preferred direction (you may have noticed some of them joining in anti-government demonstrations a few months ago).

Citizen, any idea how the political leanings of the current group of MoPH folks relate to...

1) the recently unveiled TAT program with private insurers to offer voluntary tourist health insurance policies that can cover up to one year.

2) the prior discussions under Pradit (that thus far have led to nothing, AFAIK) about trying to make health insurance some kind of mandate for foreigners living in and/or visiting Thailand?

[citizen33]

Citizen, any idea how the political leanings of the current group of MoPH folks relate to...

1) the recently unveiled TAT program with private insurers to offer voluntary tourist health insurance policies that can cover up to one year.

2) the prior discussions under Pradit (that thus far have led to nothing, AFAIK) about trying to make health insurance some kind of mandate for foreigners living in and/or visiting Thailand?

It is hard to be sure because different officials say different things. I talked to somebody in a senior position about two weeks ago, and his view was that everything was up in the air until the new Cabinet was approved, although he talked quite a bit about the difficult relationship between Dr Narong and NHSO, which he was hinting was leading to worries about both the future role of NHSO and UHC (he said he personally thought the latter was safe but some colleagues were not so sure).

There seems to be a strand of policy shared by the conservatives and reformists that says that some new programmes should be put in place to minimise unplanned cost pressures on Thai health care that arise when uninsured foreigners have to be treated free. Although I don't have any new information from what I heard months ago, there seems to be quite wide support for a tourist insurance scheme. What proved to be more difficult than anticipated was making this mandatory, and so what has emerged is the voluntary scheme - also designed to help address the problem that some overseas travel insurance policies might not cover post-coup Thailand. I think the second policy about extending coverage to new groups has narrowed now so that there is still support for a migrant healthcare card scheme, and still an in-principle commitment to build-up health care facilities in border areas (which was part of Pradit's policy), but the idea of including expats has gone on the backburner. Even the policy of border area support for Cambodia, Laos and Burma (to try to get incomers treated on their own side of the border rather than crossing into Thailand) is somewhat in limbo and will need to await the new Government before much happens on the ground.

The big unknown to me is what happens now that Rachata Rachatanavin is Minister, rather than Dr Narong. My impression is that the latter was preoccupied with ensuring that the MoPH regained control over resources and setting service priorities (at the expense of NHSO), and was less interested in UHC and extending coverage to westerners. A couple of his supporters within the MoPH I've talked with have been very clear that they think expats need to arrange private insurance. My guess is that Narong will remain as Permanent Secretary and the conservatives will continue to have the whip hand. Many of the reformists were broadly on the yellow side, and not very supportive of Dr Pradit, but I suspect they are now having to reflect on being carefull about what they wished for, One very prominent figure, who is strongly anti-Thaksin, is extremely unhappy with Dr Narong's stance.

So these are some of my impressions, but I have to emphasise that this depends on reading between the lines. My guess is that Rachata will pursue a conservative line (read no chance of a public scheme for long-term residents), but we will have to wait and see, Though I don't have any firm evidence that it is on the cards, or has been discussed recently, I do have a worry that some senior officials might go for a policy of mandatory private health insurance for long-term residents,

[TallGuyJohninBKK]

Thanks for the insights...