The new Government Health Insurance - info for TV members in Chiang Mai

[Sheryl]

The Thai government has initiated a new system which allows foreigners living in Thailand to enroll in the UC (AKA “30 baht”) scheme on a fee basis. The directive issued thus far, which involves a premium of only 2,200 baht a year plus another 600 for initial medical screening, was aimed at migrant workers, but the directive failed to specify this clearly, rather stating only “foreigner”. As a result many up-country hospitals are issuing the cards to resident resident expats. We have confirmed that this was not the original intent of the MoPH, and that they plan on introducing something for resident expats subsequently which would have a different premium, as yet to be established (it will be based on analyses of age, expected utilization etc). It will surely be more than 2,000 baht a year but also almost certainly still be much less than private insurance. Meanwhile, many resident expats are getting the cards at the 2,000 baht rate. So far there are no reports of any hospital in the Bangkok area doing this, but up-country it seems more common than not.

In the Chiang Mai area, to date we have had reports of cards being issued by Nakornping hospital and Sansai District Hospital, no reports yet from people trying at any of the others.

Given the uncertainties of the situation just described (with some risk that cards issued might later be revoked, or people run into difficulties if they have to be referred up to a higher level of care, especially in Bangkok), we do not recommend discontinuing private insurance coverage if you have it. However, those who are unable to get private insurance have nothing to lose by enrolling in the system and will certainly be better off with it than remaining uninsured. Self-insured people would also benefit from it as a means of minimizing the need to dip into their savings. The system does not exclude pre-existing conditions nor have an age limit, and the required medical exam focuses on a few infectious diseases of Public Health importance only (TB, leprosy, syphilis etc – again, aimed at migrant worker issues). People with significant known chronic diseases have been issued cards.

The terms of use are identical to those for Thais covered under the UC (AKA “30 baht” scheme) – you cannot chose the hospital but must register at the government hospital responsible for the area where you live (if in doubt ask a Thai neighbor), and can only get free care at that hospital, or at a higher level facility that the hospital you are registered at refers you to. Care will be that Thais get in government hospitals, i.e. long waits, cannot chose your doctor, but usually consistent with accepted standards of care. In-patient care would be in a ward, though you might be able to pay extra out of pocket for a semi-private or private room, if available. Military hospitals are not included, though you can certainly continue to use them (or private hospitals) on a fee basis if and when you like. Similarly, private after hours arrangements at government hospitals (e.g. Suan Dok, Chula, Ramatibhodi) will not be covered, only use of the regular public channel, but again nothing to stop you from availing from it on a fee basis if desired. The coverage includes some provision for dental care as well as a pretty comprehensive range of medical services.

To register you will need to show your passport and most (but not all) hospitals are requesting some type of proof of residence, i.e. yellow tabieen baan or rental agreement. Some TV members have managed with just their wife’s tabien baan even though they are not listed in it, but with the wife going along to attest that he lives there. As is common with new government initiatives there is a lack of consistency in how requirements are interpreted in different locations. This thread in the Health Forum details experiences people have had at various hospitals http://www.thaivisa.com/forum/topic/671391-affordable-health-insurance/

Edited October 15, 2013 by Sheryl
correcetd amount (2,000 --> 2,200 and added Sansai Hosp

[Thailand]

Definitely a wait and see for me and have followed the original thread with great interest.

Who knows,it could be something really useful.

[Dr Robert]

very comprehensive, but cautious information stream thanks Sheryl

[NancyL]

Tomorrow several older resident expats will go to Nakorn Ping hospital to register for this scheme. One, in particular, has a chronic condition and needs treatment which he cannot afford now. I'll report the results of the registration and efforts to obtain care by this one person, and others as I learn of them.

It's one thing to pay the required fees to obtain registration and quite another to actually obtain needed care.

One problem is that the hospital that serves Amphur Muang is said to be Nakorn Ping hospital, which is quite a distance from the center of town. It's not convenient for the many older expats who live long-term in the many guesthouses in and near the Old City. I'll ask if another hospital, closer to the center of town, is available.

Also, there are efforts underway to translate the Thai gov't directives into English and post them on a convenient website. I'll follow and report on the progress of that effort.

[Oscar2]

One problem is that the hospital that serves Amphur Muang is said to be Nakorn Ping hospital, which is quite a distance from the center of town. It's not convenient for the many older expats who live long-term in the many guesthouses in and near the Old City. I'll ask if another hospital, closer to the center of town, is available.

beggars can't be choosers.

[NancyL]

One problem is that the hospital that serves Amphur Muang is said to be Nakorn Ping hospital, which is quite a distance from the center of town. It's not convenient for the many older expats who live long-term in the many guesthouses in and near the Old City. I'll ask if another hospital, closer to the center of town, is available.

beggars can't be choosers.

Yes, of course, people have to understand that for 2000!/baht per year they're not going to get Bumrungrad Hospital amenities! But, in "talking up" this program to several older friends, they've expressed concern about the distance, saying maybe their money would be better spent continuing to obtain care on a fee-paid basis at Suan Dok. Yes, that's true if all they need are occasional out-patient visits, but they don't realize the costs for repair of a hip fracture or nasty infection requiring ICU hospitalization -- all conditions that can be common in people over age 75. That 2000+baht annual fee is a real bargain compared to a 150,000 - 200,000 baht bill for one of these events, even for care at Suan Dok.

[harrry]

The probability is after having been examined at their central hospital they will be refered to their nearest Government anuban clinic which will become their primary point of contact as is done with older thai people. As with the Universal care scheme the new scheme also entitles handicaped people transport for medical care so in the same way as my mother in law is picked up either by a volunteer driver or ambulance to attend apointments they would probably arange that if needed for the patient.

Edited October 15, 2013 by harrry

[Thailand]

Tomorrow several older resident expats will go to Nakorn Ping hospital to register for this scheme. One, in particular, has a chronic condition and needs treatment which he cannot afford now. I'll report the results of the registration and efforts to obtain care by this one person, and others as I learn of them.

It's one thing to pay the required fees to obtain registration and quite another to actually obtain needed care.

One problem is that the hospital that serves Amphur Muang is said to be Nakorn Ping hospital, which is quite a distance from the center of town. It's not convenient for the many older expats who live long-term in the many guesthouses in and near the Old City. I'll ask if another hospital, closer to the center of town, is available.

Also, there are efforts underway to translate the Thai gov't directives into English and post them on a convenient website. I'll follow and report on the progress of that effort.

This will be a major test of the system as it will not be long before at least one of the expats will be seeking to use the new system at which point we will have a fair idea of whether or not it will be viable- good luck.

[cmsally]

I think what happens when you register for the system (if comparable to the 30 Bt system) is that you are assigned to a hospital as well as a clinic. I'm sure if you ask at Nakorn Ping they can give you a list of hospitals that can be used.

If its any help I am in the city area and I know that some of the Thais in my area (who use 30 Bt system) go to Central Chiang Mai Memorial (Changklan). As far as I remember McCormick used to participate but doesn't now (not sure on that one though). There also used to be a small hospital near the Nawarat bridge - nearer to the market , I don't know exactly who they cater for but I think its a govt hospital.

[Mapguy]

According to OP, the program was designed for migrant workers and another program for long-stay (?) foreigners is being developed. As OP reports it, it would appear that the cost would be more than for the initial program. Either is quite a governmental commitment. Sounds promising, however.

[rcjoop]

Some comments on the new healthcare insurance in Chiang Mai.

The costs are 2200 Baht plus 600 for the screening, this is what I and others have paid and what is clearly stated in the directive.

It surprises me that you have definitive information that it was not meant for us, but time will tell.

A friend of mine was about a year ago issued a card at a district hospital and got the message a couple of weeks ago that it was impossible to renew because there was a new scheme: the 2200/600 baht one. He was issued a new card. This was in the MaeJo area in Amphur Sansai and by the Sansai district hospital.

For the NakornPing hospital, it will be unlikely to refer to another hospital as this is a provincial large hospital with 800 beds and should have most facilities.

On their website they say private room is possible, cost 1000/1200 baht and with the condition that partner/family/friend must be available for care during the night. If that is not possible the patient will be moved to the normal ward again.

On my first contact I had a copy of the Udon card and the direct comment was, Oh no we do not have the equipment to produce a card like this, you will get a printed one and if you come to the hospital bring your passport with you. Indeed the card I got is from the earlier scheme and clearly says it is for migrant workers.

Will be interesting if many of the people applying need direct long term care the system will be continued and at what price. At the moment I have a good insurance and will certainly not cancel it for another 1 or 2 years.

[Greenside]

I suspect the government might choose to make their insurance mandatory when getting certain classes of visa. Many would choose to continue to pay for private care but at least there would be a safety net for all and those choosing to buy their own would be subsidising the system to some degree as happens in the UK.

[Sheryl]

The costs are 2200 Baht plus 600 for the screening, this is what I and others have paid and what is clearly stated in the directive....

A friend of mine was about a year ago issued a card at a district hospital and got the message a couple of weeks ago that it was impossible to renew because there was a new scheme: the 2200/600 baht one. He was issued a new card. This was in the MaeJo area in Amphur Sansai and by the Sansai district hospital....

You're right, meant to say 2200 and have corrected OP accordingly. Also corrected it to include Sansai Hosp, thanks for that info.

[cloudhopper]

Hey at least it might be enough to stop us self-insured US expats from being hunted down and fined taxed by the Obamacare fiasco.

[hml367]

Why would anyone "hunt" you down for anything re Affordable Health Care?

[elektrified]

I think what happens when you register for the system (if comparable to the 30 Bt system) is that you are assigned to a hospital as well as a clinic. I'm sure if you ask at Nakorn Ping they can give you a list of hospitals that can be used.

If its any help I am in the city area and I know that some of the Thais in my area (who use 30 Bt system) go to Central Chiang Mai Memorial (Changklan). As far as I remember McCormick used to participate but doesn't now (not sure on that one though). There also used to be a small hospital near the Nawarat bridge - nearer to the market , I don't know exactly who they cater for but I think its a govt hospital.

Both the g/f and our child registered for "the system" 4 years ago by going through the official channel and speaking with a social worker in Bangkok who is responsible for Chiang Mai. The g/f was told that it is not possible to get Suan Dok as the primary provider. Two Doctors have to sign off on a transfer to SUan Dok if necessary. At the time, the hospital they were assigned was Ruam Phaet Hospital. We went there one night and it was the worst place on earth. I would not take my dog there. The g/f called Bangkok and told them what a horrible place it was and the social worker changed it to Chiang Mai Memorial. We went there, showed ID's, etc. No card given but registered in the system.

Having said that we have private insurance and have never used the government plan or a government hospital, but have it as a back up just in case.

[Jingthing]

Hey at least it might be enough to stop us self-insured US expats from being hunted down and fined taxed by the Obamacare fiasco.

Bona fide U.S. expats are exempt from the requirement of having U.S. based health insurance. Also exempt from any fines. Also not required to have foreign based insurance either. Cheers.

[cloudhopper]

Hey at least it might be enough to stop us self-insured US expats from being hunted down and fined taxed by the Obamacare fiasco.

Bona fide U.S. expats are exempt from the requirement of having U.S. based health insurance. Also exempt from any fines. Also not required to have foreign based insurance either. Cheers.

That's great news thanks.

[Sheryl]

Hey at least it might be enough to stop us self-insured US expats from being hunted down and fined taxed by the Obamacare fiasco.

US citizens living abroad are exempted under the act. So this is a non-issue.

[Sheryl]

Agree, but we'll wait a bot as more reports from outlying hospitals may come in.

[Thailand]

Agree, but we'll wait a bot as more reports from outlying hospitals may come in.

Bots are a real nuisance. (-:

[cmsally]

I think what happens when you register for the system (if comparable to the 30 Bt system) is that you are assigned to a hospital as well as a clinic. I'm sure if you ask at Nakorn Ping they can give you a list of hospitals that can be used.

If its any help I am in the city area and I know that some of the Thais in my area (who use 30 Bt system) go to Central Chiang Mai Memorial (Changklan). As far as I remember McCormick used to participate but doesn't now (not sure on that one though). There also used to be a small hospital near the Nawarat bridge - nearer to the market , I don't know exactly who they cater for but I think its a govt hospital.

Both the g/f and our child registered for "the system" 4 years ago by going through the official channel and speaking with a social worker in Bangkok who is responsible for Chiang Mai. The g/f was told that it is not possible to get Suan Dok as the primary provider. Two Doctors have to sign off on a transfer to SUan Dok if necessary. At the time, the hospital they were assigned was Ruam Phaet Hospital. We went there one night and it was the worst place on earth. I would not take my dog there. The g/f called Bangkok and told them what a horrible place it was and the social worker changed it to Chiang Mai Memorial. We went there, showed ID's, etc. No card given but registered in the system.

Having said that we have private insurance and have never used the government plan or a government hospital, but have it as a back up just in case.

As far as I know Suan Dok handles "Prakan Sangkhom" and care for govt workers mostly. Not to mention all the uni students.

[NancyL]

Yes, agreed this topic needs to be pinned, but maybe after a few more reports, including my own, come in. Perhaps, too, the mods could delete all the extraneous posts related to Obamacare, Sheryl's typing errors, etc. That would include deleting this post, too!

As with everything Sheryl does, this is very useful and doesn't deserve the usual TV - Chiang Mai treatment of being turned into an alcohol-fueled, off-topic sniping match.

[harrry]

There is a topic in the Health forum which I think it would be better to post in as this is a national issue. It is good there are topics pointing to this in all local forums however will help people most if there is one main topic.

http://www.thaivisa.com/forum/topic/671391-affordable-health-insurance/

[MESmith]

There is a topic in the Health forum which I think it would be better to post in as this is a national issue. It is good there are topics pointing to this in all local forums however will help people most if there is one main topic.

http://www.thaivisa.com/forum/topic/671391-affordable-health-insurance/

But how many people read the health forum? I only found that thread because I was redirected from another post. Also I thought pinned topics can be added to by members, as is the case with the smog thread. This is a very important subject & needs to be at the top of the page. Also agree about deleting off topic posts.

[harrry]

There is a topic in the Health forum which I think it would be better to post in as this is a national issue. It is good there are topics pointing to this in all local forums however will help people most if there is one main topic.

http://www.thaivisa.com/forum/topic/671391-affordable-health-insurance/

But how many people read the health forum? I only found that thread because I was redirected from another post. Also I thought pinned topics can be added to by members, as is the case with the smog thread. This is a very important subject & needs to be at the top of the page. Also agree about deleting off topic posts.

dd

Agree it is important. Agree it should be pinned. Agree it should point to the main topic. Believe it should contain the ldescription and the link only and be locked THe general rule is one subject one topic. Otherwise information has to b e reposted 40 times.

[MESmith]

There is a topic in the Health forum which I think it would be better to post in as this is a national issue. It is good there are topics pointing to this in all local forums however will help people most if there is one main topic.

http://www.thaivisa.com/forum/topic/671391-affordable-health-insurance/

But how many people read the health forum? I only found that thread because I was redirected from another post. Also I thought pinned topics can be added to by members, as is the case with the smog thread. This is a very important subject & needs to be at the top of the page. Also agree about deleting off topic posts.

dd

Agree it is important. Agree it should be pinned. Agree it should point to the main topic. Believe it should contain the ldescription and the link only and be locked THe general rule is one subject one topic. Otherwise information has to b e reposted 40 times.

Agree too, but this is Chiang Mai & I'm only interested in CM hospitals.

[elektrified]

I would say that people should not get their hopes set too high about this. The government offers only the most basic services and the cheapest medicines available. For some things it will be fine. But others not.

Years ago I took a friend to a government hospital that she was registered with. It was near Kawila Army barracks. She had smashed her fingers in the frame of a car door and had one finger that was almost cut off. The emergency Doctor there looked at her hand and and said that "she could fix it but she may never have use of the one finger again." She also refused to give her a Morphine injection for the severe pain she was in at the time. My friend asked if she would sign the paper and transfer her to Suan Dok to be operated on by a hand surgeon. The Doctor snapped at her and told her that she should have private insurance if she wanted first-class treatment and that she would not sign the transfer form. My friend was taken to Sriphat where she was admitted and operated on that night by a hand surgeon. Her relatives paid the bill which was a lot of money but her fingers were as good as they were before the accident. Had she gone along with the government plan she might have a deformity today. Just something to keep in mind.

[harrry]

There is a topic in the Health forum which I think it would be better to post in as this is a national issue. It is good there are topics pointing to this in all local forums however will help people most if there is one main topic.

http://www.thaivisa.com/forum/topic/671391-affordable-health-insurance/

But how many people read the health forum? I only found that thread because I was redirected from another post. Also I thought pinned topics can be added to by members, as is the case with the smog thread. This is a very important subject & needs to be at the top of the page. Also agree about deleting off topic posts.

dd

Agree it is important. Agree it should be pinned. Agree it should point to the main topic. Believe it should contain the ldescription and the link only and be locked THe general rule is one subject one topic. Otherwise information has to b e reposted 40 times.

Agree too, but this is Chiang Mai & I'm only interested in CM hospitals.

Maybe I should just have posted the original topic in the CR forum as I initially wanted to but I refrained as although it would have got to more of those in CR Sheryl probably would not even have found out about it. It does deserve general coverage but best it is not too fragmented.

Edited October 15, 2013 by harrry

[Frank James]

Hey at least it might be enough to stop us self-insured US expats from being hunted down and fined taxed by the Obamacare fiasco.

Bona fide U.S. expats are exempt from the requirement of having U.S. based health insurance. Also exempt from any fines. Also not required to have foreign based insurance either. Cheers.

How does one qualify as a "bona fide" US expat? ( I hate that term, but mai phen rai.) I'm registered with the consulate as living here, retired, does that count?

I like the sound of this new deal, and am going to sign up, whatever it takes. Finally, a break!