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

[uptheos]

People lucky enough to be born in first-world countries using-up resources meant for poor people in third-world countries. Am I missing something?

Don't hi-jack the thread with your ideology. There are a lot of people who are interested in this information and contributors who are giving a lot of well written and useful information.

[Mapguy]

He is not trying to hijack the thread. He has raised a key question, but I do agree with Upsetstomach that this thread needs to by left to the immediate Chiang Mai situation with the practical concerns and needs (some urgent, no doubt) of those already expressed.

There are very large concerns raised by this change in Thai public health policy, which was prompted by ASEAN integration. They apply to ALL of Thailand, which has been an astonishingly hospitable host to long-stay foreigners --- many of the farang who post here. So many are economically destitute for one reason or other and so many --- I suspect many, many who post on TV Chiang Mai --- are --- well, just lonely and old and worried about dying.

Give NancyL, Cheryl and some very competent other people including primarily the Thai Chiang Mai area hospital staff, a break!

Lighten up, worry warts! You are not going to collapse from ill health tomorrow (I hope) !! Those mentioned above really have hard work to do, especially the Thai Public Health staff.

Immediately Chiang Mai area hospitals must deal with not only the bureaucratic ins and outs of a new government requirement not originally intended for financially-forlorn Caucasian foreigners and pension-poor Japanese who settle here with low budgets, but with you!

The young think they will live forever, mai phen rai! But here, realistically, there are older expats living with bum knees, heart filibrations and a nasty host of other serious untreated problems (quite often exaserbated by "easy living") for which, in entirely too many cases. And --- here's the bottom line --- they have not made adequate financial provisons to take care of themselves.

Please --- now --- don't be one of the people who are among those who physically knock others down or, simply, doesn't do the homework before going to immigration, and shout rudely or just express momentary frustration at people trying to help. There is a rather remarkable opportunity for people here now to get needed care.

Don't blow it!

Edited October 22, 2013 by Mapguy

[babyjesus]

Health care should be a right, not a privelege. There are great costs to society to have sick and disabled people unable to access care. Sick people can't produce wealth or care for other family and friends who will therefore have to access formal care at a cost when their informal caregivers can not. Think macro.

[heybruce]

Ideally an expat scheme the same as or better than the Social Insurance would be good. That way you would be able to get care at Suan Dokh or Rajavej. That would be considerably better.

I would go for that as a Plan B as I can't get Social Insurance under my husbands company, as he is the owner. Relations of company owners (as well as the owners) are excluded from Social Insurance of that company.

Would you please share a bit more on the Social Insurance scheme. Is this the fund that all Thai employees pay into, as a broad social scheme? Or is ir specific to health, but different to the 30Baht scheme?

Are foreigners, with a work permit also automatically members of this fund?

If it's a health fund, is it different to what has been discussed here over the last few days.

Are permenant resident holders allowed to join this fund?

Appreciate any details you can share. Thanks.

Universal Health Care in Thailand is achieved throuhg a combination of 3 schemes:

1) A contribution-based Social Security system for the civil service. this also covers spouse and children. Unlike:

2) Regular Social Security which covers everyone employed in the formal private sector. You have to be (legally) employed for 13 months to get it. Once you do, as long as you keep up the payments you have it for life, even after you stop working.

It too is contribution based, there is a regular deduction from you paycheck.

3) The so-called "30 baht" or "gold card" scheme which picks up everyone else (Thai citizens, that is). This is free, not contribution based.

There are differences between the benefits under these various systems. Under SS, you must register at a hospital and get care only there (or at a higher level they refer you to) but you can choose which hospital from among those in your area which participates in the scheme (all government and some private hospitals). Under the "30 baht" scheme you have no choice of hospital, has to be the government hospital whose catchment area you live in. And likewise only get care there or at a higher level if referred.

All schemes cover most medical care but there are a few things that the "30 baht" covers that SS does not, I forget what exactly. The schemes are managed by different government agencies which is how that comes to be.

If you have a work permit and have been employed for 13 months, you should be under SS, if not, ask your employer why. And whatever you do, once under it never let it lapse, arrange to keep up the payments even after you stop working as this is by far the best form of inexpensive health insurance you can get. (Private insurance is better still, of course, but niot inexpensive. And many peopkle can't get it because of age or pre-exisitng conditions).

The scheme being discussed in this thread is a new arrangement whereby foreigners can get covered under the "30 baht" scheme on a contribution basis....2,200 baht a year but as I have explained that rate will almost surely rise as it wasn't calculated taking resident expats into account, only migrant workers who tend to be young and without chronic conditions.

Thank you Sheryl, this is by far the most useful and on-topic post I've read on this topic.

Praise and/or complaints about specific Chiang Mai hospitals may be informative, but they are not directly applicable to a post titled "The new Government Health Insurance - info for TV members in Chiang Mai".

[TallGuyJohninBKK]

I'm against westerners being incorrectly registered on public health insurance schemes not intended for them, although whether this applies to the 'con dtaang daao' card scheme isn't clear yet (my information is that the policy intention was that it should cover migrant workers only).

What I do think would be quite reasonable is a voluntary card scheme for (especially older) expats at an appropriate premium, and/or low-cost reciprocal healthcare agreements with certain other countries. Times are moving on and Thailand is obligated to make arrangements for reciprocal care with its ASEAN neighbours, so this might be an appropriate time to address the long stay resident issue as well.

Citizen, I'd agree that the government's communications on this subject have been far short of clear on whether this new plan either is or isn't intended to cover ( be offered for purchase to ) non-working farangs.

But, I'd also encourage you to take note of my wife's conversations with the NHSO and HIG staff in BKK this week (as posted in the main thread on this topic), where both offices told her that YES, the new plan OUGHT to cover her non-working farang husband, and that I ought to be able to register for a card.

I was originally quite skeptical, as were you, about whether the inclusion of farangs upcountry (those getting issued cards this past month) was intended or an aberration. But as more info has come in, including my wife's contacts with MOPH and DHSO, I'm beginning to believe it IS intended.

Edited October 22, 2013 by TallGuyJohninBKK

[Mapguy]

Yes, think macro, babyjesus. Socioeconomic reality macro, that is.

Please repost on "Implications," a concurrent thread.

What is hot and heavy in the practical impact in Chiang Mai is small potatoes albeit of root very personal concern of interest to so many advanced elderly and frail in Chiang Mai which has become home to a seemingly ever-increasing number. And that's not just from Anglophone countries so overwhelmingly represented here. (I do not include Australians, of course! )

All in all, wouldn't life be lovely when the last gasps of "Western" expectations transplanted to Chiang Mai were concurrent with reality. Sure, it would be wonderful if health care were a "right, not a privilege" everywhere. So, who pays for it?

Who is responsible? A society that stomachs the cost of every bellyache regardless of expense or --- perhaps more importantly --- individuals responsible for their own lifestyles?

Edited October 22, 2013 by Mapguy

[taotoo]

Am I missing something?

Affordable medical insurance?

So someone else should pay instead?

[taotoo]

Possibly you are missing that Thailand became an upper middle income country in 2011.

By GDP or something perhaps, but it's the rich dragging Thailand up the scale - not many village peasants are upper middle income. And I dare say 95% of people on this thread are from upper-upper income countries.

I'm against westerners being incorrectly registered on public health insurance schemes not intended for them, although whether this applies to the 'con dtaang daao' card scheme isn't clear yet (my information is that the policy intention was that it should cover migrant workers only).

Common sense would suggest that the policy isn't aimed at westerners who've earned hundreds of thousands of dollars in their lifetimes, spent most of it on a western lifestyle, and now wish they'd planned a bit better.

[taotoo]

Don't hi-jack the thread with your ideology

Sorry, wouldn't want to make you uncomfortable.

There are a lot of people who are interested in this information and contributors who are giving a lot of well written and useful information.

I bet there are!!!

[NancyL]

Mods -- is there some way to move the posts from people who want to discuss the morality of poor people from rich countries PAYING to enter this system and move it to the tread devoted to slagging those who join? It would be nice if this thread could continue to be focused people's efforts to understand, join and utilize this system.

[Thailand]

Am I missing something?

Affordable medical insurance?

So someone else should pay instead?

It is a contributory scheme and you don't have to join if you don't want to.

You,and the other minority,can of course continue moaning and criticizing it but preferably on a separate thread and leave this for information for those that are interested.

[mccw]

How many farang will be joining do you think?

500 or more like 5000? How many resident retirees are there in Chiang Mai?

[harrry]

How many farang will be joining do you think?

500 or more like 5000? How many resident retirees are there in Chiang Mai?

if it is 5000 it is 1 percent not the 10 percent you refered to previously. I think it will be more like 500 and probably less.

[citizen33]

The interesting thing is that different officials are saying different things (I've only had feedback from three so far, at quite a high level). It does seem that the Health Insurance Group at the MoPH have been telling people, including one of my informants, that the scheme does cover non-Asean foreigners. Against this somebody at a much higher level who was involved in the formulation of policy of the healthcare implications of the AEC says this was not the original policy intention. This is why I say things are unclear. I'm still trying to work out whether it is somebody at a middle level who has interpreted the scheme as having wide application, while leaving some senior policy makers out of the loop, or if there is support for the policy to include farang from the Minister (despite the doubts of other senior policy makers). I hope to find out more soon, but you won't get the definitive answer from the HIG or NHSO help lines, at least not until the people at the top agree a clear message.

I'm against westerners being incorrectly registered on public health insurance schemes not intended for them, although whether this applies to the 'con dtaang daao' card scheme isn't clear yet (my information is that the policy intention was that it should cover migrant workers only).

What I do think would be quite reasonable is a voluntary card scheme for (especially older) expats at an appropriate premium, and/or low-cost reciprocal healthcare agreements with certain other countries. Times are moving on and Thailand is obligated to make arrangements for reciprocal care with its ASEAN neighbours, so this might be an appropriate time to address the long stay resident issue as well.

Citizen, I'd agree that the government's communications on this subject have been far short of clear on whether this new plan either is or isn't intended to cover ( be offered for purchase to ) non-working farangs.

But, I'd also encourage you to take note of my wife's conversations with the NHSO and HIG staff in BKK this week (as posted in the main thread on this topic), where both offices told her that YES, the new plan OUGHT to cover her non-working farang husband, and that I ought to be able to register for a card.

I was originally quite skeptical, as were you, about whether the inclusion of farangs upcountry (those getting issued cards this past month) was intended or an aberration. But as more info has come in, including my wife's contacts with MOPH and DHSO, I'm beginning to believe it IS intended.

Edited October 23, 2013 by citizen33

[Tywais]

Mods -- is there some way to move the posts from people who want to discuss the morality of poor people from rich countries PAYING to enter this system and move it to the tread devoted to slagging those who join? It would be nice if this thread could continue to be focused people's efforts to understand, join and utilize this system.

Give me some time and I will try to go through this tomorrow for a cleanup. Means locking the topic temporarily tomorrow while I go through it.

[TallGuyJohninBKK]

No... I never expected we would, under the circumstances.

But I did find it encouraging that both the NHSO Hotline and the HIG people in MOPH were separately saying the same thing -- that they believed non working farangs are supposed to be eligible. That's at least a step forward from the notion that the upcountry hospitals had just gone off on a flyer of their own... Clearly, that's not what they've done, in issuing the cards to farangs thus far.

FWIW, as a follow-up to my original post on this issue, my wife did get back in touch with her contact at HIG, and they asked us to write them a memo explaining our difficulties in finding anyplace in BKK willing to accept our application for the government's health card. I wrote that memo and faxed it to HIG today, per their request.

My wife's contact said something about them having an upcoming meeting around the end of the month to discuss the issue (I don't know if that means the state of affairs in BKK or the broader issue of farang eligibility). Either way, I put forth a decent argument for why farangs should be included and ended the memo by asking MOPH to make that clear, if in fact that's their intention.

The interesting thing is that different officials are saying different things (I've only had feedback from three so far, at quite a high level). It does seem that the Health Insurance Group at the MoPH have been telling people, including one of my informants, that the scheme does cover non-Asean foreigners. Against this somebody at a much higher level who was involved in the formulation of policy of the healthcare implications of the AEC says this was not the original policy intention. This is why I say things are unclear. I'm still trying to work out whether it is somebody at a middle level who has interpreted the scheme as having wide application, while leaving some senior policy makers out of the loop, or if there is support for the policy to include farang from the Minister (despite the doubts of other senior policy makers). I hope to find out more soon, but you won't get the definitive answer from the HIG or NHSO help lines, at least not until the people at the top agree a clear message.

[scorecard]

I live in the Don Chan area.

If I register at say Nakorn Ping Hospital does it mean I have to use that hospital only, or can I use any government hospital in the greater Chiang Mai area?

By the way, anybody have any comments to share please on Thaisid Hospital?

Appreciate any guidance, thanks.

[bifftastic]

Here's the link; I dug it up from the post mentioned above.

(Application form for Govt. health insurance for migrants/foreigners - in Thai)

That seems to be just the forms, The actual MoPH directive is in the post I mentioned.

That form also specifically mentions Udon Thani

[haybilly]

I notice a reference to 'the original thread' relating to this subject- could someone give me a pointer re: the title of other thread?

Sent from my GT-P7510 using Thaivisa Connect Thailand mobile app

[elektrified]

I live in the Don Chan area.

If I register at say Nakorn Ping Hospital does it mean I have to use that hospital only, or can I use any government hospital in the greater Chiang Mai area?

By the way, anybody have any comments to share please on Thaisid Hospital?

Appreciate any guidance, thanks.

You would have to use Nakhornping only to be covered under the plan.

[elektrified]

I notice a reference to 'the original thread' relating to this subject- could someone give me a pointer re: the title of other thread?

Sent from my GT-P7510 using Thaivisa Connect Thailand mobile app

In the health and medicine forum.

[MadMac]

Been in Hang Dong Hospital this morning after the success report here and got all the tests done (blood pressure, urine, blood and x-ray), it took all together about an hour. Very friendly staff and not crowded at all like Nakornping. Was no. 7 on the list. The card itself should be ready on 30/10. Seems standard in CM to have to wait for a week, I was told the same in Nakornping.

I've tried HDH already yesterday but was told to come back today, so it appears they don't process applications everyday. So keep Thursday in mind if you'd like to apply for the health card. Passport and 2 passport pictures were sufficient but they welcome a yellow tabien baan (with names in Thai).

I think Hang Dong may be a good choice, given that they have limited staff (25 beds according to the website) and in a serious case a referral to a regional hospital with specialists is probably more likely than in Nakornping.

[cheeryble]

I think Hang Dong may be a good choice, given that they have limited staff (25 beds according to the website) and in a serious case a referral to a regional hospital with specialists is probably more likely than in Nakornping.

Surely you have no choice of hospital it is down to where you are registered on your tabien bahn?

I took grandma in to my local hospital recently and my wife found out before I saw this thread that I could also sign up with the tabien bahn etc.

No fees or medical test were mentioned.

(You are not restricted to your "home" hospital and can be referred onward fro treatment but I believe it is always the starting point.)

[MadMac]

My Tabien Baan is from Bangkok. It doesn't matter where as the house registration system works differently from what we are used to in western countries. So you can basically pick one hospital which is convenient for you or for any other reason, this will then be the place you go for all and everything. If necessary they will then refer you to a specialist. Thus you *are* restricted to your "home hospital"

Edited October 24, 2013 by MadMac

[cheeryble]

To update wife was at the hospital again today and was indeed told it would cost 2800 bt so no freebies.

[MadMac]

It's actually 600B for the checkup and 2200B for the insurance itself. They give you 2 separate bills. According to the lady in Nakornping one can already use the insurance using the receipt without having the card issued. Takes 1 week in CM.

[ramrod711]

I registered today at saraphi hospital, took 2 hours, mostly because the guy doing the blood tests was very busy. I alredy had access to the 30 baht plan because my wife registered me a year ago. The lady at the hospital told my wife that i was and am the only farang registered there, not sure why. My friends that registered at the sansai hospital said i needed to take 2 photos with me for the card but saraphi said no, does anyone know if the card features a photo?

[harrry]

I registered today at saraphi hospital, took 2 hours, mostly because the guy doing the blood tests was very busy. I alredy had access to the 30 baht plan because my wife registered me a year ago. The lady at the hospital told my wife that i was and am the only farang registered there, not sure why. My friends that registered at the sansai hospital said i needed to take 2 photos with me for the card but saraphi said no, does anyone know if the card features a photo?

Some places do it like the drivers licences with a camera on the computer.

[MadMac]

Just bring 2 pics to be safe. Hang Dong requested them. Nakornping not, so they probably have a camera. No idea about Sansai.

The lady from Hang Dong Hospital called my wife to get some more info about the insurance (she did not dare to ask me ). So it seems they run blind without really knowing what is going on. I gave her the link to the PDF document as well as the HIG Thai phone number. Hope this will make it easier for anyone in the future.

Edited October 24, 2013 by MadMac

[muchogra]

I am curious to know if any foreigner can walk into a government hospital, say Nakornping or Suan Dok, to get medical treatment and be charged the same as Thai. Same question for the long-stay expats who show a driver license. Some new comers to Thailand may also be interested in my question.

Another question. Does it mean that, with the said insurance, a foreigner may get medical treatments for free at the chosen (enrolled) government hospital?