Wading through the insurance jungle in Thailand

[Na Fan]

Hello Everyone

I am trying to understand the ins and outs (literally) of the Thai insurance system.

I do have a couple questions I'd be happy to have answered.

1) What is the definition of inpatient and outpatient in Thailand ? Does this vary per insurance company, or is it govt regulated (I doubt that it's the latter but you never know).

This has to be available somewhere, but I couldn't find it (in english).

2) I run my own Thai company and am registered as director. This makes me ineglible to sign up for social security, I'm told. Is that correct ? What is the reason for that ? It's rather retarded in my opinion.

I have a work permit, Non-B visa, the whole shebang. I pay tax. Why can't I get social security coverage ? Is this defined somewhere officially (in english) ?

3) Locals are working for me, and are registered with social security. What exactly are they covered for ? Is this defined somewhere (in english) ?

Does it make sense to get Health insurance on top of SS - to cover the gaps ?

4) My company is in IT. And some of my customers (overseas) request a general liability insurance to cover my work. Any experiences with such insurance in Thailand ?

Cheers

Na Fan

[KittenKong]

I always understood that an inpatient uses a hospital bed but an outpatient is mobile and goes home after his treatment. ie the inpatient is admitted but the outpatient is not.

Hard to imagine what other definition there could be.

[skraach]

There's a lot of information in English on the Social Security website:

www.sso.go.th

Social Security Knowledge
- Benefits
- Registration of new place of business
- How to register the insured
- FAQ

[yankee99]

I have been told as a director you should be able to afford private insurance. Personally i removed myself as director to aquire the insurance.

[Na Fan]

I always understood that an inpatient uses a hospital bed but an outpatient is mobile and goes home after his treatment. ie the inpatient is admitted but the outpatient is not.

Hard to imagine what other definition there could be.

Yes, well.. And no.

The point of this was that assuming I get insurance that only covers inpatient costs, but not outpatient costs. How exactly will the difference be made, as to whether or not they pay for a certain incident ? Surely there are certain rules the insurance company will check. I'd rather know now than "after the fact"

[Na Fan]

There's a lot of information in English on the Social Security website:

www.sso.go.th

Social Security Knowledge

- Benefits

- Registration of new place of business

- How to register the insured

- FAQ

That looks pretty elaborate indeed. I haven't checked that website, yet. After finding most of the thai govt websites to either entirely lack an english part or have one which is malfunctioning, or still in Thai, I pretty much gave up relying on that

[KittenKong]

I always understood that an inpatient uses a hospital bed but an outpatient is mobile and goes home after his treatment. ie the inpatient is admitted but the outpatient is not.

Hard to imagine what other definition there could be.

Yes, well.. And no.

The point of this was that assuming I get insurance that only covers inpatient costs, but not outpatient costs. How exactly will the difference be made, as to whether or not they pay for a certain incident ?

Doesn't the definition I gave cover that? If you are admitted and given a bed you are an inpatient. If not you are an outpatient. Seems clear to me.

Depending on the severity of your condition you could be an inpatient or an outpatient so there can be no real deciding in advance. For example, with a minor fracture you may be treated as an outpatient and sent home with just a cast but for a major fracture they may want to keep you in and so you would be an inpatient.

[Na Fan]

I always understood that an inpatient uses a hospital bed but an outpatient is mobile and goes home after his treatment. ie the inpatient is admitted but the outpatient is not.

Hard to imagine what other definition there could be.

Yes, well.. And no.

The point of this was that assuming I get insurance that only covers inpatient costs, but not outpatient costs. How exactly will the difference be made, as to whether or not they pay for a certain incident ?

Doesn't the definition I gave cover that? If you are admitted and given a bed you are an inpatient. If not you are an outpatient. Seems clear to me.

Depending on the severity of your condition you could be an inpatient or an outpatient so there can be no real deciding in advance. For example, with a minor fracture you may be treated as an outpatient and sent home with just a cast but for a major fracture they may want to keep you in and so you would be an inpatient.

I've looked around a bit, and what made me ask more specifically was things like this:

http://www.medicare.gov/what-medicare-covers/part-a/inpatient-or-outpatient.html

Yes, it's from the US - but it's still representative of the situation here, as it seems there is no clear definition ?

Particularly the quote at the bottom

"Remember, even if you stay overnight in a regular hospital bed, you might be an outpatient. Ask the doctor or hospital."

So basically it boils down to the fact that it's up to the doctor to specifically "label" you as either in- or outpatient. Which seems to move towards the famed way of doing thing the "stay on the doctor's good ($$) side to be formally treated as an inpatient if you want the insurance to cover the cost" way.

[realenglish1]

It pretty clear out patient no hospitalization In patient you are in a room. As for social security Check with your accountant They can tell you very specifically Dont rely on these guys here as you can see its speculation Do you run your business on spec I think not

[abrahamzvi]

I always understood that an inpatient uses a hospital bed but an outpatient is mobile and goes home after his treatment. ie the inpatient is admitted but the outpatient is not.

Hard to imagine what other definition there could be.

With all due respect to the Op, I would suggest that he/she refer to any English written Health policy, in the UK or the US and the same definition of Inpatient and Outpatient would appear there, if necessary with an explanation. It is no different to the Thai one.

As far as SS is concerned, I would suggest that the OP refer his question to the SS authorities, although I am pretty certain that he is not elligible. I am not familiar with the possibility of a voluntary subscription.

Regarding the question of a Third party Liability or any other insurances connected with or required by the business, the OP will be best served by an Insurance broker. Some very professional ones are active in Bangkok

[movsrus]

In the US, you can be admitted to a hospital "under observation" and still not be considered an in-patient. One of the problems with Medicare is that if you spend time in a hospital "under observation" you may not be entitled to after care and rehabilitation services under medicare. That is one of the reasons that you need to push the admitting authority in a US hospital to admit you not "under observation" otherwise you can be on the hook for a rehab services or only get greatly reduced benefits.

There was a segment on 60 Minutes (CBS News) about his a year or so ago which had specific instances of people who spend time in a hospital but were not admitted per Medicare and subsequently had to pay considerable costs out-of-pocket for rehab services.

This doesn't have a lot of relevance to the OP but other people have posted about what is "in patient" and what isn't and just spending time in a hospital bed in the US does not qualify as being 'admitted".

[Pralaad]

1) What is the definition of inpatient and outpatient in Thailand ? Does this vary per insurance company, or is it govt regulated (I doubt that it's the latter but you never know).

Inpatient is when you are hospitalized, Outpatient is when you see a GP but do not need to be hospitalized. It is regulated and is the same across all companies.

This has to be available somewhere, but I couldn't find it (in english).

2) I run my own Thai company and am registered as director. This makes me ineglible to sign up for social security, I'm told. Is that correct ? What is the reason for that ? It's rather retarded in my opinion.

I have a work permit, Non-B visa, the whole shebang. I pay tax. Why can't I get social security coverage ? Is this defined somewhere officially (in english) ?

Yes you can have Parkan Sankom, however you really do not want too, because it is only for 1 hospital in your region, long waits and pretty crappy doctors if i may say

3) Locals are working for me, and are registered with social security. What exactly are they covered for ? Is this defined somewhere (in english) ?

Does it make sense to get Health insurance on top of SS - to cover the gaps ?

They have free healthcare and medication for something like 30 baht

Being a foreigner who does not speak fluent Thai, you want to have private cover, to be treated in private hospitals by well educated, english speaking well trained doctors

4) My company is in IT. And some of my customers (overseas) request a general liability insurance to cover my work. Any experiences with such insurance in Thailand ?

Contact insurance broker or AXA direct and you can get it, its actually pretty cheap

Edited July 2, 2014 by Pralaad

[yankee99]

Like i said previously remove yourself as director and they assign you a hospital after paying ss three months and the coverage is good!

[Pralaad]

Like i said previously remove yourself as director and they assign you a hospital after paying ss three months and the coverage is good!

Do not need to be removed as director and it does not take 3 months, it is the moment you start to pay. it does take 3 months for card to come out. but one does not need the card to be treated. Hospital can contact parkan sankom with your name and check.

coverage is NOT good, if it was good, Thai's with high incomes would not be taking out private health funds

[yankee99]

Like i said previously remove yourself as director and they assign you a hospital after paying ss three months and the coverage is good!

Do not need to be removed as director and it does not take 3 months, it is the moment you start to pay. it does take 3 months for card to come out. but one does not need the card to be treated. Hospital can contact parkan sankom with your name and check.

coverage is NOT good, if it was good, Thai's with high incomes would not be taking out private health funds

I'll need to get a new accountant. Since a director can't pay SS and you need SS to be assigned your hospital please explain how this can be done?

[Jonmarleesco]

'1) What is the definition of inpatient and outpatient in Thailand?'

As anywhere, inpatient/day patient means time in a hospital bed - typically a minimum of 6 hours. Outpatient is akin to visiting a GP [General Practitioner[ in the west. No long term bed time.


'4) My company is in IT. And some of my customers (overseas) request a general liability insurance to cover my work. Any experiences with such insurance in Thailand?'

There are brokerages that can competently deal with this for you, not necessarily Thai managed.

[Pralaad]

Like i said previously remove yourself as director and they assign you a hospital after paying ss three months and the coverage is good!

Do not need to be removed as director and it does not take 3 months, it is the moment you start to pay. it does take 3 months for card to come out. but one does not need the card to be treated. Hospital can contact parkan sankom with your name and check.

coverage is NOT good, if it was good, Thai's with high incomes would not be taking out private health funds

I'll need to get a new accountant. Since a director can't pay SS and you need SS to be assigned your hospital please explain how this can be done?

Ok, each zone has its assigned hospital. For my zone, ie zone my business is at , it is Banglamung Hospital, anyone working in my zone is assigned to Banglamung.

So the 3 months wait is for the card to arrive which will have your number and Banglamung on it

However if you were to get sick prior to that, you can go to Banglamung, give them your name and ask to contact SS to confirm.

In regards to director, its also pretty easy, when submitting the form, put down manager and it is accepted.

HOWEVER

Your salary is 50 000(depends on nationality, but will use 50 000 as an average)

The SS is 8%, so you will be paying 44 000 baht per year.

Good private cover will cost you about the same(depending on the age)

So would you prefer to have private cover for private hospitals of your choice, private rooms, skilled, English speaking doctors, little wait or would you prefer to get treated at government hospitals where waits to see the doctor could be 6-8 hours, not to mention the level of service, doctor qualifications and public rooms.

[German Viking]

Check this insurance: http://www.azay.co.th/en/insurance-my-personal-accident.aspx

This is a 100% daughter of the Allianz Germany the biggest insurance in the world very serious.

https://www.allianz.com/en

Very good service, but not the cheapest.

You get what you pay for.

[MJCM]

^ i have looked at those page, interesting but it seems that it is accident only and a not health insurance, or am I missing something?

Sent from my iPad so Please excuse any typos