Health Cards for Foreigners Ceased.

[Liquorice]

Sorry if I missed something elsewhere on the forums, but I just found out today that the scheme for Government Health care for foreigners ceased on 27/6/2014 by order of the Government. I have copies of the new orders (in Thai) if anyone is interested.

This is the scheme where you pay 2,800baht for Medical tests and get 12 months health cover for the same cost as Thais.

Foreigners received a card 'Health Card for Foreigners'.

Bad news I thought............No!

It's good news...........Foreigners need only to register at your local Government Hospital and get the registration card to receive any Medical Treatment for the same cost as Thais. No Medical examination, no fees.

[Issangeorge]

" It's good news...........Foreigners need only to register at your local Government Hospital and get the registration card to receive any Medical Treatment for the same cost as Thais. No Medical examination, no fees." Is that written in the new orders?

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

[Sheryl]

It has always been possible to get treatment in govt hospitals at the same cost as a Thai paying out of pocket. but, very few Thais have to do that since almost all are covered under either the UCS or SS and thus pay nothing.

The 2,800 baht plan did not allow receipt of medical care at the "same cost" as a Thai, it was an insurance system with treatment being free of charge.

Please post a link to the documents you have as I have not seen this and have heard of cards being newly issued in some locations as recently as last week.

Possibly the order clears up the misunderstanding that resulted from the initial one i.e. that the system is for migrant workers, not resident expats? They are certainly continuing the system for the migrants....

[Liquorice]

Hi Sheryl,

I have a number of Thai friends who are often charged 30 baht for hospital visits. I'm also told by a farang friend who holds a 'Health Card for Foreigners' but attends regular visits to a hospital for physiotherapy treatment, that he also pays 30 baht for each visit.

I didn't hold a current 'Health Card for Foreigners', hence my visit today to get one. I took all my documents and expected to pay 2,800 baht and get a full medical check.

The reception initially said 'No', it was confusing because of the language barrier. I had a Thai interpreter with me during the visit.

We were directed to the main Admin Office where staff spoke perfect English to fully explain the situation. At first I misunderstood and thought Foreigners were being refused any subsidised Health Care.

What they explained to me, was that from 27th June 2004 (5 days ago) new orders were received and the 'Health Cards for Foreigners' scheme was scrapped from that date.

Under the new scheme, a Foreigner could now merely register at the hospital and receive the Hospital registration ID card that all Thais have, without the need for any medical checks, nor the need to pay a 2,800 baht fee.

I asked in detail what that meant and gave examples of possible future treatments. In each case they told me I would only be charged 30 baht for each treatment.

They even phoned the office in Bangkok who issued the orders to confirm the facts as it's new to them.

I asked if they could give me a copy of the new orders, which they promptly obliged.

I have hard copies, I'll scan them in and post ASAP.

Maybe something was left out, but that was what I was told.

Hopefully the order can be translated and you can clarify the situation for the benefit of everyone.

[Liquorice]

Sorry Sheryl I couldn't attach the files here. I sent you a message with the files.

Health Doc Page 1.pdf

Health Doc Page 2.pdf

Oops, think I sorted it?

[Sheryl]

Thanks, I will get them translated.

What you were told cannot possibly be correct, however. There is most definitely no intention to allow all foreigners to get free/30 Baht health care. The prior scheme, in fact, was never meant for other than migrant workers. It is possible that what has happened is that the prior scheme 9for migrant workers) has now been revised to eliminate the 2,800 baht subscription payment, which may make some sense relative to new efforts underway in regard to regularizing the situation of undocumented migrants.

And, TIT, possibly the revised orders, like the earlier ones, fail to make it clear that it is only for migrants. In which case we will see a continuation of the old situation, wherein most places will not issue to farang but a few (esp. in Issan) will, minus the 2,800 baht payment.

Anyhow I will get this translated. Stay tuned....

[Liquorice]

Thanks Sheryl,

It would be nice to know what the position is for Healthcare for expats under the current situation.

[KhunBENQ]

I am confused about the attachments in post #5.

Page 1 contains a date in the headline: 30 June 2553 (30 June 2010)? (๓๐ มิถุนายน ๒๕๕๓)

Edited July 3, 2014 by KhunBENQ

[Sheryl]

Both documents refer specifically to temporary foreign workers and the second one specifically says Myanamar, Laos and Cambodia. Definitely not referring to resident expats.

Also not providing 30 baht care at no extra charge. Rather sets forth the procedure for getting a health card for "temporary foreign workers" and charges as follows:

3 months – total cost B1000: 500 Baht for physical examination and insurance premium of B500

6 months – total cost B1400: 500 Baht for physical examination and insurance premium of B900

No mention of 12 months but the cost is prorated equivalent. It seems to just be a tweaking of the prior system to adjust for varying durations of work. There is also language in the first document indicating this is mandatory and that employers are responsible for arranging it

[TerryLH]

Faz

"It would be nice to know what the position is for Healthcare for expats under the current situation."

While it would be nice, why do you think the Thai government should subsidize your health coverage?

I think what you will find when you use the hospital, is that you will pay the standard price that a Thai or anyone else using the hospital would pay, if they aren't there under one of the three government plans. 4 if you count the migrant worker plan.

Many expats think they are getting some kind of special deal because for most things, it's very inexpensive compared to where they come from.

The card you got is just registering at the hospital. They use the number to find your file when you go there for service.

There was some talk several months ago about offering some kind of plan to tourists. I haven't read anything about that for a long time.

[Sheryl]

......There was some talk several months ago about offering some kind of plan to tourists. I haven't read anything about that for a long time.

Tourists and resident expats, but nothing done on it yet - lost momentum with the political upheavals.

[Jessi]

I used my Foreigners health card yesterday for a blood test ........Cost 30B

I'm returning to the Cardiologist today, I expect to be loaded up with meds again costing 30B

I shall report back.

[Liquorice]

TerryLH, on 03 Jul 2014 - 17:08, said:

Faz

"It would be nice to know what the position is for Healthcare for expats under the current situation."

While it would be nice, why do you think the Thai government should subsidize your health coverage?

I think what you will find when you use the hospital, is that you will pay the standard price that a Thai or anyone else using the hospital would pay, if they aren't there under one of the three government plans. 4 if you count the migrant worker plan.

Many expats think they are getting some kind of special deal because for most things, it's very inexpensive compared to where they come from.

The card you got is just registering at the hospital. They use the number to find your file when you go there for service.

There was some talk several months ago about offering some kind of plan to tourists. I haven't read anything about that for a long time.

Just where did I say I expected subsidized Healthcare?

I expect to pay the same as Thais, but not a separate Farang price.

If you can get decent affordable Healthcare under the Thai system, why waste money on private Health Insurance, which has claim limitations, especially as you get older.

[Liquorice]

Jessi, on 04 Jul 2014 - 04:25, said:

I used my Foreigners health card yesterday for a blood test ........Cost 30B

I'm returning to the Cardiologist today, I expect to be loaded up with meds again costing 30B

I shall report back.

Hi Jessi,

Your Foreigners Health Card is still valid until it's expiry.

As I understand it, with a Foreigners Health Card you paid exactly the same as a Thai would (unless they were covered by some Insurance scheme)

The point of my post was to advise they have stopped issuing these cards to Foreigners.

You can now get the same treatment, at the same cost, with just the Hospital Registration card.

No need to take a medical now and pay 2,800 baht.

For the time being at least, all resident expats who register at a Government hospital will get treatment at the same cost to Thais.

[Liquorice]

Hi Sheryl,

Not had time to go back to the hospital after your translation of the documents they gave me to clarify the situation, but I did speak to an off duty nurse from the hospital last night.

She confirmed what I was told by the hospital. They stopped the scheme whereby they issued 'Foreigners Health Cards' on 27/6/2014 by order of the Government in Bangkok.

New rates and limitations for 'temporary foreign workers' from Cambodia, Laos etc were renewed on this date, with 6 months being the maximum time they classify as being 'temporary'.

Although the documents the hospital gave me didn't confirm the position for 'Foreign residents', the nurse confirmed they have been instructed to treat all 'Foreign Residents' just the same as Thais, which means they scrapped issuing the 'Foreigners Health Card' and resident Foreigners merely have to register at the hospital to get the same benefits a Thai does, at the same cost.

Speaking about a scheme for Tourists! When I registered at the hospital, I entered my name, address, Passport number, DOB, etc, but at no time was I asked for any documentation as proof. I see a big loophole in that, in so far as a Tourist with a private address could also register.

If I can get any further documentation from the hospital, I'll post it, but for now I can only go with the flow.

[Sheryl]

Just where did I say I expected subsidized Healthcare?

I expect to pay the same as Thais, but not a separate Farang price.

If you can get decent affordable Healthcare under the Thai system, why waste money on private Health Insurance, which has claim limitations, especially as you get older.

Government hospitals have never had a separate "farang" price. It has always been possible to register at them and to receive care at the same price that anyone else not covered under the UCS ("30 baht" scheme) would receive, and this is about 1/5 of the rates at the more expensive private hospitals.

However most Thais receive subsidized care from government hospitals. The "30 baht" price is heavily subsidized and hospitals receive a per capita subsidy for each Thai citizen enrolled in that system in their area. No such subsidy is provided to hospitals for farang.

It is certainly much less expensive to get care at government hospitals but it still warrants having insurance. Even at a government hospital, bills for catastrophic illness/accident can easily exceed a million baht.

[Sheryl]

....Although the documents the hospital gave me didn't confirm the position for 'Foreign residents', the nurse confirmed they have been instructed to treat all 'Foreign Residents' just the same as Thais, which means they scrapped issuing the 'Foreigners Health Card' and resident Foreigners merely have to register at the hospital to get the same benefits a Thai does, at the same cost....

They were misinformed, probably by the insurance company that has been contracted to run the migrant scheme for the MoPH, who have been providing this incorrect guidance from the onset (or at least some of their staff have). When it comes to the attention of the central MoPH that farang have been enrolled, the hospitals in question are instructed to cease and desist - this already happened throughout Chiang Mai province , with the cards rescinded and insurance payment refunded.

This confusion has been going on for some time now and there are past threads on it. If the hospital in your area wants to issue you this card and charge you only the premium plus 30 baht per visit, fine but be forewarned that they are erring in doing this and it may be stopped at any time, so if you have other insurance do not drop it.

[TerryLH]

I get the impression that there might still be some confusion over this, with some still thinking that they are getting a special deal because they registered at a government hospital.

Please re-read what Sheryl has posted, especially the last couple of them.

Her description of the situation seems pretty clear to me.

[citizen33]

I am confused about the attachments in post #5.

Page 1 contains a date in the headline: 30 June 2553 (30 June 2010)? (๓๐ มิถุนายน ๒๕๕๓)

Just to clear up this loose end, that is the date of the guidance for employers of temporary foreign workers. The original says 30 June 2557 (2014) not 2553 (you missed the squiggle off the end - ๗). The document with the schedule of charges is dated 27/6/14.

Edited July 4, 2014 by citizen33

[Liquorice]

I totally agree it's confusing and about time some clear guidance for resident foreigners was issued from the government.

In Roi Et they started issuing the 'Foreigners Health Card' for a Premium of 2,800 baht last October.

600 baht for the necessary Medical and 2,200 for want of another word, the Insurance premium.

You still got charged 30 baht per visit.

Now they tell me the 2,800 premium for the Foreigners Health Card is scrapped along with the scheme.

The new deal is to register free of any charges or examinations and get treatment for 30 baht per visit the same as most Thais.

It sounds like their shooting themselves in the foot, but that is exactly what expats are now being told.

Incidentally, foreigners who are fortunate enough to have a Thai wife who work for the Government in some capacity, get free Healthcare under the cover afforded to the wife. Those policies don't discriminate between a Thai husband or a Foreign husband.

As resident expats we should be fighting to get the same treatment for the same cost as resident Thais.

[Sheryl]

I totally agree it's confusing and about time some clear guidance for resident foreigners was issued from the government.

In Roi Et they started issuing the 'Foreigners Health Card' for a Premium of 2,800 baht last October.

600 baht for the necessary Medical and 2,200 for want of another word, the Insurance premium.

You still got charged 30 baht per visit.

Now they tell me the 2,800 premium for the Foreigners Health Card is scrapped along with the scheme.

The new deal is to register free of any charges or examinations and get treatment for 30 baht per visit the same as most Thais.

It sounds like their shooting themselves in the foot, but that is exactly what expats are now being told.

Incidentally, foreigners who are fortunate enough to have a Thai wife who work for the Government in some capacity, get free Healthcare under the cover afforded to the wife. Those policies don't discriminate between a Thai husband or a Foreign husband.

As resident expats we should be fighting to get the same treatment for the same cost as resident Thais.

We already do get the same treatment at the same cost as a Thai not covered under a government subsidized health scheme. Aways have.

Are you saying you believe the Thai government should subsidize the cost of health care provided to resident expats? Why?

[sinbin]

As resident expats we should be fighting to get the same treatment for the same cost as resident Thais.

We should also be fighting for equality as farang men when it comes to the fact that farang women don't have to show money, each year, if married to a Thai man. But that's another thread hey?

[Liquorice]

Hi Sheryl,

Every Thai citizen not covered under other public schemes are covered by the UCS scheme.

The 30 baht scheme as it was known.

The Baht 30 copayment was abolished by the next government in November 2006, and the system was totally free of charge.

It is however run on a population basis of taxpayers, so may vary from region to region.

Certainly in this part of Issan all Thais have continued to pay the 30 baht for each treatment.

I'll tell you my experience so far then you'll understand where I'm coming from. I just want clarity on the position in Thailand, but that seems impossible as it varies from what you read, to what your told. I do appreciate your comments and time to reply.

I arrived from the UK 2 months ago but had an unfortunate accident. I certainly wasn't charged what a Thai would have been charged!

I'd just got back on my feet when I got an insect in my eye and an eye infection. Again I wasn't charged what a Thai would have been charged!

I couldn't get Private Medical cover from any Insurance organisations in the UK. As a tourist, Yes. As a migrant, No.

I found out about the Foreigners Health Card from other expats, and hence that was why I visited the hospital again.

I wasn't previously registered, but now I am and told I will get treatment for 30 baht per visit in the future, just the same as a Thai.

Sounds to good to be true and probably is.

We have a similar system in the UK, the NHS. It is not available to foreign tourists from outside the EU. But foreigners who have a Visa to reside in the UK get full free medical treatment just the same as a UK citizen.

Now it seems to me that Thailand has adopted a similar system, but with a 30 baht charge.

Would it be stretching it to far to expect a foreigner to get the same treatment, at the same cost.

I don't work, but still pay VAT taxes on goods and services.

I'll continue to clarify the position with the hospital and report anything new.

My fear is that if in the future I needed further medical treatment, I get told I was misinformed in the first place.

Needless to say I never had any health issues in the UK, but sods law, the minute you move out of your comfort zone, something happens.

I'm getting older, that doesn't help.

[citizen33]

Hi Sheryl,

Every Thai citizen not covered under other public schemes are covered by the UCS scheme.

The 30 baht scheme as it was known.

The Baht 30 copayment was abolished by the next government in November 2006, and the system was totally free of charge.

It is however run on a population basis of taxpayers, so may vary from region to region.

Certainly in this part of Issan all Thais have continued to pay the 30 baht for each treatment.

I'll tell you my experience so far then you'll understand where I'm coming from. I just want clarity on the position in Thailand, but that seems impossible as it varies from what you read, to what your told. I do appreciate your comments and time to reply.

I arrived from the UK 2 months ago but had an unfortunate accident. I certainly wasn't charged what a Thai would have been charged!

I'd just got back on my feet when I got an insect in my eye and an eye infection. Again I wasn't charged what a Thai would have been charged!

I couldn't get Private Medical cover from any Insurance organisations in the UK. As a tourist, Yes. As a migrant, No.

I found out about the Foreigners Health Card from other expats, and hence that was why I visited the hospital again.

I wasn't previously registered, but now I am and told I will get treatment for 30 baht per visit in the future, just the same as a Thai.

Sounds to good to be true and probably is.

We have a similar system in the UK, the NHS. It is not available to foreign tourists from outside the EU. But foreigners who have a Visa to reside in the UK get full free medical treatment just the same as a UK citizen.

Now it seems to me that Thailand has adopted a similar system, but with a 30 baht charge.

Would it be stretching it to far to expect a foreigner to get the same treatment, at the same cost.

I don't work, but still pay VAT taxes on goods and services.

I'll continue to clarify the position with the hospital and report anything new.

My fear is that if in the future I needed further medical treatment, I get told I was misinformed in the first place.

Needless to say I never had any health issues in the UK, but sods law, the minute you move out of your comfort zone, something happens.

I'm getting older, that doesn't help.

It may be worth looking at some of the old threads to get more background. To summarise though, the UCS was intended to fill the main gaps left by the existing occupation-based public insurance schemes, but was limited to Thai citizens (see 2002 National Health Security Act). Its affordability or otherwise has always been a controversial issue. But against the background of the rising global interest in universal healthcare coverage, and also impending entry to the ASEAN Economic Community, the Thai government considered certain extensions that would improve coverage for other groups. The two most obvious ones were stateless people and migrant workers, but there was also discussion of the position of tourists and long-term foreign residents and whether it was possible to devise separate schemes for these groups.

Dr Pradit - the former MoPH Minister - advocated extending healthcare to all people resident in Thailand, but there were legal obstacles and some policy makers and politicians were not in favour. Stateless people were brought within the UCS via a procedure that enabled them to register if they were included on a yellow house registration document, The next step was a proposal for a scheme for migrant workers who were in temporary employment and had not yet registered for the employment-based social security scheme (a separate scheme which was the preferred long-term option for this group). At around this time there was also a proposal for a basic insurance scheme for tourists funded by some kind of arrival tax and a scheme for foreign residents. (e.g. expats). There were press stories quoting the Minister which said that these schemes might be introduced one by one.

The migrant worker scheme was introduced on a voluntary basis, subject to a payment of 2800 baht per year, and providing similar benefits to the UCS, but with a small inpatient per diem charge, Through a process that I have been unable to fully reconstruct, some people in the MoPH division tasked with rolling out the scheme - the Health Insurance Group or HIG - decided to allow residents who were not migrant workers to join the scheme. The wording of the initial guidance seems to have been left intentionally vague, using only a term for foreigner to describe the target group. This may have been due to the poor take-up of a pre-existing scheme, but perhaps also a perception that policy was moving in that direction anyway. However, the National Health Security Office (which oversees the UCS) and some senior policy makers in the MoPH only found out about this 'interpretation' when it was implemented. As it was a voluntary scheme, it was left to individual provincial health offices or hospitals to decide whether or not to participate, with facilities in different parts of the country taking a different approach. The BMA which runs almost all public hospitals in the capital did not allow expats to register. It seems that when information that the scheme was accepting expats reached some high-level MoPH officials they let it be known that this was not the policy intention. In the meantime, of course, we were moving through a period of political instability, which affected the MoPH and resulted in a near-breakdown of relations between the Minister and Permanent Secretary. This effectively meant that plans to develop the schemes for tourists and long-term residents were put on hold. It even seems to have meant that, although senior officials decided months ago to bar expats from the foreigner card scheme, some have continued to be registered by individual hospitals and it is only in June that the new guidance has been produced. My personal opinion, which may be controversial and wrong, is that a group of more conservative MoPH officials are now calling the shots, and are unconvinced that Thailand should subsidize healthcare for expats (I was told by one that they prefer westerners to pay for private care). Thus I think the chances of the proposed scheme for expats being resurrected in the near future are slim. Probably the best longer-term hope is that the changes associated with AEC will result in some minimum safety net policy for all persons resident in the community.

In the meantime it would be quite wrong to think that the UCS has been extended to cover expats. That would require an amendment to the 2002 Act that has not happened. Additionally it is something that would be decided by the Government in consultation with the National Health Security Office rather than the MoPH. The guidance on the thread (the attachments) comes from the MoPH, and the Ministry does not control the UCS. Currently there is no reciprocal agreement between the NHSO and the British government to provide care for UK visitors to Thailand, although that would be nice if it ever happened.

So to sum up, the recent change is indeed bad news for expats who thought they had solved their affordable insurance problem. If you review the old threads, you'll see that they were warned it might not last. The foregoing is my version and I will be interested to be corrected on any points where I am in error.

Edited July 4, 2014 by citizen33

[kriswillems]

May I ask why people with a 30B card have to pay 30B?

Every time my Thai son goes to the hospital for something small, they take care of him for free. We never had to pay 30B.

Edited July 4, 2014 by kriswillems

[citizen33]

May I ask why people with a 30B card have to pay 30B?

Every time my Thai son goes to the hospital for something small, they take care of him for free. We never had to pay 30B.

Originally when the 30 baht scheme was introduced in 2001/02, the co-payment was uniform and mandatory for most members, though those with specially coded cards were exempt from the fee. Later this fee was abolished by the appointed civilian government after the 2006 coup, largely on the basis that the administration costs outweighed the extra revenue generated (the main funding came from an annual capitation payment plus DRG payments, not from what patients paid direct to hospitals). As we know, the fee was reintroduced under the Yingluck government, but this time it was left to individual hospitals to decide whether or not they wished to collect and keep it. Thus some do and some do not. I am not 100% sure, but think that those hospitals that do charge may offer fee exemptions for some poorer, older and younger patients. Bringing back the co-payment on this basis was not popular in the MoPH and NHSO because it was such a mishmash.

[Jessi]

I used my Foreigners health card yesterday for a blood test ........Cost 30B

I'm returning to the Cardiologist today, I expect to be loaded up with meds again costing 30B

I shall report back.

Saw the Cardiologist got 3 months supply of meds about 6,000B worth I paid 30B/

I'm moving to another province in a few weeks, I have been told that the card can not be transferred that I must get a new card from the hospital In my new area.

I went to that hospital last Monday and was told to have the medical and pay 2,800B and they will give me a new card.

I think a lot of the problems and confusion is being caused by a lack of communication between the hospitals and the ministry of health. Sheryl has written about this before many times and IMO this is where the confusion is coming from.

If they want to give me a new card and continue to let me pay 30B per visit I will just go with the flow, after all TiT.

[meatboy]

Hi Sheryl,

Every Thai citizen not covered under other public schemes are covered by the UCS scheme.

The 30 baht scheme as it was known.

The Baht 30 copayment was abolished by the next government in November 2006, and the system was totally free of charge.

It is however run on a population basis of taxpayers, so may vary from region to region.

Certainly in this part of Issan all Thais have continued to pay the 30 baht for each treatment.

I'll tell you my experience so far then you'll understand where I'm coming from. I just want clarity on the position in Thailand, but that seems impossible as it varies from what you read, to what your told. I do appreciate your comments and time to reply.

I arrived from the UK 2 months ago but had an unfortunate accident. I certainly wasn't charged what a Thai would have been charged!

I'd just got back on my feet when I got an insect in my eye and an eye infection. Again I wasn't charged what a Thai would have been charged!

I couldn't get Private Medical cover from any Insurance organisations in the UK. As a tourist, Yes. As a migrant, No.

I found out about the Foreigners Health Card from other expats, and hence that was why I visited the hospital again.

I wasn't previously registered, but now I am and told I will get treatment for 30 baht per visit in the future, just the same as a Thai.

Sounds to good to be true and probably is.

We have a similar system in the UK, the NHS. It is not available to foreign tourists from outside the EU. But foreigners who have a Visa to reside in the UK get full free medical treatment just the same as a UK citizen.

Now it seems to me that Thailand has adopted a similar system, but with a 30 baht charge.

Would it be stretching it to far to expect a foreigner to get the same treatment, at the same cost.

I don't work, but still pay VAT taxes on goods and services.

I'll continue to clarify the position with the hospital and report anything new.

My fear is that if in the future I needed further medical treatment, I get told I was misinformed in the first place.

Needless to say I never had any health issues in the UK, but sods law, the minute you move out of your comfort zone, something happens.

I'm getting older, that doesn't help.

couldn't get medical cover in the uk.as a tourist that's strange I thought it was insurance cover which nearly all holliday makers take out.or is it that you are not a tourist.i spoke to one of the office staff here in korat[NO CHANGE] TO WHAT IT WAS WHEN I REGISTERED,last yr.2,800bht.

[PoorSucker]

May I ask why people with a 30B card have to pay 30B?

Because it costs 50 baht to collect the 30 baht.

Why stop corruption?

[TerryLH]

"Every Thai citizen not covered under other public schemes are covered by the UCS scheme."

"The 30 baht scheme as it was known."

That's not completely true.

They might be eligible, but they have to sign up to be covered, and many haven't bothered to do that.