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Health Security for English teachers in Isan


peterkeip

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Private health insurance costs don't change by region in Thailand, at least not as far as I'm aware. Go to Bupa or Cigna websites for pricing. My personal take on this, others may disagree; get good insurance to ensure that if you unfortunately need treatment you can get care in a private hospital. Ram, Bangkok Hospital, which are in Isaan are as good as anything in the West in my view. Go to the local Government hospital...well if you don't go in as a terminal patient, you'll probably come out as one!

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One more thing. Unless you have some ongoing issue, don't take the outpatient option. It's expensive and frankly, especially if you're a dude you wont go to the Doc enough to recoup the cost.

Outpatient doctor visits even at the good hospitals are cheap compared to anything in the west. But again try to shy away from the local village quack. He'll ask 'you' whats wrong with you, then sell you some pills and shoot you up with some unknown injection....1500฿, Thank You very much

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I saw your question in the Ask ... that has gone unanswered for over a week.

"I am a teaching English in Isan and married to Thai Ladyand I am provided with Social Security from the Government School.

But when retired, Holding a marriage visa and living for the rest of my life in Thailand, is it possible to get a Thai Security Card (35 THB for doctor´s consultation) ?

Thank you so much for your reply."

You will not be eligible for the 30 baht program.

If you get in the SS program before you are 60, you can remain in the program. You just can't enter the system after you are 60.

If you remain in the system for 12 months, you can continue on your own if you lose eligibility through work. The cost for paying on your own is 432 baht per month.

Edited by TerryLH
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He'd potentially be able to get the ฿30 scheme, there's a special card I think you can sign up, for a fee, but not at all hospitals as it depends on their interpretation of the regulations (there's a vague wording in it or something)

However private insurance would like be better as then you'd be eligible to use the private hospitals, which usually offer a high standard of service and significantly less time waiting in queues (sometimes patients can wait in a queue at the public hospitals for upto 6h).

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He'd potentially be able to get the ฿30 scheme, there's a special card I think you can sign up, for a fee, but not at all hospitals as it depends on their interpretation of the regulations (there's a vague wording in it or something)

However private insurance would like be better as then you'd be eligible to use the private hospitals, which usually offer a high standard of service and significantly less time waiting in queues (sometimes patients can wait in a queue at the public hospitals for upto 6h).

Unfortunately things have moved on - as you can read in the health forum - and the MoPH has told hospitals not to allow westerners to continue in the scheme mentioned (which is the migrant worker healthcard scheme rather than the 30 baht scheme). Terry has explained entry to the Social Security Scheme above, but this is not possible for over 60s registering for the first time. As far as I know the only other way westerners can get access to a public health insurance scheme is if their Thai spouse (or child) is a civil servant, Private insurance is possible, but gets more difficult over age 60. Some universities have group schemes for staff provided through companies such as Allianz (necessary as some staff are public service officers are not covered by the civil servant scheme). I do not know if some schools have anything similar.

Edited by citizen33
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He'd potentially be able to get the ฿30 scheme, there's a special card I think you can sign up, for a fee, but not at all hospitals as it depends on their interpretation of the regulations (there's a vague wording in it or something)

However private insurance would like be better as then you'd be eligible to use the private hospitals, which usually offer a high standard of service and significantly less time waiting in queues (sometimes patients can wait in a queue at the public hospitals for upto 6h).

Unfortunately things have moved on - as you can read in the health forum - and the MoPH has told hospitals not to allow westerners to continue in the scheme mentioned (which is the migrant worker healthcard scheme rather than the 30 baht scheme). Terry has explained entry to the Social Security Scheme above, but this is not possible for over 60s registering for the first time. As far as I know the only other way westerners can get access to a public health insurance scheme is if their Thai spouse (or child) is a civil servant, Private insurance is possible, but gets more difficult over age 60. Some universities have group schemes for staff provided through companies such as Allianz (necessary as some staff are public service officers are not covered by the civil servant scheme). I do not know if some schools have anything similar.

Thank you for your reply. I am 49. So, it means, if I enter the Social Security System now, I can remain after 60. is that right ?

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He'd potentially be able to get the ฿30 scheme, there's a special card I think you can sign up, for a fee, but not at all hospitals as it depends on their interpretation of the regulations (there's a vague wording in it or something)

However private insurance would like be better as then you'd be eligible to use the private hospitals, which usually offer a high standard of service and significantly less time waiting in queues (sometimes patients can wait in a queue at the public hospitals for upto 6h).

Unfortunately things have moved on - as you can read in the health forum - and the MoPH has told hospitals not to allow westerners to continue in the scheme mentioned (which is the migrant worker healthcard scheme rather than the 30 baht scheme). Terry has explained entry to the Social Security Scheme above, but this is not possible for over 60s registering for the first time. As far as I know the only other way westerners can get access to a public health insurance scheme is if their Thai spouse (or child) is a civil servant, Private insurance is possible, but gets more difficult over age 60. Some universities have group schemes for staff provided through companies such as Allianz (necessary as some staff are public service officers are not covered by the civil servant scheme). I do not know if some schools have anything similar.

... My Thai wife and me got a daughter (2 years old), too. She was born in Thailand, so, she is a Thai civil servant. Does that mean we can join the Thai Social Security System (30 THB program) ?

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Most of us farangs use the private hospital in Sisaket as it's far more efficient/comfortable than a government hospital. If your daughter is a thai citizen then she can use the govt hospital if you really believe that's a good idea.

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He'd potentially be able to get the ฿30 scheme, there's a special card I think you can sign up, for a fee, but not at all hospitals as it depends on their interpretation of the regulations (there's a vague wording in it or something)

However private insurance would like be better as then you'd be eligible to use the private hospitals, which usually offer a high standard of service and significantly less time waiting in queues (sometimes patients can wait in a queue at the public hospitals for upto 6h).

Unfortunately things have moved on - as you can read in the health forum - and the MoPH has told hospitals not to allow westerners to continue in the scheme mentioned (which is the migrant worker healthcard scheme rather than the 30 baht scheme). Terry has explained entry to the Social Security Scheme above, but this is not possible for over 60s registering for the first time. As far as I know the only other way westerners can get access to a public health insurance scheme is if their Thai spouse (or child) is a civil servant, Private insurance is possible, but gets more difficult over age 60. Some universities have group schemes for staff provided through companies such as Allianz (necessary as some staff are public service officers are not covered by the civil servant scheme). I do not know if some schools have anything similar.

Thank you for your reply. I am 49. So, it means, if I enter the Social Security System now, I can remain after 60. is that right ?

Yes. Of course, you will need to be employed to join the scheme. As Terry said, after 60 you can make a modest monthly payment and will remain covered.

http://www.sso.go.th/wpr/eng/background.html

Just to avoid confusion with people on the thread asking about different schemes, there are three main public insurance schemes in Thalland

The social security scheme for people in formal employment (funded by employment based contributions)

The civil servant medical benefits scheme for civil servants (funded from taxation as a fringe benefit)

The universal coverage scheme for Thai citizens not covered by the above (AKA the 30 baht scheme - funded from general taxation and the co-payment).

Edited by citizen33
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He'd potentially be able to get the ฿30 scheme, there's a special card I think you can sign up, for a fee, but not at all hospitals as it depends on their interpretation of the regulations (there's a vague wording in it or something)

However private insurance would like be better as then you'd be eligible to use the private hospitals, which usually offer a high standard of service and significantly less time waiting in queues (sometimes patients can wait in a queue at the public hospitals for upto 6h).

Unfortunately things have moved on - as you can read in the health forum - and the MoPH has told hospitals not to allow westerners to continue in the scheme mentioned (which is the migrant worker healthcard scheme rather than the 30 baht scheme). Terry has explained entry to the Social Security Scheme above, but this is not possible for over 60s registering for the first time. As far as I know the only other way westerners can get access to a public health insurance scheme is if their Thai spouse (or child) is a civil servant, Private insurance is possible, but gets more difficult over age 60. Some universities have group schemes for staff provided through companies such as Allianz (necessary as some staff are public service officers are not covered by the civil servant scheme). I do not know if some schools have anything similar.

... My Thai wife and me got a daughter (2 years old), too. She was born in Thailand, so, she is a Thai civil servant. Does that mean we can join the Thai Social Security System (30 THB program) ?

I'm not sure whether I understand your post. Being born in Thailand makes your daughter a Thai citizen (subject to registration) but a civil servant is somebody who works in a public sector job designated as being part of the civil service. Obviously the state does not employ two year olds. Some public employees are public service officers rather than civil servants and do not qualify for the Civil Servant Medical Benefits Scheme. Only Thai citizens are eligible for the 30 baht scheme (though there are two small related schemes for stateless people and migrant workers from Burma, Cambodia and Laos). So from what you say you are not eligible.

Looking at other posts on the thread my advice is to be very careful about entering small private hospitals in Isaan with serious medical conditions. Contrary to what you might think they are less well equipped than the provincial or university hospitals. What they offer is shorter waits and better 'hotel' services. Of course, the small MoPH community hospitals are also not the place to be with a serious condition,.

Just as a footnote, the 30 baht scheme does not - as many assume - always equal MoPH hospital, because a contracted local health network can be based on a private hospital if that hospital can meet the NHSO criteria. There are now admittedly fewer private hospitals in the scheme than at the time of start-up in 2001-02, partly because they have since concluded that the income was insufficent. I recall a small private hospital in a central Isaan city that struggled to recruit sufficient members because of its poor local reputation and was involved in an ongoing wrangle with the provincial health office (SSJ), which it accused of allowing residents to register with the nearby provincial hospital (technically in a different catchment area) because of bias against the private sector. Patients may also be referred to contracted private hospitals for specialised tertiary care under the 30 baht scheme.

Edited by citizen33
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He'd potentially be able to get the ฿30 scheme, there's a special card I think you can sign up, for a fee, but not at all hospitals as it depends on their interpretation of the regulations (there's a vague wording in it or something)

However private insurance would like be better as then you'd be eligible to use the private hospitals, which usually offer a high standard of service and significantly less time waiting in queues (sometimes patients can wait in a queue at the public hospitals for upto 6h).

Unfortunately things have moved on - as you can read in the health forum - and the MoPH has told hospitals not to allow westerners to continue in the scheme mentioned (which is the migrant worker healthcard scheme rather than the 30 baht scheme). Terry has explained entry to the Social Security Scheme above, but this is not possible for over 60s registering for the first time. As far as I know the only other way westerners can get access to a public health insurance scheme is if their Thai spouse (or child) is a civil servant, Private insurance is possible, but gets more difficult over age 60. Some universities have group schemes for staff provided through companies such as Allianz (necessary as some staff are public service officers are not covered by the civil servant scheme). I do not know if some schools have anything similar.

... My Thai wife and me got a daughter (2 years old), too. She was born in Thailand, so, she is a Thai civil servant. Does that mean we can join the Thai Social Security System (30 THB program) ?

I'm not sure whether I understand your post. Being born in Thailand makes your daughter a Thai citizen (subject to registration) but a civil servant is somebody who works in a public sector job designated as being part of the civil service. Obviously the state does not employ two year olds. Some public employees are public service officers rather than civil servants and do not qualify for the Civil Servant Medical Benefits Scheme. Only Thai citizens are eligible for the 30 baht scheme (though there are two small related schemes for stateless people and migrant workers from Burma, Cambodia and Laos). So from what you say you are not eligible.

Looking at other posts on the thread my advice is to be very careful about entering small private hospitals in Isaan with serious medical conditions. Contrary to what you might think they are less well equipped than the provincial or university hospitals. What they offer is shorter waits and better 'hotel' services. Of course, the small MoPH community hospitals are also not the place to be with a serious condition,.

Just as a footnote, the 30 baht scheme does not - as many assume - always equal MoPH hospital, because a contracted local health network can be based on a private hospital if that hospital can meet the NHSO criteria. There are now admittedly fewer private hospitals in the scheme than at the time of start-up in 2001-02, partly because they have since concluded that the income was insufficent. I recall a small private hospital in a central Isaan city that struggled to recruit sufficient members because of its poor local reputation and was involved in an ongoing wrangle with the provincial health office (SSJ), which it accused of allowing residents to register with the nearby provincial hospital (technically in a different catchment area) because of bias against the private sector. Patients may also be referred to contracted private hospitals for specialised tertiary care under the 30 baht scheme.

Thank you very much for your detailled information. I was wrong, of course I meant my daughter is a Thai citizen. But as you said, because I am German and not Thai citizen, but (although) married to a Thai Lady, I am not eligible to the 30 THB scheme. That means, after finishing teaching at school, I need a private health insurance. Is that right ?

your reply is very much appreciated

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After you finish teaching at the school you can continue with the social security health system by making all the contributions yourself.

This is what Terry in an earlier post told you.

If you remain in the system for 12 months, you can continue on your own if you lose eligibility through work. The cost for paying on your own is 432 baht per month.

If you do not continue I believe that you will be repaid a lump sum of your contributions over the years which in some cases could be over 100,000 baht.

However, I would strongly advise you to take out private health insurance now for yourself and your whole family. There are family packages available for both health and accident insurance.

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The above is correct. You can maintain your social security coverage and that is an excellent deal, which will among other things will provide treatment for pre-existing conditions. This will not cover your wife or child, however, who would be covered by the 30 baht scheme (assuming that your wife has not also joined the SSS through work). This is where the issue of private insurance may arise, although many think that private insurance in Thailand is not a particularly great deal. The so called 'loss ratios' of most companies (read profit) are low (read high profits) compared with most Western countries. Only a small minority of Thais use private health insurance (about 8% last time I checked).

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