30 Baht scheme still available for people from Myanmar?

[jobe33]

I have a friend from Myanmar who lives in Chiang Mai and who as far as I know is legally living here. She has a passport and previously could benefit from the 30 Baht scheme. Recently she had a minor accident and she told me this 30 Baht scheme was not available at her hospital anymore so she has to pay the bills herself. Has the situation changed and can a hospital refuse to treat her according to the 30 Baht scheme?

[Sheryl]

If she is legally allowed to work in Thailand (has an L-A visa and a Work Permit) then she is not only eligible but in fact required to be in the "30 baht" system though she has to pay 2,000 baht a year for it plus undergo an initial physical exam for about 600 baht more. In fact, doing this and getting registered at a hospital is a requirement for the L-A visa.

If she did all this, paid the money and got registered and is now being denied care by the hospital where she is registered she should cal the NHSO office (call center 1330) and have them speak with the hospital.

It may be the hospital was confused as in Chiang Mai the migrant worker health scheme was originally made available to all foreigners (owing to the way the directives were worded, they failed to specify "migrant worker"). The MoPH found out and told them they had to stop it as it was only for migrants from neighboring countries. Possibly the hospital she goes to mistakenly thought that the order to stop also included migrant workers, or perhaps they failed to note that she was Burmese. If thsi is the case the NHSO office will be able to set them straight.

However if she is here on other than an L-A (work) visa then the hospital is quite correct, they were told to stop issuing this to foreigners other than migrant workers, and that would include Cambodian and Birmese here on anything other than an L-A visa.

If she has a regular work visa then she should be covered under the Social Security Scheme, unless she etaches at a private school.

[jobe33]

If she is legally allowed to work in Thailand (has an L-A visa and a Work Permit) then she is not only eligible but in fact required to be in the "30 baht" system though she has to pay 2,000 baht a year for it plus undergo an initial physical exam for about 600 baht more. In fact, doing this and getting registered at a hospital is a requirement for the L-A visa.

If she did all this, paid the money and got registered and is now being denied care by the hospital where she is registered she should cal the NHSO office (call center 1330) and have them speak with the hospital.

It may be the hospital was confused as in Chiang Mai the migrant worker health scheme was originally made available to all foreigners (owing to the way the directives were worded, they failed to specify "migrant worker"). The MoPH found out and told them they had to stop it as it was only for migrants from neighboring countries. Possibly the hospital she goes to mistakenly thought that the order to stop also included migrant workers, or perhaps they failed to note that she was Burmese. If thsi is the case the NHSO office will be able to set them straight.

However if she is here on other than an L-A (work) visa then the hospital is quite correct, they were told to stop issuing this to foreigners other than migrant workers, and that would include Cambodian and Birmese here on anything other than an L-A visa.

If she has a regular work visa then she should be covered under the Social Security Scheme, unless she etaches at a private school.

Thank you so much.

Within a few days I'll be able to find out more about her exact status (visas and all that) so maybe I'll get back to the forum with that knowledge.

[jobe33]

Like I wrote before I would update when I had more concrete information. I can see on a form that she has given me that she has applied for WP 2 and this has been granted.

I don't know exactly what kind of visa she has, but in her passport I can see that she has to register every 90 days at immigration. Furthermore I can see that immigration has extended her visa for almost 2 years.

Does this give enough information about her eligibility for the 30 Baht scheme?

[Sheryl]

Not 100%. I am still not certain if she had an L-A visa, which is for migrant workers, or a regular business visa and regular work permit. If the former, in order to get it and the work permit she will have been required to go the government hospital responsible for the area where she resides, undergo a physical exam and pay a fee of about 2,600 baht after which she would have been given a UC card. If the latter, she will be having monthly deductions made to her salary and been issued a SS card.

Can you ask to see the card she had which in the past got her free care? And maybe post a pix of it (blocking out name of course) here? Also, what hospital did this happen at, government or private?

Either way she is covered but if she is under UC then the hospital was wrong and what needs to happen is a call to the NHSO. Whereas if she is under SS it is within the realm of possibility that the hospital, if private, has opted out of that system. In which case she has to select and register at another hospital.

Also ask her if when she first got the visa an WP she had to go to the hospital for an exam and blood tests and pay about 2,600 baht. If so, this is an L-A visa and it is UC and need to report the problem with the hospital to the NHSO.

[jobe33]

I'll try to get the information as soon as possible.

She's an ordinary housekeeper, but I don't know if that's relevant information.

[jobe33]

I've asked her and she told me that she previously had the 30 Baht card but was not satisfied with the doctor and medicines. She had to pay a fee of 1850 Baht at the hospital and also had to do a blood test. (I guess no need to make a scan of her old 30 Baht card anymore?)

Her boss told her she could now apply for an SS card and her boss would deduct 400 Baht monthly of her salary, but she has to wait 3 months before this card would be issued.

Does the above make any sense? If not, please let me know and I'll continue to gather information.

Edited September 12, 2015 by jobe33

[Sheryl]

I don't follow the "previously had" part. Did she fail to renew her coverage under that scheme?

As for SS, is she working for a company or is she housekeeper for a family's home? If she works for a company she indeed can get SS. The employee's contribution is 5% of income so 400 baht sounds about right.

With SS she will have a choice of hospitals (from a defined list) and should choose with care. All medical care, inpatient and outpatient, including medications, will be covered.

[jobe33]

I don't follow the "previously had" part. Did she fail to renew her coverage under that scheme?

As for SS, is she working for a company or is she housekeeper for a family's home? If she works for a company she indeed can get SS. The employee's contribution is 5% of income so 400 baht sounds about right.

With SS she will have a choice of hospitals (from a defined list) and should choose with care. All medical care, inpatient and outpatient, including medications, will be covered.

What I've understood from the 30 Baht scheme is that you can take it for 3 months, 6 months or 1 year and you have to pay accordingly. At least that is what a Burmese man told me this morning assuming I've understood him correctly.

My Burmese friend was not satisfied with the medical care provided so she didn't extend the 30 Baht card.

When I asked the knowledgeable Burmese man about the 30 Baht card he said that there are doctors who don't provide satisfying care if they know their patients are Burmese.

She is a housekeeper at a family's home. You think she'll be able to get an SS card while having a WP 2 and a visa? Or maybe even if it's not a visa but a two year extension of stay based upon working?

[Sheryl]

It sounds like she has an L-A visa which gives 2 year extensions of stay and under which she is eligible for the "30 baht" scheme but has to pay a fee of about 2000 baht a year. In fact, failing to do so would prevent her from extending her stay next time.

If she did not renew her card, can hardly fault the hospital for charging her. It was not that the scheme stopped but that her card had expired, by her choice.

I have not heard of a domestic servant being eligible for SS. In addition to the employee contribution (which has to be deducted from the paycheck and paid monthly) there is also a monthly employer contribution. It is set up for companies and the like.

Possibly her employer has some plan in mind such as listing her on the payroll at wherever the employer works.. who knows.

BTW in my experience hospital staff may indeed behave in an impolite way to Burmese and Cambodians but I have never seen it alter the actual medical care provided.

The language barrier may impair the ability to explain treatment to the patient, and also to obtain a proper history. If she was "not satisfied with the doctor and the medicines" presumably that means her symptoms did not resolve; she should probably have gone back to that same hospital rather than shopping around for a different doctor which just worsens the continuity of care. It is not unusual for a patient's problem to not resolve with the first treatment given (especially if there were problems getting a detailed history of the problem).

Anyway back to your question -- I don't know how she could get an SS card as a maid working for a private person but possibly her Thai employer has found a way around it. Wait and see if the card materializes.

[jobe33]

It sounds like she has an L-A visa which gives 2 year extensions of stay and under which she is eligible for the "30 baht" scheme but has to pay a fee of about 2000 baht a year. In fact, failing to do so would prevent her from extending her stay next time.

If she did not renew her card, can hardly fault the hospital for charging her. It was not that the scheme stopped but that her card had expired, by her choice.

I have not heard of a domestic servant being eligible for SS. In addition to the employee contribution (which has to be deducted from the paycheck and paid monthly) there is also a monthly employer contribution. It is set up for companies and the like.

Possibly her employer has some plan in mind such as listing her on the payroll at wherever the employer works.. who knows.

BTW in my experience hospital staff may indeed behave in an impolite way to Burmese and Cambodians but I have never seen it alter the actual medical care provided.

The language barrier may impair the ability to explain treatment to the patient, and also to obtain a proper history. If she was "not satisfied with the doctor and the medicines" presumably that means her symptoms did not resolve; she should probably have gone back to that same hospital rather than shopping around for a different doctor which just worsens the continuity of care. It is not unusual for a patient's problem to not resolve with the first treatment given (especially if there were problems getting a detailed history of the problem).

Anyway back to your question -- I don't know how she could get an SS card as a maid working for a private person but possibly her Thai employer has found a way around it. Wait and see if the card materializes.

She just told me on the telephone that her boss will get her a "prakan sangkom" card, I write it down the way I've heard it. Maybe this is the SS card? She said that when she gets this prakan sangkom card after having paid 400 Baht for 3 months to her employer she can go to any hospital and only has to pay a fraction of the real medical costs, she mentioned an amount of a little bit over 100 Baht.

She's fluent in Thai so there's not a real language barrier. But she lacks education, maybe hasn't had more education than elementary school, so her understanding of medical issues is not up to Western standards.

And she indeed shops around, wanting to get better as soon as possible, getting advice from her friends about a "good doctor" who may provide temporarily relief by giving unnecessary drugs/medicines. At least that's my impression.

Can she really not return to the 30 Baht scheme in case this "prakan sangkom" card doesn't work out?

Edited September 12, 2015 by jobe33

[Sheryl]

As a migrant working in an L-A visa she not only can return to the 30 baht scheme but may be unable to get her next extension of stay if she does not.

I have no idea what this "prakan sangkom" card is. What you describe is certainly not Social Security. And there is no private individual insurance policy that would cost that little even if her employer is going 50-50 with her on the cost.

You would really have to ask her employer about this. I can only think that somehow he is arranging to get her on to an existing group insurance policy (probably through some sleight of hand). Or else she has misunderstood what he has told her.

Does she have a specific medical problem you could describe, or have these been miscellaneous unrelated things?

[jobe33]

She fell on the bathroom floor about a month ago while cleaning it. Her leg still shows minor bruises, her back hurts a bit but the most worrisome thing is her arm for which she's now wearing an elastic bandage. She told me the Thai word for her problem is "aksep". Since I can read a bit Thai I just found out on Google translate that this means "inflammation".

If I remember correctly the doctor told her initially to rest and stop working. Since she's a restless person this is very hard for her to do for a long time, so she turned to other doctors who injected her arm several times. I don't know what kind of drugs they used.

She has started to work again a few days ago while wearing her elastic bandage.

Difficult to say maybe, but what is the normal treatment for such an inflammation? How long could it last (on average) before she'll recover?

ADDITION:

She just told me on the phone that it's a company where about 20 people work and that she'd asked the other workers about this prakan sangkom card and they were enthusiastic about it. So that's the information I got from her.

Edited September 12, 2015 by jobe33

[Sheryl]

It seems her employer is adding her onto his company's payroll for purposes of getting her covered under Social Security. I checked and the Thai name for SS is indeed prakan sangkom ประกันสังคม.

However it does not work quite in the way she thinks - you have to register at a specific hospital (though there is a choice of which one) and get all care there, can't go just anywhere. It normally covers 100% with no copay. And it has to be paid for by both employer and employee monthly so I don't understand this pay for 3 months only bit.

Regarding her arm she is likely doing herself some real harm with this shopping around for more treatments, specifically the injections. The important thing is to have had an Xray to rule out a hairline fracture and a good physical exam, preferrably (since it has gone on for a while) by an ortho specialist. Assuming no fracture, treatment is only rest, compression (ace bandage), applications of ice and anti-inflammatories. If it is there is an inflammed or torn tendon it is to be expected that it will take many weeks to resolve, even longer if not resting the arm. Nothing she does will produce an overnight cure and seeking out injections etc may well cause more damage.

Sounds like she got the correct treatment in the first place and just didn't like what she was told...but it was the truth.

[jobe33]

Thanks.

[TerryLH]

"And it has to be paid for by both employer and employee monthly so I don't understand this pay for 3 months only bit."

For SS you pay into the fund for 3 months before you are able to use it.

[Sheryl]

Ah that would be where the midunderstanding arose. Seems she thinks she will have to pay only 3 months.