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Posted

Hi,

I seem to recall when sifting through Internet pages many months ago that Expats with Retirement and other types of longer term Visas who are permanently residing in Thailand can apply and be granted enrolment under the 30 Baht Medical Health-care Card.

I am now unable to find the relevant pages now that I have just been granted my Retirement Visa.

I am keen to get some kind of Health protection (be the 30 baht Health-care scheme less than perfect). I appreciate many will try pointing me to BUPA etc. BUT all the schemes I have checked so far not only are very expensive in my opinion for older ages (I am 54) BUT they are scathing in the way they apply their "Exclusions Policy rules for past problems.

e.g.

1) If you have had 1 hernia then they will not cover you for any future hernias ANYWHERE in the body (TOTALLY RIDICULOUS bearing in mind that medically a weakness in one part of the body does NOT suggest a propensity to a hernia elsewhere

2) If you have ever had a breathing problem then these types of companies say they will exclude the complete cardiovascular and respiratory system (lungs, heart and circulatory system).

I do not claim to be a doctor or that these examples are 100% bang on but I know from checking, that these companies are VERY quick to limit their risks with new entrants. Essentially they only give complete and adequate cover (in my opinion) to those young and free from any medical adverse history.

I am sure I like many are not interested in being covered for very limited items at high expense AND the primary illnesses and risks that accompany old age are excluded.

Hence my interest to set up some form of medical protection and the 30 Baht Medical Health-care System (be it not perfect by any means) seems to best and easiest way forward ASSUMING the information I found previously was accurate namely, that I am eligible to apply and be covered under it

I would very much appreciate any information on this OR what other members do for health cover (without paying an arm and a leg) where companies like BUPA are too swingeing in their exclusions policy

Hoping somebody can help advise me.

Kindest Regards

Dave

Posted

:o From the stories I have heard from family and friends I am not sure you want this. Doctors not taking the time needed to really find out what is wrong and rushing through with a "take two asprin and really dont call me in the morning"

Hi,

I seem to recall when sifting through Internet pages many months ago that Expats with Retirement and other types of longer term Visas who are permanently residing in Thailand can apply and be granted enrolment under the 30 Baht Medical Health-care Card.

I am now unable to find the relevant pages now that I have just been granted my Retirement Visa.

I am keen to get some kind of Health protection (be the 30 baht Health-care scheme less than perfect). I appreciate many will try pointing me to BUPA etc. BUT all the schemes I have checked so far not only are very expensive in my opinion for older ages (I am 54) BUT they are scathing in the way they apply their "Exclusions Policy rules for past problems.

e.g.

1) If you have had 1 hernia then they will not cover you for any future hernias ANYWHERE in the body (TOTALLY RIDICULOUS bearing in mind that medically a weakness in one part of the body does NOT suggest a propensity to a hernia elsewhere

2) If you have ever had a breathing problem then these types of companies say they will exclude the complete cardiovascular and respiratory system (lungs, heart and circulatory system).

I do not claim to be a doctor or that these examples are 100% bang on but I know from checking, that these companies are VERY quick to limit their risks with new entrants. Essentially they only give complete and adequate cover (in my opinion) to those young and free from any medical adverse history.

I am sure I like many are not interested in being covered for very limited items at high expense AND the primary illnesses and risks that accompany old age are excluded.

Hence my interest to set up some form of medical protection and the 30 Baht Medical Health-care System (be it not perfect by any means) seems to best and easiest way forward ASSUMING the information I found previously was accurate namely, that I am eligible to apply and be covered under it

I would very much appreciate any information on this OR what other members do for health cover (without paying an arm and a leg) where companies like BUPA are too swingeing in their exclusions policy

Hoping somebody can help advise me.

Kindest Regards

Dave

Posted
:o From the stories I have heard from family and friends I am not sure you want this. Doctors not taking the time needed to really find out what is wrong and rushing through with a "take two asprin and really dont call me in the morning"

Yes I would agree with your comments swain, but in the absence of anything in place, it has to be a better option than nothing.

Regards

Dave

Posted

I only heard of a couple of farangs ever getting it - and I believe they had at least PR (permanent residence) status (if not Thai nationality) and not just a mortal non-emmigrant visa like you and me.

I do remember a thread where someone mentioned that after obtaining the tabien bahn (yellow house book) for purchasing own condo, he later received some paper work for that 30 Baht card. I asked for more details, as I also hold the tabien bahn, but he never replied....

In short; I think you need PR/Thai nationality - or many years paying INTO the system (via job here) prior receiving the offer/being eligble.

Cheers!

Posted

Firefan said:

"In short; I think you need PR/Thai nationality - or many years paying INTO the system (via job here) prior receiving the offer/being eligble."

For the 30baht gold card there is no system to pay into. Thais get it whether they've ever worked, or not. You may be thinking of Thai Social Security that employees pay into. You only need be in that system for 3 months before getting coverage.

My daughter had surgery this morning under the 30 baht gold card plan. The surgery was to remove two pins from a badly broken leg. So far I've been very pleased with the level of care she's recieved.

gdhm

You're only 54? If you changed your visa to a regular O you could legally work. I think the visa change could easily be done in country.

By working you could get into the Social Security system. For that you'd get 100% coverage (at least I have, so far) for a reasonable cost. It would be 5% of your salary up to a maximum amount of 750 baht per month.

Pre-existing conditions are not excluded.

Let us know if you find out any farangs are eligible for the 30 baht gold card.

Terry

Posted

@gdhm

I was also looking for a health insurance for me, my future wife and for her mother. A couple of people told me the 30-Baht-Card isn't that bad and covers already a lot. You just have to able to insist in a proper medical treatment and this might be the problem for some thais who have too much respect of a doctor. So if the doctor gives them an aspirin and tells them to go home and they would feel better soon, that's what they are going to do!

On the other hand all the insurances that you can get - no matter which one - are quite expensive and are not what I call an insurance. The only one the insure is themself!! They don't cover a huge list of diseases that are known to become expensive. Then they exclude existing conditions as well as chronical conditions. Last but not least the pay not for than X Baht per Lifetime, year, disability, doctor room, nurse, medicin,..... and endless list! THIS IS JUST RIDICULOUS!! For what do they think do I need an insurance? I need an insurance to pay for everything that becomes to expensive to be paid by myself. If I would have a yearly self of e.g. 10000 Baht, that wouldn't really hurt me, but if I would get HIV, cancer, MS or some other serious disease, then I would like my insurance to take over.

@TherryLH

What insurance are you talking about? If I oficially get a work permit and work for the minimum salary for a european (40000 Baht), then I could get into the social security system by paying 5% up to a max of 750 Baht of my salary (in that case 750 Baht) ? What is the difference to the 30-Baht -Card? Can I go to better hospitals?

Rossi

Posted

Last year I had a fish bone caught in my throat, and went to the Emergency Department of the hospital in a medium sized town near Udon Thani. I showed them some ID (I was only on a 30 day VOA), and was issued with a blue card showing those details, plus my girlfriend's address.

Was treated by the doctor (unfortunately he couldn't find the bone - I coughed it up a couple of days later), was given some antibiotics from the dispensary, paid THB30 for the treatment, and 50 for the medicine.

So I guess I have my Health Care Card.

jack

Posted
Last year I had a fish bone caught in my throat, and went to the Emergency Department of the hospital in a medium sized town near Udon Thani. I showed them some ID (I was only on a 30 day VOA), and was issued with a blue card showing those details, plus my girlfriend's address.

Was treated by the doctor (unfortunately he couldn't find the bone - I coughed it up a couple of days later), was given some antibiotics from the dispensary, paid THB30 for the treatment, and 50 for the medicine.

So I guess I have my Health Care Card.

jack

Over two years ago I went to a private hospital (a small one,not farang oriented) for my certificate;

needed it for the Thai driver licence,paid 30 Baht and they registered me as theyr customer.

Last year went there agin,for a bad cold,same 30 Baht,but had to pay for the tablets!

My wife is working and she tells me that I'm insured through her,but have to use the government hospitals,or as she does,pay in a private hospital and later ask for reimbursement;luckily i didn't need it yet,so I'm not really sure how it works.

Yes,the Insurances are only good for young,heathy people,if you are over 50 don't even consider them! :o

Posted (edited)
I seem to recall when sifting through Internet pages many months ago that Expats with Retirement and other types of longer term Visas who are permanently residing in Thailand can apply and be granted enrollment under the 30 Baht Medical Health-care Card.

You have to produce both the Thai ID card and Batr Thong (gold card) when receiving medical care under 30 Baht medical scheme, and only at the hospital designated in the proximity of your address in Tabien Baan. And frankly I can't see how you can receive a gold card without a blue Tabien Baan (and thus a Thai ID card).

I haven't seen it documented anywhere but it appears if you are employed and have an income you will be required to waive your rights to use the gold card (even if you have received one) and will be put under Prakan Sangkom instead and asked to forfeit your gold card as it happened to my wife.

:o From the stories I have heard from family and friends I am not sure you want this. Doctors not taking the time needed to really find out what is wrong and rushing through with a "take two asprin and really dont call me in the morning"

This pretty much sums up the experience I had at a clinic near Rama 4 in a ghetto-like neighborhood designated under Baht 30 medical scheme in the district I live (Khet Pathumwan), however, for any medical case that's too complicated for them to handle and thus requires me referred to Chula Hospital (which is one of the nation's most reputable medical institution), the care and service I receive there is superb and no worse than Bumrungrad or Bangkok Hospital, but only you have to bear longer wait in the queue (both registration and at at each outpatient department) and most physicians would see outpatients only up to the noon so you have to be there very early in the morning. I have an impression the physicians don't care if you are under 30 Baht medical scheme or not, in all probability I think they don't know.

Edited by Nordlys
Posted (edited)

Rossi said:

"What insurance are you talking about? If I oficially get a work permit and work for the minimum salary for a european (40000 Baht), then I could get into the social security system by paying 5% up to a max of 750 Baht of my salary (in that case 750 Baht) ? What is the difference to the 30-Baht -Card? Can I go to better hospitals?"

Rossi- As I see the difference in the 30 baht card and Social Security: The 30 baht Gold Card is for any Thai, working or not. There may be a minimum age for it. I remember years ago my daughter wasn't eligible because she wasn't old enough. (I think this is what I remember.) Right now she is 14 and recovering in a hospital from surgery to remove pins from a broken leg. She'll be home tomorrow. The doctor feels good about the surgery. We've been pleased with the doctor and the hospital. I believe all government hospitals (???) are in this plan, plus any private hospitals that wanted to sign on for it.

The Social Security is only for employees, or at least people working when they entered the system. I'm covered this, and have used it regularly - every month. They give me 30 days worth of meds at a time and all I do is sign for them. I pay 750 a month. My employer also pays 750 a month. When I first moved to this province I went to the Soc Sec Office to change from another province. They gave me a list with nine hospitals on it. The list was a combo of govt and private hospitals. They let me choose which one I wanted. I've known many who didn't know they could choose, and were just assigned a hospital.

A couple of months ago I had to have surery on my hand. Since there is no plastic surgeon on staff at the private hospital I chose, from a list of nine hospitals, the hospital has a specialist come in to do the surgery. In this case the doctor comes from the teaching hospital associated with Khon Kaen Uni.

Rossi - if you work as a teacher, if that's an option for you, you don't need a salary of 40k. For some reason the government understands that many schools can't afford to pay that much and make exceptions for teachers. Either an exception or it was never intended for teachers when the law was written.

Abdulraman and Jackspratt

The 30 baht you mention paying probably was just the regular cost for a doctor visit at the hospital you were at. Medical care here is generally percieved as being good. It is also very cheap compared to western countries. The 50 baht for the meds re-inforces my opinion.

I know I rambled a bit. Hope it helps.

Sorry. Just thought of something else.

It doesn't matter what insurance plan you have. If you let them give you shoddy treatment, blame yourself.

I've been here long enough to see that when I go to a clinic, hospital or wherever, I get good service because that's what I expect. As a foreigner I think we have a step up in getting good care. If you are in an area that doesn't have many farangs, we're an oddity and the Thai's I've come across want to treat us well.

I take time to get explanations from the doctors or nurses. They understand that I'm not leaving until all my questions are answered.

T

Edited by TerryLH
Posted

Hi,

So, IF my understanding is correct that Farangs cannot get the 30 Baht Medical-Care card and BUPA and the likes, them have too many exclusions for past history and can are expensive for a 54 year old THEN there are no other option except pay as you get sick and hope its not financially destroying.

Paying into the Social system as a worker is NOT possible for me as I am on a Retirement Visa and even if I could change it I could not find any work (and do not wish to).

Do local hospital do insurance type schemes ( I am based in Khon Kaen City).

When considering cost I have also to bear in mind I have a 42 year old wife (who is certainly not the fittest person in the world) and a 4 year old stepson (who already has had Pneumonia and has taken more than a year to recover from coughing following it (both would get exclusions under firms like BUPA).

Am I correct in assuming that being married and retired in Thailand will not give me access to the 30 baht card system due to my being married to a Thai National and having responsibilities for a Thai stepson.

Regards

Dave

Posted (edited)
Am I correct in assuming that being married and retired in Thailand will not give me access to the 30 baht card system due to my being married to a Thai National and having responsibilities for a Thai stepson.

That is correct. Not even being a permanent resident entitles you to the 30 Baht medical care under the scheme. You have to produce both the Thai ID card and the gold card each and every time you go to the hospital to receive treatment under the scheme. And if you have a Thai ID card and a blue Tabien Baan you probably have the gold card already. I and my wife received ours by mail I think in 1992, a few month after Thaksin was elected in his first administration. We didn't ask for it.

30 Baht thing will be renamed as universal health care project and will become cmpletely free medical care.

Edited by Nordlys
Posted

Am I correct in assuming that being married and retired in Thailand will not give me access to the 30 baht card system due to my being married to a Thai National and having responsibilities for a Thai stepson.

That is correct. Not even being a permanent resident entitles you to the 30 Baht medical care under the scheme. You have to produce both the Thai ID card and the gold card each and every time you go to the hospital to receive treatment under the scheme. And if you have a Thai ID card and a blue Tabien Baan you probably have the gold card already. I and my wife received ours by mail I think in 1992, a few month after Thaksin was elected in his first administration. We didn't ask for it.

30 Baht thing will be renamed as universal health care project and will become cmpletely free medical care.

Hi thanks for your reply Nordlys but I am still regretfully a little confused.

Nordlys, are you a thai National? I only ask because you say I am not eligible for the 30 baht scheme but then you later said I and my wife received ours by mail I think in 1992, a few month after Thaksin was elected in his first administration. We didn't ask for it. which if you are not Thai suggests we are eligible.

Nordlys, you mentioned that the "30 Baht thing will be renamed as universal health care project and will become completely free medicalThai care"[completely/b].

To your knowledge will that be only available to Thai Nationals or are rule changes planned when it comes into being.

I must admit to being totally confused about the rules for the 30 Baht scheme because I have seen Internet articles referring to its value and availability to poor foreign workers living, and working in Thailand who otherwise would have not medical care.

I cannot seem to work out the "wood from the Trees" on this subject.

Hoping someone can clarify my mis-conceptions

Dave

Kindest Regards

Dave

Posted (edited)
Nordlys, are you a thai National? I only ask because you say I am not eligible for the 30 baht scheme but then you later said I and my wife received ours by mail I think in 1992, a few month after Thaksin was elected in his first administration. We didn't ask for it. which if you are not Thai suggests we are eligible.

Yes, I have dual citizenships, one of which is Thai. I have full non-Thai name so I was asked on a few occasion why I am eligible for it. I get my 15,000 Baht worth of imported synthetic hormone at Chula hospital every three months for 30 Baht under the medical scheme for the past four years.

I'm sorry, but the only avenue for you to be eligible for the universal health care is to seek Thai citizenship, which should be preceded by having obtained permanent residency first, which in itself a major deal.

Nordlys, you mentioned that the "30 Baht thing will be renamed as universal health care project and will become completely free medicalThai care"[completely/b].

To your knowledge will that be only available to Thai Nationals or are rule changes planned when it comes into being.

This was just announced by the new public health minister in the post-coup cabinet under CNA and I read this from the October 13th issue of Bangkok Post. It didn't mention anything about if there is any change to the extent of coverage or the eligibility but I'm pretty sure it remains available for Thai citizens only.

I must admit to being totally confused about the rules for the 30 Baht scheme because I have seen Internet articles referring to its value and availability to poor foreign workers living, and working in Thailand who otherwise would have not medical care.

Migrant workers' medical is probably only covered by prakan sangkom (social security), that is if they are working legally. Like I said, you have to have a Thai ID card to receive the gold card and produce them both each and every time you go to the hospital (only one hospital in the nation designated by the health ministry - believe it's not social security office).

Edited by Nordlys
Posted (edited)

This 30Baht Health Card............ like visas and who gets what type, there are here just as many different experiances, options and what not.

I have a 30Bhat Health Card and have had it since June 2003. I am a PR and have held a WP since the late 1980's for what that is worth in the context of participation in Thai social services cum health services system.

And I can name other ex-pats (who are also long time PR's & WP holders) who have it - and there are a few guys also in this catagory who dont have it and express suprize that others have it.

So what are the rules? - again like visas, it would appear that there are as many different cases of who is going to get what as there are examples of applicants, but it would appear you are going to have to be a PR with a WP.

This is not the same as paying your 5% if you are a WP holder (up to the max of Baht750 or whatever it actually is - if that figure is not spot on it is never the less very close to it), which entitles you to coverage in Thai Government hospitals as well - and agin, some WP holders are suprized to learn others have it and they dont.

Putting aside weather or not you have a Tabien Baan card, or any other type of land/property/house document of registration, one thing I think is pretty dead cert - you will have to be at least working (if not a Permanent Resident) to get government sponsored health care out of the system.

I think without exception expats working here for companies who have sponsored their WP's will inevitably also get health insurance included in their overall package - hence many of them who have any kind of health benefit under the system won't exercise it that benefit in any case. To a lesor extent, most of those on long term visas (e.g. retirement visas) also have private health care, although its obvious a lot also don't (as in your case). Sadly though they are not going to qualify for any kind of government sponsored health care - so back to your question: just what are your options.

Your cheapest option in the case of something real serious would be to go back home and seek coverage under the social system of that country - not much good if you for under a bus or off the back of a motorbike taxi (although they are proberbly bad examples because in the case of licensed public transport in Thailand yyou are legaly supposed to be covered by the transporters public liability - assuming they are properly licensed ect ect ...). In any event, anything that needs to be done would in your case best be done at home.

Your next best option would be to get treatment at a government hospital.

While alot of the small local gov sponsored clinics can look scrappy at the best of times, the main reginal provincial hospitals (what many Thais affectionatly refer to as "Kings hospital") are actually pretty good to say the least - both in terms of the service you get and what you pay for it - and here I speak from personal experiance of having nearly lost one of my legs a few years. Although now well messed up, if it were not for the excellent care I recieved never mind my leg, I would have lost my life (that was the "Kings hospita" in Loei). The cost - nothing, but otherwise it would have been Baht26 000. If that was a private hospital - god I hate to guess what it would have cost - that wouldn't have paid for the room in any of the Bkk private hospitals! And that included over 2 weeks on an ICU ward and another few weeks on a normal ward.

I think the government hospitals are underated enourmously by ex-pats. I always use government hospitals and so does the rest of the family. They are staffed in most cases by hard working underpaid but very committed people - and the government/state health services in the US and UK could take a page or 2 out of the Thai state hospital "care book". They have far more funding than the Thai's do, and granted they are perhaps geared up better when it comes to modern equipment, but really there aint much that they can do that cannot be done in a Thai givernment hospital - all the pmain rpovincial hospitals nowadays can do MRI's and CT's, liver transplants and other complicated surgical procedures.

Chula - well, theres not much Bumrungrad can do that Chula can't do - at a lot less - and there are ex-pat doctors and nurses working at Chula for the government (although just a few - working through the Red Cross).

In summary: on any type of visa - retirement or otherwise excepting a WP - I dont think you are going to qualify for government sponsored health care. Your cheapest bet would be to go to a government hospital - choose a main one for the region/area you are in, I think you'll be quite impressed - both service and cost wise.

Tim

Edited by Maizefarmer
Posted
I think the government hospitals are underated enourmously by ex-pats. I always use government hospitals and so does the rest of the family. They are staffed in most cases by hard working underpaid but very committed people

Exactly my thought.

- and the government/state health services in the US and UK could take a page or 2 out of the Thai state hospital "care book".

Or even Bumrungrad or Bangkok hospitals for that matter.

How did you come to get Batr Thong? My parents are PR too but they don't seem to have the gold card (but they sent it to three of their children including myself). My brother is no longer eligible for it as they made him forefeit his right in place of prakan sangkom.

Posted

Thanks Nordlys for a comprehensive reply.

All is clear to me now (be it not good news)

Kindest Regards

Dave

Posted
I think the government hospitals are underated enourmously by ex-pats.

They are staffed in most cases by hard working underpaid but very committed people - and the government/state health services in the US and UK could take a page or 2 out of the Thai state hospital "care book". .

I have to agree with you about the bigger government hospitals, they are defiantly first rate. I can only talk about Chiang Mai here, but the specialist that sees you in the Private CM hospital and the nurse in the private ICU ward is normally employed full time at Chiang Mai University hospital. The cardiac thoracic specialists are the same and are called to hospitals like Ram as consultants from CMU. CMU is the only hospital with Cardiac Thoracic surgeons and it has a very modern CVT ICU as good as any I've seen in Canada. This situation may not be the same in Bangkok.

If I was having a heart attack in CM, I'd go directly to CMU (Suan Dok) hospital.

BTW:- As part of my wife's contract the hospital would cover me in the CMU facility, but not other hospitals, so I carried extra coverage just in case.

Posted
....Your cheapest option in the case of something real serious would be to go back home and seek coverage under the social system of that country - not much good if you for under a bus or off the back of a motorbike taxi (although they are probably bad examples because in the case of licensed public transport in Thailand you are legally supposed to be covered by the transporters public liability - assuming they are properly licensed ect ect ...). In any event, anything that needs to be done would in your case best be done at home.

Thanks Tim for the huge amount of information.

Unfortunately with regard to the above, the UK Government have closed that door and check much more closely AND charge these days. You now have to prove you resided in the UK for a period before you get free health-care (emergency excepted). I think you need to prove 6 months continuous residence (don't quote me on the time span).

They seem have brought the rule in to save money by stopping Expats living abroad visiting home for free health-care, operations when it suits them. I suspect they have been getting many Expats hopping back from Spain where 10s of 1000s now live (only a 2 hour journey and under 100 Euros)

Most UNFAIR in my opinion as many Expats have paid into the system for a huge amount of their working live (and have therefore have paid their "National Health-care insurance premium" to the UK Government AND in many cases cannot get reciprocal free Health-care in their new country (e.g. Spain and Thailand to name 2).

Regards

Dave

Posted

I was informed in the uk that if you still pay income tax & national insurance in the uk and have a uk address then its ok to get treatment at any hospital or doctor. The last time I was in a uk hospital outpatients clinic for my check up was only last year and no one asked me for nothing to prove I had been a resident for 6 months. I was also in the uk in august and went to see my gp and was also never asked if I was a resident for 6 months. :o

Posted
I was informed in the uk that if you still pay income tax & national insurance in the uk and have a uk address then its ok to get treatment at any hospital or doctor. The last time I was in a uk hospital outpatients clinic for my check up was only last year and no one asked me for nothing to prove I had been a resident for 6 months. I was also in the uk in august and went to see my gp and was also never asked if I was a resident for 6 months. :o

I think the relevant sentence is "if you still pay income tax & national insurance in the uk and have a uk address".

Then they will consider you live in UK, but if you do not AND MANY DO NOT then it is a problem.

Regard

Dave

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