Expatriate health insurance in Thailand
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Expatriate health insurance in Thailand

Destination Thailand
>Mandatory insurance tailored to your needs
>Access to private facilities, including Bangkok Hospital
>Guaranteed payment and advance of costs in case of hospitalization
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The need for a health insurance plan in Thailand

Thailand is a popular medical tourism destination in Asia, thanks to the quality of its infrastructure and its high number of highly qualified physicians. However, the rates are freely set in the private sector, and your bills can quickly become very costly. Taking out an expatriate health insurance policy will ensure the wellbeing of your wallet in case of an emergency.

Summary
Trait

Key figures for health insurance
in Thailand

Key figures for health insurance in Thailand
Healthcare expenditure per capita and per year €507,92
Annual indexation of health expenses 9,2%
Hospitalization reimbursement rate with the Fund for French Abroad (CFE) 50%
Number of insurance companies available 15
Annual cost of hospitalization coverage for a 30-year-old €726
Annual cost of hospitalization coverage for a 50-year-old €1 188
Trait

The healthcare system in Thailand

Health as an economic driver

Healthcare is an important subject in Thailand. Just over 4% of their GDP is devoted to it, and the country has launched a strategic national development plan (2016-2025) in which healthcare is a priority, along with services, education, and research.

The government can boast of being cited as an example by the WHO for its universal healthcare coverage and national health security model. This model provides healthcare coverage for the poorest, based on the principle of strong public contribution in addition to that of the State. In 2018, Thailand was ranked 27th (out of 56 countries) in terms of healthcare efficiency, ahead of Malaysia (29th) and behind France (16th) and Singapore (2nd), according to Bloomberg rankings.

Encouraged by the gain of medical tourism, Thailand has a large number of medical centers and qualified personnel (often trained abroad), modern medical equipment, and excellent care quality.

Patients are treated like customers, with hospitals offering luxury hotel-like services: large decorated rooms, music, aromatherapy, and a wide range of services. The trade-off for quality is sometimes high bills, but still more moderate than many Western European countries.

Sanitation and precautions to take before departure

The general sanitary situation is very good in Thailand.

However, it’s better to be careful with the use of tap water. Drinking tap water directly is&espace¬ recommended: water bottles are available in the market and can be delivered to your home. Similarly, avoid ice cubes from street food vendors.

Coming from Europe, there are almost no mandatory vaccinations (except for yellow fever if you have traveled in a high-risk area).

However, it is recommended to be vaccinated against certain diseases for Thailand, namely: diphtheria, measles, mumps, rubella, tetanus, and hepatitis A and B.

It is&espace¬ necessary to take an anti-malaria treatment if you do&espace¬ go to high-risk areas: areas close to Laos, Cambodia, or Myanmar.

Beyond malaria, protection against mosquitoes – repellents, a mosquito net, or long sleeves – is recommended to avoid dengue and chikungunya, which are present in the country.

Quality of care in the public and private sectors

The public sector is very important to healthcare in Thailand, and offers good quality of care at a reasonable cost.

Public hospitals exist in great number all over the country, with the presence of at least one general hospital per large province, and many more in the tourist areas. Medical staff is equally abundant. However, since physicians and surgeons in the public sector are&espace¬ assigned to a single place of care, appointment schedules are quickly overloaded and waiting&espace× can be somewhat long.

The private sector offers excellent quality of service, but the cost of care is higher than in the public sector. Healthcare rates are close to European rates, although there can be significant differences within their open-market pricing system.

One quarter of total healthcare expenditures are private. This explains the importance of the private health sector in Thailand. At all levels, medical care in Thai private hospitals is excellent. If you are well insured, you can easily benefit from it.

It’s just a matter of finding the insurance that will suit you the best. Our advisers are here to help you.

Prices for on-site care

Prices vary depending on the healthcare facility you go to. As an expatriate, be prepared to pay top&espace$ only the holders of the "Gold Card" will be able to benefit from the universal healthcare coverage (in dedicated centers).

It’s difficult to pin down the exact price of consultations in Thailand, as each physician or establishment is free to set its own prices according to their estimation of the quality of their services. Count on paying between €25 and €35 on average for a simple consultation with a general practitioner, but this can also go up to €76.

In the case of a public hospitalization, the price of a day in a private room is around 800 to 1,000 THB. As an expatriate, the hospital will ask you to pay up front. It is therefore recommended that you take out health insurance, whether you are seeking treatment in a public or private hospital.

The most expensive hospitals are the BNH (Bangkok General Hospital), the Bumrungrad International Hospital, and the Bangkok Hospital (which has about 15 branches or hospitals throughout the country, including in Pattaya and Phuket). These are world-class hospitals. The Bangkok Hospital is accredited by JCI (Joint Commission International), which guarantees a quality of care equal or superior to the medical standards of the USA. It’s&espace¬ uncommon for local insurance companies to exclude these hospitals from the “Gold Card" third-party payment system. On the other hand, many expat health insurance companies have agreements with these hospitals.

Often, medication that is prescription-only in countries such as France, Canada, or Germany is sold freely in Thai pharmacies. Pharmacies operate like any other business, and anyone can declare themselves a pharmacist; beware of counterfeits.

Opt for large pharmacy chains such as Walgreens or Boots, for example. Note that expatriate insurers will need prescriptions in order to reimburse you. Medication purchased without a prescription will be out of pocket. Generally, your physician will provide you with your usual medication according to the duration of your treatment (you will be given a small packet or bottle), and a prescription will be written for the others.

If you opt for a complete insurance plan in Thailand, this insurance can cover your dental care and optical expenses as well. Keep in mind, however, that glasses are much less expensive than in France, with largely equivalent quality.

Dental care in Thailand is also of very good quality, and at competitive rates compared to France. You can take advantage of your stay to start dental prosthesis work with very attractive conditions.

Regarding maternity, the two most famous hospitals are the Samitivej Sukhumvit Hospital and the Bumrungrad International Hospital. An ultrasound costs on average 3,000 THB, and you will usually be invited to undergo monthly consultations. A delivery in a private hospital costs from 40,000 to 140,000 THB, depending on the place chosen, the length of hospitalization (on average 2–4 days), and the type of birth. Check your maternity coverage in advance with your insurer.

How to find a physician

It is&espace¬ absolutely necessary to see an expat physician, since Thai physicians are often trained in Europe or even the in United States and generally speak "Thaiglish." Though you might want to use an interpreter in some institutions.

Physicians in private practices can be readily found in public hospitals too, as the latter often have to reimburse their medical school fees; this helps ensures good quality of care regardless of the sector. However, finding a general practitioner can be more difficult than finding a specialist, as the number of specialists is much higher than the number of general practitioners.

In this respect, Thai urban medicine differs from European habits, as the majority of consultations are held in hospitals. This is what creates the waiting lines in the public sector.

Consulates or embassies have lists of reputable physicians, specialists, clinics, and hospitals for expats. Insurance companies also provide access to similar lists.

In addition, you can also contact the expatriate network in your community to get more details, recommendations, and good tips.

Please note that expat health insurance will allow you to benefit from teleconsultation services for non-urgent requests, and for situations in which it would be difficult for you to have quick access to a physician (in your language).

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Social-welfare coverage in Thailand

Social-welfare coverage from your country of origin

Thailand has almost no international social-welfare agreements with any other country. The only one we could identify is an agreement with the Netherlands, though details are difficult to pin down.

As an expat in Thailand, you won’t be eligible local social-welfare coverage, nor can you use such coverage from your country of origin.

Don’t add financial inconvenience to a medical problem! Get insurance! Let our advisers guide you to the best solution for you.

Local social-welfare benefits

Thailand guarantees access to healthcare for every citizen, especially since the 2001 reform and the introduction of universal health coverage (UCS).

Public healthcare facilities are financed by the government, covering their investments and staff salaries. The facilities can then keep any profits they earn, which encourages investment in human resources and medical equipment in return.

The Thai state finances this primarily through the collection of income tax and other taxes. The basic principle is that citizens/companies who have income pay for those who do not.

With UCS, two health systems have been merged: the Medical Welfare Scheme (MWS) and the Health Card Scheme (HCS). They were joined by the Civil Servant Medical Benefit Scheme (CSMBS) for civil servants and the Social Security Scheme (SSS) for employees.

Since 2007, private hospitals have been obliged to provide care to the most needy who come to their emergency rooms. And in 2011, the government estimated that 98% of the Thai population was covered (about 48 million citizens).

The UCS system allows all Thai citizens not covered by the CSMBS or SSS to access the following healthcare services: hospitalization, medicine, and emergency care.

UCS beneficiaries depend on health centers and hospitals in their community (or nearby), where they present their "Gold Card."

The National Office of Sanitary Security issues this card, which is the equivalent of the French "carte vitale," and which allows access to healthcare and the payment of fees.

You will be affiliated with SSS as soon as you are a private employee (with a work permit), whatever your nationality. It is also possible to contribute voluntarily if you are self-employed. The SSS covers sickness, maternity, and disability benefits.

The contribution rate is about 5% of your salary and entitles you to an insurance card. You can then receive free medical care in the designated network. Outside the network, you will have to pay the full cost, except in the case of an emergency or accident.

As an expat, if you are not affiliated with the SSS, you will not have any health coverage. Private international or local health insurance will be essential in a country where hospitals require you to guarantee payment before anything else.

CFE coverage (Fund for French Abraod) for non-French citizens

The CFE allows you to maintain a similar degree of social protection as you would have in France. It offers sickness, maternity, disability, death, and old age benefits.

For healthcare, CFE reimbursements are based on their “zone 2” coverage, if you have a complementary insurance company. The reimbursement rate for hospitalization is 50%. Your expatriate health insurance will always supplement this amount to reach 100%.

One particularity of CFE coverage in Thailand is 80% (sometimes 100%) reimbursement of hospitalization expenses, set up for insured members who have not taken out any complementary insurance.

This coverage is provided through VYV assistance, CFE's partner for the advance payment of hospitalization expenses.

In order to benefit from this 80%(/100%) coverage, you must first contact your assistance provider and then go to the hospital designated by the them. There is no possibility of selecting the place of treatment yourself.

Please note: in cases where 20% of the cost must be paid out of pocket, the hospital will ask you for a payment guarantee/proof of your ability to pay the remaining bill!

For example, for a hospitalization for heart surgery that costs 2,000,000 baht, you will need a pre-authorization of 400,000 baht on your bank card.

It is up to you to determine what your needs are and whether to opt for CFE coverage alone or add a complementary expat health insurance plan (or a full-coverage plan).

Having expat health insurance in addition to CFE membership ensures that you are covered for 100% of hospitalization costs in the hospital of your choice, and will provide additional reimbursements for your routine medical expenses, including vision and dental, and is especially recommended for those who want a good level of reimbursement.

Calculated according to your age and marital status (single, a couple, etc.), contributions to the CFE allow members to be covered in France and abroad, and to quickly recover your CPAM rights when you return to France for good.

You will find more information on this subject in our section dedicated to the CFE.

Local insurance in Thailand

There are several private insurance companies in Thailand. Most of these work with a network, and preexisting medical conditions are often excluded from the coverage. Maximum coverage limits are also quite restricted. Be sure to ask about them. For maternity care, costs incurred by complications at birth for the newborn are not always covered.

The principle of automatic yearly renewal is weak or non-existent; in fact, insurers may refuse to renew your contract at the end of the term. Finally, these are contracts that will only cover you locally.

Several expatriate insurers offer "Asian plans," such as April MyHealth Thailand, or Luma and AXA, for example. These are often similar to the local plans in terms of limits concerning networks, maximum coverage, and coverage zones, among other things. Ask our team for advice.

Mandatory insurance and the the “O-A” non-immigrant visa

Since October 31, 2019, candidates for the O-A Non-Immigrant Visa are obliged to sign up for health insurance to get their visa.

This Thai government decision is directly linked to the numerous unpaid bills of expatriate retirees, and to the need to limit public debt.

The health insurance taken out must guarantee a minimum of 400,000 THB for hospitalization and 40,000 THB for routine expenses. The Thai General Insurance Association has a list of approved insurance companies. The contracts offered are very limited, despite their rather high rates; if you’re considering one of these, be sure to analyze the maximum coverage limits. Be aware that this coverage will only be valid in Thailand.

Non-listed expatriate insurers have adapted to the situation and sign equivalent forms on request. The CFE, in partnership with April, has developed a contract with no specific health coverage plan, which allows you to obtain your visa without any problems.

For more information on the subject, visit the HealthForExpats blog.

Trait

Expatriate health insurance in Thailand

Why sign up?

If you’re an expat, travel insurance won’t work for you: many expatriates think they can save on expat health insurance for a few weeks thanks to their credit card travel insurance. But if something happens, the insurer will ask you to justify your travel conditions, show return ticket, investigate your type of accommodation, and health insurance reimbursement terms from your country of origin. If the insurer finds that your stay has been longer than 90 days, and not just a short trip, coverage will be refused.

Furthermore, expatriate health insurance is necessary to gain easy access to quality care. As mentioned above, the price of care can increase significantly depending on which medical facility is chosen, as costs are vary wildly in the private sector. Intensive care in these facilities can cost up to 10,000 euros, and repatriation assistance up to 100,000 euros.

In addition, your expatriate insurance policy should also cover you in your home country, for when you return for visits, and at least guarantees you coverage in case of an emergency abroad.

When and how to sign up

It is possible to purchase health insurance from Thailand if you are already there.

However, we always recommend you do it before your departure because of the risks linked to healthcare costs. It is also more beneficial to you: no waiting period, more extensive choice of plans, documents in hand, worry-free procedures (and not rushed in case of emergency), etc.

Signing up for expatriate health insurance is more complex than for traditional health insurance, so it is advisable to apply at least 30 days before your departure or the desired start date of your contract.

Our website will help you request online price quotes and compare coverage. An adviser can then help you with the entire sign-up process.

What coverage plan should I choose?

For small budgets, hospitalization insurance is the minimum required to be able to access private establishments in case of a serious problem.

For more comfortable budgets, this plan can be supplemented with coverage for routine medical expenses (consultations, pharmacy expenses, medical exams, etc.).

Given the price levels charged by health professionals, a basic-plus coverage plan should suffice in most cases.

Several French insurers offer specific plans for Thailand and for some other countries in this zone. They are generally quoted in USD and take effect on the first dollar spent (but not the CFE). They offer a good coverage/price ratio, but may seem a bit complex to understand because they are based on Anglo-Saxon rather than French models. Ask us for advice.

Do I have to pay up front?

Not if you are a SSS affiliate. In that case, your insurance card ensures direct payment of your healthcare expenses, within the infrastructures of your care network only. Outside the designated network, you have to pay the bills out of pocket.

Healthcare facilities in Thailand require a guarantee of payment in case of hospitalization, and the payment of bills up front for consultations and the purchase of medicines. It is then up to the insured person to file reimbursement claims.

With expat health insurance, in the event of hospitalization of more than 24 hours, the insurer will organize direct payment to the hospital/clinic. Routine medical and vision/dental expenses must be paid up front. Reimbursement claims are now easily filed online. The insurers all offer customer portals, and often mobile applications, for the management of your reimbursements.

In general, invoices of up to €1,000 can be transmitted digitally. Invoices over €1,000 (rarer) will have to be sent by postal mail.

Repatriation assistance

Although the quality of care is excellent in many of the facilities in Thailand, repatriation insurance should never be overlooked, especially if you live outside the Bangkok area.

Repatriation insurance is also useful when major medical treatments are needed, where evacuation to your home country or to another country would be advisable. And it also offers premium services that will be welcome in the event of a serious incident: paying for a relative to travel to your bedside, arranging for childcare or transfer, medical advice and guidance, a return ticket in case of the death of a relative, etc.

Additional insurance for expatriates

Third-party liability and legal protection

This covers all material and immaterial damages that you, or a family member, could cause to a third party.

Third-party liability will not apply when driving a motor vehicle; for this check with your auto insurance company.

Disability and life insurance

While basic coverage is provided locally for employees, it is very minimal. You must arrange your own coverage to protect your spouse and children.

It is recommended that you take out private insurance or one of the CFE options in order to be covered.

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