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Home » Reader question » Access to public health insurance in Thailand for expats?
Dear readers,
Imagine you work as an EU national (Belgian or Dutch nationality to make it easy) in Thailand for a multinational or for a Thai company as an employee with an open-ended contract. You are fully in order with your papers, you have a valid visa and you have a work permit. If you work as an expat for a company in Thailand, is part of your monthly salary deducted by the Thai government (= tax) for your public health insurance? Will you then have access to medical assistance at government hospitals as an expat?
How much does a consultation with the doctor cost? An expat told me that you pay 30 Baht for a consultation? Is that right?
What about the reimbursement of medicines for the Thai themselves and for expats in Thailand?
Do you have free access to specialists? (e.g. ophthalmologist, ear specialist,…).
Regards,
Yim (BE)
I've been working here for 10 years now and my contract is basically renewed every year.
I pay social security and that amount is automatically deducted from my salary. I can choose a hospital I wish to go to from a finite list. Not every hospital is listed, but only the hospitals that have a contract with my employer. If I am not satisfied with that, I can change hospitals once a year.
I pay nothing for all medical treatments and medicines. (except dentist).
Ok, but do you also pay the health insurance premium in the Netherlands, because if you have to go back unexpectedly and you receive medical expenses, what about it?
No. I don't live in the Netherlands and I don't have anything there anymore. So I never have to return unexpectedly, but when I go, it is for family visits, business (congress) combined with vacation. A travel insurance will then suffice. You don't pay health insurance premiums in every country where you go on holiday, do you?
Chris' info is a bit unclear.
Every formal employer is obliged to deduct Social Security contribution from the salary. This is 5% of salary with a maximum of 5% of 15,000 baht/month. So you pay a maximum premium of 750 baht per month.
This entitles you to, among other things, limited medical insurance in 1 of the hospitals affiliated with the Social Security Office. These are mainly state hospitals, but there are also a number of private hospitals.
However, the reimbursement is limited, the queues are long, and you only get free care with the minimal care that is needed.
Most large companies also insure their top people privately.
Indeed, some hospitals have a private/private and a Social Security Office department. At the first you enter through a large front door and you enter a magnificent space with lots of friendly staff and at the second you have to enter through a small back door and you are greeted gruffly.
dear tina,
I always enter through the large front door, I am greeted in a friendlier way than in a Dutch hospital; in this case also by nurses who could be movie stars (get a big discount on plastic surgery; my younger ex-colleague married one of them and I don't blame him because it's hard to find such ladies in Canada). The queues are no longer than in the Netherlands and you are helped immediately if you really need it (no queues for procedures like in the Netherlands because the money is gone) and if I have to believe you, the doctors here are just as good as in the Netherlands.
So I don't see the problem.
And wouldn't expats like me who work for a Thai salary and are insured according to Thai rules be much more integrated into Thai society than the expat who explains in perfect Thai in a hospital that he is privately insured through the Netherlands because he has the Thai health care under find the size?
What is Minimal Grooming? And which patient or doctor can judge that?
To compare the situation with the Netherlands:
– in my experience there are no queues for medical procedures (unlike the Netherlands, where you sometimes do NOT receive care while you are insured);
– I get the medicines I need (my 92-year-old mother in the Netherlands has recently stopped taking some medicines that really helped because they are TOO EXPENSIVE; the pharmaceutical industries are laughing their asses off, in the USA even more)
– the queues are no longer than in the Netherlands (and I have experiences with my sick ex-wife in about 10 hospitals in the Netherlands, from ordinary to academic);
– the doctors are no worse trained than the doctors in the Netherlands (according to doctor Tino).
In short: I don't think there is any reason to take out private insurance unless you want to make the large insurance companies richer. As many expats do: make a piggy bank of your pension in case you get sick.
Dear Chris,
Yes, patients in Thailand who receive care under the universal health care system (the old 30-baht system) receive minimal care. They often have to pay extra for certain treatments, which many cannot afford. This is much less the case for private patients or those who fall under the Social Security Office. For example, on average, 70 baht per year is available per person for the universal system (which covers 3.000% of the Thai population), 9.000 baht for SSO patients and much more for civil servants and private patients.
The difference is that in the Netherlands some extremely expensive medicines are not reimbursed for everyone, in Thailand there is a clearly hierarchical system as to who gets reimbursed for what.
Yes, doctors in Thailand are on average as knowledgeable as in Thailand. But a patient in a private hospital gets 30 minutes of a doctor's attention and that in a state hospital only 3 minutes on average.
In the Netherlands, a member of the royal family and a tramp receive almost the same medical treatment, although the service around it will differ considerably. A glass of water versus a glass of champagne.
Chris, I just looked it up for you. See:https://www.sso.go.th/wpr/main/service/กองทุนประกันสังคม_detail_detail_1_125_690/13_13
The maximum amounts that are reimbursed are so limited that both my son and his wife (both work for Thai banks) have additional private insurance, paid for by their employers. They are both just Thai with a well-paid job by Thai standards.
Just had a look at the link just for fun. And there it says (in English) this: “In case of sickness: The insured receives medical treatment without having to pay costs when treated in hospitals in which one can use one's social security card or in a network to which the original hospital belongs in addition to cases of sick leave when medical treatment is ordered by a participating physician.”
I think that means (and is also my experience in practice): NO costs. You can raise a tree about the quality of care and the hospital, but not about the costs. They are 0. Have never paid 10 Baht to a hospital in 1 years.
OK. But the Thai text contains 13 exceptions, some understandable (sex change) but some strange: complications from drug use and artificial insemination, for example. Anyway, you won't have to rely on that.
Read a little further Chris than the first paragraph. The free treatment is “unlimited” only in State Hospitals. In private hospitals there are quite low limits.
You can of course argue that treatment in a state hospital is fine, but I can assure you that in case of a serious condition with surgery, hospitalization and long-term treatment, the "free" care will be minimal. For example, if you want a private room, better or different medicines, or expensive tests are required, you will have to pay extra.
It also states that you are entitled to 50% of your salary during illness. That is correct as long as that salary does not exceed 15,000.- baht. This is the salary standard used by the SSO when calculating sickness, unemployment and pension benefits.
I own a company and both my wife and son are compulsorily insured via SSO. Yet they both have extra private insurance, because we think it is important that costs do not become too heavy a burden if the treatment runs into the millions. Reimbursement for such treatment has long ceased with the SSO.
There is no other way because the monthly contribution of the insured person is insufficient for expensive treatments.