Reader question: Health care costs for Thai residents
June 16, 2014
Dear readers,
An aunt of mine (Thai woman) is in hospital in Bangkok and needs surgery. I assume it is a normal state hospital and not a private clinic. The operation takes place quickly and according to her she has to pay 5.000 Baht for the operation.
The aunt doesn't have the money now (will she next month??) and my wife asks me to advance 5.000 Baht, which I will get back next month.
Now I have given more money, but never got it back and I don't trust it this time either. But yes, she is in the hospital and needs surgery soon.
Now my question; does anyone know how Thai health care is organized and how Thai residents are insured?
Regards,
Nico
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To make sure that the facts are as presented , you can of course also request the details for the payment , more specifically the references for payment to be made directly by you to the hospital via internet banking or transfer by your ……. Do you understand what I mean ….?
Are you at least sure that there is indeed a hospitalization and surgery .
However, I cannot give you any information about the Thai regulations, because I am ignorant in this.
Dear Nico,
It is simply an established fact that if you marry a Thai you are also, to a large extent, responsible for the well-being of the family, that does not mean that you have to be Crazy Gerritje and constantly cut corners for Jan and Alleman must be ready, but in the event of hospitalization and there is no further money, then as a husband you will have to take responsibility, but you must insist that you receive the bill for the hospital and also pay it personally, and you must request a quote from the hospital in advance, then at least you know for sure that money is well spent.
Yours faithfully,
Lex K.
The Thais are very sophisticated at extracting money. My wife has to go to the hospital every month for a check-up and then gets a bag of medicines, completely free. Now everything is not free under the Bht 30 scheme, some are very expensive They have to pay extra for medicines, but an operation falls, in my opinion, in a government hospital under the Bht 30 regulation and is therefore free of payment.
The advice is fine and from the heart, but that does not answer the gentleman's question: How is it arranged in this country for residents with Thai nationality?
Maybe someone can dig into that?
What I have experienced is that a Thai MITS in the state hospital in the place where he / she is registered receives free care according to the 'basic package' that used to be in the 30 baht system. Then there is also a threshold of 50 years, and a priority arrangement if you are 70 or + at least in my hometown….
Not everyone meets that requirement. We know how the workers in this country work hundreds of miles from home to get a job and then hop on the bus with a broken leg to go to your 'home' hospital.
Much is still unclear here and may need to be explained.
And as for the questioner, I wouldn't let anyone dangle for 5.000 baht. Not really.
Dear Nico,
Not everything is always insured. Small costs have to be paid.
Please note that the hospitals sometimes also play a game. Since the costs are skyrocketing, they sometimes try to pass on costs (wrongly or not). If the money is really not there then you should talk to the doctor. Often it is then taken from another jar. But be aware that not all actions can be performed with it.
But find it strange that you can not trust your own wife in this…. then something is not right??
Albert
I wouldn't even think about 5000 baht if my Thai girlfriend asked for that for a family member. And I've also lent something a few times to people who promised to pay it back with the next harvest. Tears in their eyes because I didn't have to pay interest, and beers and sweets to thank me. The last time it was 70.000 baht to someone who had a daughter in college, received back in time in February after the harvest. Was all family I should add, the last one an aunt.
Thanks for the responses
And of course I immediately gave that 5000 Bhat and of course you wonder afterwards, how are the health regulations in Thailand.
But unfortunately I have not received any response yet.
Nico
The Thai rules are similar to ours. If you are in the hospital and you (only) take out insurance then you are usually too late. !! NO insurance does that, not even Thai.
Your question is also very unclear, because you don't know whether she is private or in a general hospital. Then I would start with that and then ask the question. And if she doesn't have the money now, she won't have it next month either. If you were married in Thailand, you might have thought about it earlier, how the health insurance fund works here,? That applies to you but also to your wife? I would ask the hospital for a cost proposal. It states how the amount has been calculated or not. Then you know if you are being cheated.
If you've loaned money to this aunt before and never got it back, this will
be the case again. Or don't lend to this woman because she cheated on you before
or ask for collateral (land title, motorbike booklet or gold) or accept it now
again not getting your money. In the latter case you are seen as the simpleton of the family
who has come back before.
If Thais have a job at a company or hotel, they are usually insured
by the employer and a personal contribution is deducted from their wages.
If they have their own business and are smart, they often take out a policy for that
in the event of hospitalization, for example, pay out 50.000 baht or 100.000 baht or more.
In addition, there is free medical assistance for the poor part of the population in the locale or region
hospitals. Often not everything is covered and, for example, medicines must be paid for yourself.
There are often waiting lists and if you want to get your turn earlier you also have to pay.
There is therefore no clear answer and depends on the circumstances. An operation of 5.000
bath is not much. A father of a friend of mine was bitten while working on the land
by a highly venomous snake. Was dying at the local clinic. My 3000 bath allowed him to go
getting a local hospital and antiserum which saved the man. I will be sent a photo
that he was in the hospital in green hospital pajamas with his finger wrapped in the bandage.
It gave me a very pleasant feeling to have saved his life for 3000 baht. Probably my best release ever.
regards,
YES
There are a few possibilities why 5000 baht should be docked.
1 – You are being scammed.
2 – Aunt is not registered with that particular hospital, so no 30-baht arrangement.
3 – Aunt does not want to lie “in a room”, so in a separate room, which must be paid for.
4 – Aunt does not want to be on the waiting list;
5 – Doctor wants to earn some extra money;
6 – Someone in the family sees in this recording an ideal opportunity to extort some money.
Take your pick, feel free to combine points.
Do ask for the bill, from the computer!!!!!
Or pay yourself...
All these points are where my wife has had cancer for a year and a half very expensive and very good surgeries cost about 130000bt now a great after care but never had to pay a penny has had a thirty bt card for a long time but that money from which town or city you come there you need help nothing but praise for this state hospital Buriram
5000 Baht is approximately 100 euros. I would dock.
What kind of surgery is it?
Is it a broken little finger or open heart surgery / cancer / brain damage?
(Does the amount match the type of operation?)
Is this operation included in the basic package?
Is that 5000 Baht for a package or will there be additional costs afterwards. (drugs, aftercare, etc.)
Furthermore, HansNL's list has almost everything you need to think about.
My experience about Thai healthcare. An acquaintance of mine has no insurance. Had to have an urgent operation. The operation cost 50000. The hospital paid 20000 because there was no money. And an arrangement was made. Pay half and the remaining amount on installment term of 3 months. This happened in the stabbing hospital in Fang northern Thailand.
I know of a Thai family who also went to San Paolo Hospital in Hua Hin, this is not a state hospital. They also had to pay 5000 TBT as a first run-up. Even though the person concerned was well insured. All further treatments had to be paid first and then declared by the insurance company. If there is no insurance, the costs will continue to rise and it will therefore not remain with the 5000. Who will pay for that? If there is insurance, the money will be refunded to the account of the insured and not to the person who paid. So someone will have to trust you to get that money back. Hear good, but also annoying stories about it (money lenders, debts with the bank, so that the bank simply sees the money as repayment, etc).
15-year-old boy, too young to be allowed to drive a motorbike, hit by 2 cars at the intersection of main provincial roads; 2 weeks coma, 3 weeks intensive care; floated back to earth from just before the gates of heaven. Visit a few times every day. His father had talked to the doctor: the doctor could obtain special food that would help the boy recover from brain damage. It cost a lot, so I would like a loan of many thousands of THB. Strange story. So keep asking questions: a personal meeting with that doctor was not possible and there would be no bill either. So it turned out to be cheating to extract money due to gambling debt. Well, you use your own son's misery to get money; should be possible right?
The insurance policies of the motorbike involved, cars have paid part of the total damage (including hospital), also through the 30 Baht hospital scheme, it has ended up financially reasonably on its feet. But at some point the boy became too costly to treat and was discharged from the hospital; much too early for Dutch standards. Should actually go to a specialized hospital (brain injury); there was no money for that. Family buys second-hand hospital bed and wheelchair with their own money for home nursing, nursing by family. The hospital did provide a few hours of training for family members to take over care: from physiotherapeutic exercises to changing nappies and administering food and medicines. Fortunately, the boy has recovered reasonably well after a year, and even goes back to school, a miracle.
For Thai residents, the 30 baht scheme provides more than a safety net. Some hospitals provide extensive and free assistance, such as medicines, physical check-ups and education to HIV and AIDS patients. Many hospitals also have dentists: a lot of service for 30 THB, which would cost gold in the Netherlands.
But a 30 baht hospital can send an overcharged patient home at some point, then either pay for continued service or be left to the gods.
Know the case of a seriously ill man (kidney disease), had already become too expensive for the 30 THB hospital over time; daughter had also used her scholarship for a university to pay for the extra care of the hospital, at a certain point the money ran out, the man was sent home by the hospital and died there after a few months.
Affordable health insurance is regularly advertised on TV. Many people could afford. Indeed, some do not even have the money for that, but many others have slightly different priorities: propitiate the gods and the temple with offerings for a good and healthy future, rather spend money on gambling or a bottle of whiskey.
In brief:
– The 30 Baht scheme and associated hospitals go very far with their care. In the small village hospitals, the staff sometimes have more time/attention for the sick person. Especially in the large, busy regional hospitals, family often helps: changing, getting extra food and drinks, sometimes spending the night in a hotel, car or under the patient's bed because their own home is far away.
Often with many people in the room, for a (for us) small extra charge, sometimes your own room with TV and refrigerator is possible.
– I think the 30 Baht scheme is bound to the region where you are officially registered. If you want to go to a 30 Baht institution outside your own region, you pay more.
– If you don't have extra insurance, it can go wrong at some point: you will be fired, possibly resulting in death.
– Do you have enough money or are you well insured, then the sky is the limit: private hospitals; admission for as long as you want, including all necessary and unnecessary treatments; with the appearance of a XNUMX-star hotel, associated service and bill.
– Sometimes a long wait, but the help is sometimes very good; some doctors work in private clinics in addition to their hours in state hospitals.
– Farang can also go there: sometimes you pay a surcharge as a farang.
It seems that it is always difficult to answer someone's question.
The question was:
How Thai health care is organized and how Thai residents are insured point.
Dear Nico,
Your question is, what is the arrangement like?
Translated as well as possible, I have heard that things go differently, but that differs from the scheme.
Locally you can go to your local hospital for the 30 Bath scheme, if you are lucky that is also your regional hospital. If you are elsewhere in Thailand, you will only be helped elsewhere if there is a great urgency.
If the local hospital cannot provide the treatment, you go to a regional hospital. If you cannot handle the treatment, you go to a specialized hospital in Bangkok.
In all hospitals, if surgery is required, the costs of any necessary blood transfusions may have to be paid out of pocket. If there is no money, this can be compensated by donating an equal amount of blood for the blood bank by family, friends, etc.
If you want specific medicines that deviate from what the hospital offers, you have to pay for them yourself.
And all that for the THB 30 scheme.
Incidentally, I was told that 50% of the Thai population does not use this scheme and goes directly to a regional hospital or a private hospital, these people then have their own insurance or pay the bill themselves.
There is enough in the responses to check whether there is actually an operation.
Incidentally, I wouldn't worry about THB 5.000. It's apparently necessary for whatever, however strange that position may sound.
I think it's mainly about how often you get such a request from your wife, I call it the grandma operation story, and there would be a reason to distrust her, I hope not for you.
Nico B
Hello, I don't know everything about the scheme, and you can find something useful above. (or google it) Fortunately, you have paid the 5000 thb, regardless of what it is needed for. Everyone knows stories about fake operations and family members who have already died 3 times. This is simply part of the culture (shy), although it is a pity that they cannot honestly say what they need it for. So we quickly start to doubt whether the money is for that purpose. I'm just saying, don't think..... but do. I have a Thai friend myself, who told me the first time he asked for money that he should tell me honestly what he needed it for. Answer: Actually I wanted to buy new clothes. Fine, I said, I'll send you money today. I never have to second guess because when that happens you have to stop.
The 30 Bath scheme is a safety net for people without their own insurance. A safety net with a good amount of holes, however. The care is very limited, you are at the back of the queue, regardless of the possible urgency, and unfortunately the insured take precedence in practice. The examples mentioned by others are recognisable.
How much does a relatively good insurance policy cost?
As a 20 year old you pay about 8000 baht per year for good health care. You will therefore be taken care of, for example during admission.
As a 70 year old you easily pay 12000 per year….but you have to be healthy, otherwise it will quickly become more expensive or you will be rejected.
Regards,
Willem
As far as I have understood it correctly from my Thai partner, Willem has worded it well; the 30 Bath scheme is no more than a safety net with many gaps and depending on the care and hospital there are costs associated with hospitalisation. Throughout Thailand many things have to be paid for (and often without a receipt) so why should it be any different in hospitals? To be treated faster or better, you have to dock, rightly or wrongly, it's just that simple. State hospitals cannot be compared to private hospitals, simple care, such as washing and feeding, is usually done by family members of the patient in the state hospitals. Glad you helped your wife's aunt!
I heard from my girlfriend if she or one of the children was sick and I told her to go to the doctor: “no money, no doctor darling”. Turns out that half of the neighborhood where she lives doesn't even know how the 30 Bath scheme works exactly, so they always make do with Paracetamol. No more pain, we are healed. This doesn't work for me. I lost my wife way too early due to illness and don't want to take any extra risk. I took out private AYA insurance for my girlfriend and her 2 children. Costs 38.000 Baht per year, but everything is covered. For her (as the breadwinner) even bed allowance when hospitalized. And within 20 years she will still have quite a piggy bank left. I don't have to worry anymore, if anything, she will go to the doctor. And yes, often she doesn't have to pay anything and she hasn't needed the insurance yet. When I was with her, I also had to go for a consultation, directly to a regional hospital. As a farang I only paid 200 Baht for 2 leaves… paracetamol, a few sachets of powders… and some good advice. Roughly 5 EUR, no insurance certificate required. So nothing twice, but for many Thais in the Isaan something to think twice about.
Hello Patrick,
I read that you have taken out an AYA private insurance, my question is whether anyone can do that and whether it is possible from Thailand. Given that I have lived here for over a year, this seems a reasonable price, especially if everything is covered.
Please note that I am 65 years old.
Thanks in advance for your information.
Dunghen.
Dunghen
you can send me your details and I will pass this on to a representative of AYA. They can then contact you and together you can check whether this offers a solution for you.
[email protected]
Dear All,
Possibly a contribution for the questioner. Most Thai residents go to a state hospital if necessary as this is free regarding costs. In fact, if you are married to a Thai woman and she works for a coverment, all family members of the household will benefit equally from this. So in this case me too. In other words, if this aunt has to pay 5000 baht, it seems to me that she has not been admitted to a state hospital. 5000 bath is very little for any operation whatsoever. This gives some food for thought.
Questioner, if you really want to know this, first find out whether it is a state or private clinic. Furthermore, my Thai mother-in-law has been in the state hospital for more than 4 months with a bacteria in her foot and various transplants have taken place. Don't have to pay bath, medicine free.
Don't worry about 5000 bath is 125 euros and you can know for yourself how the family works.
Dunghen success
The '30 Baht' insurance is free for Thais & their relatives. It is a basic insurance that does not cover everything, but the package is constantly being expanded. The hospital receives 30 Baht for every '2800 Baht' insured person in their area – per year, that is.
The less well off can appeal to the hospital to make an arrangement for the costs that are not covered. Every state hospital has a 'social services department' for this, but they also apply the rule that 'the family' must pay, because the 3-generation family is the cornerstone of the Thai social security system.
Incidentally, I am very sorry for all derogatory comments about 'profiteering Thais'. These people certainly do not know what they are talking about and assume that the Thai health care system & social services are the same as the almost unaffordable system in the Netherlands. Big news: in Thailand there is a completely different system (see previous paragraph) and you become part of it when you have a Thai partner.