Ricky Batten

Buying hospital inpatient (IPD) coverage in Thailand

The 5 areas of health insurance coverage that you should be aware of

Most medical insurance plans sold in Thailand, including those packaged with life insurance policies, focus on providing basic hospital Inpatient (IPD) coverage.

With IPD coverage, a doctor has to admit you to the hospital to stay overnight. To get you admitted, the doctor has to certify that you have a medical problem that requires you to stay in the hospital at least one night. (While some insurance plans only require that you stay in hospital for 6 hours, the insurance company is still required to pay the hospital for full 24 hour occupancy of your room).

Packaged with many hospital IPD plans is Supplemental Major Medical coverage. It helps to enhance your medical coverage while keeping the premium more affordable. 

The 5 most important areas of health insurance coverage that you should be aware of and be able to evaluate for your own needs when purchasing health insurance are: 

1) The maximum amount of coverage provided by the plan

2) The Daily Room and Board benefit

3) The Hospital General Expenses maximum coverage

4) The maximum coverage for Surgery

5) The maximum payment per day for Inpatient Doctor Visits

1. The Maximum Amount of Treatment Coverage provided by a plan can sometimes be a little confusing. Is the maximum coverage per disability, per year or for life? The maximum coverage is "per year" with most plans; But for some plans it is per disability. If they say per disability/per year, it just means whichever comes first. But what can really be misleading, though, is when a plan covers low daily charges for a longer period of time than most insurers and puts a lower limit on the maximum coverage for the fast-building hospital costs. If you totaled up the amount that they would be willing to pay for low, fixed daily costs, the maximum amount of coverage could appear to be quite high. Unfortunately, you could go broke having to pay the more costly charges that the plan didn't adequately cover.

2. Hospital Daily Room and Board Coverage also includes the charge for daily nursing care and any hospital service charge for the room. Every Thai-based medical insurance plan has a fixed limit on the amount of Daily Room and Board coverage that plan provides. (International plans generally don't have a fixed limit, but tend to be more costly). If you look around for a hospital where the daily room and board charge matches your R & B coverage, make sure that this charge also includes the cost of daily nursing care and any service charge for the room. If you want to stay at one of the hospitals popular with medical-tourists and local expats, expect the cost to be about 6 to 8 thousand baht per day, maximum The majority of the hospitals in Thailand, though, charge less than 3 thousand baht per day.

3. Hospital General Expenses can be the most costly part of a hospital stay and can eat into the limits of your coverage very quickly. General expenses include the cost for diagnostic tests, special consultant fees, medications, bandages and dressings, emergency outpatient care, ambulance and much more, including post-hospitalization follow-up outpatient care

4. Surgery can be another costly drain on your coverage. So make sure that your coverage for surgery is adequate to cover the cost of most common operations. You also need to be aware that there are two types of surgery coverage, Actual Cost and Surgery Schedule. Actual Cost pays 100% of the actual cost of the surgery up to the limit of the plan maximum for surgery coverage. Surgery Schedule pays a percentage of the plan maximum, determined by a surgery schedule that is standard within the industry. It pays up to 100% of the coverage maximum for major surgeries and a lower percentage for less major ones.

5. Inpatient Doctor Visits covers payment to the doctor for visiting you once a day in your hospital room. The amount of coverage you should need is predictable depending on the hospital you choose to use.

The benefits shown above make up what is called Basic Hospital Inpatient coverage. They provide 100% coverage up to the limits in the plan you chose. When each limit has been exceeded, that area of coverage stops. Your main areas of concern should be Hospital General Expenses coverage and Surgery coverage. Daily Room & Board and Inpatient Doctor Visits costs are predictable and can only used up over a long period of time. Coverage for General Hospital Expenses and Surgery, though, can be wiped out almost immediately if you don't have adequate coverage.

This is where supplementary Major Medical coverage steps in, if your plan has it. The Major Medical coverage rides on top of the Basic Hospital Inpatient plan and acts as back up coverage. It pays 80% or 90% (and sometimes 100%) of any additional Hospital General Expenses costs and Surgery costs up to the plan's Major Medical Maximum.

For more information on medical insurance plans and inpatient benefits in Thailand, please feel free to reach out to Pacific Prime Thailand Insurance Brokers, or email Walter directly at walter@pacificprime.com


No comments yet

Post your comment

Comments are moderated and will not appear instantly.

Featured Jobs

Pre-school Teacher at International School

฿90,000+ / month


Passionate, Experienced Music Teacher

฿50,000+ / month


School Nurse

฿25,000+ / month


NES Teachers (Lat Krabang and Bangkok)

฿40,000+ / month


Full-time Native English Teachers

฿47,500+ / month


Full-time Literacy / EFL Teachers

฿50,000+ / month


Featured Teachers

  • Myat

    Myanmarese, 31 years old. Currently living in Myanmar

  • Anas

    Syrian, 44 years old. Currently living in Thailand

  • Peter

    British, 58 years old. Currently living in Thailand

  • Adams

    Ghanian, 36 years old. Currently living in Thailand

  • Eduardo

    American, 49 years old. Currently living in Thailand

  • Steven

    American, 68 years old. Currently living in Thailand

The Hot Spot

Will I find work in Thailand?

Will I find work in Thailand?

It's one of the most common questions we get e-mailed to us. So find out exactly where you stand.

The dreaded demo

The dreaded demo

Many schools ask for demo lessons before they hire. What should you the teacher be aware of?

Teacher mistakes

Teacher mistakes

What are the most common mistakes that teachers make when they are about to embark on a teaching career in Thailand? We've got them all covered.

Contributions welcome

Contributions welcome

If you like visiting ajarn.com and reading the content, why not get involved yourself and keep us up to date?

Need Thailand insurance?

Need Thailand insurance?

Have a question about health or travel insurance in Thailand? Ricky Batten from Pacific Prime is Ajarn's resident expert.

Can you hear me OK?

Can you hear me OK?

In today's modern world, the on-line interview is becoming more and more popular. How do you prepare for it?

Renting an apartment?

Renting an apartment?

Before you go pounding the streets, check out our guide and know what to look out for.