Ricky Batten

Understanding medical insurance

What does the small print all mean?

Most medical insurance sold in Thailand, including medical insurance riders found on life insurance, is formed around Basic Hospital Inpatient Coverage, which is broken down into four areas of coverage: 

  1. Daily Room and Board
  2. Hospital General Expenses
  3. Surgery
  4. Inpatient Doctor Visits

1. Every Thai-based medical insurance plan has a fixed limit on the amount of Daily Room and Board coverage that plan will provide. This daily limit also includes the cost of nursing care and any hospital service charge. If you shop for a hospital whose daily room and board charge matches your coverage, make sure that their daily room and board charge also includes the cost of daily nursing care and any service charge for the room so that you avoid any unexpected charges.

Insurance companies will normally pay up to double the daily room and board coverage for a stay in the ICU (Intensive Care Unit).

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. The majority of the hospitals in Thailand, though, charge less than 3 thousand baht per day.

2. Hospital General Expenses can be the most costly part of a hospital stay and can eat into the limits of your coverage very quickly. These include diagnostic tests, special consultant fees, medications, bandages and dressings, emergency outpatient care, ambulance and much more.

3. The cost of Surgery can be another expensive 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 Maximum Coverage. Surgery Schedule pays a percentage of the Maximum Coverage determined by a surgery schedule that is standard within the industry. It pays 100% of the coverage maximum for major surgeries and less for more minor ones.

4. Inpatient Doctor Visits covers payment to the doctor for visiting you once a day in your hospital room. The amount of coverage is determined by the plan you choose.

The benefits shown above make up what is called Basic Hospital Inpatient coverage. They provide 100% coverage up to limit in the plan you chose. When each limit has been exceed that area of coverage stops. The main problem is with Hospital General Expenses and Surgery. Daily Room & Board and Inpatient Doctor Visits 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 Major Medical coverage steps in, if your plan has it. The Major Medical coverage rides on top of the Basic Hospital Inpatient plan and pays 80% or 90% of any additional Hospital General Expenses costs and Surgery costs up to the plan's Major Medical Maximum. You pay the other 10% or 20% yourself

Under the Ajarn.com coverage the Major Medical pays 90% .

For more information on medical insurance 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

Full-time Native English Teacher

฿50,000+ / month


English Teachers for Adults / Kids / Kindergarten

฿105,000+ / month


Math, English & Science Teachers for November 2020

฿40,300+ / month


NES and Non-NES Teachers (16-70K)

฿16,000+ / month


Fun Native English Teachers for November Start

฿42,000+ / month


Health and Sport Science Teacher

฿65,000+ / month

Nakhon Pathom

Featured Teachers

  • Md.

    Bangladeshi, 36 years old. Currently living in Bangladesh

  • Romain

    French, 33 years old. Currently living in France

  • Anna

    Polish, 38 years old. Currently living in Poland

  • Prathmesh

    Indian, 33 years old. Currently living in India

  • Cecil

    French, 38 years old. Currently living in Thailand

  • Patricia

    American, 28 years old. Currently living in USA

The Hot Spot

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.

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?

Renting an apartment?

Renting an apartment?

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

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?