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National Health System for Expats in Thailand

Submitted: August 2014

In Thailand, foreign nationals generally have no or little healthcare coverage, though many have some form of social health insurance. If you are uninsured, you can still go to public hospitals and clinics, but you will have to pay the full bill. The good news, however, is that public healthcare services in Thailand tend to be fairly cheap.

In practice, expats have to take out private health insurance during their stay in Thailand. There is no tax relief for private health insurance premiums in Thailand.

 

Thai healthcare system - overview

There is a socialised, comprehensive healthcare system, which provides free public health services at user point, subject to certain exceptions. It results from the Universal Health Care (UHC) reforms of 2002, before which government assistance was limited to means-tested healthcare benefits. Funding mostly comes from general tax revenue and social security contributions.

Strictly, entitlement to healthcare coverage is conditional on being:

  • A civil servant covered by the civil service welfare system – under the Civil Servant Medical Benefit Scheme (CSMBS)
  • A private sector worker paying social security contributions – under the Social Security Scheme (SSS)
  • Any other uninsured Thai citizen (under the UHC).

The UHC tends to be less generous than the first two schemes. It is the residual, tax-financed healthcare coverage for Thai citizens.

 

Social Security Scheme

The Social Security Scheme is Thailand’s social insurance scheme for private sector employees, regardless of nationality. Its scope is limited to those currently and actually working in the formal sector (mandatory coverage), plus employees in the informal sector and the self-employed (voluntary coverage). In general, the contribution rate is 5%.

You should normally be signed up for the Social Security Scheme if you have been assigned for work in Thailand and been issued a work permit. If this is the case, social security contributions should be deducted from your monthly payroll and you should have been issued a medical card by the Social Security Office. You should carry your medical card with you at all times.

By being insured, your contributions count towards a variety of social security benefits, including sickness benefits, maternity benefits and invalidity benefits. Sickness benefits include sick pay and free medical treatment in the network of “registered hospitals”.

Medical attention outside of registered hospitals is not covered except for emergencies or accidents. In such cases, upfront payment at the unregistered hospital will be needed, and the reimbursement may be only partial.

If you cease to work, your insurance coverage should be extended for a further 6 months. Voluntary coverage is possible later on.

 

Foreign nationals not covered by the Social Security Scheme

The estimated 3 million foreign nationals resident in Thailand cannot avail themselves of the UHC scheme. Accordingly, they are excluded from healthcare coverage if they are not insured under the SSS.

This is in fact a genuine challenge from a public health perspective insofar as migrants are considerably more exposed to diseases. In practice, foreigners have to rely on private health insurance, out-of-pocket payments, or even hospital exemptions.

Many foreign nationals in Thailand prefer not to seek treatment at all unless they condition is already acute. Common reasons that have been reported so far include:

  • Fear of arrest and deportation in the case of migrants without valid travel documents
  • Discrimination at the hospital
  • Language barrier
  • Inability to pay the fees.

 

Trends

Thailand’s healthcare system is an evolving one. From a public policy standpoint, some of its biggest challenges in the future include:

  • Improving the emergency response
  • Reducing disparities among the regions within Thailand
  • Introducing mandatory healthcare coverage for foreign nationals
  • Disease prevention
  • Addressing the costs of Thailand’s ageing population.

 

Mosquito bite prevention

When you are going to Thailand, you must take the risk of mosquito bites very seriously. Do take all the necessary steps to avoid them.

Diseases that may result from mosquito bites include:

  • Malaria
  • Dengue fever
  • Chikungunya

Vaccines do not exist for now, but you can think of taking tablets against Malaria.

 

Travel advice

Many countries provide updated travel information to their citizens, and this often includes health advice. You should regularly check the Foreign Office website of your home country to see if there are any specific steps you need to make. Alternatively, you can go to your local embassy in Thailand.

 

Contribute

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