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For expats planning to travel or move to Thailand, understanding the healthcare system—the quality of care available, coverage options, and the process for accessing care—is crucial.

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Thailand’s progressive healthcare system

Thailand's healthcare system is one of the most developed in Southeast Asia and is renowned for its high-quality and affordable services. On the 2021 Global Health Security Index, Thailand has placed fifth in the world and first in Asia, which measures countries' abilities to combat infectious diseases. The country has a well-trained workforce, with many doctors and nurses per capita.

Thailand’s healthcare expenditures totalled $25.3 billion in 2013, growing to $47.9 billion by 2026. Thailand allocates 13.3% of its budget to public health services. Since its Universal Coverage Scheme was introduced, the government has been responsible for the rapid increase in medical services and drug demand.

Public vs. private healthcare in Thailand

Thailand has a dual healthcare system, which means both public and private hospitals are available. Many international hospitals, clinics, and medical centres offer both standard and specialised treatments in the private sector.

The public healthcare system, managed by the Ministry of Public Health (MOPH), is free for Thai citizens, but foreigners are charged for treatment at government hospitals. The cost varies depending on the type of treatment needed and whether it is given at a government or private hospital.

Private doctors are available in all major cities and tourist destinations across Thailand. They charge fees for their services and may require payment upfront before providing treatment. Private hospitals can cost tens of thousands of dollars per year, but they offer a higher standard of care required for specific conditions or if you want to ensure that your needs will be met by someone who speaks your language. Many expats choose to combine both public and private healthcare coverage.

The quality of healthcare between cities vs. rural locations

Healthcare in Thailand is available at various levels, ranging from private hospitals to small clinics or "sick houses." It is not that the quality of healthcare is better or worse, but instead, it can vary depending on where you live in the country and what kind of treatment you require.

For example, if you're travelling to Bangkok, Chiang Mai, or Phuket, you will access high-quality medical care at affordable prices. However, suppose you're travelling to less developed areas of Thailand, such as Trang or Surat Thani, there will likely be fewer options available, and the quality of care may not be as good as that offered in larger cities.

For instance, if you have an acute condition, such as appendicitis or a broken bone, you will receive excellent care at any hospital in Thailand. However, if you have a chronic condition like diabetes or asthma, there are some differences between city and rural hospitals.

Both public and private hospitals offer a high level of care with excellent facilities, highly trained staff, and the latest equipment. But due to their reputation for better care and facilities, many people prefer to seek treatment at private hospitals, like Samitivej Hospital or Bangkok Hospital for instance. Private hospitals in Thailand are accredited by the Ministry of Public Health (MOPH), which maintains a National Accreditation Committee (NAC). Most people will use public health facilities for minor ailments and injuries.

Comparing local vs. international health insurance plans in Thailand

Expatriates living in Thailand should consider purchasing a private medical insurance policy to cover treatment costs at private hospitals and clinics. Local and international health insurance policies differ, so it is wise to understand the pros and cons of both.

Benefit levels
International plans tend to offer more benefits than those offered by local plans. These include higher annual benefit limits and certain types of coverage, such as cancer, HIV/AIDS, or pregnancy complications.

Local Thai insurance plans typically often have limitations, such as a daily or per-visit limit on benefits. International medical plans, by contrast, are generally more generous and less limiting in their coverage.

A lower annual limit or more specific limits on your plan’s benefits may increase your out-of-pocket expenses, so you may want to keep that in mind if you’re trying to avoid those costs.

Ability to offer direct billing
One area where local insurance providers excel is that they usually have extensive direct billing networks for inpatient and outpatient healthcare providers.

For international medical insurance plans, the scope of direct billing networks in Thailand for outpatient treatments depends on the company you choose.

Coverage outside of Thailand
Most international health insurance plans are globally portable, so you can take them with you when you move outside Thailand. This offers the convenience of having continuous coverage and eliminates the need to go through the underwriting process again, which may exclude pre-existing conditions from coverage.

For APRIL members, they must send their request for pre-authorisation at least five working days in advance for non-emergency hospitalisation or treatment. Once approved, APRIL will issue a Letter of Guarantee (LOG) to the chosen medical facility and settle the cost of treatment directly. Today, we are able to place LOGs in most hospitals around the world.

However, this is not the case with most local health insurance plans, which only cover treatment in Thailand. Expenses incurred outside of Thailand on a local plan are not eligible for coverage, and local insurance providers cannot issue a Letter of Guarantee to hospitals outside the country.

Calculating renewal premiums
When insurers set their premium rates, they use one of two methods: experience rating or community rating. 

Like most international insurance providers, APRIL International uses community rating. Instead of looking at individual cases, we examine the performance of everyone insured under a product and then apply a fixed premium increase to everyone based on the portfolio's performance. In other words, APRIL's approach is to look at the entire portfolio and not break it down into individual members. This means that your annual increase will be the same regardless of your health and your consumption.   

The other way insurers calculate renewal premiums is through experience rating, where the insurer reviews a person’s claim history for the year at renewal before deciding how much to raise the premium. So, if you have a year of low claims, your premium won’t rise much, but if you’ve had a high claims year, your premium will likely see a dramatic rise at renewal. 

For Local Thai insurers, some use community rating, while others rely on experience rating when calculating renewal premiums for private health insurance.

Under a local plan, if you have multiple years with high claims or developed a chronic condition that requires recurring treatment, this could cause your premium to be so high after a few renewals that it is simply unaffordable anymore. Alternatively, your insurer may add limits, co-insurance, or deductibles on some benefits or simply decline to renew your policy, which leaves you looking for health insurance with a serious pre-existing condition.

Insurance for Expatriates in Thailand

MyHEALTH offers you the best of both worlds in Thailand, the great benefits of an international medical insurance plan with a local insurance company's easily accessible customer service and direct billing network.

Whether you just need to cover yourself or need to insure your family as well, you can build a plan that suits your personal situation. In addition to our inpatient plan, which includes cover for major treatments such as kidney dialysis, cancer treatments, or even organ transplants, you can also add outpatient, maternity, and dental & optical benefits modules and choose one of three levels of coverage for each module.

MyHEALTH offers you a flexible coverage option that will cover you in hospitals worldwide, not just in Thailand. Plus, if you ever move out of Thailand, your MyHEALTH plan is globally portable and can travel with you to your new home with no breaks in coverage at all.

 

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