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Private Hospitals Consider Leaving the Thai National Health Insurance Scheme
Paiboon Eksaengsri, president of the Private Hospitals Association (PHA), revealed that many private hospitals are considering leaving the Social Security Fund (SSF), a Thai national health insurance scheme that provides health coverage for employees in the private sector.
Foreign expats working in Thailand are required to register to the SSF. This Pacific Prime Thailand article will provide you with an overview of the SSF system, what is going on with it, and other options to ensure your healthcare is seamlessly covered in Thailand.
What is the Social Security Fund?
The Social Security Fund (SSF) is one of the three pillars in the Thai national health insurance system. Together with the civil servant insurance scheme and universal coverage scheme, the SSF ensures all Thais have access to essential healthcare.
The SSF, run by the Social Security Office, provides healthcare coverage to employees in the private sector. Five percent of employees’ monthly remuneration is deducted into the Fund, where employers contribute a matching amount and the government contributes 2.75% of the total amount of the fund.
Foreigners working in Thailand are required to be registered in the SSF and must contribute to the fund the same way as Thai employees. Once registered, foreign workers can enjoy the same benefits of the SSF as the Thai workers.
The SSF allows employees to receive free healthcare at the hospital they register with. In case of a medical emergency, the SSF will cover all the costs during the emergency service. Patients will then have the choice to be transferred to their registered hospital for free health coverage or another hospital of their choice.
As of 2023, 260 hospitals have registered with the Social Security Fund. This includes both public and private hospitals in Thailand. These are hospitals where employees can register their name and receive medical services covered by the SSF.
Hospitals in the SSF system receive a reimbursement from the Fund for medical services employees receive in the hospital.
The SSF takes care of around 25 million members each year. However, fractures have been growing in the system, and a number of private hospitals are leaving it.
Why Are Private Hospitals Leaving the Social Security Fund?
The decreasing reimbursement from the Social Security Fund is driving a number of private hospitals to leave the SSF system. In the last decade, 30 private hospitals have left the system, making the number dwindling from 123 hospitals to 93 private hospitals in the system.
The Thai society is aging, with fewer people coming into the workforce and more people entering retirement age. This means there is less money coming into the Fund compared to going out.
Apart from health coverage, the SSF also provides other safety nets and welfare services for private-sector employees. These include compensation in cases of disability, accident, unemployment, as well as pension payment upon retirement.
Now, concern has arisen that the expenditure could surpass the Fund’s income as early as the next 10 years, and its reserves could be depleted within 30 to 40 years.
Several solutions have been proposed to rescue the Fund including:
- Extending retirement age
- Increasing premium caps
- Introducing gradual premium increase.
Another is to cut reimbursement for registered hospitals. In 2022, the reimbursement for patients with serious or chronic health problems was cut to THB ฿10,000 from THB ฿12,000 set in 2020. In 2024, the reimbursement has been reduced to THB ฿7,200 according to the PHA.
The reimbursement cut is driving private hospitals away from the SSF as costs per patient mounts. Public hospitals are the next in line to take the burden. However, public hospitals are already overloaded, and the strained system is unlikely to be able to stretch further.
Other Health Insurance Options in Thailand
The Thai national health insurance system consists of three pillars: the civil servant insurance scheme, the Social Security Fund, and universal coverage scheme. However, foreigners living in Thailand are unlikely to be eligible for the civil servant insurance scheme and universal coverage scheme.
The civil servant insurance scheme provides free healthcare to all civil servants and their direct family members (father, mother, spouse, and up to 3 children).
Foreign employees who receive remuneration from the government budget may be eligible for the civil servant insurance scheme if their contract does not specify other types of medical coverage.
Foreign spouses of Thai civil servants may be eligible to be registered under the civil servant insurance scheme as well.
The universal coverage scheme provides healthcare coverage for those who are not covered by the civil servant insurance scheme and the Social Security Fund. However, as Thai nationality and Thai identity number are required for the eligibility of this scheme, foreigners are unlikely to be able to receive care under this scheme.
Foreigners’ most likely helper to ensure their medical costs are covered and do not mount while they are in Thailand is a private health insurance plan.
Apart from allowing seamless coverage for medical care, private health insurance can give you extra peace of mind by unlocking the comfort and prompt services of private hospitals for you.
Though Thai public hospitals provide quality healthcare at affordable prices, the system is overloaded with patients, and waiting time can be excruciatingly long.
Private hospitals in Thailand are known for exceptional service, world-class facilities, as well as staff and interpreters that can assist overseas patients. The waiting time to see doctors and to receive any procedures are also significantly shorter in private hospitals.
About Pacific Prime Thailand
If you are considering purchasing health insurance plans for your stay in Thailand, let us help. For over 20 years, Pacific Prime Thailand has been assisting expats in securing the right insurance plans that fit their budgets and needs in Thailand.
Pacific Prime Thailand works with top insurers, both local and international, to ensure that clients have the best selection of insurance plans that work best for them. However, as we do not work for any specific insurer, our clients can rest assured that our consultation is impartial and unbiased.
Contact us now for free consultation and no-obligation quotes!
Coming to Pacific Prime, she is ready to utilize her experience for the new pursuit. With a strong passion for storytelling and writing, she hopes her words could help bring people closer to the best international health insurance plan that works for them. After all, as a writer, there is no greater honor than when one’s words can add clarity to the world of the readers.
Apart from writing, she is an avid planespotter. On the weekends, you can expect to find her loitering around the airport, gawking at all the aircrafts taking off and landing. When the weather does not permit planespotting, you can find her huddling on her cozy couch, watching ballet and figure skating as well.
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