So you’re in Thailand and need medical treatment. You have health insurance but have never used it until now. And you probably want to know how it works too. Need some proper answers from a health insurance expert? Learn more from this article as I briefly explore Thailand’s healthcare system and discuss the methods of settling your hospital bills in Thailand.

In general, the process of settling your hospital bill differs depending on where you go in Thailand. This is why as an expat myself, I always advise my clients to do their research on their local hospitals and the medical services they offer. 

Fortunately, a health insurance plan will have details of the hospitals in the insurer’s network, which means you can do your research by visiting them and in the process of doing so register your details. You’ll also be able to check out the different channels of settling the hospital bills and what to do after. To give you an idea, here’s my experience of what to expect.

Thailand’s healthcare system - private vs. public

The one thing I love about Thailand’s healthcare system is that it’s pretty straightforward - you just have to know which ones are private and which ones are public. As an expat or teacher in Thailand, you’ll likely want to visit private hospitals because of the high level of services and medical attention provided. Whereas, public hospitals can be a little less memorable - except for a few top ones in cities like Bangkok. Let me go through the differences below. 

Visiting a Thai private hospital

Private hospitals in Thailand - especially in Bangkok and other major cities and destinations like Chiang Mai, Pattaya, and Phuket are renowned for their outstanding medical services.

Medical professionals are incredibly attentive and are likely to speak other languages too. On several of my visits to private hospitals in Bangkok, I was amazed by the level of communication from all those I approached. From the doorman to the doctors and nurses, everyone was professional and welcoming. Also, the hospitals are clean and the process of getting treatment is pretty straightforward. 

The cherry on top was when I had to pay for my hospital bills. It was seamless and incredibly simple too. However, from my experience alone, public hospitals tell a different story. But to be fair, that’s because they are more focused on treating local Thais than foreigners and expats.

Visiting a Thai public hospital

Personally, I don’t have anything against public hospitals. I believe they do their very best and you can find that some of the top and most experienced doctors practice there. After all, it’s where all experienced doctors develop their skills and knowledge. However, when it comes to services and operations, it’s often the complete opposite to private hospitals. This is because most public hospitals face several challenges like being overcrowded and having long queues for treatment.

 What’s more, expats and foreigners without prior knowledge of the public hospitals will find it difficult to navigate and get full medical support in English or in another language they are familiar with. The underlying reason is that staff in public hospitals will mainly communicate in Thai as the main demographic seen and treated are local Thais. They won’t have expat-focused services in place unless you visit a top public hospital like King Chulalongkorn Memorial Hospital and Siriraj Hospital in Bangkok.

Additionally, local hospitals' medical equipment may not be the most up-to-date and effective for treatment, compared to the state-of-the-art equipment and tools available at private hospitals. Last but not least, my major concern is that public hospitals in Thailand often lack a proper system to process health insurance claims on your behalf. 

Now that you have a better understanding of public and private hospitals, allow me to share my experience of settling hospital bills in Thailand.

Settling your medical bill in both a private and public Thai hospital

So you've been discharged by your doctor and need to settle your hospital bill before going home. What to expect next?

Of course, this scenario will vary from hospital to hospital and the type of hospital you are in.  Generally, if you have health insurance you could settle your bill by “paying and claiming” or through the pre-authorization / direct billing process. From my experience, here are the differences below:

Pay and claim

This method of settling your hospital bill is common in public hospitals. Here’s what to expect when paying and claiming from your health insurer:

1) You are normally given your hospital bill upon discharge and are asked to pay the sum out-of-pocket at the cashier’s office.

2) The cashier will give you options to pay including cash, direct debit, credit, or a wire transfer. Before you do pay, I’d recommend you to review the bill, as Thailand is known for having dual pricing. Just make sure what’s included is reasonable and acceptable.

3) Once you have paid your hospital bill, you’ll also have to gather all the necessary paperwork including your discharge letter to make a claim with your health insurer.  (Note: Depending on the terms and conditions of your insurance plan, you may have to settle deductibles either with the hospital or insurer too.)

In some cases, the back and forth discussion and request for documents and specific details can be a tedious process. Additionally, most regulated insurers in Thailand request original claims documents, which can delay the claims process if hospitals and/or insurers have several steps in between for you to complete. 

This is why pre-authorization or direct billing is a better alternative if you already know beforehand what you need treatment for or if the doctor who is taking care of you recommends it. Let’s see below.

Pre-authorization and direct billing

This method will offer you peace of mind, regardless of whether you attend a public or private hospital.  (Note: For convenience and satisfaction, most expats, teachers, and foreigners with international health insurance coverage will often opt for the private route due to the higher level of medical services available and benefits as mentioned earlier.)

What is pre-authorization?

To give you some background, pre-authorization is the process of approaching your insurer and informing them that you need a particular medical treatment carried out at a particular hospital. These treatments are typically major ones such as heart surgery and total knee replacement surgery. 

Your insurer will then contact the hospital directly to establish the reason and diagnosis; confirm whether medical treatment is medically necessary; and how it falls under the plan coverage in order to determine the amount to cover.  (Note: Don't be surprised if the hospital requests a deposit or holds an amount on your credit card before receiving confirmation from your insurer on payments.)  

If the insurer believes that your treatment is eligible for full coverage, they will issue a guarantee of payment (GOP) letter stating the coverage amount. All of which is done before you are admitted for treatment. 

What is direct billing?

Direct billing essentially means that the hospital will bill the insurer instead of you. Unlike pay and claim, you don’t have to put in a separate claim with your insurance company. Note that this method is most often available on international plans and from larger insurers offering local plans in Thailand.

Here are the steps for the direct billing approach:

1) Make an appointment with a healthcare provider.  (Note: For a greater level of service and reliability, choose a local or reputable private hospital instead of a public hospital).

2) Register at the hospital before receiving care.

3) Present your ID, Hospital card (if you have one previously issued by the hospital), insurance card, and any other requested documents.

4) Read and sign all paperwork.

5) Receive care.

6) Sign the bill.

7) Go home.

All in all, the best thing about direct billing is that once you’ve left the hospital, there’s nothing else you will need to worry about, except to focus on your full recovery and continue living a good life in Thailand.

Want to learn more? Reach out for a chat today!

I truly hope that after reading my blog you will be able to settle your hospital bills with ease. If you’ve got any questions at all - either about settling your hospital bill in Thailand or about expat health insurance, you’re more than welcome to reach out to me at ajarn@pacificprime.co.th or contact my team at Pacific Prime Thailand.