Unit: Baht
Area of Coverage | Thailand | Thailand | Thailand/Asia*/ Global except the United States of America and U.S. Minor Outlying Islands / Global | |||
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Maximum Benefit per policy year | 10-million THB | 30-million THB | 50-million THB | 80-million THB | 100-million THB | |
1. In-patient benefits | ||||||
Group 1 | Hospital daily room & board, food and hospital service charges (in-patient) per confinement | 8,000 per day | 10,000 per day | 12,000 per day | 15,000 per day | 25,000 per day |
In the event of ICU, such benefit will be paid for hospital daily room & board, food and hospital service charges (in-patient), with all Group 1 benefits combined and not exceeding 365 days. | As charged | |||||
Group 2 | Fees for medical service, diagnosis, treatment, blood service, nurse service, medicine, intravenous nutrient and medical supplies, per policy year | As charged | ||||
Subgroup 2.1 | Medical service fees for diagnosis | |||||
Subgroup 2.2 | Treatment medical services, blood services and nursing services | |||||
Subgroup 2.3 | Medicine, intravenous nutrition and medical supplies | |||||
Subgroup 2.4 | Take-home medicine and medical supplies (Medical Supply 1), not exceeding 30 days | |||||
Group 3 | Fees for medical professional services (physician), examination, physical services per confinement, not exceeding 365 days | As charged | ||||
Group 4 | Fees for surgery and procedures per policy year | As charged | ||||
Subgroup 4.1 | Operating or medical procedure room | |||||
Subgroup 4.2 | Medicine, intravenous nutrition and medical supplies and surgical devices | |||||
Subgroup 4.3 | Medical professional services, physician (and assistant) fees for surgery & procedure | |||||
Subgroup 4.4 | Physician fees-Anesthesiology | |||||
Subgroup 4.5 | Medical expenses for organ transplantation are covered as charged (Limited 1 time per lifetime for this supplementary contract) | |||||
Group 5 | Day Surgery | As charged | ||||
2. Out-patient benefits | ||||||
Group 6 | Fees for diagnosis before and after in-patient treatment or fees for follow up OPD treatment, which are directly related to in-patient treatment, per policy year | As charged | ||||
Subgroup 6.1 | Fees for diagnosis directly related to in-patient treatment within 30 days before and after admission | |||||
Subgroup 6.2 | Fees for follow up OPD treatment (per admission) within 30 days after hospital discharge (excluding fees for diagnosis) | |||||
Group 7 | Fees for OPD treatment of injury within 24 hours of each accident | As charged | ||||
Group 8 | Rehabilitation fees after admission per policy year (1 time per day within 60 days after the admission) | Not covered | When combined with the benefits in Group 10 Extended rehabilitation benefits, must not exceed | |||
5,000 | 10,000 | 50,000 | ||||
Group 9 | Medical services fees for chronic kidney failure treatment by hemodialysis per policy year. | As charged | ||||
Group 10 | Medical services fees for tumour or cancer treatment by radiation therapy, interventional radiology, nuclear medicine, per policy year | |||||
Group 11 | Medical services fees for cancer treatment by chemotherapy including targeted therapy per policy year | |||||
Group 12 | Emergency ambulance fees | |||||
Group 13 | Minor surgery | |||||
Deductible | None | |||||
Additional benefits | ||||||
3. Medical services fees for Physical therapy, occupational therapy, and speech therapy (Subgroup 2.2 extension) (not exceeding 30 days per disease) | As charged | |||||
4. Orthopedic braces or durable medical devices which are necessary while getting sick or injured or prosthesis (for the insured’s lifetime) | 50,000 | 80,000 | 100,000 | 200,000 | 400,000 | |
5. Private nurse fees as recommended by a doctor after the admission, not exceeding 60 days per policy year | As charged | |||||
6. Fees for follow up OPD treatment of injury within 15 days per accident | As charged | |||||
7. Dental care due to accident | ||||||
8. Advanced diagnostic body imaging | ||||||
9. Outpatient charge for general practitioners and specialists including the cost of medicines and diagnostic laboratory services (maximum 2 times per day and not exceeding 360 times per policy year) | Not covered(1) | 15,000 | 30,000 | As charged | ||
10. Rehabilitation benefit extension (group 8 benefit extension) per policy year
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Not covered | When combined with the benefits in Group 8 Rehabilitation, must not exceed | ||||
5,000 | 10,000 | 50,000 | ||||
11. Hospital Income Benefit in case of in-patient but not exercising an in-patient benefit claim (not exceeding 10 days per policy year) | 2,000 per day | |||||
12. Waiver of Premium for sickness with critical illnesses (limit 1 critical illness and 1 time throughout the contract period) | 1-year premiums exemption | |||||
Example Standard annual premium for males and females aged 30 years old, under coverage area of Thailand | 18,611 | 19,818 | 33,237 | 38,817 | 90,176 |
The total benefits of group 1-13 and additional benefits must not exceeded the maximum benefits per policy year.
(1) Prestige Health coverage plans 10-million THB and 30-million THB can be purchased along with an endorsement of OPD medical treatment expenses package (OPD Sabai jai Prestige). Conditions are as specified by the Company.
*Remark : The insured can purchase only one Prestige Health insurance policy and can choose only one area of coverage. Insurance premiums vary for each coverage area • Asian continent includes: Bangladesh, Bhutan, Brunei, Cambodia, China, Hong Kong, India, Indonesia, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau, Malaysia, Maldives. Mongolia, Myanmar, Nepal, Pakistan, the Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Tajikistan, Turkmenistan, Uzbekistan, Vietnam and Thailand