Unit : Baht
Benefits | Plan 1 | Plan 2 | Plan 3 | Plan 4 | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Maximum total benefit per confinement for medical treatment due to illness or general injury | 500,000 | 1,000,000 | 5,000,000 | 10,000,000 | ||||||||||||
Maximum total benefit per confinement for cancer, heart disease or stroke | 550,000 | 1,100,000 | 5,500,000 | 11,000,000 | ||||||||||||
1. In-patient benefits | ||||||||||||||||
Group 1 | Hospital daily room & board, food and hospital service charges (in-patient) per confinement, not exceeding 180 days | Single patient room starting price per day | ||||||||||||||
In the event of ICU, such benefit will be paid for hospital daily room & board, food and hospital service charges (in-patient), according to as charge, not exceeding 60 days, combine the number of days with group 1 must not exceeding 180 days | As charged | |||||||||||||||
Group 2 | Fees for medical service, diagnosis, treatment, blood service, nurse service, medicine, intravenous nutrient and medical supplies per confinement | จ่ายตามจริง | ||||||||||||||
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 7 days | 5,000 | 20,000 | 20,000 | 50,000 | |||||||||||
Group 3 | Fees for medical professional services (physician), examination, physical services per confinement, not exceeding 180 days | As charged | ||||||||||||||
Group 4 | Fees for surgery and operation per confinement | |||||||||||||||
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, according to the doctor fee guideline | |||||||||||||||
Subgroup 4.4 | Physician fees-Anesthesiology, according to the doctor fee guideline | |||||||||||||||
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 | |||||||||||||||
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 confinement | 1,000 | 2,000 | 2,000 | 10,000 | |||||||||||
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 | Not Covered | 10,000 | |||||||||||||
Group 8 | Fee for each of the post-treatment rehabilitation per policy year | Not Covered | ||||||||||||||
Group 9 | Medical services fees for chronic kidney failure treatment by-hemodialysis per policy year | 50,000 | 100,000 | 100,000 | 200,000 | |||||||||||
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 | As charged | ||||||||||||||
Group 13 | Minor surgery | |||||||||||||||
Deductible per confinement ครั้งหนึ่ง | None | 30,000 | 50,000 | None | 30,000 | 50,000 | 100,000 | None | 30,000 | 50,000 | 100,000 | None | 30,000 | 50,000 | 100,000 | |
Additional Benefits | ||||||||||||||||
Daily compensation for medical expenses in case of being an inpatient but does not claim inpatient benefits with BLA Happy Health insurance without deductible, not exceeding 10 days per policy year | 1,000 | - | - | 2,000 | - | - | - | 2,000 | - | - | - | 2,000 | - | - | - | |
Example: Standard annual premium for male aged 35 year-old | 16,085 | 8,764 | 6,956 | 16,960 | 9,225 | 7,322 | 3,148 | 18,434 | 10,333 | 8,713 | 3,747 | 20,944 | 12,343 | 11,028 | 5,291 | |
Example: Standard annual premium for female aged 35 year-old | 16,915 | 9,793 | 7,168 | 18,020 | 10,308 | 7,545 | 3,244 | 19,587 | 11,339 | 8,979 | 3,880 | 22,104 | 13,157 | 11,036 | 5,135 | |
The Company will pay benefits for necessary and reasonable expenses that are caused by medical treatment prescribed by the doctors and must follow the medical standard. The grand sum benefit amount is as charged by the hospital, but must not exceed the benefits specified in the coverage benefit table. |