IGLU’s Social Security Information
As an employee of Iglu, you are automatically eligible for Thailand’s National Social Security. If the employee has not received his/her physical Social Security card and needs to go to the hospital, the employee only needs to use their Social Security number with their passport to receive the benefits.
The Iglu employee has to pay contributions for a period of not less than three (3) months. For Iglu employees, a minimum of three (3) months of employment with Iglu is required before Social Security benefits can be used.
The following information is provided by the Thailand government, and has been modified slightly by Iglu for easier readability.
The following are services you will receive from your chosen contracted hospital.
The hospital will provide medical diagnosis and treatment services to the insured person according to the medical service standard. If the hospital is unable to provide service and has to transfer the insured to another hospital, that hospital will be responsible for expenses incurred.
The insured person can receive medical services based on the contracted hospital (including its networks) indicated on the medical card, free of charge.
The following 13 diseases or treatments are NOT covered by Social Security.
1. Disease or injury due to drug addiction under the Narcotics Control Act.
2. Renal replacement therapy and chronic renal failure except the end stage of chronic renal failure which the insured person can receive hemodialysis by Chronic Peritoneal Dialysis (CPD) and by kidney transplant based on the specified criteria, conditions and rates set by the SSO.
3. Any action taken for beautifying purposes with an absence of medical indications.
4. Researching treatment.
5. Infertility treatment.
6. Tissue biopsy for organ transplantation except the biopsy for bone marrow transplantation that the insured person has to pay as actually incurred not exceeding 7,000 THB per person according to the criteria and conditions specified by the Medical Committee.
7. Non-medical indicated procedure.
8. Organ transplantation operation except:
- Bone marrow transplantation—The capitation of medical service based on the specified criteria and condition is payable to the contracted hospital certified by the Medical Committee within the amount of 750,000 THB/person until the end of bone marrow transplant process.
- Corneal transplantation—The capitation of medical services is payable to the contracted hospital at the amount of 20,000 THB and 5,000 THB to the Red Cross Eye Center according to the specified criteria and conditions.
- Heart, lung, liver, pancreas and organ transplantation according to the specified criteria and conditions.
9. Sex reassignment surgery.
10. Artificial insemination.
11. Recovering period care.
12. Dental Services except tooth extraction, filling, removal of dental plaque, impacted tooth extraction, and
fitting of removable partial or full dentures.
Benefits for dental services / Regulations and Conditions
Tooth extraction, filling, dental plaque removal and impacted tooth extraction can be reimbursed, as necessary, not exceeding 900 THB per calendar year.
The expense for removable partial dentures can be reimbursed, as necessary, not exceeding 1,500 THB within a period of 5 years from the date of fitting as follows:
- Expense for up to 5 removable partial dentures can be reimbursed, as necessary, not exceeding 1,300 TH.
- Expense for more than 5 removable partial dentures can be reimbursed, as necessary, not exceeding 1,500 THB.
The expense for complete removable dentures can be reimbursed, as necessary, not exceeding 4,400 THB within a period of 5 years from the date of fitting as follows:
- Expense for removable complete dentures either upper or lower can be reimbursed, as necessary, not exceeding 2,400 THB.
- Expense for removable complete dentures both upper and lower can be reimbursed, as necessary, not exceeding 4,400 THB.
In the case where the insured person(s) meet the criteria of eligibility for sickness benefit, but they haven’t received a medical card yet and then, they have to be admitted to their registered hospital:
In this case, the insured person(s) who receive treatment in public hospitals will be reimbursed the full cost insured while those who receive treatment in private hospitals will be reimbursed at the rates specified by the Medical Committee.
If it is necessary to be admitted as an inpatient—The insured or a related person has to notify the Social Security Office nearby immediately, so that the SSO can assign the hospital for the insured person to be admitted for medical treatment.
Sickness cash benefit
Cash benefit will be provided for sick leave to receive medical treatment by physician orders only. In a calendar year, if the insured person(s) are on sick leave and receive wages from employer during sick leave for 30 days, according to the Labour Protection Act of Department of Labour Protection and Welfare, and then they still have to take leave according to the physician orders, the Social Security Office (SSO) will pay income replacement which is called “cash benefit” to insured persons for 50% of monthly wages, for not more than 90 days each time, but for not more than 180 days in one calendar year, except for chronic disease that the insured persons will be paid cash benefits not more than 365 days.
At present, the SSO defined six (6) types of chronic disease as follows:
2. Chronic Renal Failure.
3. Acquired Immune Deficiency Syndrome (AIDS).
4. Brain injury, injuries of spinal cord and vertebrae, which are followed by paralysis.
5. Complication of bone fractures such as infection, delay of healing, deformity or plate and screw operation for treatment.
6. Other diseases or sickness that required continuous medical treatment for more than 180 days. In cases when the insured person is unable to work during treatment, he or she has to submit request for the approval of the Medical Committee.
If the beneficiaries are not satisfied with the official order or decision of the benefits payment, they can submit an appeal to the Appeal Committee within 30 days from the date they receive that order.
You are entitled to receive medical treatment services at the hospital which is associated to your card. You won’t be charged any expenses, unless it’s associated to the 13 diseases or treatments listed above.
- If you receive medical treatment services at a Public Hospital or Government Hospital, you can be reimbursed up to actual cost per illness with unlimited time.
- If you receive medical treatment services at a Public Hospital or Government Hospital, you can be reimbursed up to actual cost per illness with unlimited time, except for the cost of food and room, not exceeding 700 THB/day.
- If you receive medical treatment services at a Private Hospital, you can be reimbursed up to 1,000 THB per illness.
- If you receive medical treatment services at a Private Hospital, you can be reimbursed up to 2,000 THB per illness, except cost of food and room, not exceeding 700 THB/day. Additionally, ICU rooms can be reimbursed up to 4,500 THB/day. Also, surgery can be reimbursed, not exceeding 8,000-16,000 THB/day, depending on the period of operation.
- If you go to a hospital which is not registered, you will need to pay in advance and can be reimbursed with the policies listed above.
Please note, this document is provided by Iglu for Information Purposes Only and all official information and policies pertaining to Social Security in Thailand can be found on the SSO website.