If you’re working in Thailand, chances are your employer provides some form of group health insurance. It’s a convenient, cost-effective perk and often included as part of your employment package. But is this benefit enough?
In this article, we’ll explore when it makes sense to get your own individual health insurance, even if you’re already covered by your company’s plan.
What is group health insurance?
There are two main types of health insurance in Thailand: group and individual health insurance. Group health insurance is a company-sponsored plan provided as a benefit to employees, and it covers employees for medical expenses. In Thailand, this type of coverage is often automatically included when you start a job.
The benefits of group insurance include lower premiums or no premiums at all if the employer pays, simple sign-up process with no medical exams needed, and basic coverage for common health issues and hospital visits.
However, group plans typically come with limitations with group insurance, as it’s not tailored to your individual health needs, with limited coverage amounts and it may not cover dependents. Plus, you lose coverage if you have to leave your job.
What is individual health insurance?
On the other hand, individual health insurance is a policy you buy directly from an insurance provider and it covers only the insured person. It’s designed around your lifestyle, health history, and personal preferences.
With individual insurance, you get the flexibility in choosing coverage types and limits. Individual plans also give access to additional benefits like dental, maternity, or specialist care with a broader hospital network. Most importantly, it ensures continuity of coverage, even if you change jobs or become self-employed.
What does health insurance typically cover?
While insurance coverage varies based on the policy and provider, most health insurance plans in Thailand offer options for the following:
Inpatient coverage (IPD)
This covers treatments that require hospitalization for at least six hours. It includes room and board, doctor’s fees, surgery, and nursing care. Some procedures may be classified as “Day Case”, such as laparoscopic surgery or kidney stone removal, depending on the insurer’s policy. Some plans require full admission to claim benefits, while others allow outpatient claims for these minor surgeries.
Outpatient coverage (OPD)
Historically, health insurance only covered hospitalisation. But now, many insurers offer OPD coverage which allows policyholders to claim for general doctor visits without being admitted, like when you catch a cold or have food poisoning.
Critical illness coverage
This provides coverage specifically for serious illnesses such as cancer, stroke, or heart disease. While the exact list of covered critical illnesses may vary slightly by insurance, the idea is to cover high treatment costs and long-term care, which are often financially burdensome.
Accident coverage
Most health insurance policies include basic accident coverage. It applies to injuries caused by accidents, ranging from minor cuts to disabilities or death. Claims are typically valid only if you seek treatment within 24 hours of the incident. For those seeking higher accident protection, standalone personal accident insurance offers more substantial payouts.
Daily hospital income compensation
Some plans allow you to add coverage that compensates you for lost income during hospitalisation. This benefit pays a set daily amount whole you’re admitted, ranging from THB 500 to several thousand per day. For example, if your plan pays THB 2,000 per day and you’re hospitalised for four nights, you’ll receive THB 8,000. Most plans limit the number of compensation days (e.g. up to 14 or 30 days).
When should you consider getting individual insurance?
While group insurance is a great foundation, it’s not always enough to cover your personal needs. Group insurance may not fully cover high-cost treatments, chronic conditions or certain medications. Additionally, if you leave your job, your coverage ends, so if you’re planning for a career change or pursue freelance work, individual insurance offers better long-term security.
Here are a few signs you might need an individual policy in addition to your employee health benefits:
- You have specific health needs not covered by your group plan.
- You want more control over treatment options or hospital choices.
- You need coverage for your spouse or kids.
- You want peace of mind in case your group coverage is suddenly reduced or lost.
Combining group and individual insurance: Is it worth it?
Yes, if you approach it smartly. Here’s how combining plans can work:
- Use group insurance as your first layer of coverage for outpatient visits or minor illnesses.
- Let your individual insurance cover bigger risks like surgery, cancer treatment, or maternity care.
- Choose individual plans that fill in the gaps, such as higher hospital room limits, dental coverage, or global protection.
Final thoughts
Group health insurance is an excellent start, but it’s not always enough, especially if you have long-term health goals, a family to care for, or changing job plans. By supplementing your employee health benefits with individual coverage, you ensure continuity, customisation, and confidence that you’re protected no matter what comes next.
If you’re unsure where to start or need help understanding what type of plan suits your lifestyle, Roojai is here to help. We’re committed to making insurance simple, affordable, and reliable, whether you’re looking for personal health coverage, car insurance, or motorcycle protection.
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