Not only is it physically ill, but we also have to deal with financial problems. Every time we go to the doctor, our wallets come back empty. What should we do when the health insurance provided by the company is not enough?
In fact, working people like us have an option by purchasing additional OPD insurance to prevent this problem.
What is OPD insurance?
“If you are sick or unwell, go for treatment but do not have to stay in the hospital.”
OPD insurance is health insurance for outpatients (OPD – Out Patient Department). The meaning of outpatients is patients who are treated in the hospital but can go home immediately without having to stay in a hospital.
How important is OPD insurance and what types of treatment does it cover?
“If you are sick or unwell, you don’t have to worry about expenses anymore.”
Many working people overlook having OPD insurance, which means that when they get sick, they have to pay extra for going to the hospital or even buying medicine to treat themselves. The cost of medical treatment makes many people spend thousands of baht per year, some spend tens of thousands of baht. Their savings are also depleted due to illness, or for some, worse, they end up in debt from having to find money to pay for medical treatment.
OPD insurance provides coverage in cases where the insured is hospitalized for less than 6 hours or does not need to stay in the hospital. Just see a doctor, get diagnosed, and get medication, then you can go home. Or in cases where there are minor injuries, such as minor accidents, falls, sprained ankles, knife wounds, colds, headaches, fevers, sore throats, coughs, allergies, etc.
Therefore, if we have OPD insurance, when we are sick, we no longer have to worry about expenses. We can go to a hospital near our home and receive treatment immediately.
The company already has welfare benefits, so why do we need OPD insurance?
“Although the company already has group health insurance, it may not be enough.”
Company health insurance is mostly group health insurance, which is insurance that we receive from our employer or the company we work for. The advantage is that we don’t have to pay for it ourselves, plus we already have coverage for most of the necessary things. But the problem is that the medical expenses in the case of OPD are very low. For example, some companies provide an OPD coverage of 500 baht per visit for their employees. If you have a cold, go to the hospital and need to take medicine, do you think 500 baht will be enough? And if you are sick with other more serious problems, how much more will working people like us have to pay?
Don’t forget that nowadays, every working person is at risk because the chance of getting sick or ill from work is already high. Therefore, the cost of medical treatment is something we need to plan for. Having OPD insurance can help you cope with this expense.
If we have social security, can we use it together with the company’s health insurance?
Yes, but the insured person must have
social security under Section 33. Having social security is similar to having health insurance from an insurance company because the insured person will receive various benefits and coverage, such as
in the case of illness, childbirth , disability , death, child support , old age, and
unemployment.
The condition is that the payment for medical treatment can be made using the group health insurance rights together with social security, but it must be the same hospital as specified in the social security rights only.
We can use it for both inpatient and outpatient (OPD) medical treatment. However, if the company’s health insurance and social security do not cover the expenses, the payer must transfer the difference to the social security.
Although using group health insurance and social security together can help reduce the burden of medical expenses, it may not be enough for those who need to be hospitalized or undergo physical surgery, such as in-patients.
If we had a choice, what kind of OPD insurance would we, as working people, want?
“I want OPD insurance that is worthwhile, complete, and worry-free, suitable for working people’s lives.”
The problem with most OPD insurances found in the market is that they set a limit on the number of times per year and a limit on the amount of each visit, such as a limit of 1,000 baht. If we are sick and go to a private hospital near our house, it will be over. And if the number of visits is set again, in some years, we get sick often, we may have to pay for the amount that exceeds the limit and the amount that exceeds the specified amount.
“I want an OPD insurance with no limit on the number of visits and an unlimited amount per visit for doctor visits.”
The number of times may not be the main issue, but the amount per visit is very important because each time you go to the doctor, there may be quite a lot of expenses. If there is OPD insurance that specifies the annual amount, then each time we go to the doctor, the actual expenses are calculated, we will not have to worry, for example:
Suppose that our OPD insurance has an annual coverage of 12,000 baht. We get sick and go to the doctor. This time, the expenses are 3,500 baht. This can be deducted from the annual coverage. We will not have to pay more. The remaining annual coverage is 8,500 baht.
But if we use general OPD insurance, which the admin also uses, it has a limit of 1,000 baht per time. And if there is another 500 baht for the company’s OPD (totaling 1,500 baht), it still does not cover the 3,500 baht expense. In any case, you have to pay another 2,000 baht yourself.
Also, I would like to ask for another thing: Don’t have so many conditions or exceptions that it can be confusing or confusing when you need to use insurance. Because when we are sick or have this or that, we don’t want to be surprised that the insurance we have purchased does not cover us, causing us to have to pay more. If we do it and it’s not finished, and we have to pay more like this, it definitely doesn’t meet the needs of working people.
Conclusion
So, at this point, if we understand and know the benefits of our company’s group health insurance, and if we include social security, do we think it is enough?
If you want to buy additional health insurance to prevent risks, you will know how much you should buy. Which is better than buying too much insurance or more than necessary. At least, thinking like this helps us save money on both medical expenses that may occur in the future and the health insurance premiums that we have to pay each year.
