Covid Claim

If I am infected with covid and have to quarantine, home isolation, or community isolation, can I reimburse medical expenses?

You can reimburse if there is a document confirming the infection and the health care provider deems appropriate, the patient can be isolated. This will be considered conditions.

To reimburse medical expenses, there are details as following requirements.

1. In case of OPD privilege, pay for medical expenses as actually paid according to the OP limit.
2. In case of IPD privilege, pay for medical expenses as an outpatient under the limit “general service fees for medical treatment”.
3. In case of both OPD and IPD privileges, pay for medical expenses as OPD type under “general service fees for medical treatment” and OP limit.

However, medical expenses and medical equipment expenses can be reimbursed as actually paid on an outpatient basis but not exceeding the amount. Benefits for expenses incurred from medical treatment and must be ordered by a doctor only, for example:

1. Actual medical expenses.
2. General medication and andrographis paniculata medication.
3. Thermometer expenses (non-digital).
4. Face masks and alcohol (provided by hospitals and clinics participating in home isolation or community isolation projects only).

*Not coverage of medication delivery

*Conditions are as specified in the policy and additionally referenced from the OIC document, Registrar Order No. 44/2564.

• What does home isolation or community isolation of medical expense documents include?

1. Coronavirus disease 2019 (COVID-19) detection document, which can verify the identity of the person who has been tested for the infection from a laboratory certified by the Department of Medical Sciences by RT-PCR method.
2. Medical certificate from a healthcare facility providing evidence that it is a facility capable of providing home isolation or community isolation services.
3. Receipt from a medical facility or government agency detailing medical expenses.
4. Compensation claim form. Download click.
5. Copy of ID card and copy of the insured's identity card.
6. Copy of the first page of the bank account showing the name of the insured as the account owner.

• If I buy myself an antigen test kit and get a positive result after being tested, and then buy my own medication without the service of home isolation or community isolation, can the expenses be reimbursed?

Unable to reimburse medical expenses. If found to be infected, it is necessary to register according to the conditions for treatment in home isolation or community isolation according to the announcement of the National Health Security Office (NHSO)by registering via https://crmsup.nhso.go.th/.

• You can reimburse according to the following criteria:

1. There is a document showing that the insured is a patient diagnosed with Coronavirus 2019 (Covid-19) by a medical care provider.
2. There is a medical need to be treated as an inpatient in a hospital, but there is no medical facility to support the insured including with those at risk include people aged 60 years and over, those with a body mass index (BMI) of greater than or equal to 30 kg/m², or weighing more than 90 kg, patients with chronic obstructive pulmonary disease, chronic kidney disease, cardiovascular disease, stroke, and uncontrolled diabetes.
3. Compensation will be paid up to 14 days from the date of medical need to be treated as an IPD in a hospital but not supported by a medical facility.

• What do I need to request for the form of daily income reimbursement from home isolation or community isolation?

You will need as follows.

1. Coronavirus disease 2019 (COVID-19) detection document, which can verify the identity of the person who has been tested for the infection from a laboratory certified by the Department of Medical Sciences by RT-PCR method.
2. Medical certificate stating medical need for hospitalization or if there is no medical facility to support the insured but it is medically necessary to be admitted as an IPD, and the doctor must state that the patient is classified as a green, yellow or red patient.
3. Compensation claim form. Download click.
4. Copy of ID card and copy of the insured's identity card.
5. Copy of the first page of the bank account showing the name of the insured as the account owner.