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Bupa Private and Confidential Date if required1 Bupa Health Insurance (Thailand) Public Company Limited Present to : Khon Kaen University By : Ms.Chanapat.

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Presentation on theme: "Bupa Private and Confidential Date if required1 Bupa Health Insurance (Thailand) Public Company Limited Present to : Khon Kaen University By : Ms.Chanapat."— Presentation transcript:

1 Bupa Private and Confidential Date if required1 Bupa Health Insurance (Thailand) Public Company Limited Present to : Khon Kaen University By : Ms.Chanapat / Bupa Khon Kaen Date :18/08/2014

2 About Bupa

3 Bupa’s purpose is ‘to help people live longer, healthier, happier lives’  As a leading international healthcare group, we offer health insurance and medical subscription products, run care homes, retirement villages, hospitals, primary care centres and dental clinics. We also provide workplace health services, home healthcare, health assessments and long-term condition management services.  We have over 26m customers in 195 countries. With no shareholders, we invest our profits to provide more and better healthcare and fulfil our purpose. We employ more than 70,000 people, principally in the UK, Australia, Spain, Poland, New Zealand and Chile, as well as Saudi Arabia, Hong Kong, India, Thailand, China and the USA. For more information, visit www.bupa.com.www.bupa.com

4 Bupa Private and Confidential Date if required4  We have been established for over 35 years. Formerly known as Blue Cross Health Insurance, Bupa is the leading health insurance specialist in Thailand.  We now have over 250,000 members and more than 2,000 organizations. With our local knowledge and Bupa's world-wide presence, we ensure that our members have access to some of the best ideas and innovations in the world as well as global health care expertise.  To make quality healthcare accessible, we guarantee lifetime renewal (as per Bupa policy), enable cashless treatment with our medical card and have the medical network more than 350 in Thailand. Bupa Thailand

5 Service of Bupa

6 6 What Is Covered Covers expenses arising from medical treatment that caused from “INJURY” or “SICKNESS” INJURY means bodily injury which is caused directly and solely from an accident. SICKNESS means that you have illness or disease.

7 Benefits Plan

8 8 Benefit Structure GETTING TREATED In-Patient Benefit Out-Patient Benefit Personal Accident You can choose to buy IPD only. Or both IPD and OPD.

9 9 DEFINITIONS INPATIENT / Hospitalization means you have a condition which justified the occupation of a bed for 6 hours or more. OUTPATIENT means you require a treatment for a condition which does not require you to occupy a hospital bed. In some circumstances you may have a surgical procedure which can be performed on an outpatient basis of which is called “Day Case” i.e. mole excision, cauterization, upper GI endoscopy pterygium excision, breast mass excision. In these cases the actual surgery and its associated costs will be paid out of your hospitalization benefits. Per disability (Inpatient) means expenses relating to the continuous treatment in connection with or in relation to one previous injury or sickness arising from other causes occurred at the same time of one hospitalization, those treatment will be counted as the same disability.

10 Benefits Description Sapphire Plan A) Room an board including nursing charge (Max. payable per day) ICU room and board including nursing charge 1,400 Baht/day 2,800 Baht/day B) Hospital General Expenses Hospital general expenses including drugs, dressing, x-ray, lab test, physical therapy and use of operating theatre and emergency treatment & 30 days of follow up ER Accident - first visit within 24 hrs. of emergency & 15 days follow up (including in hospital general expenses) Ambulance – maximum per disability 16,000 Baht/disability 2,200 Baht/accident C) Surgical Fee - pay percentage of benefit in accordance with complexity of procedure as per policy schedule 22,000 Baht/disability D) Physician ‘s Fee - inpatient physician’s fee for doctor visits (1 visit/day) 300 Baht/day * MAJOR MEDICAL - pay 80% of benefit in excess of basic in-patient benefits (excluding room, board, nursing service) up to the maximum shown below Maximum Payable of In-Patient Benefit Overall maximum inpatient benefit payable under the plan 300,000 Baht/ disability E) Personal Accident - lump sump payment in the event of death or dismemberment cause of accident 20,000 Baht IN-PATIENT Benefits

11 SAPPHIRE Outpatient - Including doctor consultation, drugs, X-ray and laboratory tests (maximum benefit per visit) CLASSIC PLUS DELUXE 400 Baht/day 500 Baht/day 600 Baht/day OUT-PATIENT Benefits Allows 1 visit per day. Maximum 30 visits per year.

12 To Use Benefits

13 1. Using your membership card at our network hospitals Check the list of hospitals which are in Bupa network Show your membership card along with your passport Be covered under the benefit plan you bought Room& Board 1,400 / Day Hos.Service 16,000 Surgery 22,000 (Per Schedule) Doctor’s Visit 300 / Day ER Accident 2,200 OPD 500 Contract no: 50054733-00213113 Period of cover : 20/08/2014-20/08/2015 Mark Zuckerburg * Membership Card

14 Bupa Network in Khon Kaen No. Hospital Name Direct Settlement (not to pay first) In-patientOut-patient 1.Srinakarin Hospital (KKU) Government  2.Khon Kaen Hospital Government  3.Ratchapruek Hospital Private Hospital 4.Khonkaenram Hospital Private Hospital If you are admitted to a hospital which is on our hospital list, tell them that you are a Bupa member and show them your membership card, The hospital will contact us to recheck your cover and eligible for benefit. When eligible, hospital will send your bill directly to us for settlement.

15 15 After the treatment, please pay the bill yourself To obtain reimbursement, you will need to obtain a Doctor’s certificate showing diagnosis, Original receipt and Attending physician’s report. Submit to Bupa’s Claim Department within 90 days after the treatment. 2. If you attend a hospital or clinic which is not on our list For claim with no further investigation required will take not more than 10 working days. Bupa pays your claim by cheque or money transfer.

16 Bupa16 What Is Not Covered General Exclusions :  Pre-existing conditions.  Treatment for congenital abnormalities.  The following disease or conditions are not covered during the first 6 months of cover in the first policy year – tumors or cancers, polyps, cysts or benign tumors, hemorrhoids, hernia, pterygium pinguecula and cataract, tonsillectomy or adenoidectomy, stones, varicose veins, hallux valgus, ganglion and endometriosis.  Pregnancy delivery and Miscarriage. Birth control and treatment infertility.  Annual health checks, eye sight examination, eye sight laser treatment, dental and cosmetic treatment (acne, melasma etc.)  HIV / AIDS and HIV related diseases.  Appliances such as spectacle, lens, hearing aids or wheelchair.  Treatment arising from a self-inflicted injury, suicide attempt, alcoholism, drug abuse or sexually transmitted diseases.  Mental illness or stress related conditions.

17 17Bupa Cromwell Hospital – Business Update Customers Service Center Tel. 02 232 8666 Email : csc@bupa.co.th Our Service includes Medical consultation. Medical consultation. Check your benefit entitlement and eligibility. Check your benefit entitlement and eligibility. How to maximize your health benefit comparing to the expected expense of your treatment. How to maximize your health benefit comparing to the expected expense of your treatment. Pre-arrangement the treatment at your choice of hospital or specialist ensuring it is suitable to your entitled benefit. Pre-arrangement the treatment at your choice of hospital or specialist ensuring it is suitable to your entitled benefit.

18 18 Thank you. Any questions?

19 Bupa Khon Kaen Branch Ms.Chanapat Panyachatphol (Branch Manager) Email : CTP@bupa.co.th Office : 043 000 666 ext.103 Mobile : 089 145 2929


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