Long Stay Visa
| BENEFITS | Platinum 1 | Platinum 2 | Platinum 3 |
| Maximum Limit per Disability per Policy year | 420,500 | 508,000 | 645,500 |
| Inpatient Benefits | |||
| Room and Board, Nursing Charge, Other Medical Charge (Maximum limit per day, 45 days per disability) | 3,000 | 4,000 | 5,000 |
| Intensive Care Unit and Coronary Care Unit (Maximum limit per day, 15 days per disability) | 6,000 | 8,000 | 10,000 |
| Operating Theatre | Included in Hospital Expenses | ||
| Surgical’s Fee Including Pre-Surgical Assessment and Normal Post-Surgical Care (Actual Expenses) | 100,000 | 100,000 | 100,000 |
| Organ Transplant’s Fee for Liver, Heart, Lung, Kidneys, Bone Marrow and Kidney Dialysis Including Donor’s Costs (Maximum per disability) | Included in Surgical Fee | ||
| Anaesthetist’s Fee | Included in Hospital Expenses | ||
| Private Nurse Fee recommended by physician immediate after hospitalization (Up to 30 days) | 10,000 | 10,000 | 10,000 |
| Hospital Expenses : Diagnostic Laboratory Fee, X-rays, Prescribed Medicines, Blood and Plasma, Wheel Chair Rentals, Surgical Appliances | 50,000 | 50,000 | 100,000 |
| Permanent implanted medical devices and artificial organs (Please see remark no. 7) | Included in Hospital Expenses | ||
| Physician’s Daily Hospital Visit (Maximum limit per day, 45 days per disability) | 1,500 | 2,000 | 2,500 |
| Specialist’s consultation fee | 6,000 | 8,000 | 10,000 |
| Emergency OPD within 24 hours, maximum per accident | 6,000 | 8,000 | 10,000 |
| Emergency Local Ambulance Service Including equipment and staff fee | 1,000 | 2,000 | 3,000 |
| Outpatient Benefits | Platinum 1 | Platinum 2 | Platinum 3 |
| Maximum Limit per Policy year | 45,000 | 60,000 | 75,000 |
| Doctor Consultation, Medicines, X-ray, Laboratory tests, Outpatient Surgery, Dressings, Chemotherapy, Radiation, and Alternative Treatment when referred by attending physician (Maximum 1 visit per day/30 visits per year) | 1,500 | 2,000 | 2,500 |
| Allowable number of visits to Chiropractor, Acupuncturist, and Physiotherapist permitted without first reference to an attending physician (Maximum visit per year) | 3 Visits/Year | ||
| Emergency Expenses | |||
| Emergency Assistance: 24 Hours a Day and 7 Days a Week | Fully Indemnified | ||
| Emergency Medical Evacuation* | Fully Indemnified | ||
| Other Benefits | |||
| Personal Accident Benefit: Covers loss of life, loss of one or both hands, loss of vision in one or both eyes, or permanent and total disability caused directly and solely by accident | 100,000 | 150,000 | 200,000 |
| Annual Premium (BAHT) – INCLUDES TAX and Stamp Duty | |||
| Age Group | Platinum 1 | Platinum 2 | Platinum 3 |
| 6-10 | 28,228 | 34,001 | 45,296 |
| 11-15 | 21,426 | 25,768 | 34,628 |
| 16-20 | 19,041 | 23,057 | 30,587 |
| 21-25 | 17,601 | 21,692 | 28,795 |
| 26-30 | 16,957 | 21,692 | 27,268 |
| 31-35 | 18,569 | 22,660 | 29,571 |
| 36-40 | 20,509 | 25,070 | 32,940 |
| 41-45 | 23,614 | 28,818 | 37,748 |
| 46-50 | 26,749 | 32,715 | 42,928 |
| 51-55 | 30,626 | 37,381 | 49,509 |
| 56-60 | 35,795 | 43,276 | 57,584 |
| 61-65 | 51,074 | 60,386 | 81,746 |
| 66-70 | 54,357 | 64,221 | 87,138 |
| 71-75 | 70,190 | 81,058 | 111,505 |
Long Stay Visa Platinum Plan
* Remarks
- Applicant must be aged 6 – 75 years old.
- If a claim is made by any insured or covered person under the Policy during a Policy year, any No Claim Discount achieved will be lost and the status of the discount will be as at 1st policy year shown above.
- If a claim relating to the previous year is subsequently submitted and accepted, and a No Claim Discount has already been given, The Company reserves the right to deduct the equivalent monetary amount of the No Claim Discount from the value of the claim. Any No Claim Discount achieved will be lost and the status of the discount will be as at 1st policy.
- Elective treatment for North America, Japan, HongKong, EU countries and Switzerland – This benefit is permitted only on a case by case basis with no guarantee of acceptance. In all others countries pre-approval of treatment is required.
- The applicant must be Thai resident or reside in Thailand at least 6 months in 12 months period.
- The emergency medical evacution service shall activate while the insured person travelling more than 150 kilometres away from home for less than 90 consecutive days.
- The coverage of the permanent implanted medical devices and artificial organs are subject to 5 years waiting period.
- The insured has the ability to continuously renew the policy up to age 99 years, premium and coverage may be adjusted following the claim experience, health condition, increasing age.
- Information in this brochure is only preliminary information provided for the applicant to consider for applying for health insurance coverage from the company, all insuring conditions shall be referred to Definition, General Definition, General Exclusions, and Insuring Agreement of the health insurance policy of the company.
