Cabinet approves new ceiling for SSO health fund coverage

Cabinet approves new ceiling for SSO health fund coverage

The cabinet has approved a proposal by the Social Security Office (SSO) to double the health care coverage ceiling of people covered by the Social Security Fund.

The move is designed to help offset high-cost treatment for work-related injuries or illnesses and to catch up with the rising costs of medical treatment. Approved by the cabinet on Tuesday, the ceiling has been doubled to two million baht and is expected to come into effect in about a month.

Those under the social security system will then be assured that if they have serious injuries or illnesses associated with their work, their treatment will be covered by the SSO as long as the cost is under the new ceiling, advocates say.

The new rule will, however, only apply to medical treatment that begins and ends at a state hospital or where patients are transferred from a private medical institution within 72 hours -- or when their condition stabilises -- to a hospital where his or her SSO card has been registered, SSO secretary-general Suradej Waleeittikul said.

If the cost exceeds one million baht, the patient will need to be transferred to a state hospital from a private one for further treatment, he added. If high-cost medical treatment is performed elsewhere than at a state-run hospital, the ceiling for the treatment will remain at one million baht, said Nathaporn Jatusripitak, adviser to the commerce minister. A ministerial regulation will need to be amended to double the ceiling, Mr Suradej said. Later, it will be forwarded to the Council of State before the labour minister signs it off, he said.

The regulation is required to solve the problem of medical treatment costs often exceeding the one million baht ceiling in severe injury and illness cases. This occurs most often in private hospitals, he said. The changing economic situation lies behind the move, said Mr Nathaporn.

"It's the Social Security Fund that will shoulder the higher cost of medical treatment for insured employees, while their employers will still contribute the same amount to the fund. They won't have to pay more but their employees will get better coverage," he said.

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