In-Patient Coverage (IPD), Maxi Healthy

In-Patient Coverage is a patient who needed to be admitted as an inpatient in a hospital or in a medical facility for a minimum of 6 hours, and is registered as an inpatient under the advice of a licensed physician according to the standard medical practice, with reasonable length of stay, to treat for injury or sickness, including the case that a person is admitted and dies within 6 hours after being inpatient hospitalized. 

Maxi Healthy plan is different from Simply Healthy plan at the deductible coverage. In Maxi Healthy, you will always have deductible at every claim made. And the insurer will pay at 90% of claim amount. 

Although Maxi Healthy has the deductible amount, its coverage is high with lower premium which most suitable for those who already has health insurance policy and want to increase their coverage with Major Medical Covarage. 

Please be noted, this policy has high complexity than other available plan. For example, Room payment if this is your second policy, it will payable at day 61 onward. But if Maxi Healthy is your first policy, Room coverage will cover room from day 1. 

The IPD coverage of Maxi Healthy limits per Disability per Time per Life-Time, which mean if you hold MC1500 which has total coverage at 150,000 Baht. Then, for example, if you claim under “A disease” for 50,000 Baht on year 1, your total available will be 100,000 Baht left for life-time on “A disease”. However on year 2, if you get new “B disease”, you will have 150,000 Baht, as normal. But if in year 2, you get the same “A disease”, your total max limit will still be 100,000 Baht for that particular disease.

In conclude, this Maxi Healthy plan suitable for those who already have basic health insurance plan, but still worry in case of excess coverage from first policy, then Maxi Healthy will help you pay under Major Medical Coverage.

Inpatient Coverage
Health Insurance Coverage Maximum Payable per Disability/Time/YearMC1500MC2000MC3000MC4000MC6000MC12000
Major Medical Coverage
Maximum Payable per Disability/Time/Life Time150,000200,000300,000400,000600,0001,200,000
Maximum Payable per Disability/Time/Life Time
- Pays 90 Percent of the Eligible Expenses in Excess of the Deductible
15,00020,00030,00040,00060,000120,000
- Room and Board, Including Nursing Care (Max. per day)

- From the first day, in case there is no coverage from other health insurance
- From the 61st day, in case there is coverage from other health insurance
1,5002,0003,0004,0006,00012,000
Worldwide Emergency Assistant Coverage (By Allianz Globall Assistance)
- Emergency Medical EvacuationUSD 1,000,000USD 1,000,000USD 1,000,000USD 1,000,000USD 1,000,000USD 1,000,000
- Medical Repatriation""""""
- Repatriation of Mortal Remain""""""
Personal Accident Coverage (PA 2)
- Accidental Death, Dismemberment, and Total Permanent Disability100,000 100,000 100,000 100,000 100,000 100,000

Outpatient Coverage (optional)

Out-patient Benefits (OPD) (Optional Purchase)OPD800OPD1000 OPD1500OPD2000OPD2500OPD3000
- Maximum Payable(per Year)32,00040,00060,00080,000100,000120,000
- Maximum Payable per Day (Max. 1 visit per day, limit 30 visits per year)8001,0001,5002,0002,5003,000
- X-ray and Laboratory Test Expenses (Maximum per year)8,00010,00015,00020,00025,00030,000
Premium (annually)

Please see your premium in the table. If you would like to buy OPD, it is required to have IPD first as your main policy and buying OPD as addition.

IPD – Inpatient Annual Premium (included Stamp  Duty)

ช่วงอายุ (ปี)MC1500MC2000MC3000MC4000MC6000MC12000
15 วัน - 5 ปี9,45712,38118,23024,07835,77649,812
6 - 104,5835,883 8,48211,08216,28022,519
11 - 203,1213,9335,5587,18210,43214,331
21 - 352,6343,2834,583 5,8838,48211,601
36 - 402,9263,6735,1686,6639,65213,239
41 - 453,1213,9335,5587,18210,43214,331
46 - 503,6084,5836,5338,48212,38117,060
51 - 554,0965,2337,5079,78214,33119,789
56 - 604,5835,8838,48211,08216,28022,519
61 - 655,6427,26610,51613,76520,26328,061
*66 - 70 (เฉพาะต่ออายุ)7,75910,03414,58319,13228,22939,147
*71 - 75 (เฉพาะต่ออายุ)11,02014,26920,76727,26640,26355,859
*76 - 85 (เฉพาะต่ออายุ)15,89420,76730,515 40,26359,75883,152

*Renewal only

OPD – Outpatient Annual Premium (included Stamp Duty) 

OPD – Outpatient only available as additional policy to IPD policy.

 
Age (Years)OPD800OPD1000OPD1500OPD2000OPD2500OPD3000
15 Days - 5 Years22,51227,61840,38353,14865,91378,678
6 - 1010,00612,27517,94823,62129,29534,968
11 - 206,2537,67211,21814,76318,30921,855
21 - 355,0036,1378,97411,81114,64717,484
36 - 405,7537,05810,32013,58216,84420,107
41 - 456,2537,67211,21814,76318,30921,855
46 - 507,5049,20613,46117,71621,97126,226
51 - 558,75510,74015,70520,66925,63330,597
56 - 6010,006 12,27517,94823,62129,29534,968
61 - 6512,50715,34422,43529,52736,61843,710
*66 - 85 (Renew only)17,51021,48131,40941,33751,26661,194
Remarks
  • Standard premium for each age band for the first policy year only
  • Eligible to apply for the first year coverage form 15 days up to 70 years of age, renewable up to 85 years of age for IPD and OPD.
  • IPD coverage must be purchased first in order to be able to purchase OPD coverage, in case of purchase OPD as optional, OPD premium will be added to IPD premium.
  • Renewal year premium will be adjusted according to increasing age of each insured person.
  • Renewal year premium of each insured person may be charged higher, up to 100 percent of standard premium, according to underwriting experience of the previous policy year.
  • 10 percent discount for the renewal year for no claim bonus.
Insuring Agreement
  • This health insurance covers for treatment expenses resulting from injury from an accident or suffers from sickness fro the actual expenses paid, up to the maximum limit of benefit as stated in the schedule of the insurance policy.
  • Details of insuring agreement shall be referred to the insurance policy.
Coverage Commencement
  • Coverage for sickness shall be start covered after the first 30 days waiting period, except 8 types of sicknesses that stipulated in the insurance policy shall be start covered after 120 days waiting period. However, in case there is presence or make known of symptom of any disability for the first time during waiting period, the company reserves the right to void the policy.
  • Coverage for injury from accident and shall be start covered immediately from the policy effective date
Exclusion
  • Pre-existing conditions, including related symptons and chronic conditions that the applicant has had before this insurance policy is in effect, congenital abnormality or genetic disorders
  • Cosmetic surgery, beautification treatment, or aging relieve treatment
  • Treatment or surgery related to eyesight, dental or gum
  • Treatment related to mental disorder
  • Treatment which is not considered a modern medicine including alternative medicine
  • Health check up and preventive vaccination
  • Suicide or suicide attempt, self inflicted injury
  • Other exclusions shall be referred to the insurance policy
Apply for Coverage and Support Document
  • Fill the Application Form and Applicant’s Health Condition Declaration Form truthfully and sign to certify**
  • Submit copy of ID card or copy of Passport for foreigner
  • For the youth, submit copy of ID Card or Birth Certification together with copy of ID Card of the parent
  • The company reserves the right to reject any application or accept with exclusions, according to underwriting standard of the company.
  • The company reserves the right not to renew each insured person within the first 2 years after start coverage

* The insured person can request for policy cancellation within 90 days after the first policy year effective date, and the company shall refund full premium before tax and duty to the insured person, in case there is no claims.

** In case the applicant knows any fact but declares false statement or fails to declare it, in which should the company acknowledge it prior, the company may increase the insurance premium or reject the application, this insurance policy shall be voided, according to the Civil and Commercial Code, Section 865. The company has the right to dissolve it.