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ประกันสุขภาพเหมาจ่าย, แผนประกันสุขภาพ เฟิร์สคลาส บีดีเอ็มเอส

 

 

 

 

My First Class @BDMS (HSMFCP_S/ HSMFCB_S)

No matter how serious your illness is. It is no worry, because we pay the actual medical treatment fee up to THB 120 Million per the Policy Year.

Provide the medical treatment fee on the actual lump sum basis up to THB 120 million per the Policy Year in the hospitals and clinics of BDMS Network in Thailand and Cambodia.

Key Benefits

With the benefits limit up to THB 120 million per the Policy Year for health coverage in hospitals and clinics of BDMS Network in Thailand and Cambodia.
Cover for all medical treatment for both an Inpatient and Outpatient, dental, vision, maternity, surgery fees, Lab & Xray, Hemodialysis, Chemotherapy including Targeted Therapy and the psychiatric disorder treatment fees.
Provide preventive coverage for both vaccination fee and annual health
check-up fee.

What is good about this insurance plan?

Cover the medical treatment whether the Insured is admitted in a hospital with the actual payment of the medical treatment fees up to THB 120 million per the Policy Year at over 44 hospitals of BDMS networks throughout Thailand and Cambodia

There are 2 coverage plans available for selection: Beyond Platinum (Maximum benefit: THB 120 million per the Policy Year) and Platinum Plan (Maximum benefit: THB 60 million per the Policy Year).

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Highlights
Benefits and Coverage per the Policy Year 		Beyond Platinum Plan,
Maximum benefits:
THB 120 million 		Platinum Plan,
Maximum benefits:
THB 60 million
Medical treatment fee – Inpatient
(Having the limitation of the benefits such as room and board and service fees in the Hospital per day, daily cost of taking care Insured aged under 16 years old, psychiatric disorder treatment fees)

Actual payment

Actual payment
Medical treatment fees – Outpatient
(Maximum of 30 visits per the Policy Year) 		Actual payment

Actual payment

Able to purchase additionally for OPD

Vaccination fee*

80,000 Baht

50,000 Baht

Annual health check-up fee*
(Maximum of 1 visits per Policy Year)

30,000 Baht

15,000 Baht

Dental treatment fees
(Compensated 80% of medical treatment fees)

100,000 Baht

45,000 Baht
 (additional from the
benefits 60 million Baht)

Able to purchase additionally for Dental

Eye examination and treatment fees*
(Compensated 80% of treatment fee)

15,000 Baht

Not cover
Medical treatment fees for pregnancy and childbirth per each pregnancy and childbirth** 200,000 Baht for Normal childbirth
400,000 Baht for Complication status 		Not cover
*The benefit can be used after this Endorsement must be effective continually more than 12 months.
**The benefit can be used after this Endorsement must be effective continually more than 10 months for childbirth and 3 months for miscarriage.

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Years
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THB

Beyond Platinum Plan

Maximum Benefits

(Coverage per Policy Year)

THB 120 Million

Initial premium
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Platinum Plan

Maximum Benefits

(Coverage per Policy Year)

THB 60 Million

Initial premium
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Remark

  • The above premiums are calculated from the My Whole Life 90/21 life protection plan. The insured amount is 200,000 baht and the insured in occupational stages 1 and 2 chooses to pay annual premiums only.
  • For sales reasons only, this information is only preliminary. Customers should review further details on the policy's coverage, terms, conditions, exceptions, and benefits.
  • The company reserves the right to determine insurance in accordance with its criteria.

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Coverage and Benefits

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Beyond Platinum Plan

Maximum Benefits per the Policy Year
120 million Baht.

Platinum Plan

Maximum Benefits per the Policy Year
60 million Baht.

1. Benefits for the case of Inpatient

1.1 Room and board and service fees in the Hospital.
20,000 Baht per day.
9,000 Baht per day.
1.2 Nursing service fees
Actual payment
Actual payment
1.3 Room and board service fees in the Hospital and nursing service fees in the ICU
Actual payment
Actual payment
1.4 Physician fees for treatment.
Actual payment
Actual payment
1.5 Medicine prices for taking home
(Maximum 30 days per each medical treatment in the Hospital)
Actual payment
Actual payment
1.6 Other medical treatment fees as specified in the contract

having example as follows: 

  • Medical service fees for diagnosis or treatment.
  • Medicine prices, parenteral nutrition fees and medical supplies fees.
  • Medical treatment fees for surgical operation (surgery) and procedures.
  • Day surgery.
Actual payment
Actual payment

2. Benefits for the case of Outpatient having examples as follows:

2.1 Hemodialysis fees, chemotherapy fees including the Targeted Therapy, and radiation therapy fees for tumor or cancer
Actual payment
Actual payment
2.2 Medical treatment fee for the Injury due to the Accident for the Outpatient within 24 hours
of each Accident
Actual payment
Actual payment
2.3 Diagnostic radiology fee and clinical laboratory diagnostic fee (which occurs within 30 days before the Hospital Confinement and within 60 days after such Hospital Confinement as Inpatient)
such as X-ray, CT scan, MRI, Ultrasound and Blood test etc.
Actual payment
Actual payment
2.4 Medical treatment fee for the Outpatient after the Hospital Confinement per time for the continuous treatment within 30 days after such Hospital Confinement
Actual payment
Actual payment
2.5 Emergency ambulance service fees.
Actual payment
Actual payment
2.6 Medical treatment fees for minor surgery
such as incision of abscesses, wart excision, hemorrhoids etc.
Actual payment
Actual payment

3. Other Additional Benefits for the case of Inpatient and Outpatient Cases having example as follows:

3.1 Daily cost of taking care in case the Insured age is under 16 years old
(maximum 30 day per each medical treatment in the Hospital)
3,000 Baht per day. 
2,000 Baht per day. 
3.2 Specialist Physician consulting fee
Actual payment
Actual payment
3.3 Reconstructive surgery fees due to the Accident or cancer.***
Actual payment
Actual payment
3.4 Dental treatment fees due to the Accident***
Within 7 days from the date of the Accident.
Actual payment
Actual payment
3.5 Psychiatric disorder treatment fees***
(Waiting period is 365 days.)
500,000 Baht
Through this Rider and Endorsement 
400,000 Baht
Through this Rider and Endorsement
3.6 Medical treatment fees for pregnancy and childbirth.**
- Normal childbirth.
200,000 Baht
Not cover
- Complication status during pregnancy or childbirth.
400,000 Baht
Not cover
3.7 Medical treatment fees as Outpatient.
(Maximum 30 visits per the Policy Year.)
Actual payment
Actual payment

Able to purchase additionally for OPD
3.8 Rehabilitation fees and physical therapy fees.
per the Policy Year.
40,000 Baht
20,000 Baht
3.9 Medical device and durable device for the Outpatient per the Policy Year
Such as hearing aid device, respiration aid, oxygen aid, wheelchair, supportive devices, artificial organ etc.
40,000 Baht
10,000 Baht
3.10 Vaccination fee*
per the Policy Year.
80,000 Baht
50,000 Baht
3.11 Annual health check-up fee*
(Maximum 1 time per the Policy Year)
30,000 Baht
15,000 Baht
3.12 Dental treatment fees (compensated 80% of medical treatment fee)
Maximum per the Policy Year such as dental examination, tooth scaling, dental fillings, extraction, wisdom tooth extraction, root canal treatment, nerve root treatment, radiological diagnosis an laboratory examination, treatment relating to gum disease, crowns, inlays, Adhesive Reconstructions, or Restorations, bridges, dentures [and artificial root implants only for the Beyond Platinum Plan (120MB)]
100,000 Baht
45,000 Baht
(additional from the benefits 60 million Baht)

Able to purchase additionally for Dental
3.13 Eye examination and treatment fees* (Compensated 80% of the actual amount)
Maximum per the Policy Year such as optical measurement and visual acuity test, optical frame, optical lens, contact lens, lens cleaner, including artificial tears
15,000 Baht
Not cover

4. Level of Benefit Payment

4.1 In case the medical treatment occurs in Hospitals or Clinics in the BDMS network
100% of medical treatment fees
according to the benefits under
Clause 1-3. 
100% of medical treatment
fees according to the benefits
in Clause 1-3.
4.2 In case the medical treatment occurs outside hospitals or clinics in the BDMS network
- In case of treatment occurring in Thailand, it will cover only the Emergency Patient or Critical Emergency Patient
100% of medical treatment fees
according to the benefits under
items 1.1 – 1.6
2.2 – 2.6
3.1 – 3.2
and 3.4 – 3.7
100% of medical treatment fees
according to the benefits under
items 1.1 – 1.6
2.2 – 2.6
3.1 – 3.2
and 3.4 – 3.5
- In case of treatment occurring outside Thailand, it will cover only the Critical Emergency Patient****
100% of medical treatment fees
according to the benefits under
items 1.1 – 1.6
2.2 – 2.6
3.1 – 3.2
and 3.4 – 3.6
but not exceeding 5,000,000 Baht
per hospital confinement.
100% of medical treatment fees
according to the benefits under
items 1.1 – 1.6
2.2 – 2.6
3.1 – 3.2
and 3.4 – 3.5
but not exceeding 3,000,000 Baht
per hospital confinement.
* The benefit can be used after this Endorsement must be effective continually more than 12 months.
**The benefit can be used after this Endorsement must be effective continually more than 10 months for childbirth and 3 months for miscarriage.
***The Company shall pay the benefits in Clause 1, item 2.5, 3.1, and 3.2.
****In case the Emergency Patient outside Thailand, the starting date of hospitalization outside Thailand, must be within 30 days from each date of departure from Thailand (according to date and time in Thailand).
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Optional Coverages

My Whole Life A90/21

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Underwriting for
My First Class @BDMS 		Beyond Platinum Plan
(120 Million Baht) 		Platinum Plan
(60 Million Baht)
Entry age 11 – 70 years old
 11 – 70 years old
Renew up to age 84 years old, cover up to age 85 years old
The basic plan which attachable
  • Ayudhya Term
 Sum assured 100,000 Baht Sum assured 50,000 Baht
and 100,000 Baht
  • My Whole Life A90/21

The regulations are as follows

  1. Minimum sum assured 200,000 baht or
  2. Minimum annual premium 6,000 baht with minimum sum assured 100,000 baht
  • Other basic plan which can attach the health rider as specified by the Company
 Sum assured 100,000 baht and above
Other Conditions
  • The Insured can apply My First Class @BDMS - Platinum Plan (60MB) or My First Class @BDMS - Beyond Platinum Plan (120MB) only one.
  • The underwriting shall follow the Company's underwriting guideline.
The Insured is entitled to a personal income tax deduction for the premium of health coverage, not exceeding 25,000 Baht per year (if any) and the premium of the life coverage but both shall not exceed 100,000 Baht per year, according to the Revenue Department regulations.
  • Non-conventional medical treatment which is not a current medical practice, including the Alternative Medicine.
  • Health check-up, a request for the medical treatment in a Hospital, or request for a surgical operation, recovery or rehabilitation or rest cure or treatment in the Hospital to have by way of a general care giver, any examination or treatment not relating to a disease causing of being hospitalized, an examination to diagnose an Injury or Illness, treatment or analytical examination to investigate any cause, which is not the Medical Necessity or Medical Standard.
  • My First Class @BDMS-Platinum Plan (60MB) and My First Class @BDMS-Beyond Platinum Plan (120MB) are the marketing name. The name of insurance plan stated in the Policy are Health Coverage Rider First-Class: Platinum Plan (For the Specified Hospitals/Clinics) and Endorsement of Health Coverage Rider-First Class: Platinum Plan (Other Benefits) and Health Coverage Rider First-Class: Beyond Platinum Plan (For the Specified Hospitals/Clinics) and Endorsement of Health Coverage Rider-First-Class: Beyond Platinum Plan
    (Other Benefits)
  • The Company shall pay the benefits for Illness occurring after 30 days from the Rider Effective Date except for some benefits stated particularly.
  • The payment under My First Class @BDMS – Platinum Plan (60MB) or My First Class @BDMS – Beyond Platinum Plan (120MB) altogether shall not exceed the maximum benefits per the Policy Year as specified in the Table of Benefits. In case the medical treatment occurs outside Hospitals or Clinics in BDMS network either in case of planned or unplanned, the Company shall cover the medical treatment only for the Emergency Patient or Critical Emergency Patient in Thailand and the Critical Emergency Patent outside Thailand.
  • The premium of a rider or endorsement may vary by gender, age, occupation, and the coverage plan of the Insured. / The premiums for the renewal year may be adjusted according to age and/or occupation of the Insured. In addition, it may be adjusted according to the Company’s regulations.
  • The information contained in this website is provided as illustrative information only. The customer is advised to study further information regarding an insurance coverage, terms and conditions, exclusions and benefits from the Company’s policy only.
  • The customer should understand the details, coverage and conditions of the insurance plan before applying the insurance.

Services Accompanying the Health Insurance Plan

บริการดูแลยามพักฟื้น
Nursing Care
Coverage by Allianz Ayudhya Assurance Public Company Limited
DBD e-Registration