Benefits and Coverage
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Coverage Plan (Baht)
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Plan 1
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Plan 2
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Plan 3
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1. Benefits for the case of Inpatient.
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1.1 Room and board and service fees in the Hospital per day**
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3,000
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6,000
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15,000
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1.2 Nursing service fees**
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Actual payment
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1.3 Room and board, service fees in the Hospital and Nursing service fees in ICU**
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Actual payment
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1.4 Physician fees for treatment per day**
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2,000
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4,000
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10,000
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1.5 Taking home medication prices per time
(Maximum of 15 days per each Hospital Confinement)
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20,000
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30,000
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50,000
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1.6 Other medical treatment fees as specified in the contract having examples 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
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Actual payment
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2. Benefits for the case of Outpatient, having examples as follows.
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2.1 Hemodialysis fees, chemotherapy fees including the Targeted Therapy, and radiation therapy fees for tumor or cancer.
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Actual payment
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2.2 Medical treatment fee for the Injury due to the Accident for the Outpatient within 24 hours of each Accident
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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) such as X-ray, CT scan, MRI, Ultrasound and Blood test etc.
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2.4 Medical treatment fees as the Outpatient after the Hospital Confinement for the continued treatment within 30 days after such Hospital Confinement (OPD Follow up) (Maximum of 2 times per the Hospital Confinement)
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2.5 Rehabilitation fees after the Hospital Confinement per time (Maximum of 2 times per the Policy Year)
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2.6 Emergency ambulance service fees
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2.7 Medical treatment fees for minor surgery such as incision of abscesses, wart excision, hemorrhoids etc.
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3. Other Additional Benefits having examples as follows:
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3.1 Annual health checkup and/or vaccination fees per the Policy Year
(This Endorsement must be effective continually more than 12 months)
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1,000
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2,500
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5,500
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3.2 Medical treatment fees as the Outpatient for the treatment of continuous Injury within 30 days from each date of Accident and the treatment of such Injury shall occur within 24 hours of such Accident such as physician charge for the
follow-up visit, clean the wound and stitch off etc.
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Actual payment
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**There are no limits on the maximum number of days per the Policy Year, but it must not exceed the maximum limit of the benefits per the Policy Year as stated in the Table of Benefits.
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