Bupa Health
Insurance
(Thailand) Public
Company Limited
Present to : Khon Kaen University
By : Ms.Chanapat / Bupa Khon Kaen
Date :18/08/2014
Bupa
Private and Confidential
Date if required
1
About Bupa
Bupa’s purpose is ‘to help people live longer, healthier, happier lives’

As a leading international healthcare group, we
offer health insurance and medical subscription
products, run care homes, retirement villages,
hospitals, primary care centres and dental
clinics. We also provide workplace health
services, home healthcare, health assessments
and long-term condition management services.

We have over 26m customers in 195 countries.
With no shareholders, we invest our profits to
provide more and better healthcare and fulfil our
purpose.
We employ more than 70,000 people,
principally in the UK, Australia, Spain, Poland,
New Zealand and Chile, as well as Saudi
Arabia, Hong Kong, India, Thailand, China and
the USA.
For more information, visit www.bupa.com.
Bupa Thailand
Bupa
Private and Confidential
Date if required

We have been established for over 35 years.
Formerly known as Blue Cross Health
Insurance, Bupa is the leading health
insurance specialist in Thailand.

We now have over 250,000 members and
more than 2,000 organizations. With our local
knowledge and Bupa's world-wide presence,
we ensure that our members have access to
some of the best ideas and innovations in the
world as well as global health care expertise.

To make quality healthcare accessible, we
guarantee lifetime renewal (as per Bupa
policy) , enable cashless treatment with our
medical card and have the medical network
more than 350 in Thailand.
4
Service of
Bupa
What Is Covered
Covers expenses arising from medical
treatment that caused from
“INJURY” or “SICKNESS”
INJURY means bodily injury which is
caused directly and solely from an
accident.
SICKNESS means that you have
illness or disease.
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Benefits Plan
Benefit Structure
GETTING TREATED
In-Patient Benefit
Out-Patient Benefit
Personal Accident
You can choose to buy IPD only.
Or both IPD and OPD.
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DEFINITIONS
INPATIENT / Hospitalization means you have a condition which
justified the occupation of a bed for 6 hours or more.
OUTPATIENT means you require a treatment for a condition which does
not require you to occupy a hospital bed.
In some circumstances you may have a surgical procedure which can be
performed on an outpatient basis of which is called “Day Case” i.e. mole
excision, cauterization, upper GI endoscopy pterygium excision, breast mass
excision. In these cases the actual surgery and its associated costs will be
paid out of your hospitalization benefits.
Per disability (Inpatient) means expenses relating to the continuous
treatment in connection with or in relation to one previous injury or sickness
arising from other causes occurred at the same time of one hospitalization,
those treatment will be counted as the same disability.
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IN-PATIENT Benefits
Benefits Description
Sapphire Plan
A) Room an board including nursing charge (Max. payable per day)
ICU room and board including nursing charge
1,400 Baht/day
2,800 Baht/day
B) Hospital General Expenses
• Hospital general expenses including drugs, dressing, x-ray, lab test, physical therapy
and use of operating theatre and emergency treatment & 30 days of follow up
• ER Accident - first visit within 24 hrs. of emergency & 15 days follow up
16,000 Baht/disability
(including in hospital general expenses)
2,200 Baht/accident
• Ambulance – maximum per disability
C) Surgical Fee - pay percentage of benefit in accordance with complexity of
procedure as per policy schedule
22,000 Baht/disability
D) Physician ‘s Fee - inpatient physician’s fee for doctor visits (1 visit/day)
300 Baht/day
* MAJOR MEDICAL - pay 80% of benefit in excess of basic in-patient benefits (excluding room, board,
nursing service) up to the maximum shown below
Maximum Payable of In-Patient Benefit
Overall maximum inpatient benefit payable under the plan
300,000
E) Personal Accident - lump sump payment in the event of death or dismemberment
cause of accident
20,000 Baht
Baht/ disability
OUT-PATIENT Benefits
SAPPHIRE
Outpatient - Including doctor consultation, drugs, X-ray
and laboratory tests (maximum benefit per visit)
• CLASSIC
• PLUS
• DELUXE
400 Baht/day
500 Baht/day
600 Baht/day
Allows 1 visit per day.
Maximum 30 visits per year.
To Use
Benefits
1. Using your membership card at our network hospitals
Check the list of hospitals which are
in Bupa network
Mark Zuckerburg
Room& Board 1,400 / Day
Hos.Service 16,000
Surgery
22,000
(Per Schedule)
Doctor’s Visit 300 / Day
ER Accident 2,200
OPD
500
Contract no:
50054733-00213113
Period of cover :
20/08/2014-20/08/2015
*Membership Card
Show your membership card along
with your passport
Be covered under the benefit plan
you bought
Bupa Network in Khon Kaen
No.
Hospital Name
Direct Settlement (not to pay first)
In-patient
Out-patient
1. Srinakarin Hospital (KKU)
Government

2. Khon Kaen Hospital
Government



3. Ratchapruek Hospital
Private
Hospital
4. Khonkaenram Hospital
Private
Hospital




If you are admitted to a hospital which is on our hospital list, tell them that you are
a Bupa member and show them your membership card, The hospital will contact
us to recheck your cover and eligible for benefit.
When eligible, hospital will send your bill directly to us for settlement.
2. If you attend a hospital or clinic which is not on our list
After the treatment, please pay the
bill yourself
To obtain reimbursement, you will
need to obtain a Doctor’s certificate
showing diagnosis, Original receipt
and Attending physician’s report.
Submit to Bupa’s Claim Department
within 90 days after the treatment.
For claim with no further investigation required will take not more than 10
working days. Bupa pays your claim by cheque or money transfer.
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What Is Not Covered
General Exclusions :
 Pre-existing conditions.
 Treatment for congenital abnormalities.
 The following disease or conditions are not covered during the first 6 months of cover in the first
policy year – tumors or cancers, polyps, cysts or benign tumors, hemorrhoids, hernia, pterygium
pinguecula and cataract, tonsillectomy or adenoidectomy, stones, varicose veins, hallux valgus,
ganglion and endometriosis.
 Pregnancy delivery and Miscarriage. Birth control and treatment infertility.
 Annual health checks, eye sight examination, eye sight laser treatment, dental and cosmetic
treatment (acne, melasma etc.)
 HIV / AIDS and HIV related diseases.
 Appliances such as spectacle, lens, hearing aids or wheelchair.
 Treatment arising from a self-inflicted injury, suicide attempt, alcoholism, drug abuse or sexually
transmitted diseases.
 Mental illness or stress related conditions.
Bupa
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Customers Service Center
Tel. 02 232 8666
Email : csc@bupa.co.th
Our Service includes
• Medical consultation.
• Check your benefit entitlement and eligibility.
• How to maximize your health benefit comparing
to the expected expense of your treatment.
• Pre-arrangement the treatment at your choice of
hospital or specialist ensuring it is suitable to your
entitled benefit.
Bupa Cromwell Hospital – Business Update
17
Thank you. Any questions?
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Bupa Khon Kaen Branch
Ms.Chanapat Panyachatphol
(Branch Manager)
Email : CTP@bupa.co.th
Office : 043 000 666 ext.103
Mobile : 089 145 2929