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About Us
ประกันสุขภาพ ​แผนเพอร์ซันนัลแคร์

Personal Care

Take care of yourself and your family with
affordable health insurance for every illness
or injury up to THB 600k

 
 

Highlights

Limits range from THB 300,000 – 600,000
Cover for illness or injury on a per
disability basis, with no limits on the
number of confinements per year
24-hour worldwide coverage for medical treatment in case of illness or accident (excluding the U.S., where cover is only available for injuries resulting from accidents)
Optional outpatient treatment (OPD), maternity, and personal accident cover
Extensive medical network of over 490 hospitals and clinics nationwide
vHealth telemedicine consultations with free nationwide prescription delivery*
Tax savings on premiums paid, up to
THB 25,000**
Can be purchased independently, not bundled with life insurance

Remark:
*vHealth Telemedicine Service is provided by Aetna Services (Thailand) Limited.
**Click here for more information on using health insurance premium as tax deductions.

Please see plan documents for full details of coverage. Before purchasing a plan, you should consider the terms and conditions of the plan carefully.

Table of benefits

Coverage/Benefits

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Description Benefits (THB)
Sapphire 08 Ruby 08 Emerald 08 Diamond 08
Inpatient Hospitalization Benefits        
Maximum benefit for an injury or sickness per disability* (including Major Medical Treatment benefit) 300,000 400,000 500,000 600,000
Room and Board including Fees for Nursing Services        
Non-intensive Care Room (maximum payable per day) 1,400 2,500 4,000 5,000
Intensive Care Unit (ICU), maximum payable per day (with a maximum limit of 15 days per disability*) 2,800 5,000 8,000 10,000
Hospital General Expenses        
Hospital General Expenses 16,000 30,000 40,000 50,000
Emergency Accidental Outpatient Treatment (first visit within 24 hours
after the accident and follow-up treatment within 15 days), included in Hospital General Expenses 		2,200 4,000 5,000 7,000
Ambulance (maximum per disability), included in Hospital General Expenses 1,000 1,000 1,000 1,000
Surgeon’s fees        
Surgeon’s fees including Consultation fees (as per Surgical Schedule) 22,000 40,000 50,000 70,000
Physician’s hospital visit fee        
Physician’s hospital visit fee (maximum payable per day) 300 600 900 1,200
Major Medical Treatment        
Major Medical Treatment pays 80% of the actual costs for a sum exceeding the inpatient hospitalization benefits (excluding room and board and fees for nursing services), up to the maximum benefit by plan
Personal Accident        
Personal Accident (Or.Bor.2)** 20,000 40,000 60,000 100,000
Remarks
*Per Disability or Single Confinement means the case when the Covered Person is confined to a Hospital or Medical Center as an Inpatient at any time, which include the confinements for 2 times or more due to the same cause, disease, or complication, with intervals of not more than 90 days from the most recent discharge from a Hospital or Medical Center. Outpatient treatment for no more than 30 days from the most recent treatment due to the same cause, disease or complication shall also be deemed a Single Confinement.
**Personal Accident insurance (Or.Bor.2) provides benefits in case of death, dismemberment, loss of sight, loss of hearing, loss of speech, and total permanent disability (50% of the sum assured for personal accident coverage while riding a motorcycle whether as a rider or passenger).
- For Major Medical Treatment benefit, the Company pays 80% of the actual costs for a sum exceeding the inpatient hospitalization benefits including hospital general expenses, surgeon’s fees and physician’s hospital visit fee.
- Medical expenses for a sickness that happens in the course of 30 days from the initial effective date of the insurance policy will not be covered.
- Costs associated with tests such as PET Scan, MRI, CT Scan, Echocardiogram or Exercise Stress Test (EST) will normally be paid under the Outpatient Benefits unless such tests have been prior approved by Aetna, they will be paid under the Inpatient Hospitalization Benefits : Hospital General Expenses.
- Policyholder who purchases a health insurance policy before 60 years old and continuously renew the policy will be eligible for lifetime renewal. However, policyholder who purchases the policy after 60 years old will be eligible to renew the policy till 70 years old.
- For Maternity Benefits, policyholder who will be covered must have been insured for at least 280 consecutive days before the childbirth and at least 90 consecutive days for a miscarriage.

Optional benefits

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Maternity benefits* (Policyholder is able to purchase one of any maternity benefit plans) Plan 1 Plan 2 Plan 3 Plan 4
Eligible for expenses related to pregnancy and childbirth (regardless the expenses related to a child).
- Normal Delivery, Assisted Delivery or Intentional Cesarean Delivery 40,000 60,000 90,000 120,000
- Ectopic Pregnancy or Emergency Cesarean Section 80,000 120,000 180,000 240,000
- Miscarriage 20,000 30,000 45,000 60,000

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Additional Personal Accident Sapphire 08 Ruby 08 Emerald 08 Diamond 08
Personal Accident (Or.Bor.2)**        
- PA 200 200,000
- PA 400 400,000
- PA 900 (Occupation Class 1 and 2 only)
 900,000

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Outpatient benefits Sapphire 08 Ruby 08 Emerald 08 Diamond 08
Outpatient Benefits (maximum 1 visit per day and 30 visits per year)
- Classic 400 500 1,000 1,500
- Plus 500 800 1,200 2,000
- Deluxe 600 1,000 1,500 2,500
​Remarks
*For Maternity Benefits, policyholders must make an advance payment for medical services.
**Personal Accident insurance (Or.Bor.2) provides benefits in case of death, dismemberment, loss of sight, loss of hearing, loss of speech, and total permanent disability (50% of the sum assured for personal accident coverage while riding a motorcycle whether as a rider or passenger).
- For Major Medical Treatment benefit, the Company pays 80% of the actual costs for a sum exceeding the inpatient hospitalization benefits including hospital general expenses, surgeon’s fees and physician’s hospital visit fee.
- Medical expenses for a sickness that happens in the course of 30 days from the initial effective date of the insurance policy will not be covered.
- Costs associated with tests such as PET Scan, MRI, CT Scan, Echocardiogram or Exercise Stress Test (EST) will normally be paid under the Outpatient Benefits unless such tests have been prior approved by Aetna, they will be paid under the Inpatient Hospitalization Benefits : Hospital General Expenses.
- Policyholder who purchases a health insurance policy before 60 years old and continuously renew the policy will be eligible for lifetime renewal. However, policyholder who purchases the policy after 60 years old will be eligible to renew the policy till 70 years old.
- For Maternity Benefits, policyholder who will be covered must have been insured for at least 280 consecutive days before the childbirth and at least 90 consecutive days for a miscarriage.

Underwriting conditions

Health insurance

  • Eligible for persons aged 15 days to 65 years
  • For members with more than one policy with Aetna, we will pay up to THB 5m per injury or illness depending on eligible plan limits.
  • For Major Medical benefits, we will pay 80% of costs exceeding the plan's inpatient hospitalisation benefits - this includes hospital general expenses, surgeon fees and physician hospital visit fees.
  • Costs associated with diagnostic tests such as PET scans, MRI, CT scans, Echocardiogram or Exercise Stress Test (EST) will typically be paid under outpatient benefits, unless such tests have been pre-approved by us. If pre-approved, they will be paid under inpatient hospitalisation benefits.
  • Worldwide coverage excluding the U.S., where cover is only available for injuries caused by accidents.
  • Members who purchase their plan before 60 years old and continuously renew the plan will be eligible for lifetime renewal. Members who purchase their plan after 60 years old will be eligible to renew the policy until they are 70 years old.
  • For maternity benefits, members must have had this cover for at least 280 consecutive days before childbirth claims are eligible, and at least 90 consecutive days before claims for miscarriage are eligible.

Personal Accident

  • For members with more than one policy with Aetna, we will pay up to THB 1m per member, depending on eligilbe plan limits.
  • For the Personal Accident limit option of THB 900,000, we will only cover members who are in class 1 and 2 occupations. Please contact your Aetna representative for more details.

Examples of Exclusions

Please see your plan documents for a full list of exclusions. Examples of our typical exclusions are as follow:

Health insurance  

  • Pre-existing conditions or medical expenses for an illness that occurs within 30 days of policy inception
  • Treatment for congenital anomalies or developmental disorders
  • Medical expenses incurred from the treatment of attempted suicide or self-inflicted injury
  • Acquired Immune Deficiency Syndrome (AIDS), including related complications or sexually transmitted diseases
  • Any medical treatment that is experimental, including alternative treatments
  • Treatment that is not medically necessary
  • Pregnancy, childbirth, miscarriage (unless the maternity option is purchased), contraception, sterilisation
  • Visual acuity, laser eye treatment, LASIK, dental treatment and cosmetic treatments such as for acne or blemishes
  • Specific illnesses that occur within 6 months of policy inception, such as tumors or cancers, polyps or cysts, hemorrhoids, hernias, pterygium, pinguecula or cataracts, tonsillectomy or adenoidectomy, kidney stones, endometriosis, varicose veins, hallux valgus, ganglions

Personal accident  

  • We will cover you for death, dismemberment, loss of sight, loss of hearing, loss of speech, or permanent disability arising from injury due to accident. 
  • We may not cover injuries resulting from:

      -Dangerous sports

      -Flying in a non-commercial aircraft or whilst serving as a crew member in any aircraft

      -Being under the influence of drugs or alcohol

      -Suicide or self inflicted injury

      -Driving or riding as a passenger on a motorcycle - only 50% of the benefit will be paid and not more than THB 200,000

      -Bacterial infections

      -Miscarriage resulting from an accident

      -Taking part in a fight

      -Criminal acts

      -War

      -Radioactivity

  • Personal accident cover is not available for children under 18 years.