Social Security, Gold Card, and Health Insurance, the Right Choice to Meet the Retirement Age

By Nipapun Poonsateansup CFP®, Independent financial planner, writer, and lecturer
 

In retirement planning, one of the important things that we all have to pay attention to is planning to manage expenses related to medical expenses, which is considered to be a higher proportion of expenditure when we get older. At working age, we usually are not worried about this expense, since the company that we work in, there are often insurance benefits that help take care of medical expenses. In addition, we are also able to use medical treatment rights according to the money send to social security, which can help to alleviate the burden of the medical treatment cost to a certain extent. However, at retirement age, health begins to deteriorate. Therefore, it is likely that medical expenses will increase, but the medical welfare that we received from the company had expired. This makes us more prepared to plan for this matter. This article will help conclude what rights do we have for medical treatment? And how to choose to meet our needs.

Social Security VS Gold Card

For medical treatment from that social security, even if we retired, we still have the option to cancel or retain medical treatment from social security. The details are as follows:


       1. If resigned or contact expired due to retirement, according to Social Security Article 33, we will no longer receive benefits from social security, which includes the right to medical treatment as well. If the insurer pays contributions for more than 15 years (180 months), he will receive an old age pension instead. However, we are able to use medical treatment from the universal health insurance card or gold card.


       2. If choosing to maintain the status of social security, members will have to submit Social Security Section 39 within 6 months from the date of resignation. In this case, the insurer will have to pay a contribution of 432 baht per month, equivalent to 5,184 baht per year (9% on the salary base that is used to calculate the contribution of 4,800 baht, determined by social security). This causes the insurer to remain entitled to medical treatment, including other benefits of social security (disability, childbirth, child allowance, old age, and death).
 

Therefore, most retirees often have questioned that whether they should resign from the Social Security membership under Article 33 to receive the old age pension and as for the medical treatment, they will use the medical treatment rights according to the gold card, or should they maintain benefits according to social security by sending Social Security Article 39. However, if choosing to maintain Social Security Article 39, will receive an old age pension only when resigned from being an insurer, causing the average salary of 60 months to be used to calculate the pension will be left only 4,800 baht, resulting in a pension that we will receive is lesser (while the average salary for calculating the Social Security Article 33 pension is 15,000 baht). Therefore, we have to consider our needs carefully whether we should get the old age pension (from Social Security Article 33) or need the medical treatment (from Social Security Article 39).


Moreover, the right to medical treatment according to social security and the right to medical treatment under universal health insurance (gold card), what are the differences? To answer these questions, here’s the comparison of different benefits between the two options:


            Comparison table of medical rights between social security and gold cards 
 (from  www.nhso.go.th  and  www.sso.go.th)

BENEFITS SOCIAL SECURITY GOLD CARD
1. Services Selected contracting hospital. The community hospital that is participating and is in the registered area. Only if there is no specialist doctor, they can be sent to a hospital with a specific specialist.
2. Specific Illness* Such as not protecting bone marrow transplants if having the type of cancer that the social security prescribed before and do not protect chronic kidney transplantation. Protection whether it is before or not.
3. Dental Insurance Tooth extraction, tooth filling, scaling, not more than 900 baht per year. Unlimited use and no money limits.
4. Continuous Treatment Not protected. Providing rehabilitation services after returning home and physical rehabilitation after the end of treatment.
5. Medicine and Medical Supplies Can be used both inside and outside the national main account. Use drugs that are in the national main account. For drugs outside the main account, at the doctor's discretion including the case that patients are willing to pay themselves.
6. Room and Food Costs Room rates and ordinary food fees, not more than 700 baht per day. Covering room and ordinary food costs.

*Learn more about treatment rights at   www.nhso.go.th  and www.sso.go.th


According to the table, we can see that the rights to medical treatment under universal health insurance (gold card) is not inferior to the rights to medical treatment according to social security rights. Therefore, resignation from Social Security Article 33 to receive pension and choose to use medical treatment from the gold card should be a better choice than continuing with social security under Article 39 due to receiving a more old age pension and still be able to use medical treatment according to the gold card, which is an alternative to alleviating the medical expenses incurred in retirement.


However, the hope of relying solely on state welfare may not be a good retirement plan due to the aging society, causing more elderly people and until we retire, we do not know what the universal coverage policy will be. Will the budget be enough? Will it be canceled first? Thus, if we don't have our financial planning in this regard, at that time, it might be too late. Therefore, we should have a reserve for medical expenses for ourselves and the family, together with the purchase of additional health insurance.


In choosing to buy health insurance, we must consider various conditions and considerations as follows:

  • Health insurance may "not protect the disease that we have before insuring"

  • Health insurance will not start the coverage immediately because there is a "waiting period", which during this period, we will not be able to claim medical expenses. In the case of general illness, there is a waiting period of 30 days from the date the policy comes into effect. While some diseases may have a waiting period of 90 - 120 days or more, which is mostly a chronic disease that is difficult to cure or have high medical expenses such as cancer, tumors, gallstones.

  • "Health insurance conditions" are exempted from protection against certain diseases such as treatment related to beauty, facial surgery for beauty, childbirth and other treatment fees for having children, non-modern medical treatments such as acupuncture, reflexology.
  • Health insurance must disclose the real information.


As mentioned above, we can see that the conditions of health insurance, whether it is not protecting from the disease that we have before insurance or having a waiting period, which leads us to have a plan for health insurance to be done on the right time. If we are to do at retirement, we must always take good care of our health so that we do not have health insurance problems and receive complete protection. However, if there are no financial restrictions, we should plan to make health insurance early, considering the risk management because life is uncertain and the purchase of health insurance, with money only, may not be able to buy but must have good health as well.