Thailand Office of Insurance Commission backs Healthy Body Comfortable Wallet initiative and promotes flexible OPD cover allowing pharmacy purchases with prescriptions

The Thailand Office of Insurance Commission announced support for the Ministry of Commerce’s Department of Internal Trade project “Healthy Body, Comfortable Wallet”, positioning the insurance sector to help households manage rising healthcare costs. As part of this approach, it has discussed with insurers a set of outpatient (OPD) coverage conditions that would allow insured persons to take a doctor’s prescription and buy medicines at pharmacies, reducing the need to select high-limit OPD plans. The Office’s analysis of health insurance underwriting highlighted that medicines and medical supplies account for more than 30% of treatment costs and have risen by an average of up to 25% per year over the past four years. It also noted that policyholders in both individual and group health insurance often buy relatively high coverage limits to keep pace with medical inflation, which can push premiums to levels that may not be sustainable over time, while some product designs relying on pharmacy dispensing can be constrained by limited availability of specialist medicines. As an illustration of the premium impact of lower OPD limits, it cited a policyholder aged 31–35 reducing an OPD limit from THB 3,000 per visit (THB 9,365 annual premium) to THB 1,500 per visit (THB 4,683 annual premium). For group schemes, it pointed to employers managing employee medical costs by limiting OPD plan limits and, where premium reductions are sought, selecting plans with copayments or deductibles.