How health insurance limits work in Thailand
Two policies can advertise the same limit and pay very differently. The difference is what that limit attaches to.
When people compare health insurance they usually compare two things: the premium and the headline limit. That works only if both policies mean the same thing by “limit”. In the Thai market they frequently do not.
The four structures
- Per confinement
- Limits apply to each hospital stay. A long or repeated admission can exhaust a line more than once in a year.
- Annual limit
- One pot for the policy year. Whatever the claim, it draws down the same annual limit.
- Lump sum per illness
- A fixed sum paid per covered illness, not a reimbursement of costs incurred.
- As per schedule
- Each line has its own stated limit; the schedule, not a single overall figure, defines the cover.
Why we never rank across them
Consider two plans, each stating a limit of one million baht. Under an annual-aggregate plan that is the most the policy pays in the year, across every claim. Under a per-confinement plan it is the most it pays for one hospital stay — a second admission later in the year gets its own limit.
Sorted into a single list by price, the per-confinement plan often looks worse value when it is not, or better value when it is not, depending entirely on how you happen to claim. So we split them, label the structure on every card, and rank only inside a group.
Top-ups are a separate case again
A top-up plan pays only what an underlying policy does not. On its own it is not cover at all. Wherever a top-up appears on this site it carries the flag requires an underlying policy, and it is never included in a ranked list of standalone plans.
Is an annual limit better than a per-confinement limit?
Neither is universally better. An annual aggregate is simpler to reason about and protects against one very large claim. A per-confinement limit can pay more in total across several separate admissions. Which suits you depends on how you would claim, which nobody knows in advance — so the honest comparison is within a structure, not across.
What does 'as per schedule' mean?
Each benefit line carries its own stated limit, and there is no single overall figure that summarises the policy. You have to read the schedule line by line, which is why we show all of it rather than a headline number.