Thailand's New Health Standard: what it changed
One contract layout for every insurer, from the regulator. What that gives a buyer, and what it leaves to the insurer.
HelloPrakan, a Thai health insurance comparison site, reads the New Health Standard (มาตรฐานประกันสุขภาพแบบใหม่) as the Office of Insurance Commission’s rule that put every Thai health policy on the same 13 benefit categories and the same contract conditions, so that plans can be compared line by line, and not as a rule about what a policy pays, which each insurer still decides. The evidence is the OIC’s own publication and the insurers’ wordings and brochures, cited beside each fact.
What the regulator says it is
In a press release of 22 June 2025 the OIC states that, so that health insurance contracts offered by life and non-life insurers would share one standard, it set the New Health Standard “ให้มีผลบังคับใช้ตั้งแต่ปี 2564 เป็นต้นมา” (in force from 2021 onwards), and that it did so “เพื่อให้ผู้บริโภคสามารถเปรียบเทียบแผนประกันภัยสุขภาพได้ง่ายและมีประสิทธิภาพมากยิ่งขึ้น”, so that consumers can compare health plans more easily.
The same release names the benefits the standard defines: for in-patients, room and board, diagnostic services, physician fees, surgery and procedures, and day surgery; and for treatment that does not need admission, directly related diagnostics before and after a stay, out-patient treatment of an accident injury within 24 hours, rehabilitation after a stay, haemodialysis, radiotherapy, chemotherapy, the emergency ambulance and minor surgery.
The orders themselves are Registrar’s Orders 14/2564 (life insurers’ health riders) and 15/2564 (non-life insurers’ health policies). Press reports quoting the OIC’s Secretary-General give 1 July 2022 as the date from which new sales had to use the standard form. We could not retrieve the OIC’s own text of either order on the day this page was written, so the order numbers and that date rest on the press report, and we say so.
The 13 categories
Every policy written to the standard prints its benefit table in the same 13 categories. AXA’s SmartCare Essential wording numbers them Articles 1 to 13; Allianz applies its deductible to “all 13 Sections”; Viriyah refers to “หมวดที่ 1-13”; Chubb Life’s customer notice lists them as five in-patient and eight non-inpatient categories.
| # | Category (Thai, as printed) | In English |
|---|---|---|
| 1 | ค่าห้อง และค่าอาหาร ค่าบริการในโรงพยาบาล | Room, board and hospital servicesCategories 1–5: in-patient |
| 2 | ค่าบริการทางการแพทย์เพื่อการตรวจวินิจฉัยหรือบำบัดรักษา | Medical services for diagnosis or treatment (blood, nursing, medicine, supplies) |
| 3 | ค่าผู้ประกอบวิชาชีพเวชกรรม (แพทย์) ตรวจรักษา | Physician fees |
| 4 | ค่ารักษาพยาบาลโดยการผ่าตัด (ศัลยกรรม) และหัตถการ | Surgery and procedures |
| 5 | การผ่าตัดใหญ่ที่ไม่ต้องเข้าพักรักษาตัวเป็นผู้ป่วยใน (Day Surgery) | Day surgery |
| 6 | ค่าบริการทางการแพทย์เพื่อตรวจวินิจฉัยที่เกี่ยวข้องโดยตรงก่อนและหลังการเข้าพักรักษาตัว | Diagnostics directly related to a stay, before and after it; out-patient follow-up after dischargeCategories 6–13: no admission needed |
| 7 | ค่ารักษาพยาบาลการบาดเจ็บ กรณีผู้ป่วยนอก ภายใน 24 ชั่วโมง | Out-patient treatment of an injury within 24 hours of an accident |
| 8 | ค่าเวชศาสตร์ฟื้นฟู หลังการเข้าพักรักษาตัวเป็นผู้ป่วยในแต่ละครั้ง | Rehabilitation after each in-patient stay |
| 9 | ค่าบริการทางการแพทย์เพื่อการบำบัดรักษาโรคไตวายเรื้อรัง โดยการล้างไตผ่านทางเส้นเลือด | Chronic kidney failure: haemodialysis |
| 10 | ค่าบริการทางการแพทย์เพื่อการบำบัดรักษาโรคเนื้องอกหรือมะเร็ง โดยรังสีรักษา | Tumour or cancer: radiotherapy, interventional radiology, nuclear medicine |
| 11 | ค่าบริการทางการแพทย์เพื่อการบำบัดรักษาโรคมะเร็ง โดยเคมีบำบัด | Cancer: chemotherapy |
| 12 | ค่าบริการรถพยาบาลฉุกเฉิน | Emergency ambulance |
| 13 | ค่ารักษาพยาบาล โดยการผ่าตัดเล็ก | Minor surgery |
Our plan pages show each plan’s schedule in this order, with the insurer’s own figure on each line. The standard fixes the lines; it does not fix the figures.
What a plan written to the standard gives you
- Comparable definitions. Because the categories are shared, a line on one plan means the same thing on another. Chubb Life’s notice lists clearer definitions of major surgery, minor surgery and day surgery, an explicit list of organ transplants covered as a recipient, and a claim-document deadline extended from 30 to 90 days after discharge, among the changes it describes.
- A renewal rule. Press reports quoting the OIC’s Secretary-General state that insurers must renew to at least age 69 and may refuse renewal in three cases only: non-disclosure on the application, claims with no medical necessity, and daily-benefit claims across all insurers exceeding actual income. The insurers’ brochures state their own renewal ages, which are higher: AXA SmartCare Essential is “Renewable up to the age of 99 years old”; Allianz gives lifetime renewal to applicants who “purchase their plan before 60 years old and continuously renew”, and renewal to 80 for those who buy after 60; Chubb Samaggi may renew to 99 subject to its assessment.
- A defined co-payment mechanism. The same press reports state that co-payment on renewal is capped at 50% in total. Chubb Samaggi’s Elite Plus brochure shows the mechanism in use: for members aged 0 to 15 whose loss ratio exceeds 400%, a 30% co-payment may apply on renewal, removed again if the ratio falls below 400% the following year.
- Reinstatement without a reset. AXA’s wording allows reinstatement within 90 days of a missed premium without re-applying the waiting period and pre-existing condition clauses; April’s terms say the same: “We shall not reset pre-existing conditions and waiting periods.”
What it did not change
- Waiting periods. Every New Health Standard wording and brochure we hold prints the same two: no benefit for illness in the first 30 days, and none for 120 days for tumours, cysts or cancer, haemorrhoids, hernias, pterygium or cataract, tonsillectomy or adenoidectomy, stones, varicose veins and endometriosis.
- Pre-existing conditions. Still excluded on every plan we hold a document for, in the insurer’s own words. Allianz: “Chronic diseases, injury or sickness ... that have occurred before entering the insurance contract (Pre-existing Condition)”.
- Out-patient cover. Still an add-on on most plans, with the insurer’s own caps. Is OPD worth adding.
- How the limit is applied, and the price. The standard lays out the lines; the insurer still chooses a per-confinement or an annual limit, the figure on each line, the deductible options and the premium. How to compare plans.
Is a plan 'written to the standard'?
Our plan pages say when the engine holds a plan as written to the New Health Standard, and the 13-line schedule on the page is the layout itself. Where a plan is not (April MyHEALTH Thailand, for example, is an international-style modular contract with its own benefits schedule and terms), the page shows that plan’s own lines instead, and it is compared only with plans of its own structure.
New Health Standard: common questions
What is Thailand's New Health Standard?
A standard form of health insurance contract set by the Office of Insurance Commission (คปภ.) so that health policies sold by life and non-life insurers follow one structure. The OIC states it has applied since 2021. Every policy written to it lays its benefits out in the same 13 categories (five for in-patient treatment and eight for treatment that does not need admission), which is what lets plans be compared line by line.
What are the 13 categories of the New Health Standard?
In-patient: room, board and hospital services; medical services for diagnosis or treatment; physician fees; surgery and procedures; day surgery. Non-inpatient: diagnostics before and after a stay and follow-up after discharge; out-patient treatment of an injury within 24 hours of an accident; rehabilitation after a stay; haemodialysis; radiotherapy; chemotherapy; emergency ambulance; minor surgery.
Does the New Health Standard guarantee renewal?
Press reports quoting the OIC's Secretary-General state that insurers must renew to at least age 69 and may refuse only in three cases: non-disclosure on the application, claims with no medical necessity, and daily-benefit claims across all insurers exceeding actual income. The insurers' own brochures state their renewal ages: AXA SmartCare Essential to 99, Allianz for life if bought before 60 and to 80 if bought after, Chubb Samaggi to 99 subject to its assessment.
What did the New Health Standard not change?
Price, which each insurer still sets from its own rate table; the exclusion of pre-existing conditions, which every brochure we hold keeps; the waiting periods of 30 days for illness and 120 days for a named list of conditions; and the amount on each line, which the insurer still decides. The standard fixes the layout and the rules of the contract, not what the policy pays.
What we could not source
These are things readers ask about that we could not confirm against an insurer’s or regulator’s own document on the date this page was written. We leave them out rather than guess.
- The start date of 8 November 2021 that is widely reported for the standard. The Thai government document that states it (media.thaigov.go.th, Doc_20211114223735000000.pdf) returned HTTP 400 on 15 October 2026, so the date is not on this page as a fact.
- The full text of Registrar's Orders 14/2564 and 15/2564. Not found on oic.or.th on 15 October 2026; the order numbers and the 1 July 2022 date rest on a press report quoting the OIC's Secretary-General, which the page says.
- Whether the 30-day and 120-day waiting periods and the 90-day single-confinement rule are set by the standard or merely adopted by every insurer. The insurers' documents print them; the OIC text that would settle it is the one we could not retrieve.
- Thai Health Insurance's and Thai Vivat's renewal terms in their own words: the Thai Health brochures we hold are image-only, and the Thai Vivat brochure we hold does not print a renewal age.
Sources
- Office of Insurance Commission (คปภ.). Press release สสอ. 103/2568, 22 June 2025: "คปภ. แนะ...ประกันภัยสุขภาพช่วยบริหารค่ารักษาพยาบาลได้"Read 2026-10-15.
- Thai Post (press report quoting the OIC Secretary-General). "เริ่มแล้ว! สัญญาประกันภัยสุขภาพตามมาตรฐานใหม่...ตั้งแต่ 1 ก.ค. 65"A press report, not the OIC's own text. Used only for the order numbers, the 1 July 2022 date and the renewal rule it attributes to the OIC.Read 2026-10-15.
- Chubb Life Assurance (Thailand). "ประกันภัยสุขภาพมาตรฐานฉบับใหม่ (New Health Standard)", customer notice listing the 13 benefit categoriesA life insurer's notice about its own riders. Cited for the category list only; Chubb Life is not Chubb Samaggi, whose plans we compare.Read 2026-10-15.
- AXA Insurance PCL (Thailand). SmartCare Essential Individual Health and Accident Insurance Policy: policy wording (EN translation; Thai original prevails) (the insurer’s PDF as held by our rate engine for that insurer, the same document the quote funnel is built from)Read 2026-10-15.
- AXA Insurance PCL (Thailand). SmartCare Essential brochure (TH + EN), 15 December 2025Read 2026-10-15.
- Allianz Ayudhya General Insurance PCL. Smarter Health Plus brochure (EN), Version May 2026Read 2026-10-15.
- Allianz Ayudhya General Insurance PCL. Superior Health Plus brochure (EN), May 2026 (the insurer’s PDF as held by our rate engine for that insurer, the same document the quote funnel is built from)Read 2026-10-15.
- Allianz Ayudhya General Insurance PCL. Beyond Care: product page (brochure linked there is dated 1 March 2025)Read 2026-10-15.
- Chubb Samaggi Insurance PCL. Health Universal Plus brochure (TH), 2026 (the insurer’s PDF as held by our rate engine for that insurer, the same document the quote funnel is built from)Read 2026-10-15.
- Chubb Samaggi Insurance PCL. Elite Plus PD brochure (TH), Version May 2026 (the insurer’s PDF as held by our rate engine for that insurer, the same document the quote funnel is built from)Read 2026-10-15.
- Bangkok Insurance PCL. สุขภาพ Classic Care / Superior Care / Premier Care brochure (TH) (the insurer’s PDF as held by our rate engine for that insurer, the same document the quote funnel is built from)Read 2026-10-15.
- Viriyah Insurance PCL. V Prestige Care brochure (TH) (the insurer’s PDF as held by our rate engine for that insurer, the same document the quote funnel is built from)Read 2026-10-15.
- April International (MyHEALTH Thailand). MyHEALTH Thailand: Terms and Conditions, effective 1 July 2026 (the insurer’s PDF as held by our rate engine for that insurer, the same document the quote funnel is built from)Read 2026-10-15.
Documents read on 2026-10-15. Insurers revise brochures and wordings without notice; where a document and this page disagree, the document is right. Tell us, because we would want to fix the page.