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OPD cover in Thailand: is it worth adding?

HelloPrakan explains what out-patient cover is, what the base policy already pays without it, and how each insurer caps it.

Nomi, HelloPrakan's robot-elephant mascot, turned to the side

HelloPrakan, a Thai health insurance comparison site, finds that OPD cover is worth adding when the out-patient visits you expect would cost more than the premium difference and fit inside the insurer’s cap, and that it is not a choice at all for one group, because the Non-Immigrant O-X visa requires it. The evidence is below: what the insurers’ own documents say OPD is, what a policy pays for out-patient treatment without it, and how each insurer we compare limits it.

What OPD means on a Thai policy

AXA’s SmartCare Essential wording defines an out-patient as a patient treated in the out-patient or emergency department of a hospital “without medical necessity to be admitted as an Inpatient”. OPD cover, then, is cover for the visits that do not involve a bed: seeing a doctor, tests ordered at that visit, and the medicine prescribed.

Nearly every Thai policy sells it as an endorsement or module on top of the in-patient policy. The exception on our panel is Pacific Cross, whose Standard plans include out-patient treatment and whose application form offers a discount for removing it.

What the base policy already pays without OPD cover

Policies written to the New Health Standard carry a set of non-inpatient benefits as standard. The Office of Insurance Commission lists them in its own description of the standard: diagnostic services directly related to a hospital stay, before and after it; out-patient treatment of an injury within 24 hours of an accident; rehabilitation after a stay; treatment of chronic kidney failure; cancer treatment by radiotherapy and by chemotherapy; the emergency ambulance; and minor surgery.

The insurers’ wordings put a time limit on the first of those. AXA’s SmartCare Essential pays out-patient treatment after discharge “for each consequential treatment within 30 days after such discharge”; Allianz, Chubb Samaggi, Bangkok Insurance, Viriyah and Thai Vivat print the same 30-day follow-up line in their benefit tables.

So without OPD cover a policy still pays for the out-patient side of an accident, of a hospital stay, and of dialysis and cancer treatment. What it does not pay for is the ordinary visit: a fever, a prescription, a specialist you see without being admitted. That is the gap OPD cover fills, and the only honest way to value it is against how often you would make that kind of visit.

How each insurer caps it

The pattern across the panel is consistent: a per-visit limit, a per-year limit, or both, and usually a ceiling of one visit a day and 30 visits a year. The figures are the insurers’ own, from the documents listed at the foot of the page.

Insurer · planHow OPD is soldWhat the document states
AXA Insurance (Thailand)SmartCare EssentialOptional add-on3,000 baht per visit or 50,000 baht per policy year; one visit a day, 30 visits a year.
AXA Insurance (Thailand)SwitchCareOptional add-on, with a 10% or 20% out-patient co-payment optionAn annual OPD maximum set per plan; the brochure prints the figure for each of the four plans.
Allianz AyudhyaSmarter Health PlusOptional add-onThe brochure lists OPD as optional and the plan as Thailand-only; the per-visit figures sit on the plan's own benefit table.
Allianz AyudhyaSuperior Health PlusOptional add-on30,000 or 50,000 baht a year, depending on the option; non-inpatient benefits are paid in Thailand only.
Allianz AyudhyaBeyond CareOptional add-on1,500 baht a visit, one visit a day, 30 visits a year, with an annual maximum of 28,000, 40,000 or 60,000 baht by option.
Chubb SamaggiHealth Universal PlusOptional add-on1,000 to 2,500 baht a visit by plan; one visit a day, 30 visits a year.
Bangkok InsuranceClassic / Superior / Premier CareOptional add-on, priced on a separate rate table1,000 to 3,000 baht a visit by plan; one visit a day, 30 visits a policy year.
Pacific CrossStandard / Premier / Maxima / UltimaIncluded, with an option to remove itStandard plans: one visit a day, 30 visits a year, amount by plan. The application form offers a 20% discount for removing out-patient benefits.
April InternationalMyHEALTH ThailandOptional module, with a 20% co-insurance optionAn out-patient module at the Essential, Extensive or Elite level; a 20% co-insurance on the module reduces the premium.
Thai VivatDelightListed as an additional benefit1,000 to 3,000 baht by plan. The brochure line does not say whether that is per visit or per year, so we do not.

Thai Health Insurance and Viriyah are on our panel but are not in this table: the Thai Health brochures we hold are image-only and the Viriyah brochure we hold does not print its OPD rider terms. See the box below.

What OPD cover does to the premium

We do not print premiums on a guide, because a premium depends on your age and comes from the insurer’s rate table. The insurers do state the mechanics, and those are worth knowing before you quote:

  • Bangkok Insurance prints its premium tables twice, once “กรณีไม่คุ้มครองผู้ป่วยนอก (OPD)” and once “กรณีคุ้มครองผู้ป่วยนอก (OPD)”: without and with OPD.
  • Pacific Cross’s application form offers “Removal of outpatient benefits (-20%)” as a discount option.
  • April lets you “apply a 20% co-insurance to your Outpatient module to reduce your annual premium”.
  • AXA SwitchCare prints an out-patient co-payment of 10% or 20% as an option.

Run a quote for your age and the funnel shows the insurer’s own premium with and without OPD, which is the only number that should decide it.

The case where OPD is required: the O-X visa

For the Non-Immigrant O-X visa, the Thai General Insurance Association states that the policy must provide “not less than 40,000 Thai Baht per policy year for outpatient” alongside 400,000 baht for in-patient treatment, and that the policy must be a Thai one. An in-patient-only plan does not meet that, however large its in-patient limit. The O-A visa is different: TGIA states USD 100,000 of cover, accounted as 3 million baht, with no separate out-patient figure for a first-year applicant. The visa guide has both rules in full.

How to decide

  1. Count the out-patient visits you actually made last year that were not tied to an accident or a hospital stay. Those are the ones OPD cover would have paid.
  2. Check the cap on the plan you are quoted (per visit, per year, and the 30-visit ceiling) against what those visits cost. A per-visit cap below a specialist’s fee leaves you paying the difference.
  3. Compare the insurer’s premium with and without OPD in a live quote. If the visits you expect, within the cap, cost less than the difference, leave it off; if you are applying for an O-X visa, it is not optional.

See real premiums with and without OPD

OPD cover: common questions

Is OPD cover worth adding to health insurance in Thailand?

It is worth adding when the visits you expect to make would cost more than the premium difference, within the insurer's cap. Every Thai OPD add-on we hold a document for caps out-patient cover per visit, per year, or both, and most limit it to one visit a day and 30 visits a year. It is required, not optional, for a Non-Immigrant O-X visa: TGIA states not less than 40,000 baht per policy year for out-patient treatment.

Does a Thai health policy pay anything for out-patient treatment without OPD cover?

Yes, for specific situations. Policies written to the New Health Standard include non-inpatient items such as out-patient treatment of an injury within 24 hours of an accident, follow-up out-patient treatment within 30 days of discharge, and out-patient dialysis, chemotherapy and radiotherapy. A GP visit for a cold is not among them.

How much does OPD cover cost in Thailand?

We do not print a premium on this page because it depends on your age and plan. The insurers state the mechanics: Bangkok Insurance prints separate premium tables with and without OPD, Pacific Cross offers a 20% discount for removing out-patient benefits, and April offers a 20% co-insurance on its out-patient module to reduce the premium. A live quote shows the insurer's own figure with and without OPD.

Is there a waiting period on OPD cover?

AXA's SmartCare Essential out-patient endorsement excludes any illness that happens within the policy's waiting period, and its brochure prints a six-month waiting period beside the optional OPD and wellness block. Other insurers' brochures we hold do not state a separate OPD waiting period, so check the wording of the plan you are quoted.

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.

  • Thai Health Insurance's Simply Healthy and Wealthy Healthy brochures we hold are image-only PDFs with no text layer, so we could not quote their OPD terms.
  • Viriyah's V Prestige Care brochure we hold does not print the terms of its OPD rider, only the in-patient and post-discharge lines.
  • Thai Vivat's Delight brochure lists an 'Additional Outpatient (OPD) Benefit' of 1,000 to 3,000 baht by plan without saying whether the figure is per visit or per year.
  • Allianz's Smarter Health Plus brochure (May 2026) says OPD is optional but the per-visit amounts for that plan are not on the pages we hold.
  • The actual premium difference for adding OPD on any plan. It is not printed on any public document we hold; the quote funnel returns it live from each insurer's rate table.
  • What an out-patient visit costs at Thai private hospitals. No insurer or regulator document we hold states it, so this page does not either.

Sources

  1. Office of Insurance Commission (คปภ.). Press release สสอ. 103/2568, 22 June 2025: "คปภ. แนะ...ประกันภัยสุขภาพช่วยบริหารค่ารักษาพยาบาลได้"Read 2026-10-15.
  2. AXA Insurance PCL (Thailand). AXA SmartCare Essential: product pageRead 2026-10-15.
  3. 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.
  4. AXA Insurance PCL (Thailand). SmartCare Essential brochure (TH + EN), 15 December 2025Read 2026-10-15.
  5. AXA Insurance PCL (Thailand). AXA SwitchCare brochure, 19 May 2026 (document effective since 27 July 2022) (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.
  6. Allianz Ayudhya General Insurance PCL. Smarter Health Plus brochure (EN), Version May 2026Read 2026-10-15.
  7. 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.
  8. Allianz Ayudhya General Insurance PCL. Beyond Care: product page (brochure linked there is dated 1 March 2025)Read 2026-10-15.
  9. 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.
  10. 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.
  11. Pacific Cross Health Insurance PCL. Health & Accident Insurance: Standard plan page (brochure linked there is dated 15 September 2025)Read 2026-10-15.
  12. Pacific Cross Health Insurance PCL. New Normal Lifestyle Series: application form (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.
  13. April International (MyHEALTH Thailand). MyHEALTH Thailand: Brochure, 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.
  14. Thai Vivat Insurance PCL. The new Delight plan brochure (TH + EN) (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.
  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.
  16. Thai General Insurance Association (TGIA). Long-stay insurance portal: Non-Immigrant O-A guidelineRead 2026-10-15.
  17. Thai General Insurance Association (TGIA). Long-stay insurance portal: Non-Immigrant O-X guidelineRead 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.