(Updated as of 19 May 2022)
according to the policy contract and coverage condition
The conditions of COVID-19 Claims Coverage: IPD (IPD), (OPD)
and HB (or HB incentive for Group Insurance)
Fall into one of the following indicators
1. Doctor considers to order admit according to medical necessary and standard of Clinical Practice Guidelines (CPG)
or
2. อาการเข้าเกณฑ์การส่งต่อเพื่อรักษาแบบ “ผู้ป่วยใน” ในโรงพยาบาล (Hospital) ซึ่งต้องมีอาการ “ข้อใดข้อหนึ่ง” ดังต่อไปนี้
or
3. Patient with no severe symptom but have one of the following condition or underlying diseases that may contribute to be risky of severe condition
In case that Covid1-19 condition align with IPD criteria, fax claim, or reimbursement claim are applicable.
In case that Covid1-19 condition does not align with IPD criteria, fax claim is not applicable. Medical treatment will be covered under OPD benefit (if available).
For OPD, insured can use OPD cashless at any hospital network or reimbursement which according to OPD coverage and service condition.
In case of Home Isolation, Community Isolation or Hotel Isolation will be cover in OPD benefit (if available) only.
- Filled claim form
- Original receipt
– ใบรับรองแพทย์ (ต้องมีรายละเอียดหรือหลักฐานทางการแพทย์ที่แสดงว่าการรักษาครั้งนั้นเข้าเกณฑ์ความคุ้มครองผู้ป่วยโควิดที่สามารถคุ้มครองได้ ภายใต้การรักษาแบบผู้ป่วยใน)
- Detail of drug and expense (if any)
- Filled claim form
- Original or copy receipt
– ใบรับรองแพทย์ (ต้องมีรายละเอียดหรือหลักฐานทางการแพทย์ที่แสดงว่าการรักษาครั้งนั้นเข้าเกณฑ์ความคุ้มครองผู้ป่วยโควิดที่สามารถคุ้มครองได้ ภายใต้การรักษาแบบผู้ป่วยใน)
This condition is applicable for insured who is under Covid-19 treatment from 17 May 2022 onward
(eligible from the first treatment day)
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