ประกันสุขภาพเหมาจ่าย, ประกันสุขภาพแผนแม็กซ์แคร์

 

Max Care Plan

Cover up to THB 5 million
Room & Board benefit up to THB 12,000 with cover for 365 days
Top-up your cover with Major Medical
benefits with 80% of the eligible expenses of the inpatient hospitalization benefits limit
  • Lifetime renewal guarantee*
  • No requirement to buy additional life insurance plan
  • Obtain unlimited health and well-being advice from qualified doctors via telemedicine service**

Remarks:

*Applicants who purchase their plan before 60 years old and continuously renew the plan will be eligible for lifetime renewal. Applicants who purchase their plan after 60 years old will be eligible to renew the policy until they are 80 years old.

**Available only for telemedicine providers within the company's network. To use Allianz Ayudhya’s proprietary telemedicine service please contact 02 677 0999.

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Remark

  • Subject to the insurance policy’s terms and conditions.
    Warning: Buyers should understand in detail coverage and conditions before making insurance decisions every time.
  • This premium is an approximate based on minimum sum insured only. Please contact our sales staff or leave your information in "Are you interested in Allianz Ayudhya’s Health insurance?" box for our staff to contact you.

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Coverage/Benefits

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Description Benefit (Baht)
Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Plan 6
Maximum benefit for an injury or sickness per confinement* 300,000 400,000 500,000 600,000 1,000,000 5,000,000
1. Benefit for Inpatient Care  
Section 1 Room and board including service charges (inpatient) per confinement*            
Non-intensive care room, maximum payable per day 1,400 2,500 4,000 5,000 8,000 12,000
Intensive Care Unit (ICU), maximum payable per day (with a maximum limit of 15 days per per confinement*) 2,800 5,000 8,000 10,000 16,000 24,000
Section 2 Hospital medical expenses for diagnostic and therapeutic procedures, blood and blood components, nursing service, medicines, and parenteral nutrition, and medical supplies per confinement*  
2.1 Hospital medical expenses for diagnostic procedures 16,000 30,000 40,000 50,000 80,000 200,000
2.2 Hospital medical expenses for therapeutic procedures, blood and blood components, and nursing service
2.3 Medicines and parenteral nutrition, and medical supplies
2.4 Home medications and medical supplies 1
Section 3 Medical practitioners’ fees per confinement* 300 600 900 1,200 1,800 4,500
Section 4 Fees for surgery and medical procedures per confinement*  
4.1 Operating theater and procedure room 22,000 40,000 50,000 70,000 100,000 250,000
4.2 Medicines, parenteral nutrition, medical supplies, surgery and procedure equipment
4.3 Surgeons fee including surgical assistants
4.4 Anesthesiologists’ fees
4.5 Organ transplantation 150,000 200,000 250,000 300,000 500,000 1,000,000
Section 5 Day Surgery Included in Section 4
2. Benefits for Non-Inpatient Care  
Section 6 Hospital medical expenses for diagnostic procedures before or after hospitalization relating to the condition diagnosed, or outpatient treatment after hospitalization per confinement*  
6.1 Hospital medical expenses for diagnostic procedures relating to the condition diagnosed within 30 days before and after hospitalization Included in Section 2
6.2 The expenses for OPD visit post hospitalization within 30 days (excluding hospital medical expenses for diagnostic procedures)
Section 7 Medical expenses for an injury (OPD) within 24 hours of accident 2,200 4,000 5,000 7,000 10,000 25,000
Section 8 Rehabilitation post hospitalization per confinement* รวมอยู่ภายใต้หมวด 2
Section 9 Hospital medical expenses for treatment of chronic kidney disease by hemodialysis per policy year 10,000 10,000 15,000 15,000 25,000 50,000
Section 10 Medical expenses for treatment of tumor or cancer by radiation therapy, interventional radiology, nuclear medicine therapy per policy year 300,000 400,000 500,000 600,000 1,000,000 5,000,000
Section 11 Medical expenses for treatment of cancer by chemotherapy per policy year
Section 12 Emergency ambulance services, maximum payable per trip 1,000
Section 13 Minor surgical expenses Included in Section 4
3. Additional Benefits   
Major Medical Treatment Major Medical Treatment paid up to 80% of eligible expenses for inpatient hospitalization**, up to the maximum limit for each plan
Specialist’s consultation fees - no operation case 1,600 3,000 4,000 5,000 8,000 20,000
Specialist’s consultation fees - operation case 2,200 4,000 5,000 7,000 10,000 25,000
Personal Accident (Or.Bor.2)*** 20,000 40,000 60,000 100,000 100,000 100,000
Fee for special nurse care at home, maximum payable per day (limited to 15 days per Confinement) 500

​*Each hospitalization as Inpatient for medical treatment(s), or each major surgery treatment without the hospitalization as inpatient (day surgery), in a hospital or medical facility. In this regard, hospitalizations as Inpatient for treatments, or major surgery treatments without hospitalization as inpatient (day surgery) in a hospital or medical facility, regardless of how many times, due to the same injury or sickness which has not been cured, including related or continuous complications, within 90 days from the date of last discharge from the hospital or medical facility will be considered as a single confinement.

**Except Section 1, 4.5, 7, 9, 10, 11, 12

***Applicable to the Insuring Agreement for Personal Accident, Death, Dismemberment, Loss of Sight, Loss of Hearing, Loss of Speech or Permanent Disability Benefits (Or.Bor.2). 50% coverage in case of motorcycle accident.

 

Remark :

- Worldwide coverage (excluding the United States of America where the benefits will be paid for the injury from an accident only). Medical expenses for treatments of chronic kidney disease by hemodialysis and organ transplantation are covered in Thailand only.

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Description Benefit (Baht)
Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Plan 6
Maximum benefit for an injury or sickness per confinement* 300,000 400,000 500,000 600,000 1,000,000 5,000,000
Optional Benefits            
The Insuring Agreement for Outpatient Medical Treatment, per visit (maximum benefit 1 visit per day, 30 visits per year) Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Plan 6
Classic plan 400 500 1,000 1,500 2,000 2,500
Plus plan 500 800 1,200 2,000 2,500 3,000
Deluxe plan 600 1,000 1,500 2,500 3,000 3,500
             
Maternity Benefits* (Applicant is able to purchase any of the 4 maternity plans) Plan 1 Plan 2 Plan 3 Plan 4    
- Normal delivery, assisted delivery or intentional cesarean delivery 40,000 60,000 90,000 120,000    
- Emergency cesarean section or ectopic pregnancy 80,000 120,000 180,000 240,000    
- Miscarriage 20,000 30,000 45,000 60,000    
             
Personal Accident (Or.Bor.2)**      
- PA 200 plan 200,000      
- PA 400 plan 400,000      
- PA 900 (for occupation class 1 and 2 only) 900,000      

​*For maternity benefits, policyholders must make an advance payment for medical services.

**Applicable to the Insuring Agreement for Personal Accident, Death, Dismemberment, Loss of Sight, Loss of Hearing, Loss of Speech or Permanent Disability Benefits (Or.Bor.2). 50% coverage in case of motorcycle accident.

 

Remark :

- Maternity coverage will be provided following a waiting period of 280 days, except in the case of miscarriage, which will be covered following a waiting period of 90 days.

  • Eligible for persons aged 15 days to 65 years. Applicants who purchase their plan before 60 years old and continuously renew the plan will be eligible for lifetime renewal. Applicants who purchase their plan after 60 years old will be eligible to renew the policy until they are 80 years old.
  • Applicants under 10 years old must apply policy together with parent(s).
  • For insured members who hold more than one insurance policy with Allianz Ayudhya Health Insurance, the maximum payable for medical treatment of any illness will be THB30 million. The maximum payable for personal accident insurance will be THB 1 million across all Allianz Ayudhya policies.
  • Term Health Insurance: Yearly Basis
  • Acceptance is subject to underwriting assessment.
  • Telemedicine
Health insurance premium is eligible for tax-deductible benefit, in accordance with the terms and condition prescribed by the Revenue Department.
  • The Applicant is advised to always study details of coverage and conditions carefully before deciding to buy insurance. After receiving the Insurance policy, the insured is advised to study the terms and conditions of the policy contract.
  • It is the responsibility of the Insured to make premium payments. Insurance agencies and brokers only facilitate the service.
  • Beyond Care is the marketing name of Special Personal Health and Accident Insurance Policy.
  • Should coverage provided by any insurance policy be in violation of any United States (US), United Nations (UN) of European Union (EU) economic or trade sanctions, such coverage shall be null and void. For example, we cannot pay for healthcare services provided in a country under sanction by the United States unless permitted under a written Office of Foreign Assets Control (OFAC) license. Learn more on the US Treasury’s website at :  www.treasury.gov/resource-center/sanctionsz
  • Chronic diseases, injury, or sickness (including complications), condition(s) or abnormality(ies) that has occurred before entering the insurance contract.
  • Medical expenses incurred for
  •    * Sickness that occurs within first 30 days form the effective date of the insurance policy.
  •    * Sickness or disease that occurs within 120 days of policy in the case of Tumor Cyst or Cancer, Hemorrhoids, Hernias, Pterygium or Cataract, Tonsillectomy or Adenoidectomy, Stones, Varicose veins, and Endometriosis.
  • Medical expenses incurred for the treatment of attempted suicide or self-inflicted injury.
  • Acquired Immune Deficiency Syndrome (AIDS), including related complications or sexually transmitted diseases.
  • Any unconventional treatment, alternative medical treatment or experimental treatment.
  • Health check-ups, requests for hospitalization, requests for surgery or convalescences that are not medically necessary.