Reviewing and Developing Revision Proposal on the Benefit Package of the Health Insurance Card Scheme for Migrants

Abstract

The Ministry of Public Health issued the Health Insurance Card Scheme (HICS) for migrants who were not covered by any health insurance schemes; however, the benefit package under the HICS has not been significantly revised for the last 10 years. This study aimed to review and develop a proposal to revise the benefit package of the HICS for migrants. The study was conducted by reviewing documents, including clinical practice guidelines and cost-effectiveness studies of health interventions of the first 20 important health problems among migrants in Thailand, 10 communicable and 10 non-communicable diseases. The benefit packages of the HICS and the universal health scheme were also compared. A focus group discussion was arranged with 13 representatives from relevant agencies and healthcare providers, and in-depth interviews were conducted with 33 key informants comprising decision-makers/ government officers, healthcare providers, non-governmental organizations and 15 migrants. The study showed that the HICS covered diagnosis and treatment of almost all (90%) of the prioritized health problems. About 80% of the non-listed or unclear health services in the current benefit package were related to health promotion and disease prevention activities. Those unclear benefits led to disparities in services availability and user charge for access to service. The analysis of qualitative data suggested that health interventions that should be included in the benefit package and provided in all hospitals consisted of the maternal and child health diary (in translated version), the screening and treatment for common mental disorders, and breast self-examination advice.