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Table 1 Key characteristics of the three main public health insurance schemes in Thailand as of 2020

From: Financial risk protection of Thailand’s universal health coverage: results from series of national household surveys between 1996 and 2015

Insurance scheme Population coverage Source of revenue Mode of provider payment Access to service
Civil Servant Medical Benefit Scheme (CSMBS) 9%, government employees plus dependants (parents, spouse, and up to 2 children) General tax, non-contributory scheme Fee for service, direct disbursement to mostly public providers and Diagnostic Related Groups (DRG) for inpatient treatment Free choice of public providers
Social Health Insurance (SHI) 16%, private sector employees, excluding dependants Tripartite contribution, equally shared by employer, employee and the government Inclusive capitation for both outpatient and inpatient plus additional adjusted payments for accident and emergency and high-cost care Registered public and private contractors
Universal Coverage Scheme (UCS) 75%, the rest of the ‘Thai’ population not covered by the SHI and the CSMBS General tax Capitation for outpatients and global budget plus DRG for inpatients Registered contractors, notably the network of public hospitals (Contracting Unit for Primary Care)
  1. Source: Tangcharoensathien et al. [4]