First thing: no Social Security here
Spain and Thailand don't have a healthcare agreement, and the European Health Insurance Card stays in Europe. Thai public healthcare exists, but it's designed for Thais; the expat track is the private one. The good news: it's excellent and, compared with any private healthcare in Europe, cheap. The bad news: without insurance, an ICU stay eats through savings in weeks.
What it costs without insurance
| Medical service | In baht | In euros |
|---|---|---|
| General practitioner consultation | ฿500–900 | €13–24 |
| Specialist consultation (same-day appointment) | ฿1,000–1,500 | €26–39 |
| Dental cleaning | ฿900–1,500 | €24–39 |
| Night in a private hospital (bed only) | ฿8,000–15,000 | €210–395 |
| Full appendectomy (indicative) | ฿150,000–300,000 | €3,900–7,900 |
The pattern: everyday care is affordable out of pocket; serious care isn't. That's why the right policy is the one that covers hospitalization well, not the one that throws in free consultations.
Insurance: how much to pay
| Age | Local policy | International policy |
|---|---|---|
| Children | €30–50/month | €50–90/month |
| 30–40 years | €40–80/month | €80–150/month |
| 50–60 years | €80–170/month | €150–280/month |
| 65+ years | €150–300/month | €250–500/month |
- Local (Pacific Cross, Luma, AXA Thailand…): cheaper, covers you within the country. Enough for most people.
- International (Cigna Global, April, Allianz…): covers you outside Thailand too, useful if you travel a lot or want to be treated in Spain.
- What's worth reading twice: pre-existing condition exclusions, the annual coverage limit (a reasonable minimum: €100,000), copays, and whether it includes medical evacuation — key on the islands.
Which hospital, in each city
| City | Expat go-to | Note |
|---|---|---|
| Bangkok | Bumrungrad · Samitivej · Bangkok Hospital · Vejthani | Top tier in Asia; serious surgery happens here |
| Chiang Mai | Chiang Mai Ram · Bangkok Hospital CM | Everyday care covered; complex cases go to Bangkok |
| Phuket | Bangkok Hospital Phuket (JCI) · Bumrungrad Phuket | The best-covered island |
| Hua Hin | Bangkok Hospital Hua Hin · San Paulo | Bangkok is 2h30 by highway |
| Koh Samui | Bangkok Hospital Samui · Samui International | For serious cases: a 1h10 flight to Bangkok |
Pharmacy and everyday life
Pharmacies dispense a lot without a prescription and generics are very cheap (your everyday ibuprofen, pennies). Medication bought at the hospital itself carries a markup: ask for the prescription and fill it at a street pharmacy. Dentistry is so good and cheap that some people fly to Bangkok just to get their teeth done — you'll have it in your neighborhood.
Frequently asked questions
Does Spanish Social Security cover me?
No: there's no healthcare agreement, and the European Health Insurance Card doesn't work in Thailand. The expat plan is private insurance with solid hospitalization coverage.
How much do I pay for insurance?
As a guide: €40–80/month at 30–40; €80–170 at 50–60; €150–300 from 65 (local policies). International policies cost more, in exchange for covering you outside the country too.
What if I see a doctor without insurance?
Everyday care is affordable: a specialist for €26–39 with a same-day appointment. Serious care isn't: one night in hospital is €210–395 for the bed alone, and an operation runs into the thousands.