The following 13 diseases or treatment are not covered
1. Disease or injury due to drug addiction under the Narcotics Control Act.
2. Renal replacement therapy and chronic renal failure except the end stage of chronic renal failure which the insured person can receive hemodialysis by Chronic Peritoneal Dialysis (CPD) and by kidney transplant based on the specified criteria, conditions and rates set by the SSO.
3. Any action taken for beautifying purpose with absence of medical indications.
4. Researching treatment
5. Infertility treatment
6. Tissue biopsy for organ transplantation except the biopsy for bone marrow transplantation that the insured person has to pay as actually incurred not exceeding 7,000 baht per person according to the criteria and conditions specified by the Medical Committee.
7. Non-medical indicated procedure
8. Organ transplantation operation except,
(A) Bone marrow transplantation
The capitation of medical service based on the specified criteria and condition is payable to the contracted hospital certified by the Medical Committee within the amount of 750,000 baht/person until the end of bone marrow transplant process.