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Designated medical facilities are authorized to claim reimbursement for diagnosis and treatment services related
to sleep apnea as follows:
• Sleep Test: Reimbursement up to 7,000 baht, based on actual expenses.
• CPAP Device: Reimbursement up to 20,000 baht, based on actual expenses.
• Nasal Mask: Reimbursement up to 4,000 baht per unit.

2) Inclusion of Automated Peritoneal Dialysis (APD) as a Renal Replacement Therapy Option, where
the Social Security Office has expanded medical benefits to cover Automated Peritoneal Dialysis (APD) as an
alternative renal replacement therapy for insured persons with end-stage chronic kidney disease (ESKD).
APD is performed automatically during the night while the patient is asleep, using a pre-programmed
dialysis machine to administer dialysis solution in volumes prescribed by a physician. Treatment typically
takes 8 to 12 hours per session. The Social Security Office reimburses medical expenses based on actual
costs-covering diagnostic tests, dialysis equipment, dialysis solutions, and patient training-not exceeding
32,700 baht per month, provided that the treatment is administered at one of the 63 contracted health care
providers.

3) Revised Criteria for Vascular Access Preparation for Hemodialysis Without Upfront Payment, where
the criteria for vascular access preparation, including arteriovenous fistulas or catheter placement, required for
hemodialysis treatment using artificial kidneys, have been revised. Insured persons diagnosed with end-stage
chronic kidney disease are now entitled to receive vascular access procedures without the need for advance
payment, at any of the 133 contracted healthcare facilities. Reimbursements are provided based on actual
costs, up to the ceiling rates specified for each procedure.
Note : In cases where insured persons receive treatment at non-contracted healthcare providers, they

must initially pay out-of-pocket and may later submit a reimbursement request to the Social Security Office
provincial or branch office.
4) Expansion of Medical Innovations Covered Under the Social Security Fund, where effective 3 April
2024, the Social Security Office has expanded its coverage under the Social Security Fund to include three new
categories of advanced medical treatment, aimed at enhancing insured persons’ quality of life and promoting
physical and emotional well-being. These treatments include:
- Custom-Made Cranial Implants Provision of cranial prostheses for insured persons suffering from
skull deformities or skull loss due to injury or illness. This benefit addresses both functional and psychological
needs, helping restore physical appearance and self-confidence, thereby enabling insured persons to resume

normal daily life with dignity.
- Plasma Rich Growth Factor (PRGF) Treatment for Knee Osteoarthritis, which is non-invasive
alternative for insured persons with knee osteoarthritis. PRGF therapy utilizes high-quality plasma to help prolong
the functional lifespan of the knee joint. The treatment aims to reduce long-term reliance on pain medication,
lower the risk of associated complications, and promote better mobility and well-being.
- Surgical Implantation of Custom Ocular Prostheses, where this benefit supports insured persons
who suffer from permanent loss of vision or phthisis bulbi by providing access to individually crafted ocular

prostheses (custom artificial eyes). The surgery improves facial appearance, alleviates emotional distress,
boosts self-confidence, and facilitates social reintegration.
Note : The PRGF treatment for knee osteoarthritis and the surgical implantation of custom ocular
prostheses are being introduced as pilot benefits under a one-year trial period.

SOCIAL SECURITY OFFICE ANNUAL REPORT 2024 113