• HMO Philippines

    HMO or Health Medical Organization is a set of plans and offers that provide customers with a wide variety of healthcare options and services along with a network of hospitals and doctors and other providers who supply medicines and related services to its members. This plan offers myriad preventive health services as compared to other plans. Although there are many different options, these plans usually allow customers to procure a range of services at reduced and economical prices. These plans are usually for those who wish to avail preventive services such as immunizations and check up coverages along with low premiums. These plans are usually procured by Filipinos for free when they are employed. Customers should note that, in the Philippines, unlike the United States of America, only HMO plans are provided and not PPO or Preferred Provider Organization plans.

    There is no greater wealth than health and without good health, all other aspects of life seem irrelevant as it is impossible to experience life’s joys without enjoying good health. With the increase in research and development in the field of medicine, the lifespan of people along with the healthcare facilities and quality of life has improved dramatically. However, along with this, sedentary habits and an unhealthy and fast lifestyle has contributed to early aging and disorders that usually do not appear before the age of 60 to 70.

    Despite this, most customers have a lacklustre view towards procuring health insurance schemes and HMO options. Health is taken for granted. Although accidents and hospitalizations may not be very common, it still takes a huge chunk of savings and frequent fever, cold, other minor ailments also take a toll on a person’s finances. Therefore opting for HMO plans is an option that is advisable for all. However, some would also prefer medical insurance and other schemes. HMO is advised for those who wish to possess network of hospitals, doctors and clinics wherein they can avail benefits, disability and other treatment benefits. This plan also provides protection in the most economical way against a wide range of diseases and disorders. As compared to medical insurance, HMO offers greater protection against a higher inpatient limit.

    However, each plan along with its pros, also has its own set of cons. The main issue with HMO plans are when patients find it difficult to stick to their plan but go beyond which will result in customers having to shell out money for the same.

    What are the HMO options available for Filipino citizens ?

    There are a large number of companies providing HMO plans. The top companies based on market share are Medicard Philippines, Inc., Maxicare Healthcare Corp., Intellicare, Phil healthcare, Inc.

    Some of the other companies include Blue Cross, Insular Life and Fortune Care. The table below gives an idea regarding the various plans and benefit limit provided.

    Company Benefit Limit Outpatient Benefit Pre-existing Condition Accidental Death Monthly Premiums
    Medicard VIP Plan Suite 700,000 Yes Yes 20,000 5578.58
    Medicard VIP Plan Large Private 450,000 Yes Yes 20,000 3811.08
    Medicard VIP Plan 250,000 350,000 Yes Yes 20,000 2090.00
    Maxicare Silver 60,000 Yes No 25,000 1199.17
    Maxicare Platinum Plus 200,000 Yes No 25,000 3458.83
    Maxicare Platinum 150,000 Yes No 25,000 1923.50
    Insular Life iCARE C 150,000 Yes Yes No 2028.33
    Insular Life iCARE B 120,000 Yes Yes No 1386.67
    Insular Life iCARE A 100,000 Yes Yes No 1155.00
    Fortune Care Plan 900 180,000 Yes No No 1123.83
    Fortune Care Plan 800 160,000 Yes No No 1089.17
    Fortune Care Plan 700 140,000 Yes No No 1054.50
    Blue Cross Select Standard Plan - Ward 500,000 Yes No 25,000 504.25
    Blue Cross Select Standard Plan - Suite 3000,000 Yes No 100,000 2076.00
    Blue Cross Select Standard Plan - Semi private 750,000 Yes No 50,000 828.08

    Tips to keep in mind before opting for a particular plan

    • Customers should opt for Health Maintenance Organization plans that provide them with both ‘no-cash-out’ option and as a private patient for later reimbursement.
    • Users should also opt for those plans that provide access to the most distinguished and best clinics and hospitals such as Cardinal, Asian Healthway, Makati Med and so on.
    • Customers should also look for plans that provide complete pre existing conditions and complete coverage of special procedures such as MRI and others.
    • Individuals must also look for Health Maintenance Organization plans that are not dependent on Philhealth. This is because, for plans that are dependent on it, customers will have to pay for the Philhealth part of their bill during checkout, even if they don’t have it.
    • Customers must also ensure that their HMO plan provides APE and dental benefits throughout the Philippines for a comprehensive coverage.

    In addition to the above,

    • Customers must ensure that they reconsider all those factors that have been termed as exceptionals, such as pre-existing conditions such as diabetes, hypertension, etc. Customers can request for these to be waived after a certain amount of time or opt for a plan that covers the pre-existing disorders as well.
    • Customers must ensure that they utilize their HMO benefits to the maximum before it gets expired at the end of the term. One of the ways through which they can ensure this is by procuring all the necessary immunizations and vaccinations that are covered by the HMO plan before the expiration of the plan.
    • Users are also requested to not just go with HMO plan as it is but request for additional benefits if required urgently such as if someone is looking to have a child, then including maternity benefit package as an add on is advised.

    The above are some of the tips that customers can keep in mind before opting for a particular plan. However, in addition to this, they must also look through the plan, understand all its terms and conditions before signing up for it. Health is something that must be given top priority to and HMO plans works to ensure the same.

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