Health Insurance is the number one basic financial necessity that every individual or family should own. It protects you and your family when getting sick. This is most important when you are a freelancer or self-employed because when you get sick you pay your own medical bills and no employer to take care of your health insurance.

What is (Health Maintenance Organization) HMO?

Republic Act 7875 (National Health Insurance Act of 1995) defines HMO as an “entity that provides, offers, or arranges for coverage of designated health services needed by plan members for a fixed prepaid premium.”

HMOs are not healthcare providers. They are the middlemen between healthcare providers and patients.

Philippines Standard HMO Benefits
• Out-patient care (consultations, laboratory and diagnostic tests, etc.)
• In-patient care (hospitalization, operating room, and recovery room, professional fees, etc.)
• Emergency care (professional fees, hospital bills, emergency room, medicines for treatments, etc.)
• Preventive care (annual physical exam, immunizations, etc.)

Blessed are those who are company employed for HMOs are usually included on their company benefits. Since Health Insurance is usually expensive most people don’t avail of one, so here I am telling you that there are affordable HMOs in the Philippines that you can get for yourself and for your family.

What is Prepaid HMO or Prepaid Health Card

Prepaid Health Card is the 2nd type of HMO. It is a more affordable option compared to the 1st type which is Comprehensive HMO Plans. For a minimal one-time payment of around 500 php to 4,000 php, you get an HMO coverage (usually for single-use) in a year.

Advantages of Prepaid HMO or Health Card
1. Affordable. Prepaid HMO offers a lower one-time payment premium compared to a Comprehensive HMO Plan. For as low as 500 php you can receive basic healthcare within a year.

2. Peace of Mind. Having an HMO gives you a sense of security that anytime a medical expense arises, you won’t need to worry about how to pay for your medical bills.

3. Wide range of healthcare providers. Most HMOs have large networks of doctors or medical specialists and hospitals in the Philippines.

Disadvantages of Prepaid HMO or Health Card
1. Most HMO plans exclude pre-existing conditions (cancer, stroke, diabetes, etc.), maternity benefits, and dental care. Other offers a higher premium for such condition mentioned above.

2. HMO Benefits can only be used within your HMO’s provider network. This means you can only avail of the service in hospitals and with doctors that are affiliated with the HMO you use. So make sure to choose an established HMO with a wide range of network or an HMO that your doctor and your nearest hospital is accredited to. You can easily look up your doctor and hospital in your HMOs website provider network list.

Difference between Prepaid HMO and Comprehensive HMO Plan

The main difference between the Comprehensive HMO Plan and the Prepaid HMO Plan is that the Prepaid HMO can only be used once within the year even if you haven’t used up all the coverage.

Example: Your coverage is 50K pesos and you use only 20K pesos, you cannot use anymore the remaining 30K pesos, and to get the protection you need, you have to purchase a new Prepaid HMO Plan.

While for the Comprehensive HMO Plan, using the example above, you can still avail of the 30K pesos within the coverage period.

Another difference is that unlike comprehensive HMO where you get all the benefits of a Standard HMO, for the Prepaid HMO you have to purchase them separately.

Recommendation

Purchase an In-patient care plan with attached out-patient care. Separately purchase an emergency care plan even if your in-patient care plan has already emergency care attached to it because often time’s emergency medical bills are smaller compared to in-patient care. You do not want to use the 50K php coverage plan for a 10K php medical bill.

Important Reminders before Availing a Prepaid HMO
1. You must be a member of PhilHealth or a beneficiary of a PhilHealth member.

2. Prepaid HMO plans have one-year coverage. If not use within the one-year period the plan is good as canceled and cannot be used anymore. (on the brighter note let us be happy if we do not use our HMO plans)

3. If your medical bill exceeds the coverage limit then you will have to pay for the succeeding medical bills.

4. Usually, the Prepaid HMO can be used 12 days after activation of the plan.

5. Always read your HMO Policy.

The Perfect and Safest Healthcare Plan

The perfect and safest plan is to live a healthy lifestyle. Eat a well-balanced diet (go, grow, and glow foods). Exercise regularly (a minimum of a 30-minute walk, thrice a week). Get enough sleep (a minimum of 6 hours sleep daily for 25+ year old).

Here is a Prepaid HMO List that you can check and download for free. I highly appreciate it if you share this with your family, relatives, and friends. The many people that are being protected through Health Insurance the easier it would be for every Filipino.

NOTE: IamGeemiz and the author of this article are not affiliated nor being paid by any HMO company or agency. This article aims to help and guide fellow Filipinos who are looking for an affordable healthcare management option.

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