[MERGED] Health Card Recommendations / Health Maintenance Organization ( HMO )

[falin4u]

Thanks for all the replies. I will try to contact them.

Thank you again.

Thank you also to PEX

[Rumdumb]

Hi,

I just want to ask kung covered ng Cocolife Health Insurance ang Orthodontics.

[froshie1]

kung binayaran ng company mo ang pagseserbisyo ng ortho eh di yes. depends on the paying capacity of your company.

[Seldoml]

I hate Philamcare. Since our company was small, we couldn't get a group account so we had individual health plans. When the agent told us were qualified for a group plan and that we'd get a better deal with it, we moved to a group plan. After that I had all sorts of illnesses and I kept getting letters about pre-existing conditions! HELLO!!!? The agent didn't tell us it's like we'd start again from scratch! To think I never used my health card for the past few years I was on an individual plan, not even the dental.

[muff_puff]

What is the best HMO or health card in the Philippines? I'm planning to get one. Pls enlighten. Thanks!

[japanese staff]

bad experience din ako sa philamcare accredited doctor; ang bungad ba naman sa akin ay "ayoko ng mga pasyenteng card ang tagal magbayad ng insurance". Tama ba naman na sabihin mo yun sa patient?E di sana hindi na lang sya nagpa accredit diba?

[Papichulo168]

I'm currently looking into several HMOs and I've shortlisted Medicard na mukhang maganda and affordable.

Plan 2500 (In-Patient only)
Premium: P12000 / year
Benefits:
P150,000 limit dreaded disease
Emergency at non-accredited hosp: NONE
OutPatient: NONE
OP Medicines: NONE
Executive Check up (APE / ECU): NONE

VIP 2500
Premium: P14,936 / year
Benefits:
P100,000 limit dreaded disease
Emergency: P75,000 (80% at non-accredited hosp)
OutPatient: P5,000 / year
OP Medicines: P1,000 / year
Executive Check up (APE / ECU): Yes (In-House)


VIP 8000
Premium: P44,000 / year
Benefits:
P300,000 limit dreaded disease
Emergency: P200,000 (80% in non-accredited hospital)
OutPatient: P12,000 / year
OP Medicines: P3,000 / year
Executive Check up (APE / ECU): Yes (Premium)

Parang maganda ang value nung VIP 2500 among the 3. Sayang kasi yung VIP 8000 kung hindi mo magagamit. Compared naman to the basic Plan 2500, just an additional P 3,000 a year, you get out patient care worth P5,000 plus Emergency Care.

[ispammy]

hi guys! any suggestions for a health card for senior citizens? thanks!

[darling18]

Hi, ibig ba sabihin mas okay na kumuha muna ng mas mababang plan for the first year kasi nga sayang lang because of pre existing condition?? tapos upgrade ka na lang sa 2nd year mo.

And also ibig sabihin lahat ng nakalista sa mga PEC hindi yun pwedeng icover? or yung present ailment mo lang like me... i have hypertension. yun lang ang macoconsider ko na existing as of the moment. what if bigla ako mag ka amoebaiasis (do i spelled it correctly) pwede yun icover?

saan kaya office ng maxicare na malapit lapit dito sa caloocan? gusto ko mag avail ng family plan.. ang layo kasi kung makati pa.

Please enlighten me... thanks!

[geliq]

anyone knows ano number ng Caritas? i'm looking for hospitals or clinics na accredited sila, aside from St. Lukes and the other big hospitals. Thanks.

[purpleheadd07]

^^san ka ba malapit? pwde ang world citi sa may aurora blvd., may clinic din sila sa may farmers plaza.

[jashel_0208]

My sister consulted last year or I think couple of months ago bec she had scabies.The Physician or maxicare in that institution didnt even advise her that it was not covered prior consulation. I just felt that it was unfair for maxicare to charge us of something we were not even informed or even gave an option to look for other physician who has lower rate to check the skin disease.The letter just arrived today asking to settle the balance otherwise they will terminate my membership. Maxicare is part of the benefits I get from the company I am working with and the reason why we go to accredited institution is because we want to utilize our sickness benefits that company is giving us.In this case, we felt like we were deceived in a way were not given options to refuse or to agree if we would like to continue with the consultaion and shoulder the charge. That's really unfair especially for those who have limited resources like us.

[megan_sexy]

guys, please do enlighten me (please..............)

I'm about to resign in my current employer and about to hop on my next company to work for come next month. My problem is, they don't provide HMO plan until you get regularized, which I think after 6 months.

I'm now contemplating as to whether temporarily avail an HMO plan for myself and my parents (51 and 57 years old, who can be my dependents) or not. But, I know that you really can never tell that during my probationary period, which would run for 6 months long to be regularized, I or should I say we, would encounter sickness.

My questions are:

1.) How would I pay for such plan? Is it gonna be over-the-counter thing?

2.) I browsed some *top HMO providers websites, but cannot seem to grasp everything. How much ba talaga ito every month? or every year ang payment?

4.) Like how much is the range kung monthly? or kung yearly? Halos pare-pareho lang naman ata sila, give me a sample range pls. (pero sana monthly.

3.) What's the most affordable HMO provider to apply for, yet ok ang coverage?

4.) After 6 months, I'll then be entitled for an HMO corporate account under my company, would I be able to terminate my HMO individual account then?

Pls pls pls hoping for your kindness to answer such questions

Thank u in advance, guys!

[Noyz]

Post here any bad experiences you might have had with HMOs or health insurance companies.

[Noyz]

My wife was recently diagnosed with gallstones, but our HMO, Medicard, denied complete coverage because they assessed it to be preexisting based on one equivocal ultrasound finding after another and even when it's already past the contestability period.

There's a reason why exclusion of preexisting conditions by HMOs is about to be outlawed in the US. I saw first hand now why that is.

[matulis]

My wife was recently diagnosed with gallstones, but our HMO, Medicard, denied complete coverage because they assessed it to be preexisting based on one equivocal ultrasound finding after another and even when it's already past the contestability period.

There's a reason why exclusion of preexisting conditions by HMOs is about to be outlawed in the US. I saw first hand now why that is.

Noyz,

Last month I operated on a patient with the same situation that your wife has. I argued with the HMO and sent them a letter stating that the current condition is not pre-existing. They eventually approved the procedure for Lap Chole. If your wife had no previous symptom then the HMO may be able to approve the procedure.

[Noyz]

Thank you for your reply, matulis. I commend you for arguing with the HMO for your patient.

[Noyz]

By the way, it seems like your patient's HMO is more reasonable. What's the name of the HMO. Perhaps others in this forum who are shopping around for a good health insurance might want to consider it. After all, the purpose of this forum, I suppose, is to help people considering getting an HMO to make informed decisions.

[mark_mark]

hi, i just found this thread and I would like to help you in some of your questions.

guys, please do enlighten me (please..............)

I'm about to resign in my current employer and about to hop on my next company to work for come next month. My problem is, they don't provide HMO plan until you get regularized, which I think after 6 months.

That is the standard practice in most companies. They offer you the HMO benefit as an incentive or added bonus when you get regularized. For some companies, they do not even offer a salary increase and only offer the newly regularized employee some incentives like the HMO, rice allowances etc. You cannot do anything about this. You can perhaps negotiate this with your employer especially if you are on the managerial level and ask them if they can give you the HMO benefit on your first day. The HMO cannot do anything about this since this is a prerogative of the company. The HMO is just a supplier.

I'm now contemplating as to whether temporarily avail an HMO plan for myself and my parents (51 and 57 years old, who can be my dependents) or not. But, I know that you really can never tell that during my probationary period, which would run for 6 months long to be regularized, I or should I say we, would encounter sickness.

That’s true. No one can tell. So it’s better that you are prepared and cautious. Would you know if your company covers dependents? This is not automatic. Having dependents is not automatic once you have an HMO card. The company pays the HMO company the total headcount including the dependents. Again, the HMO is just a supplier and executes what your company has designed for its healthcare program. If they allow dependents, do they allow single employees to have dependents? Double check. They just might be allowing married employees only. If yes, how many dependents are they allowing.

My questions are:

1.) How would I pay for such plan? Is it gonna be over-the-counter thing?
I am not sure about the practice for other HMOs but for Maxicare, you can pay your dues at any branch of BDO (in cash) or at the head office either cash or credit card.

2.) I browsed some *top HMO providers websites, but cannot seem to grasp everything. How much ba talaga ito every month? Or every year ang payment?
I am not sure if other HMOs have a monthly mode of payment. For Maxicare, it’s at least quaterly. The rates are based according to the choice of plan, age bracket and mode of payment. Check out http://maxicareinquiry.blogspot.com for more info

4.) Like how much is the range kung monthly? or kung yearly? Halos pare-pareho lang naman ata sila, give me a sample range pls. (pero sana monthly.
The rates are based according to the choice of plan, age bracket and mode of payment. Check out http://maxicareinquiry.blogspot.com for more info

3.) What's the most affordable HMO provider to apply for, yet ok ang coverage?
I am not sure about the rates for other HMOs. Check out http://maxicareinquiry.blogspot.com for rates for individual and family plans.

4.) After 6 months, I’ll then be entitled for an HMO corporate account under my company, would I be able to terminate my HMO individual account then?
For Maxicare yes you can if you choose the semi annual or quarterly mode of payment. Just don’t pay your bill and your coverage is automatically terminated.

Pls pls pls hoping for your kindness to answer such questions

Thank u in advance, guys!

_________________________________________
Is your purse ready when you get sick?
Secure yourself with MAXICARE
For Individual, Family & Corporate
Tel: (02) 4964690 Mobile: 09226047864
Email: maxicareinquiry@gmail.com
YM: slime_ateneo
http://maxicareinquiry.blogspot.com/

[mark_mark]

My wife was recently diagnosed with gallstones, but our HMO, Medicard, denied complete coverage because they assessed it to be preexisting based on one equivocal ultrasound finding after another and even when it's already past the contestability period.

There's a reason why exclusion of preexisting conditions by HMOs is about to be outlawed in the US. I saw first hand now why that is.

Hi.
Are you under an Individual Plan or Corporate Plan?
How long have you had your card? If it's from the company, how has long the company been with your current HMO? How many are you in the company that has an HMO card, employees only?
There are 2 types of pre existing conditions, non dreaded and dreaded conditions. What was stipulated in the contract? How do you know that this is covered? Do you have a copy of their summary of benefits?




_________________________________________
Is your purse ready when you get sick?
Secure yourself with MAXICARE
For Individual, Family & Corporate
Tel: (02) 4964690 Mobile: 09226047864
Email: maxicareinquiry@gmail.com
YM: slime_ateneo
http://maxicareinquiry.blogspot.com/