On HMOs

Health care is really important.

You've probably read it, but I think few really appreciate it. If you're prone to sickness you probably do. If you're like me, where most things pass after a week, sometimes even without medication (or at least that used to happen when I was younger) you probably don't.

If you're a parent though, you'll probably be so thankful that you'll not only appreciate it but also spread the word.

Like early this year. For some reason (which we later learned was caused either by some bad biscuits or a virus), my daughter suddenly started vomiting. Unfortunately, that's happened a few times before so I wasn't too worried. At least not at first. But then she just wouldn't stop vomiting. She'd even throw up water within 10 minutes of drinking it.

For a first-time parent that's pretty scary. We rushed her to the ER, and she ended up confined and hooked to an IV (and we had to guard her 24/7; you don't know persistence until you meet a toddler trying to get rid of an IV!). Fortunately she got discharged the next day.

Additionally fortuitous is that I didn't have to pay anything. At least not from my own pocket. And that's even after "checking in" at the favorite hospital of embattled and jailed politicians. My company's HMO footed the bill.

Of course, it has to be one of their accredited hospitals, and I would have had to pay for extra "perks". But thankfully we had a good, accredited hospital relatively nearby.

Being a "corporate slave" isn't very glamorous, but at least it's got some very useful benefits.

But now I'm thinking what would happen to my parents after they turn older than 65, as they won't be covered anymore. And I guess right at the time it would be most "useful" to be covered.

One of my wife's acquaintances actually cited a better HMO for her aging mother as a reason for joining a new company. (Though her mother is probably younger than 65; most if not all HMOs don't cover anyone over 65, as far as I know)

I guess I'll just have to research more on that and hopefully post about it too.



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photo credit: Alex E. Proimos via photopin cc

8 comments:

  1. I'll be following you sir carlos, please do some research here... Problem ko rin yan sa parents ko kasi, di na sila covered ng healthcard ng kapatid ko & they are both 66 yrs old na. :)

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    1. Hi Grace!

      Ouch. You can try asking about Caritas Health Shield and Blue Cross. Don't wait for me, sometimes I drag my feet and procrastinate:)

      But I've heard before that Blue Cross covers even those over 65 years old. I'm not sure about Caritas Health Shield, but I think it does too (and despite the seemingly scammy text campaign, I've read they're actually legit).

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    2. Hi, fyi - Philhealth card is given free to senior citizens. You just need to show their senior citizen ID to the nearest Philhealth office:)

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  2. kala ko naman may i-share ka info about the best HMO as per your experience.
    im an OFW, im covered where i work but my family is not. im researching a decent HMO that would cover sana a family. i browsed maxicare kasi they have affiliate dito sa country where i work pero grabe naman ang premium. i say grabe kasi a friend of a friend was also using the same but paid minimal premium kasi naka company rider sya. hes not related to the company.its complicated and not sure if legal. pls dont publish this comment of mine. will wait for your entry detailing hmo..thanks.

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    1. HI Anonymous,

      I've read and re-read your comment, and since it doesn't contain any personally identifiable information, I decided to publish it anyway because you bring up some very interesting topics.

      1. I would like to talk about the different HMOs. Unfortunately, my (and your) experience with them will depend almost entirely on the company you were working for while you had it. Depending on the money the company is willing or able to shell out, it could be really great or sort of cheap.

      2. I tried getting an HMO for my parents. I thought maybe I could get Maxicare or Intellicare and pay for it on my own. Unfortunately, when I tried, I learned that I had to be a company with at least 10 employees.

      I could maybe start a company and hire 10 relatives. I'm not sure that's illegal as long as the company isn't a shell company and doesn't do anything illegal.

      But then, that would be also be lot more expensive - and a lot more work.

      3. Regarding your friend: I personally don't think that's something that can land him in jail (at least not in the Philippines). But then, I'm no lawyer.

      The HMO might get angry and revoke the coverage, I don't know. Or someone in the company may take the fall for it. But that's pure speculation already on my part.

      4.) I would love to detail what I know about HMOs, but aside from what I've written in the post and this comment, I'm not sure what else would be of use. If there's more info you wanted to know, leave another comment and I'll try to answer it or research it.

      Thanks!
      Carlos

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  3. thanks for the reply Mr.Carlo.
    im still not comfortable having my comments being published since i worry that hmo concerned might be stricter that would cause inconvenience to members opting such scheme. it is legit i guess, dahil ang friend ng friend ko have used it with all his medical expenses, still, parang cheating kasi,just my opinion, not against people using it though.
    anyway, about more details, i was referring to the way you blogged about car loan and interests from different banks. it was so comprehensive.
    have u browsed caritas website? its useless, its like a glorified marketing flyer, if you know what i mean.
    but i spoke to an agent there, i was offered a combo scheme, like i pay 37k annually for 5yrs and i get to enjoy health insurance for 15yrs plus i get to get back 100k at the end of 15th yr.seemed like a win win but the downside is they have low maximum benefit per year for their medical (eg 1st year is only 40k, 2nd year is 45k,etc). eh knowing the medical expenses dyan sa phil. last year i got my foot fractured and i pad 7k for an hour of an outpatient care,labs & meds).
    maxicare has online computation where i learned their premium, its 50% off talaga sa friend of a friend ko using a company rider.
    anyway, ayun lang po. salamat.

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    1. Well, I can still remove the comment, so let me know if you prefer that I do.

      I see what you mean. I'll try to do something like that for health insurance.

      But I would like to say that there's a slight difference between HMOs and Health Insurance (reportedly; I just read it on a forum myself and have no firsthand knowledge). Maxicare and Intellicare are HMOs, and unless I start jumping companies with similar benefits but have different providers I'll never get to compare them head to head (HR people though, can do so. If you know anyone, that would be awesome).

      Pure Health Insurance is almost like a basic life insurance, where you pay a premium and they pay out on certain events. Another slight difference is that apparently some may just pay out, and don't interact with the hospital, unlike HMOs. So the convenience factor may not be there.

      If you can get company riders, that usually the better option (using the "non-cheating" way).

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