Everything You Need to Know About HMOs in the Philippines

Big companies often offer their employees medical benefits as an additional perk of working for them. We’re not talking about PhilHealth contributions—those are actually required by the law—we’re talking about the benefits provided by a health maintenance organization or HMO like MediCard, Maxicare, and Intellicare. In fact, an HMO form is one of the first forms they’ll ask you to fill up upon regularization. But, first things first, what does HMO mean?

What is HMO?

HMO stands for health maintenance organization. It’s a type of health plan that gives its clients access to a specific network of hospitals, clinics, and health care practitioners. Some HMOs are paid annually while others come in prepaid packages. 

HMOs aren’t just limited to members of the workforce. Whether you’re an entrepreneur, an investor, or a freelancer, you, too, can benefit from one.

How is it different from health insurance plans?

Like regular health insurance plans, HMO plans have a specific set of benefits depending on the coverage amount. They also have certain limitations when it comes to the kinds of health conditions they cover. 

However, unlike regular health insurance plans where you can choose where to use the lump sum or allowance (within their set guidelines, of course), HMO plans actually tie you to specific health care practitioners and health institutions. This means that if your chosen doctor or hospital is not on the list, you won’t be able to use your HMO plan. 

HMO plans tend to be more affordable than health insurance, but the premiums aren’t fixed. Unlike health insurance plans whose premiums are standard from the day you availed them, HMO plans tend to increase yearly. 

What’s good about HMOs is that your health card is as good as cash. With regular health insurance plans, you’ll still need to pay the hospital or doctor upfront and get reimbursed by your insurance provider later. 

How do I know which HMO is right for me?

There are many factors to consider when choosing the right HMO and the right HMO plan for you. On top of your list should be dependability. Has the HMO done a good job of servicing its clients? Scour the Internet for reviews. You don’t want to end up with an HMO that doesn’t deliver when you need it to. 

Another thing to look at is compatibility. Are both the HMO and the plan in question a perfect fit for your needs? Don’t just consider your present situation. Skip to years ahead in the future. If you have a preferred hospital or doctor, are they in the HMO’s list? If you want to get an HMO for your loved ones, you’ll have to consider their needs as well.

Affordability is another thing to consider. What can you realistically afford? Which plans are actually worth it and which ones are overpriced? However, don’t make this the primary basis of your decision. 

What HMOs are available to me?

What HMOs are available to me?
These are the most popular ones:

Choosing the right HMO and HMO plan requires a lot of cross-referencing. However, you’ll breathe easier at the end of the day, knowing that you’ve chosen the best possible option for you. 

While we’re on the subject, you might want to think about getting a life insurance plan or upgrading your current portfolio. Click here to see the Top 10 life insurance companies in the Philippines.

Wondering if you need life insurance to begin with? This article might shed more light on the matter.

PHOTO: Pexels.com

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