I was exhausted, cranky, in need of a long, warm bath and some chocolate bars to perk up my mood. Worrying about someone in the family who is sick, especially if that person is a baby, does that to you.
But the voice of the man near the admission counter of the hospital where my son was admitted pierced the cloud of selfishness around me. He was obviously in pain. And he could not get a room at the hospital.
“I’m sorry, sir. We don’t have a room for you. You can wait in the ER until we have a room that fits your card,” the clerk said.
“Why, what’s wrong with my card?” the man said.
“We need to double check if you can get a private room just as you requested. I know that the maximum for your card is P1,900 per night, but we will have to check again,” the attendant said.
In the end, he decided to go home while waiting for a room. He was seventh on the list and it was already 4 p.m.
Sickness is a financial planning wild card. Even if you stock up on vitamins, eat lots of fruits and vegetables, swear by the benefits of eating wheat bread, there’s no telling if or when you will get sick. There are just too many factors when it comes to health – including genes. It’s a probability that each family needs to prepare for.
Are you prepared for the cost of getting sick? Is there room in your finances right now for sickness in the family?
I have long wanted to do a comparative study on HMOs in the Philippines, but my son’s condition prompted me not to put the topic in the backburner any longer. However, instead of presenting you with data, I will have to throw questions at you, hoping that you will share your experiences so that we can have an initial data scan of what options Filipinos have out there when doing emergency planning.
What HMO do you have?
How much are you paying?
What are your benefits?
How would you rate the delivery of these benefits?
How would you rate the quality of their service?
Let me be the first to answer:
My family’s HMO is Intellicare. We pay P1,484.40 per month for five cards, one of which is for a 1.6-year old baby, which I understand is the most expensive one. We have dental benefits, annual executive check-ups, check-ups with doctors affiliated with their network. The HMO covers room rates up to big private room for my husband who is the main cardholder and small private room for his beneficiaries. Whenever someone is hospitalized, they give P1,000 per day in cash, I suppose to cover other expenses during hospitalization. Ours is a corporate plan. The service is excellent.
What about serious illnesses? Are you prepared for them? Last week, I attended a press conference organized by Stryker Corp., one of the biggest orthopedic implant maker in the world, which has entered into a tie-up with HSBC and BPI Credit Cards so that Filipinos can avail of an operate-now-pay-later plan.
Orthopedic implants cost around P80,000 to P150,000. The entire operation can reach up to half a million. Under this scheme, if you have been recommended to have an operation, you can use your card to pay for the implant at zero percent interest and in so doing defray the cost.
Using our litmus test for those zero-percent advertisements, I asked them what would happen if the patient wanted to pay in cash. Same price, they said. I was able to have a good talk with their Finance guy (they are my favorite people in every company) and he said that Stryker was charged one percent per month by the card companies, totaling 12 percent per annum, but the company decided to shoulder the cost for the first year of the program.
I guess, a good deal, all in all, as long as you don’t default on your payments. One-month default would lose that zero percent deal and trap you into paying a 42 percent per annum interest on a huge amount of debt. That would give you a headache to go with your new bone transplant. Not a nice combination.
The best strategy is still to have an emergency plan in place. Make sure you have three to six months worth of expenses as emergency buffer, and a good HMO to back you up. Medical insurance companies, are in general, cheaper than HMOs. But they operate by reimbursement, so you need that cash for this to work.
Let the HMO story sharing begin :).
June 22nd, 2007 at 1:52 pm
g: my company is medicard too but they allow me to buy a plan for my mom. Its around P1,000/month for a P300k max plan. I went to Chong Hua Hospital here in Cebu the other day and hassle free naman ang medicard.
Medicard, however, has some trouble with all doctors in Davao. The cos won’t recognze the card. So you have to pay them first then get a refund from Medicard.
June 22nd, 2007 at 12:18 pm
Need more about HMO.
June 21st, 2007 at 5:08 pm
i work for a company that shoulders cost of hospitalization and medicines of its employees (including all legal dependents) on a 75-25 sharing (75% paid by the company, 25% paid by the employee), on top of medicare. while i’ve been working for the company i don’t feel the need to get health insurance. does everybody need it?
June 21st, 2007 at 1:22 pm
i have a corporate HMO - Philamcare. My hubby has another HMO Medicard but their plan does not allow for dependents so i’m carrying our son under my plan.
Some companies pay 100% of their employee’s insurance. In our company we do 80-20 sharing of cost. I’ve looked at my files and the last one i have is dated 2005 and my employee share amounts to Php 1791.87 annually. I don’t know if there has been increases and i think that amount has not taken my dependent into consideration. I will compute the correct amount in another post.
Benefits: annual physical (including executive checkup for 35 yo above), annual dental cleaning + 2 free fillings, room and board max limit up to 130,000 (per illness per year is my understanding), free check-up with affiliated doctors as well as in their clinic, comprehensive maternity coverage (very very important as i had an emergency C-section and we even had to shell out money despite my insurance coverage), all charges deemed necessary by the affiliated doctor in the treatment (emergency or in-patient) of patient.
RATING: excellent really. they have a wide coverage of doctors. they periodically give out a list of affiliated docs under their respective specialties. when someone gets hospitalized, a coordinator comes to visit and guides you thru the steps needed. they even cover those maternity tests that may not be done at all (like the stress test) and all related tests (i had 2 more ultrasounds prior to giving birth as my doc was afraid my amniotic fluid had dried up). so all in all i am grateful for our insurance coverage.
June 21st, 2007 at 11:05 am
My former employer issued us with intellicare. I agree that their services are great - not hard to get a referral if you don’t want to be treated in their clinic, and i think they got a large network from the best hospitals (MMC, St. Lukes, etc). They can give you extra cards for 2 dependents, and they have the same benefits as you do. too bad they stopped offering services for individual accounts, now that I left the company I cannot enjoy the services of Intellicare even if I wanted to shell out extra cash. My employer now offered us SPCare as part of our employees medical benefit. we paid a one-time payment of 5,800 per employee, and sadly if I wanted to cover dependents I have to pay the same amount for them. Just yesterday we had our annual physical exam. We also have dental services that we can avail on affiliated doctors. Since this company is relatively small, their network is not that large although they have some affiliated hospitals in the provinces.