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 25th, 2007 at 12:01 pm
I got this HMO(MedServ) for my parents thru my brother company. I pay P 5,000 each in four consecutive months. I would say mostly they’re covered and they’re pretty good in terms of benefits and service. It’s a little bit pricey because of the age bracket which is common in most HMO’s. The catch for most of the HMO’s if you get first time is the pre-existing, though some HMO’s waive this if they meet there quota as far as I know..
June 23rd, 2007 at 5:09 pm
i had a bad experience with medicard when i met an accident while working in a call center here in makati…although i know that they have to have a proper documentation with regards to the incident that i encounterd…they refused to entertain my concerns first without that documentation. since our company shelled out huge amount for this medicard annually i still ended up paying my hospital bills…maybe it would be better think twice before getting one….we are just making these HMO rich without us getting the right benefits….
June 23rd, 2007 at 1:31 am
Ur benefit package under corporate HMOs depends on the specifications ur employer & the HMO provider negotiate on. Actually, almost anything can be included or excluded in d HMO package if the company client wants so…but of course there’s a tagprice for each inclusion of benefit / special arrangement.
Hence, employees of Company X can be very happy about their coverage w/ HMO provider ABC; while employees of Co.Y can be very discontented about their HMO, also w/ provider ABC, coz they have different packages.
On the other hand, 2 companies may have exactly the same package from the same HMO provider but their annual costs differ. Why? Coz their utilization cost or ratios differ.
Based on my years of experience as an HMO agent (aside from being a life, & nonlife insurance agent, pre-need agent, & investment solicitor) the trickiest benefit features have to do w/:
1) the HMO package’s benefit limits coz there are diff ways of measuring & treating these limits w/c are not too obvious for the client & sometimes even confusing.
2) how the HMO covers/treats pre-existing conditions (very important!)
June 23rd, 2007 at 12:50 am
Is it enough to have one HMO? Like if i have Philhealth already, will it be to my advantage to get another HMO like Philamcare? Or will this be just a waste of money? How many insurance coverage and HMO does one need?
June 22nd, 2007 at 9:56 pm
i think some cheaper HMOs have tie-up with philhealth.you have to be a philhealth member to avail extended health coverage.premiums for group or corporate is much lower than individual rate. i hope there should be a bill that unemployed/retired people can also avail of the lower group or corporate rate.or when you resign from a company giving you health insurance you can continue by paying the same corporate rate which is lower than individual rate.