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 27th, 2007 at 8:50 pm
Don2x–
There is no such thing as contestability period with HMO plans. This is why I posted earlier that this is one of the trickiest matters in HMOs if not fully understood & explained well. If pre-existing conditions are not waived, if an illness is detected even after 5 years, but if it is proven that is was already pre-existing, then it will not be covered. This is for anti-selection. Pre-existing conditions are waived depending on the # of employees enrolled, w/c varies among HMOs. That is why corporate plans are better (& cost lower) than individual plans so encourage ur employers to get HMO plan even if w/ employees sharing on cost. & of course it is best to enrol in an HMO while still healthy so you are already fully covered when the inevitable happens.
June 26th, 2007 at 10:08 am
@jsalamat,
don’t rely on philhealth alone. the coverage is very minimal and it can only be used if you get confined. I might exagerate, but sometimes you can get, say, only 500 discount on a 5000 hospital room. most HMOs can be used in conjuction with philhealth, so you will pay only for the medication/maintenance that you will need. If your company offers this then I think you may consider this.
June 25th, 2007 at 9:55 pm
most HMOs do not cover pre-existing conditions. but is there a time limit for that condition, say after 2 years all pre-conditions are covered? like life insurance there is a 2-year contestibility period.
June 25th, 2007 at 3:55 pm
hello starter boy,
incidentally, we also live here in Cebu but unfortunately the H’s company plan does not allow for beneficiaries and i don’t mind carrying our son in my plan though coz i am already comfortable with how it works.
correcting my own post earlier: i computed my annual share and it amounts to Php 1900 for me and my son. Not too bad a deal and we can just directly go to any Philam affiliated specialist and get a checkup (with the correct form filled up of course) for free.
also re the question on HMO’s, i think it’s more important you get one for your old age. I actually am paying for an insurance geared for long term health plan. I am insured now under this but if i don’t use it until maturity then by age 60 or so i can get about Php 100,000 coverage annually. Yes that won’t be a big amount by that time but it’s better than nothing. I just hope i don’t outlive this HMO…
June 25th, 2007 at 3:02 pm
Would anybody here know if it’s really true that HMOs only cover those who are age 65 and below? Because if that’s true, retirees might end up spending all their savings and investments on medical bills.