Adulting: Which HMO in the Philippines is Best?

Philippine HMOs

Just like in the US, we are at the mercy of private insurance companies when it comes to healthcare.

I envy Canada’s publicly funded health care system. PhilHealth is supposed to be the local version of it, but it pales in comparison to the universal health care provided to Canadians. Of course, we can’t compare the Philippines to Canada, but it is really stressful to think of future illnesses or accidents that might affect us and our uninsured family members. This growing insecurity is affecting our emotional well-being, too. Being uninsured robs us of peace of mind.

Emergency health expenses are high, even in public hospitals in the Philippines. This should be enough reason to persuade anyone to get an HMO plan, right? True, but limited income and lack of assets and savings prevent many Filipinos from getting insured.

Some employed Filipinos get HMO coverage for themselves and for their parents (if they’re single) or their spouses and children (if married). Employer-based HMOs are great, but for single parents, unemployed, self-employed, retired, or freelancers, getting an HMO plan is expensive, with rates starting from P10,000 to P40,000 a year.

The top HMO providers in the Philippines

Maxicare is the number one HMO company in the Philippines in 2018 – at least in terms of membership fees. It is a private health maintenance organization that charges its members based on the kind of coverage they require, so the cost varies. I had this insurance while I was still employed, yet I was never sick so I was only able to use it for dental services and maternity consultations.

Intellicare is the second most popular HMO provider for employed Filipinos. Like Maxicare, though, I was not able to use it for checkups as I was never sick. My colleagues, however, were able to use it for emergencies.

That’s the beauty of HMOs – you just need to present your membership card to accredited doctors and hospitals during a consultation or emergency, and you pay ‘almost’ nothing. (Giving birth is a different story, though, so be sure to check if it’s covered by your HMO provider. Mine wasn’t, so while the checkups were free, the delivery wasn’t. Thankfully, SSS got my back.)

How to Choose an HMO Plan

I recently had a chat with a friend about health insurance and HMO. I was surprised to find out that these are two different terms. While they are both helpful during hospitalization, the former works like savings that beat inflation, not a health emergency prepaid card. A health insurance plan provides health coverage during your lifetime and increases in value (depending on the market), while an HMO plan increases in cost as you age, and it’s something that you need to pay for annually for renewal. For clarity, Etiqa and AXA are examples of health insurance providers while Maxicare, Intellicare, and Medicard are examples of HMO providers.

IMoney PH suggests to get both to have the best coverage. But if you have to choose and your budget is limited, getting an HMO plan is a top priority. It seems that some private insurance companies have been responding to the needs of Filipinos by providing a cheap alternative in the form of health cards.

Here are some health cards that can be purchased and used during emergencies:

  1. Insular Life ER Care All-In 100 Adults (Cost: P1,750/year): Php 100,000 worth of coverage for emergency cases
  2. Philcare ER Shield (Cost: P800/year): P50,000 worth of coverage for emergency cases at 500+ Philcare-accredited hospitals
  3. Medicard RxER (Cost: P1,998/year): for an annual physical exam, outpatient consultations, dental services, and emergency care
  4. Maxicare EReady (Cost: P699 – P899/year): P15,000 worth of coverage for medical-related emergency conditions

These health cards are not HMO plans, but they are better than zero coverage. They offer a lot of perks and exclusions. Many medical conditions are not covered, so be sure to read the fine print before purchasing one.

Since I was more interested in better coverage, I inquired at Maxicare (a big HMO company usually has more accredited hospitals/doctors, so I believe it’s the best choice). The quote I got through their online quick plan computation was P18,904 a year for my age and the terms I preferred. Not so bad, I thought.

What about you? Which HMO plan do you think is best?

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