A Mom’s Guide to Health Insurance Plans in the Philippines
Hey there, momshies! Today we’re focusing on something that is a bit headache inducing but is kind of a thorn taken from your side after you’re done with it. Let’s be real – navigating the world of health insurance can feel like a maze, But if you wanna ensure your family’s well-being, you gotta step up and bear it. I know. With so many acronyms and options out there, it’s easy to get overwhelmed. But don’t worry, I’ve got your back! In this article, we’ll break down the different types of health insurance plans available in the Philippines, so you can make an informed decision that fits your family’s needs like a glove.
HMOs (Health Maintenance Organizations)
HMOs are like your family’s personal healthcare squad. When you enroll in an HMO plan, you’ll have access to a network of healthcare providers, hospitals, and clinics that have partnered with the HMO. Think of it as a club where you get exclusive perks and discounts for being a member.
One of the biggest advantages of HMOs is that they often offer lower out-of-pocket costs for services within their network. However, you’ll typically need to choose a primary care physician (PCP) who will coordinate your care and provide referrals if you need to see a specialist.
Some popular HMO options in the Philippines include:
- Maxicare: Known for its extensive network and comprehensive coverage, Maxicare is a go-to choice for many families. Maxicare has been convenient and easy for me to book at-home lab tests because it’s all covered by the HMO.
- Medicard: Medicard is a bit of a mixed bag as some reviewers online mention unreliability. But it remains a popular option for its affordability and family-friendly plans.
- Intellicare: Praised for its responsiveness and hassle-free reimbursements, Intellicare is a top contender according to online reviews. Intellicare staff are really approachable and easy to talk to; with hassle-free reimbursements; hassle-free admissions.
PPOs (Preferred Provider Organizations)
PPOs offer a bit more flexibility than HMOs. With a preferred provider organizations (PPO) plan, you can visit healthcare providers both inside and outside the plan’s network, but you’ll typically pay less for in-network services.
One of the biggest advantages of PPOs is that you don’t need a referral from a PCP (primary care physician) to see a specialist. However, this flexibility often comes with higher premiums and out-of-pocket costs compared to HMOs.
Some PPO options in the Philippines include:
- Pacific Cross: Known for its comprehensive coverage and global network, Pacific Cross is a popular choice for those seeking flexibility. Pacific Cross offers coverage up to 100 years old and you can use unlimited amount for a certain illness unlike others which has a limit per illness.
- AXA GHA/HCA: Offering a range of medical insurance plans, AXA GHA/HCA is a reputable option for those seeking in-patient coverage. AXA and GHA/HCA uses Intellicare/AVEGA network.
- Kwik.insure: While not a traditional PPO, Kwik.insure offers a flexible and user-friendly platform for purchasing health insurance. It’s very easy to enroll, with easy-to-reach support via FB Messenger. Their customer agent replies and resolves issues instantly. Requesting for LOA is hassle-free and quick, they cover a lot of hospitals and clinics, high coverage even for pre-existing conditions (after 6mos of continuous subscription.
EPOs (Exclusive Provider Organizations)
EPOs are like the strict cousins of PPOs. With an EPO plan, you’ll have access to a network of healthcare providers, but you’ll typically need to stay within that network for your services to be covered (except in emergencies).
While EPOs can offer lower premiums than PPOs, they also come with less flexibility. If you visit an out-of-network provider, you’ll likely have to pay the full cost of the services.
Some EPO options in the Philippines include:
- Philhealth: While not a traditional EPO, the Philippine Health Insurance Corporation (PhilHealth) is a government-run program that provides basic healthcare coverage to all Filipinos. Although not as good with support based on users xperience, it remains a widely used option for its affordability.
- Etiqa: Offering a range of health insurance plans, Etiqa is a reputable option for those seeking comprehensive coverage within a network of providers.
- Cigna: While not a traditional EPO, Cigna is a global health insurance provider that offers plans with a network of healthcare providers in the Philippines.
POS (Point of Service) Plans
POS (point of service) plans are like a hybrid between HMOs and PPOs. With a POS plan, you’ll have a primary care physician (PCP) who coordinates your care within a network of providers. However, you’ll also have the option to seek care outside the network, but at a higher cost.
POS plans can offer a balance between the cost-effectiveness of HMOs and the flexibility of PPOs, but they can also be more complex to navigate.
Some POS options in the Philippines include:
- InLife: While not a traditional POS plan, InLife offers a range of health insurance products that may provide a similar level of flexibility.
- Carewell Health Systems, Inc.: Offering a range of health insurance plans, Carewell Health Systems, Inc. may provide POS-like options for those seeking a balance between cost and flexibility.
- Cooperative Health Management Federation: As a cooperative organization, the Cooperative Health Management Federation may offer POS-like plans tailored to the needs of its members.
As every family’s healthcare needs are unique, it’s essential to carefully evaluate your options and choose a plan that aligns with your budget, healthcare requirements, and preferred level of flexibility.
Don’t hesitate to reach out to the providers directly or consult with a financial advisor to ensure you’re making the best decision for your loved ones. And hey, if you found this guide helpful, why not sign up for our newsletter? We’ll keep you updated with more tips and tricks to navigate the world of health insurance like a pro!
