HEALTHCARE OPTIONS

[Published in Manila Bulletin last June 2011]

In my last article, I talked about medical crisis and how you can take charge of your health and cushion yourself from exorbitant medical bills in case you get sick and hospitalized. (To read the article, you may check out my blog at http://hrclubonline.blogspot.com)

This time, I'd like to discuss the healthcare plans and types available in the Philippines since shopping for a health card can get overwhelming and confusing. Here are some of the healthcare programs that are being offered in the market. I find that each type of plan has strong and weak points and choosing your plan will all depend on your budget and preference.

SSS and Philhealth

If there are items in my pay slip that I'm more than willing to get deductions for, these would be at the top of my list. SSS provides maternity benefits, sick benefits and even a small pension as long as you pass their requirements. I personally have had the privilege of using my maternity benefit this year and it was a big help. Philhealth also provides you a sizable discount off your hospital bills so it made my hospital stay more affordable.

Both the employer and employee are legally required to give shared contributions for these funds. Your HR or Accounting Department will process payment for you so it's pretty easy to join and maintain membership. Be sure to go and get your SSS and Philhealth ID so that you can avail of the benefits. It is also prudent to check if your company is indeed remitting your payments to these agencies. There are a few irresponsible companies out there who deduct SSS and Philhealth contributions from their employees' pay slips but fail to remit them to the right agencies.

Although our SSS and Philhealth benefits will help us during a medical crisis, more often than not, they are not enough. So to protect themselves, employers and individuals enroll in extra healthcare programs that are offered by insurance companies. There are various healthcare plans and types out there and if you are seriously interested in getting a health plan for you, your family or employees, be sure to research and do due diligence.

HMO - Health Maintenance Organization

When you become a policy-holder of an HMO, you get access to their network which consists of hundreds of doctors, clinics and hospitals. You also can avail of the network's medical services with no cash outlay. This means that when you go visit an accredited doctor or get hospitalized, all you have to do is present your card and follow procedures, but you won't have to spend as long as costs are within you maximum benefit. This type of plan usually covers in-patient and out-patient services. Dental services and personal accident insurance are optional.

Medical Insurance

Not all doctors are created equal. Some are really just better. If you are like me who take time and great effort to find great doctors with experience and good bedside manners, then you may want to get a healthcare plan that allows you to choose your own doctor. Most Medical Insurance Plans allow this, but they are usually reimbursement type. This means that you will still have to put up the money to pay your doctor, but you can reimburse from the insurance company later on as long as you follow their process and requirements. Some Medical Insurance companies offer flexibility and let you choose coverage. You can go with basic in-patient and you can just add on outpatient, dental and others. There are even plans that let you add on an HMO component which offers access to their medical services network without cash outlay.

HMO with Pension

There are also some companies who offer combination plans wherein you pay premiums for several years with a locked-in arrangement. You get access to their network of doctors, clinics and hospitals with no cash outlay. Then after a certain number of years, you get a portion of your money back. The money back feature is an attractive offer, but rates are a little bit higher initially. It's worth a look if you have extra cash to spare.

Hospital Confinement Insurance

If you get hospitalized, you are faced with many issues. Aside from the medical bills you have to pay, you also will lose the opportunity to earn income. The purpose of this type of insurance is to give you an allowance during your period of hospital confinement. It is supposed to supplement you income loss. Some plans offer money back guarantee while other's don't.

There are many other types of Insurance that will suit your needs. These are just some of them. If you want to invest in healthcare insurance plans, be sure to research, investigate and ask other plan-holders. Read the policy very well. Ask about pre-existing conditions (if you don't know what this means, ask the agent to explain as this is a crucial point). Know and understand the benefits and limitations of your plan before you plunk your hard-earned money on it. The last thing you want when you are in a medical crisis is to be denied coverage. So read and ask a lot of questions.

I hope this article has shed a little light on important features of healthcare plans. If you are a jobseeker, don’t just look at how much salary you will get, but check if the company provides healthcare benefits. If your company offers healthcare, be very grateful. If they don't, consider getting a plan for yourself or your family.

We all work really hard to earn and save money. A single disease can easily wipe us out. So take charge of your health and finances while you are still healthy.