[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.
Showing posts with label hmo. Show all posts
Showing posts with label hmo. Show all posts
Wednesday, June 22, 2011
MEDICAL CRISIS
[Published in Manila Bulletin last June 2011]
When illness strikes, it could be very devastating to any hardworking person. Medical bills can wipe out your entire savings. If your disease is contagious or debilitating, you will be asked to stop working for awhile and this means loss of income for a critical period in time. And if you are the breadwinner in your family, you can just imagine how this will impact your loved ones who depend on you.
Let me share with you the experience of one reader and the issues he is faced with during his illness...
Dear Ms. Jhoanna,
I was recently diagnosed with Pneumonia. At first, my company allowed me to take a break for a few weeks to recover. But I got hospitalized and during that time, it was discovered that I also contracted tuberculosis.
My medical bills reached Php95,000 and I did not have enough money to pay the hospital so I asked my employer if they could help. They provided financial aid as well as a salary loan, but it's not enough to cover my hospital expenses. Our HR manager then suggested that we go for termination due to prolonged illness with an option to reapply to the company when I get better. She said, this way, I can get a separation pay. I agreed to this, but they are asking me now to submit a medical report, as well as sign a quit claim before they release the money. I'm very stressed right now and I can't help but feel paranoid with all the paperwork they are letting me sign. Is this really necessary?
Honestly, I feel very depressed. I have spent years working so hard trying to save up but I'll have to spend it all to pay for my medical bills. It's so unfair! I'm sick. I can't work. I don't have money. How can hardworking people like me move up in life? What can I do to improve my situation?
From,
Kevin
My response:
I'm sorry to hear about your illness and I sincerely hope that you will get well soon. It is normal to feel emotional distress when you are physically ill, not to mention the pressure of being faced with a steep medical bill. But do know that this too will pass, so hang in there.
Based from your letter, I think your company is pretty decent as they have provided you medical assistance and salary loan. They are also willing to give you separation pay as well as give you a job when you get better, so you can at least get some relief and not worry about job opportunities for the time-being, while you are recovering.
The paperwork is necessary. Legally, if a company is terminating an employee due to prolonged illness, a medical report must be submitted and this must be issued by a duly authorized public health officer. It is also prudent for companies to document all things related to termination. Efficient HR practitioners will normally ask you to sign a salary release, clearance and quit claim form. So just read the documents properly and sign, if everything is in order.
As an optimistic person, I don't really enjoy talking about sickness, disability or even death. But I know that Illness can strike anyone regardless of race, educational attainment and economic status. So for my peace of mind, I've chosen to face these issues head on and find ways to protect me and my family from these types of crisis. I urge everyone to do the same.
To protect yourself and your family against illness-related disasters and to cushion the financial blow that comes with it, take the time and effort to...
Invest in Health
In the movie "Tanging Ina", Ms. Ai Ai says: "Ang batang masipag, paglaki... pagod," (A kid who works hard, grows up to become... tired!). Many people who work hard, do just that---work hard. In the midst of all that hard work, they forget to eat properly, to rest well and to do the right kind of exercise. So they end up working hard for money, then they get sick and lose the money they earned while working hard in the first place! It's a vicious cycle that needs to be stopped. The best way to prevent illness-related blows is to stay healthy. Eat if you have to eat. Take a break if you need to rest. Wash your hands often to avoid bacteria and viruses. If you get sick, stay home until you get better. Don't ever act like a martyr by forcing yourself to go to work when you are seriously ill or worse, contagious. Other people might catch what you have and they won't be happy about it. Learn to work smarter, not harder. You will become healthier and happier in the long-run.
Invest in Affordable Health Insurance
Honestly, today's medical costs can give you a heart-attack. Depending on the illness and treatment required, bills can run from thousands to millions. Your SSS and Philhealth membership will help a bit, so make sure your contributions are up to date. If your company provides healthcare or HMO, good for you. It will help pay for your hospitalization in case you get confined. But if your company does not provide this benefit, you can proactively research and look for an affordable plan for you and your family (or even get free healthcare if you're a Makati resident with that magic yellow card).
See, companies are not required by law to give healthcare benefits aside from SSS and Philhealth. So they are not legally bound to cover your medical costs. Employers will pay you for your day's work. They are responsible for providing good working conditions, but they are not accountable for your health. In other words, you are ultimately responsible in taking care of yourself.
Hardworking people must not just work hard, but more importantly, they should live smart. Take care of your health and finances now, because nobody else will do it for you. Stay healthy!
When illness strikes, it could be very devastating to any hardworking person. Medical bills can wipe out your entire savings. If your disease is contagious or debilitating, you will be asked to stop working for awhile and this means loss of income for a critical period in time. And if you are the breadwinner in your family, you can just imagine how this will impact your loved ones who depend on you.
Let me share with you the experience of one reader and the issues he is faced with during his illness...
Dear Ms. Jhoanna,
I was recently diagnosed with Pneumonia. At first, my company allowed me to take a break for a few weeks to recover. But I got hospitalized and during that time, it was discovered that I also contracted tuberculosis.
My medical bills reached Php95,000 and I did not have enough money to pay the hospital so I asked my employer if they could help. They provided financial aid as well as a salary loan, but it's not enough to cover my hospital expenses. Our HR manager then suggested that we go for termination due to prolonged illness with an option to reapply to the company when I get better. She said, this way, I can get a separation pay. I agreed to this, but they are asking me now to submit a medical report, as well as sign a quit claim before they release the money. I'm very stressed right now and I can't help but feel paranoid with all the paperwork they are letting me sign. Is this really necessary?
Honestly, I feel very depressed. I have spent years working so hard trying to save up but I'll have to spend it all to pay for my medical bills. It's so unfair! I'm sick. I can't work. I don't have money. How can hardworking people like me move up in life? What can I do to improve my situation?
From,
Kevin
My response:
I'm sorry to hear about your illness and I sincerely hope that you will get well soon. It is normal to feel emotional distress when you are physically ill, not to mention the pressure of being faced with a steep medical bill. But do know that this too will pass, so hang in there.
Based from your letter, I think your company is pretty decent as they have provided you medical assistance and salary loan. They are also willing to give you separation pay as well as give you a job when you get better, so you can at least get some relief and not worry about job opportunities for the time-being, while you are recovering.
The paperwork is necessary. Legally, if a company is terminating an employee due to prolonged illness, a medical report must be submitted and this must be issued by a duly authorized public health officer. It is also prudent for companies to document all things related to termination. Efficient HR practitioners will normally ask you to sign a salary release, clearance and quit claim form. So just read the documents properly and sign, if everything is in order.
As an optimistic person, I don't really enjoy talking about sickness, disability or even death. But I know that Illness can strike anyone regardless of race, educational attainment and economic status. So for my peace of mind, I've chosen to face these issues head on and find ways to protect me and my family from these types of crisis. I urge everyone to do the same.
To protect yourself and your family against illness-related disasters and to cushion the financial blow that comes with it, take the time and effort to...
Invest in Health
In the movie "Tanging Ina", Ms. Ai Ai says: "Ang batang masipag, paglaki... pagod," (A kid who works hard, grows up to become... tired!). Many people who work hard, do just that---work hard. In the midst of all that hard work, they forget to eat properly, to rest well and to do the right kind of exercise. So they end up working hard for money, then they get sick and lose the money they earned while working hard in the first place! It's a vicious cycle that needs to be stopped. The best way to prevent illness-related blows is to stay healthy. Eat if you have to eat. Take a break if you need to rest. Wash your hands often to avoid bacteria and viruses. If you get sick, stay home until you get better. Don't ever act like a martyr by forcing yourself to go to work when you are seriously ill or worse, contagious. Other people might catch what you have and they won't be happy about it. Learn to work smarter, not harder. You will become healthier and happier in the long-run.
Invest in Affordable Health Insurance
Honestly, today's medical costs can give you a heart-attack. Depending on the illness and treatment required, bills can run from thousands to millions. Your SSS and Philhealth membership will help a bit, so make sure your contributions are up to date. If your company provides healthcare or HMO, good for you. It will help pay for your hospitalization in case you get confined. But if your company does not provide this benefit, you can proactively research and look for an affordable plan for you and your family (or even get free healthcare if you're a Makati resident with that magic yellow card).
See, companies are not required by law to give healthcare benefits aside from SSS and Philhealth. So they are not legally bound to cover your medical costs. Employers will pay you for your day's work. They are responsible for providing good working conditions, but they are not accountable for your health. In other words, you are ultimately responsible in taking care of yourself.
Hardworking people must not just work hard, but more importantly, they should live smart. Take care of your health and finances now, because nobody else will do it for you. Stay healthy!
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