Are Prepaid HMOs As Good As Regular HMOs?
The painful reality is that healthcare is an expensive necessity that not everyone can afford. Sure, we are all covered by Philhealth, but until Universal Healthcare is in full swing, the cost of healthcare services from consultation to hospitalization can cost a fortune for most Filipinos.
A Wellness Index study released by a local insurance company in 2019 reports that nearly 38 percent of Filipinos used their savings to pay for hospital bills, while 25 percent had to seek help from other people. This shows that the existing coverage provided by Philhealth isn’t enough and Filipinos still end up with out-of-pocket expenses whether we like it or not.
As we all know, private health insurance can provide us the coverage that we need, but they aren’t exactly affordable to everyone, at least not until prepaid health cards become available.
What is a prepaid HMO?
Prepaid HMOs (Health Maintenance Organizations) provide similar coverage as a regular HMO, the only difference is, you don’t need to pay a hefty amount to get a yearly consultation and hospitalization coverage. It is a more affordable option offering customers a prepaid card that’s good for a year for a very affordable one-time payment.
For a minimal one-time payment of around PHP100 to PHP5,000, you get HMO coverage which is good for a year.
How do prepaid health cards work?
Prepaid HMOs work the same as a regular HMO; simply present your card to any affiliated hospitals or clinic and they will charge your expenses through the HMO provider. The only downside is that these prepaid health cards can only be used for a single hospital admission or Emergency room treatment.
What are the advantages of getting prepaid HMO care?
We’re glad to tell you that prepaid HMO cards have similar coverage and benefits as regular HMOs. The amount of coverage however is lower and can only be used once for hospitalization.
The max coverage of prepaid HMOs is ₱50,0000 a year.
Since prepaid HMOs are still HMOs at the core, you’ll get to enjoy similar benefits as the latter such as the following:
- A large network of medical facilities. Hospitals and clinics affiliated with HMOs are very competitive since it usually involves accreditation that is filtered by HMOs set qualifications. So you are in good hands with doctors and you always have the choice to prefer which provider you would like to have tests or procedures done.
- A prepaid HMO is less costly than most medical plans or a regular HMO. Basically, it is a more practical way of getting yourself a health plan. Most of the treatments that you typically do within the HMO network are dependent on the Maximum Benefit Limit (MBL) which is usually per illness per year, some providers even go as far as to use all hospital services that you desire to avail just as long you are within the MBL.
- You can easily buy another one once you’ve consumed your existing prepaid HMO.
What are the disadvantages of prepaid HMOs?
- Just like a regular HMO, prepaid HMOs have a network of medical practitioners but you can only see a specialist (e.g. neurologist, physical therapist, etc.) if your doctor referred you to see the specialist. Although this is not exactly the case for the Philippines at the moment since most specialists are also with many HMO networks because of it being relatively new.
- You will pay for treatments done outside your HMO’s network. If you live in a city with very few affiliate hospitals or clinics, your HMO coverage won’t really work as intended.
- HMOs generally cater to those who need basic healthcare services such as consultations and annual physical exams—and nothing more.
- Most HMO plans exclude pre-existing conditions (cancer, stroke, diabetes, etc.), maternity benefits, and dental care.
Why should you get a prepaid HMO?
After breaking down the pros and cons of a prepaid HMO, is it still worth getting?
Well, the answer is an easy “yes!” and here’s why”
- First of all, you can never have too much health coverage. The more, the better as long as you can afford it.
- Even if you own a health insurance policy, a prepaid HMO will provide you with more financial cushion when the need calls for it. And for the most part, owning one will save you from paying upfront fees in hospitals if (God forbid) you get admitted.
- Philhealth coverage isn’t enough (at the moment). Another fact that we want to put out there is that Philhealth does not cover many outpatient services like your regular check-ups, diagnostic exams, and even dental services.
It’s actually something to be happy about because it means you’re healthy. However, if you want to make the most out of your converge without getting sick, you can do the following
- If you purchased coverage that includes dental services, use it up before your card expires.
- Most prepaid HMOs have coverage for outpatient check-ups and laboratory exams, so you might as well use that coverage for your own annual physical check-up.
What are the best prepaid HMO cards you can get today?
There’s a wide range of prepaid HMO providers to choose from today, each catering to different needs and budget. Below is a curated list of prepaid HMO you can get today according to your budget
₱1,000 and below
1. MediCard Health Check
This prepaid health card is from one of the country’s leading HMO providers. With a starting insurance of ₱500, it’s perfect for Filipinos who have a low income but still wish to have his or her own health card.
Price: ₱500
Type of coverage: Preventive healthcare only
This is clearly one of the most affordable prepaid HMO cards you can get today. However, do keep in mind that it’s only limited to preventive healthcare only such as regular checkups in MediCard free-standing clinics. Consultations with affiliated specialists will cost you an additional fee of ₱350 per visit. The good news about this card is that it doesn’t come with an age limit like other HMO policies.
2. Maxicare EReady
From the name itself, it’s a prepaid card catered to provide coverage during medical emergencies. This prepaid HMO is from Maxicare, another prominent HMO provider in the country.
Type of coverage: Emergency care such as ER admission and hospitalization.
Price:
- ₱549 for emergency care in their affiliated hospitals (not including major hospitals)
- ₱ 749 for emergency care in their affiliated hospitals including major hospitals
This is a budget-friendly option for people who are looking to get some coverage for medical emergencies. Do take note that this does not provide coverage for check-ups and hospital admission, only for emergency care in hospitals. You do get access to Maxicare’s 1,000 accredited hospitals nationwide, so you’re rest assured that you’ll be able to get their services whenever you need emergency care anywhere in the country.
Where can I buy a Maxicare prepaid card?
You can easily buy these cards online and register it at the same time via https://shop.maxicare.com.ph/
₱1,000 to ₱2,000
1. PhilCare ER Vantage Plus
This prepaid HMO provides more comprehensive emergency care coverage for people with a bigger budget. It’s still considered low cost though, but the coverage provides so much more.
Type of coverage: Emergency care such as ER admission and hospitalization.
Price
The prices are different for adults and kids, but for this article, we’ll showcase insurance quotes for adults.
| Type of card | Price | Maximum Coverage |
| ER Vantage Plus 40 for Adults | ₱1,050 | ₱40,000 |
| ER Vantage Plus 60 for Adults | ₱1,350 | ₱60,000 |
| ER Vantage Plus 80 for Adults | ₱1,750 | ₱80,000 |
Unlike other Emergency Care coverage, this card also provides coverage for hospitalization, though limited to viral and bacterial diseases and injuries from accidents. Other than that, you will also get the following:
With this card, you won’t be required to pay a hospital deposit if you’re going to be admitted. However, the downside is, it’s only limited to emergency care, including hospitalization. If you’re admitted due to reasons that don’t stem from an accident or emergency, you will need to shell out your own money to pay for your hospital admission. While it’s comparable to a regular HMO service, it does have some limitations that otherwise are covered by a regular HMO provider.
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