Filipinos usually acquire health care plans for free through employment. For Filipinos traveling to other countries, international health insurance is also available. In the same way, aside from international insurance from their own countries, foreigners staying in the Philippines can also acquire expatriate health insurance in the country.
In the Philippines, a health insurance similarly refers to how a car or life insurance works (it is used for emergencies such as critical illness or hospitalization); while an HMO offers outpatient and prevent care services, along with hospitalization assistance within a planholder’s maximum benefits.
More Filipinos prefer an HMO than a health insurance plan. Employers typically provide HMO plans and not health insurance plans to its employees. People who can afford both an HMO and a health insurance plan (whether acquired on their own or through employment) make the latter a supplemental package, along with the government health insurance plan provided by the Philippine Health Insurance Corp. (PhilHealth).
Like in the U.S., HMO in the Philippines also provides a form of managed care requiring the policy holder to only use physicians and facilities with which it is under contract. Interestingly, the country has a very wide network of most HMOs in clinics and hospitals (whether seeking in-patient or outpatient care). Their presence in these medical establishments and health care facilities allows Filipinos to still get the medical attention they need, especially those under emergency situations. It is not difficult to find the doctor or specialist that can accommodate the planholder in most Philippine hospitals. In certain instances, when admitted in an ER not accredited by the HMO, the patient just needs to pay a small percentage of the bill as the HMO can still accommodate the most part of the bill.
Types of Health Care/Health Insurance Plans in the Philippines
PhilHealth, the national health insurance program, provides sustainable, affordable and continuing social health insurance for Filipinos of any age at an affordable rate of about $4 per month, as of June 2010. This program ensures hospitalization discounts for contributing members at any accredited hospital in the Philippines.
There are three kinds of PhilHealth membership available: employed membership, individually paying membership and lifetime membership. Filipinos who are regularly employed pay less than individually paying (self-employed and freelance) members because employers provide monthly co-payments for their employees, as required by Philippine law. A lifetime member doesn’t have to pay the monthly contribution, since this kind of membership requires paying a lump-sum amount to cover the lifetime membership.
Private Health Insurance
A private or public health insurance in the Philippine setting is a term more popularly used for insuring a person from critical illness and hospitalization. Since a separate health insurance generally works independently from an HMO plan, a basic health insurance policy covers hospital expenses as a supplement to HMO coverage.
Private health insurance companies cover health expenses for individuals, families and groups. Plans are either paid in full by freelance or self-employed members or partially paid or acquired for free by regular employees. An individual plan may be upgraded to a family plan to extend coverage to family members. Group insurance is designed for groups of three or more persons. Like with a family plan, it can offer customized coverage with premium discounts.
Health Maintenance Organization
HMO is the common managed care plan in the Philippines while a health insurance plan works separately for emergency cases and hospitalization. While there are available packages offered by health insurance companies for additional coverage, the affordability of HMO plans are more amenable to Filipinos with average income, especially those who are of considerably healthy age.
An HMO plan is usually acquired for free through employment. However, freelancers and non-working individuals can also avail themselves of individual and family HMO accounts to cover basic medical expenses for preventive and outpatient care, medical treatment and hospitalization. Unlike in the United States, the Philippines only offers HMO plans and not preferred provider organization (PPO) plans. There are also health discount cards offered by specific groups, mostly medical and diagnostics clinics, to also supplement HMO and health insurance coverage. Those who can’t afford an HMO plan usually avail of such health discount cards to help them ease the burden of medical expenses.
International Health Insurance
An international health insurance is designed for individuals, families and groups intending to be covered while outside the Philippines. This type of health insurance plan protects a member for a few months to one year. There are insurance companies that can provide straight coverage for up to three years. International health insurance for Filipinos generally provides two options for coverage: worldwide and worldwide except the United States. Including a U.S. coverage requires a higher premium as the cost of medical expenses in this country is much higher than in other parts of the world. Also, when including preventive services and outpatient care instead of just the basic hospitalization coverage, the premium becomes higher as well.
Expatriate Health Insurance
Expatriate health insurance is designed for a non-Filipino intending to maintain health insurance coverage while staying in the Philippines. This type of plan insures a legally residing foreigner of his medical expenses in the country. It is generally a renewable type of plan suitable for individuals of all ages, nationalities and occupations.