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Best Health Maintenance Organizations for Freelancers in the Philippines

Caught up on hospital bills? 

One advantage of working in the corporate world is that employers provide healthcare or insurance to their employees. It is considered to be one of the benefits that the employees get from the company. 

But what if you are a freelancer?

This is one of the most important aspects you should consider. Since you don’t have an employer to provide healthcare, it’ll be your responsibility to get one. 

In the industry, many freelancers are enjoying their paychecks. However, some do not get a reliable paycheck. And for those freelancers who don’t earn a reliable paycheck, getting an HMO is quite a financial challenge for freelancers. 

In this article, you will understand and find helpful information about why you, as a freelancer, should get an HMO.

Add to that, after reading this article, it will help you decide which HMO company and plan that best suits your budget.

Table of Contents

What is HMO by the way?

Why should a freelancer get an HMO?

Advantages of HMO for Freelancers in the Philippines

Disadvantages of HMO for Freelancers in the Philippines

Top HMOs Plans for Freelancers in the Philippines

Things to Consider in Choosing your HMO

Tips on How to Maximize your Health Care Savings

What is HMO by the way?

HMO stands for Health Maintenance Organization. According to the Republic Act 7875 or “National Health Insurance Act of 1995”, HMOs are third party companies that act as the middle-men between patients and healthcare providers. They give their members access to healthcare providers – clinics and/or hospitals – that are partnered with them.

Why should a freelancer get an HMO?

“Mahal magkasakit…” (getting sick is expensive) sounds familiar? 

That’s reality. If not prepared, medical issues can wipe out your total savings with just one snap if you don’t have any financial support.

As we talk about financial support, health is a priority – hospitalization and/or medication. You should prepare for it, and part of that preparation is getting an HMO. They exist to fund healthcare in exchange for a monthly premium. 

If you’d ask me how it works…it’s simple. 

HMO will offer a certain amount that you can consume within a year. You can then use it for checkups, medicine, emergency room visits, and lab tests. 

Some healthcare companies have premiums of at least P10,000 a year. It could range up to fifty to sixty thousand consumable within a year. With such an amount, it could cover around P50,000 to P700,000 a year. 

It’s just like a prepaid card for your hospital bills.

Advantages of HMO for Freelancers in the Philippines

Affordable

There are HMO companies in the Philippines that offer low premiums compared to other health insurance companies. You can avail premiums for as low as Php 100.

If you are a member of any HMO company, you don’t have to pay anything before you can avail of any medical services provided by facilities. As long as they are accredited by the HMOs.

Variety of Coverage Options

Another benefit of being a member of an HMO is that you can customize your plan according to your healthcare needs. It is something that employees cannot do. It is their employers that choose the HMO coverage for them.

Reliable Healthcare Providers

Most big HMO companies are partnered with reliable medical facilities and health specialists. That means that you can receive the best healthcare services.

Most of these HMO companies have networks in health care providers and facilities. By this, you can choose from their health institution based on their accessibility or based on your preference.

Sense of Security

Being a member of any of the HMO companies will give you peace of mind. You won’t have to worry about your expenses when illness or accident occurs.

Disadvantages of HMO for Freelancers in the Philippines

Out-of-Network Healthcar

If you avail services from institutions that are not accredited by your HMO company, you have to pay for the bills.

In case of emergency, most of the HMOs would allow you to reimburse at least 80% up to 100% of your total cost from a non-accredited healthcare facility.

Limited Healthcare Service

Being a member of HMO companies may limit your choices with healthcare providers and services. Being a member of HMO companies may limit your choices with healthcare providers and services.

For example, you have a preferred physician for you and your family, but that medical provider is not affiliated with the HMOs. That means that you cannot avail of their service. 

Exclusions on Benefits

HMO companies provide basic healthcare services to its members. Such healthcare services are consultations and annual physical examinations.

Those members who have existing conditions before membership are excluded from most of the HMO plans. Those existing conditions are cancer, stroke, and diabetes. Maternity benefits and dental care are also excluded.

Though some HMO offer them as an additional option. That means that you need to pay for an additional premium.

Top HMO Plans for Freelancers in the Philippines

Medicard Health Check

Cost: Php 500

Benefits:

  1. Unlimited consultation from physicians, general practitioners, internists, family doctors, pediatricians, and ob-gynecologists. Maternity-related services are excluded. Consultation is only applicable to healthcare providers that are under Medicare.
  2. Low cost for consultation from MediCard specialists. Like ENT doctors, ophthalmologists, and rehab medicine physicians. The consultation price could start at Php 350. The consultation price could start at Php 350. 
  3. You will be given a 20% discount on all laboratory and diagnostic procedures.

Maxicare E-Ready

Cost: Php 699

Benefits:

  1. One-time coverage on emergency conditions and treatments that is up to PHP15,000
  2. Access to selected Metro Dental Services that gives you a 20% discount. 
  3. Access to selected MyHealth Services that gives you a 15% discount
  4. Group Life with accidental death, dismemberment, and disablement coverage that is up to Php 50,000.

PhilCare ERVantage Plus for Adults

Cost: It starts at Php 1,050 (Plans: PLUS 40, PLUS 60, PLUS 80 )

Benefits:

  1. One-time coverage on accidents that is up to PHP40,000 for wardroom and board.
  2. One-time coverage on accidents that is up to PHP60,000 for semi-private room and board.
  3. One-time coverage on accidents that is up tp PHP80,000 for regular private room and board.

MediCard RxER

Cost: Php 1,998

Benefits:

  1. Emergency Trauma Care coverage is up to PHP20,000. Cases should be within six hours from the time of the incidents. Incidents such as burns, animal bites, and accidental chemical poisoning.
  2. Emergency diagnostic procedures and lab tests such as CT scan, ultrasound, and MRI. The coverage is up to PHP5,000.
  3. Unlimited coverage with primary care physicians and specialists. The specialists are a general surgeon, ob-gyne, and pediatrician. This also includes family medicine, general practitioner, and general internists. 
  4. You will be given 30% discounts on procedures that are done at MediCard free-standing clinics.

Pacific Cross Select

Cost: Starts at Php 4,482

Benefits:

  1. The hospital expenses forward membership is up to PHP500,000.
  2. Monetary coverage on emergency, hospitalization, critical care, and surgical benefits.
  3. Annual physical exam
  4. Out-patient benefits
  5. Dental benefits

Things to Consider in Choosing your HMO

There are a wide number of HMO companies in the Philippines. Their cost and coverage vary, so choosing the best HMO could be a bit challenging and confusing to some.

Here are the things that you need to consider in choosing your preferred HMO.

Financial Stability

The best indicator to know if the HMO company is stable is its years of operations. If it has been operating for a long time, that means a certain HMO company is reliable.

Some of those HMOs that have been operating for the longest time in the Philippines are HMI and PhilCare. MaxiCare, Medicard, and Insular Health Care are also included.

You may also check their performance on their website. Check their paid-up capital and net worth. These will or show their financial performance.

Premium Cost

When choosing HMO, you must also consider the cost of their premium and its coverage. 

Most low-priced premium offers limited coverage. The pricey premium gives more coverage that might not be beneficial for you. 

To get the best premium plan, you need to set your budget range and look for plans that give you the offers that you need. 

Healthcare Needs

Here are some Healthcare needs that should be covered by your chosen HMO.

  • Access to hospitals that are included in major hospitals in the country such as The Medical City and Asian Hospital and Medical Center. This also includes Makati Medical Center, St. Luke’s Medical Center, and Cardinal Santos Medical Center.
  • Access to clinics such as Healthway and FortMED
  • Coverage of pre-existing conditions such as diabetes, cancer, and hypertension.
  • Diagnostic and laboratory tests
  • Dental Care
  • Maternity Care
  • Coverage for your dependents
  • Maximum number of dependents that you can enroll
  • PhilHealth Benefits
  • Reimbursements for services and providers that are not accredited by your HMO.
  • Accidental death and dismemberment insurance

Accredited Facilities

If you have a preferred doctor, they should be a member of the accredited healthcare providers by the HMO.

If the doctor is a non-accredited health care provider or specialist, some HMOs allow you to reimburse the amount that you have spent later on.

Here are the HMO providers that has a wide number of medical facilities and specialists:

  • PhilCare
  • ValuCare
  • MaxiCare
  • EastWest Healthcare
  • Medicare
  • MEDOCare

Another thing to consider is the location of the medical institution. Make sure that the HMO accredited health facility is accessible in case of an emergency.

Customer Service

Ask members of the HMOs for feedback. You can also read reviews on the internet where you can find HMOs that give good customer service.

Take note of all the pros and cons of the HMOs that you have listed. This will help you choose the right HMO for you.

Tips on How to Maximize your Health Care Savings

  1. Use your PhilHealth membership with your HMO plans to get more discounts on your hospital bill.
  2. Utilize clinic or hospital consultations as much as possible. If your case does not require urgent healthcare, avoid going to the emergency room for consultation because it is more expensive.
  3. Utilize consultations, physical examinations, and dental exams. If your HMO offers private rooms, do not use wardrooms.
  4. Go to healthcare providers and use healthcare services that are accredited by your HMO. This will prevent you from spending bills from non-accredited facilities.

Thousands of Filipinos are working in the freelance industry – local or international. However, not all freelancers are receiving stable paychecks making it hard for them to get an HMO.

Unlike being an employee, you as a freelancer have to take responsibility for your needs – that includes your safety needs (health). If you suddenly get sick and don’t have enough money to spend, the only choice you have is to use your savings.

Getting an HMO is about preparing for health (which is supposed to be a priority of every individual). When a sudden illness occurs, you have something to use for your hospitalization without hurting your savings. 

You can choose an HMO company and plan mentioned above which best suits your budget. You have to think and review carefully before you choose. This way, it will be less stressful for you.

Got an HMO but your health care needs isn’t covered by your plan?

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