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Health Insurance & HMO

Health and medical symbols

Insuring one’s health in the Philippines can be through:

-Medical Insurance 
-Health Maintenance Organization

What is Health Insurance?

Health insurance is a type of coverage that pays for medical expenses incurred by the insured. It provides financial protection against unexpected medical costs due to illness, injury, or hospitalization. In the Philippines, health insurance can be obtained through various sources, including the government’s health insurance program (e.g. Phil Health) private individual health insurance plan, and employer-provided plans.

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Healthcare Plan for Individuals

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Healthcare Plan for Employees

Ways to have Health Insurance coverage in the Philippines

1. PhilHealth

The Philippine Health Insurance Corporation (PhilHealth) is the country's national health insurance program. It provides basic health coverage to its members, including hospitalization, outpatient services, and certain medical procedures. PhilHealth membership is mandatory for all employed individuals and voluntary for self-employed and unemployed Filipinos.

2. Individual Health Insurance Plan

 Private health insurance companies offer a wide range of plans with varying coverage and benefits beyond what Phil Health provides. These plans may include coverage for hospitalization, outpatient services, preventive care, and additional benefits such as dental and optical services. Premiums and coverage options vary depending on the insured’s age and the chosen plan.

3. Employer-Provided Health Insurance: 

 Many companies in the Philippines offer health insurance benefits to their employees as part of their employment package. These plans are often comprehensive and may cover not only the employee but also their dependents. Coverage may include hospitalization, outpatient services, and other medical expenses.

Exclusions and Limitations. Understand the exclusions and limitations of the insurance plan, including waiting periods, pre-existing conditions, and coverage limits.

Benefits of having a Health Insurance Policy or a Health Care Plan

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Financial Protection

Health insurance provides a safety net against unexpected medical expenses, reducing the financial burden on individuals and families.

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Access to Quality Healthcare

With health insurance, individuals can afford to seek medical care without worrying about the high costs.

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Preventive Care 

Some health insurance plans offer coverage for preventive services such as vaccinations, screenings, and wellness programs, promoting overall health and well-being.

Factors to Consider When Choosing Medical Insurance or Healthcare Plan

Coverage  

Evaluate the extent of coverage offered by the insurance plan, including inpatient and outpatient services, maternity benefits, and coverage for pre-existing conditions.

Premiums: 

Consider the cost of premiums and any additional fees associated with the insurance plan. Compare different plans to find the most affordable option that meets your needs.

Network of Providers 

Check the network of hospitals, clinics, and healthcare providers affiliated with the insurance plan to ensure convenient access to medical services.

Exclusions and Limitations. 

Understand the exclusions and limitations of the insurance plan, including waiting periods, pre-existing conditions, and coverage limits.

Healthcare Plans

 

Maxicare Individual and Family Plans 

Maxicare for SMEs

Maxicare for Large Corporations

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