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What to consider when getting an HMO plan

/ 12:05 AM June 21, 2014

Filipinos are increasingly realizing the value of getting a plan from health maintenance organizations (HMOs) as they offer a practical fallback when dealing with health-related concerns.

Settling on a plan can be tricky, though, since not all HMOs offer the same benefits and price ranges. For an investment as important as this, there are many things to consider before arriving at the plan best suited to one’s needs.

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1Know your budget. HMOs typically come with premiums to be paid on a regular basis. Before picking a dependable provider, it is advisable to identify and compute the cost of the medical services that you will need in a year, and then check the amount you can spare for the premiums.

Each HMO specifies a maximum amount it will cover for a medical service. For as low as P7,782 per year, MediCard, a leading HMO provider, covers most of the common medical services such as hospital confinement, outpatient care, preventive healthcare, emergency care, dental care and even financial assistance for its members.

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2Know the company. Knowing the HMO is just as important as knowing the plans it offers. You will experience greater confidence and peace of mind knowing your health plan provider has a good industry standing and is trusted by numerous members.

MediCard, for instance, is on its 26th year of being a pioneer in the HMO industry and boasts more than half a million members. To drum up the importance of having a reliable HMO, the company’s “Why Worry?” campaign demonstrates further the assurance one gets if he/she is financially covered by a plan, especially during medical emergencies.

3Know the network. An HMO provides patients health coverage within a network of doctors and hospitals, so its directory list is an important yardstick when choosing or maintaining a plan. If you have a doctor you’ve trusted for years, find out if he or she is part of the medical network. If a specific doctor you want isn’t part of the network, you may have to shell out the cash.

Having been in the industry for 26 years, MediCard has amassed a network of more than 40,000 accredited doctors, specialists and dentists operating in close to 1,000 hospitals and clinics nationwide. Such a vast network ensures that you will get the medical attention you deserve.

4Know how to use the benefits. Each HMO plan has an annual allowable expense. This expense is dependent on your chosen premium, so it is best to take advantage of your health plan instead of letting your benefits remain unconsumed by yearend. You may, for instance, visit any MediCard free-standing clinic (FSC) for reasonably priced checkups and tests, which allow you to stretch your benefits as a MediCard member.

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TAGS: health and wellness, hmo, medical plans
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