Healthcare in the Nick of Time

Healthcare is a very important component to productive living. Without good health, people will find themselves unable to live life comfortably even in the midst of great affluence. The need to have access to it transcends economic class however. We all need to be assured that we will be able to make use of it when the time comes. For the working class wherein I am included, that often equates to having an HMO Health Card, ready to be swiped at the health provider’s terminal at the first sign of sickness.

The HMO Healthcare Plan

Health Maintenance Organizations or HMOs are entities that offer health coverage through accredited providers such as hospitals, clinics, laboratories, and medical practitioners including dentists. Such coverage is provided for in a policy and is typically evidenced by the HMO Health Card. There are specific parameters for coverage and it is very important for health card holders to fully understand them.

The main purpose of HMOs is to make available quality healthcare which is efficient, accessible, affordable and compassionate. All these should be present in the healthcare plan. Remove one and you end up with a useless health coverage.

Healthcare Coverage

A typical HMO Healthcare Plan covers out-patient, in-patient, emergency, and dental availments. Most do not include pre-existing conditions or medical conditions that have already showed signs prior to entering into the contract. This is based on the logic that healthcare plan covers the risk of getting sick and not the certainty of getting sick. For HMOs that provide such coverage, specific conditions and limitations are set.

While healthcare coverage from HMOs can be availed of on an individual capacity, most health card holders are employees of corporations that have entered into an agreement with HMOs. The latter set-up is obviously more practical with HMOs getting more clients and clients getting the service on a much lower price. HMO health cards for individuals and families usually cost more than those for company employees by virtue of the big difference in numbers.

My Say

I have long felt the disadvantage of not having a health card to use. Having none required me to have ready cash if I or any member of my family need to consult a doctor, much more if there would be a need for hospital confinement. There was always the nagging fear that I will not be ready for any unexpected health expenses. It was distressful to be caught off-guard financially when confronted with a health emergency. That was one of the prices I had to pay when I decided to leave corporate life many years ago.

Now that I am again employed, I gained the advantage of having HMO coverage. The activation of my card and that of my dependents couldn’t have come at a better time as it came a day before my youngest daughter started to have fever which eventually led to hospitalization. This was reliable healthcare that came in the nick of time. Knowing that I had an HMO provider to back-up my expected medical bills left me more strength to concentrate on getting my daughter better. That my dear readers, is more than enough reason to be thankful for having HMO coverage.

The way my hospital bill totaling PHP 28,549.59 was taken cared is one more reason:

Intellicare: PHP 20,768.24

Philhealth: PHP 7,500.00

My Share: PHP 281.35

Special thanks to Intellicare for the very simple procedure and to Philhealth as well for having a dedicated representative at the hospital. My employer was likewise very quick in providing me the needed requirements. All these made a very stressful situation a lot less so. This just shows how much we can help other people by just being efficient in our jobs.