10 Questions to ask when choosing a health insurance plan
This coming 2018, as I decide to become a full time freelancer, I came to ask myself if I can get a health insurance plan. Finding the right healthcare plan is not always easy, especially if one is doing it on their own. Availing of a health insurance is a highly individual exercise because each person has different needs. A freelancer’s requirements, for instance, will be very different from that of an employed parent. Someone who lives a sedentary lifestyle will have different needs from that of someone more active. There are many things to consider when one is trying to decide on a plan best for them, so it’s important to closely study one’s options before eventually selecting one.
To help Filipinos decide, Maria Health, the country’s first online healthcare exchange platform has listed the top 10 questions to ask when evaluating health plans from different health maintenance organizations:
1. Why should one get an HMO coverage? There are different types of health insurance plans such as a medical insurance plan that covers one’s medical and surgical needs or prepaid health cards that cover a specific treatment or medical procedure. Plans by a Health Maintenance Organization (HMO) have a more comprehensive coverage from its network of healthcare providers. HMO plans also mean one gets to enjoy cashless transactions and discounted HMO rates.
Tip: Ensure to do thorough research by reading up on the offerings of health plan providers.
2. What does the plan cover? The most basic of them all. One has to start to know what services the plan will include and how much will it cover. Other items to consider: emergency services, ambulance transport, and medicine.
Tip: Before one starts with their search, take the time to list down and prioritize the things that one wants in a healthcare plan. Use this list to determine which plan covers their needs.
3. What hospitals are part of the plan’s network? Given the traffic problem of the Philippines, the location of hospitals in a health plan’s network should be an important consideration.
Tip: Ask if the HMO could give access to major hospitals in one’s area, whether private or public. Also, inquire if they include access to clinic systems such as those found in malls.
4. Is my current doctor included in the coverage? Several HMOs have noted that more Filipinos are becoming more conscious in wanting to have the flexibility to consult their choice of doctor, especially those who understands their medical history. Not all HMOs allow this, so one has to pay attention if this is offered.
Tip: To make things easier, one could ask their doctor which healthcare plans he/she is part of. If there is an HMO one really wants but does not include their doctor, ask if he or she is willing to be accredited by the HMO.
5. How does the plan handle out-of-network medical services? If flexibility is of utmost importance, one should look closely into checking if the HMO reimburses medical services availed from doctors, hospitals, and clinics that are not part of their accredited network.
Tip: Ask if the HMO provides reimbursements at a special HMO or discounted rate if one avails of out-of-network medical services.
6. What happens when I get sick while traveling? If one travels a lot, one would want global health coverage, since hospital visits outside one’s home country can prove costly. If this is an important consideration for you, find out what exactly your HMO can provide.
Tip: Ask the HMO how much – if any – of the costs the plan will cover if one needs to go to the doctor while traveling.
7. Does it have restrictions on my pre-existing conditions? If one has a chronic or a preexisting condition such as asthma, diabetes, or heart disease, one would want to make sure that he or she doesn’t get a health plan that excludes such conditions, or at least has limits on these exclusions.
Tip: Ask how long pre-existing conditions are excluded from the health plan. Inquire if they have packages that would also cover medical services related to pre-existing conditions.
8. Are annual examinations included? Prevention is better than cure, and some HMOs include routine examinations like mammograms, physical exams, basic laboratory tests, and even immunizations in their health plans.
Tip: Ask if the health plan includes an annual physical exam and what types of tests are included. Also ask if the additional tests recommended by doctors during the routine examinations will also be covered.
9. What other benefits are included? Other than medical care, some health plans also cover dental, vision care, and even medical prescriptions. If these benefits matter, choose a plan that includes these benefits.
Tip: Ask for specific details about these additional services. For dental, are minor surgeries included or are just routine check-ups? For vision, are multiple examinations allowed or just a limited number a year?
10. How can I avail of the services? Some HMOs have a complicated availment process while others make it very easy to go in for medical services. No one likes tedious procedures, so look for an HMO that makes availment simple and quick.
Tip: Ask what one needs to do to avail of services covered by the health plan. Does one need to just show their health card or would one need to call their HMO for approval prior to availing of medical services?
Given that everyone’s needs are unique and specific from each other, it is important to find the health plan with the coverage that matches their needs.
With the launch of Maria Health, it’s now more convenient to understand one’s healthcare options. The newest technology platform allows Filipinos to easily compare and shop healthcare options at one’s fingertips as it provides instant quotes, full enrolment support, and unbiased guidance to help every Filipino find the health plan that’s most suited to their needs.
Maria Health has partnered with the top HMOs in the country to provide simple, easy access to healthcare, with a wide range of affordable comprehensive health care plans and prepaid health cards that cover specific procedures and treatment.
Visit Maria Health at www.mariahealth.ph to find the health plan for yourself, for your loved ones, or your business.