HMO

An individual looking for health insurance may find a variety of insurance providers with unique features. One popular type is the health maintenance organization (HMO), which provides coverage through a network of physicians and accredited hospitals and clinics.

There are several key differences between HMO plans and medical insurance. With an HMO plan, your primary care physician will refer you to specialists and you must stay within a network of providers to receive coverage. HMO plans typically have lower premiums, which also mean that coverage is also lower than medical insurance. 

Health insurance is a type of insurance that covers the cost of medical expenses for the insured. It provides financial protection against high healthcare costs, helping individuals pay for a range of medical services, such as emergency room treatments, outpatient care – consultations with doctors and specialists, preventive care, laboratory works and diagnostic tests, as well as annual physical exam, inpatient care – hospital stays, surgeries, operations, post-hospitalization treatments and prescription drugs during confinement. The primary goal of health insurance is to ensure that individuals have access to necessary medical care without incurring prohibitive out-of-pocket expenses. When getting an HMO insurance, it is imperative for the policyholder to be a PhilHealth member. 

One excellent and supreme benefit of getting a group or corporate HMO package is that pre-existing conditions are already covered from day one of effective date. If you can afford, it is best to have both an HMO plan (to take care of all outpatient needs) and medical insurance (to handle high inpatient claims) to guarantee the best coverage for your financial security and convenience.