Medical Insurance

Medical costs are one of the most pressing concerns in today’s times. When you or your family’s health is at stake, we know you need a sensible medical plan that will give you the best care possible. Medical insurance is a type of insurance coverage that pays for medical and surgical expenses incurred by the insured. Medical insurance provides coverage for specific medical expenses related to an illness or injury.  It can cover a variety of healthcare services, including emergency room treatments, hospital stays, prescription medications during inpatient confinement, outpatient care, preventive services, special procedures, annual physical exam, and immediate post-hospitalization care/ treatments. A one-year waiting period is mandatory prior to coverage for pre-existing conditions, though policyholders are already covered for injuries from accidents starting on day one while viral illnesses are covered after 30 days from start of effective date. Take-over accounts are also possible to ensure continuous uninterrupted enjoyment of existing policy benefits. 

This type of insurance is designed to provide financial protection against the high costs of medical care that may not be covered by a typical health insurance policy. Medical insurance covers you with a maximum benefit limit of Php 1 million to Php 3 million and above. Higher maximum benefit limits are available with dollar options to give higher coverage especially for those seeking treatment abroad or for those who are frequent travelers. Depending on the plan, medical insurance may also include benefits for specialized treatments, rehabilitation, and mental health services. 

The insured typically pays a premium, and may also be responsible for copayments or deductibles before the insurance coverage kicks in. Deductible is an amount that the insured must pay out-of-pocket before the medical insurer pays its share. For example, policyholders might have to pay a $1,000 deductible per year, before any of their medical care is covered by the insurer. Deductibles are a good option to help reduce cost of premiums, however the policyholder risks cashing out in the event of a claim. In the Philippines, medical insurance primarily includes PhilHealth (Philippine Health Insurance Corporation), which provides health coverage to citizens. PhilHealth is funded through contributions from taxpayers and offers both basic and supplemental health benefits. The PhilHealth portion is roughly around 15 to 20%. When taking a medical insurance, usually it is immaterial (to the policyholder) whether or not one is a PhilHealth member since for as long as the claim is valid, the insured will be covered accordingly to the policy and plan purchased. This is not the case when getting an HMO plan. It is a prerequisite for the policyholder to be a PhilHealth member.