Best Posts in Thread: Current health insurances

Doesn't it make you wonder why the Advantage Plan is a zero premium and any insurance that really covers anything cost quite a bit more? The advantage plan may look good to you as far as what it covers. The way it really works is that you signed away your medicare to the insurance company. Any claims you have are paid from Medicare to the company. Then the company pays whatever they pay as far as what they cover for you, and they keep the difference. If they collect your medicare claims and then provide you treatment from that money they collect, you must realize that they are going to do their best, and will succeed, in giving you less money for treatment than Medicare gives them on your behalf. That is how it works. You signed away your rights to your medicare claim payments to United through AARP and they will keep more than they give, you can rely on it. I had a full coverage F Plan with low deductibles and of course it was expensive. During the enrollment period AARP/ United solicited me for an Advantage Plan. Zero Premium. I said how can that be? They said well, we have a special program for people in your CA zip code and that is the way it is, It's free. I said, well CA is flaky enough to do that, so OK. I went into the hospital. I had to use their Drs. the coverage was the worst you could imagine. It was a horrible experience. I have a lot of experience with insurance because of providing insurance for employees, and learned a fair amount about it. I won't go any further about the scam Advantage Plans, but I had mine for one month and it took some doing to get SS to allow me to switch to the plan I have now, but they did. No copays, no deductibles, no named perils or coverage. A good policy says "We cover everything but this", A poor policy tells you what it covers and if it is not named, it is not covered. You can try but you cannot beat the insurance companies. Zero premium will be worth what you pay for it. Of course when you throw the Philippines into the equation the point may bcome moot. Medicare won't pay here. So you are right, it doesn't matter how much they intend to screw you, if you can't use medicare here, and you are staying then zero premium makes since. However, if you wind up using that plan in the States you may be disappointed. The policy I have pays 60 per cent here but I would definitely have anything major done in the US anyway if I could get there.

 

But the coverage of the Caritas Health Shield looks not that great. Paying 2 parts premium for a 3 part coverage.

Pacific Cross looks better.

 

That is right, although not immediately... coverage of pre-existing illness begins at start of 2nd year of membership. As for 7 - <71 year coverage, you must be less than 71 when you enroll. I clarified just now -- even a few days shy of 71st birthday is still technically considered <71 years old.

For baby-boomers, MAX Health Care Program, Supreme Health Care Program, and Enhanced Core 6 Health Care Program all provide Annual Physical Examination, Special Diagnostic & Therapeutic Procedures, Hospitalization Benefits, Emergency Care, Credit Life, Term Life, Accidental Death, Waiver of Installment Due to Disability, Coverage of Pre-Existing Illness at start of 2nd membership year, Assignability, Transferability, Membership Substitution (Plan Beneficiary) upon death, and Grace Period. Aside from these, there are also other benefits not common to all but exclusive to a plan.

Monthly or annual premium cost depends on number of units enrollee purchases for membership -- lowest allowed is 5 units and highest alllowed is 50 units for all plans -- yet this is best clarified from Caritas Health Shield, Inc. (Archie A. Tubog), 2/F Caritas Health Bldg., North Road, Daro, Dgte., Phones: (035) 225-9589, (035) 422-9547; Mobile (0917) 878-7537, (0998) 841-2590

While PhilHealth can be availed at any hospital, a private HMO cannot be used at a government hospital and can usually be availed only at HMO-accredited medical establishments.

 

Yes... it appears that there is no HMO covering +71 new enrollees in RP. But if you had enrolled any time between 7-<71 and have paid premiums per plan, then you are covered with HMO benefits beyond +71 even if you are no longer paying.

Here is the list I painstakingly surveyed from to verify coverage and benefits, in order to decide on an appropriate HMO provider -- Health Maintenance Organization | Official Website of the Insurance CommissionHealth Maintenance Organization | Official Website of the Insurance Commission

 

It's like I'm given a choice....Have my own account and pay 17,000 OR stay on wife's account and pay nothing. It's a no brainer.

 

I prepaid for 2017 at Philhealth in January [ 2400]. I understand that that policy will not be in effect after June 30, 2017 due to the new rates. I do NOT expect to get a rebate for the last half of the year. It might be possible but I am sure not worth the effort that will be required !! haha

 

Yes , once you sign on with PhilHealth , a minimum of 90 days must pass for it to become effective. No bills are ever sent.

 

I believe you need to have had Philhealth for a period of time and be in good standing to be able to use it. Your "policy" was probably backdated for those months you paid for before you actually came in and signed up. I have heard people say that if you are delinquent and admitted to the hospital someone should run down and make the payment and any ah, irregularities will be overlooked.

 

Very simple . Just take your Phil Health card to the payment clerk ( not da Phil Health booth ) and tell them if you want to make a quarterly payment or whatever . They will give you a receipt . If you are delinquent .....it does not matter ........you need not pay retroactively ! Maybe the only way to be sure that payment was credited is to go back in a couple days and ask the lady for a status update .

 

You can make your payments online.
Accredited Collecting Agents: Collecting Partners | PhilHealth
We make our payments at LBC, no crowds and very fast.